Cell Therapy in Ischemic Heart Disease: Interventions That Modulate Cardiac Regeneration

Figure 1

Factors that can modulate the cardiac regeneration in association with the stem cell therapy. The sedentary lifestyle and unhealthy dietary habits (as diets with elevated levels of fat and sugar) characterize risk factors that may contribute to the development of heart diseases, mainly due to the triggering of harmful issues that arise from the ischemic process which is generated in consequence of these behaviors. Therefore, the ischemia activates pathological cardiac remodeling mechanisms, the results of which may be the hypertrophy (a) or dilation (b) of the ventricular muscle, and both contribute to a decrease in ventricular ejection function. In an attempt to control the disease, there are commonly prescribed drugs that may interfere with mechanisms of cell proliferation and differentiation. These combined habits may adversely influence the effectiveness of cell therapy (CT). Subsequently, protocols that use stem cells are poorly effective in the regenerative process. Drugs that stimulate the antioxidant properties and control the inflammatory response, as well as the practice of physical activity and diets rich in cardioprotective elements (PUFAs, antioxidants, etc.), may balance the immune system. Besides that, a decrease in the ROS demand and increase of angiogenesis are stimulated by these approaches, providing a better environment for cell homing activation. This scenario intensifies mechanisms for cell regeneration and may lead to an increase in myocardial perfusion and improvement of the cardiac function (c). Thin black arrows indicate the blood flow in normal or damaged heart situation. White arrows suggest the improvement of the global contractility in the left ventricle after the regeneration process by stem cell enforcement (the figure was made from publicly available images).