Regenerative Medicine – ABC CARDIOL

ABC

Original Article

Safety and Efficacy of Adipose-Derived Mesenchymal Stem Cell Therapy for Ischemic Heart Disease: A Systematic Review

Fernando Rabioglio Giugni et al. Melina de Oliveira Valdo Giugni Henrique Trombini Pinesi Fabio Cetinic Habrum … Lígia Nasi Laranjeira Erica Regina Ribeiro Sady Erica Aranha Suzumura Luis Henrique Wolff Gowdak José Eduardo Krieger

Abstract

Background

Cell therapy using adipose-derived mesenchymal stem cells (ADSCs) shows great potential as a treatment for cardiovascular diseases.

Objective

We conducted a systematic review to describe the safety and efficacy of ADSCs in ischemic heart disease.

Methods

We searched PubMed/MEDLINE, EMBASE, Web of Science, CENTRAL, and LILACS (from inception to March 2024) for clinical studies involving ADSCs in patients with ischemic heart disease. We excluded studies involving patients with other types of heart disease, studies using mesenchymal stem cells derived from other tissues, as well as ongoing studies. Two independent reviewers screened the retrieved citations, extracted relevant data, and assessed the risk of bias in the included trials, using the Cochrane Collaboration criteria modified by McMaster University and Methodological Index for Non-Randomized Studies (MINORS). We used a narrative synthesis to present the results.

Results

Ten studies (comprising 29 publications) met our inclusion criteria, including 8 randomized controlled trials and 2 uncontrolled trials. No severe adverse events associated with ADSC therapy were reported. While most efficacy endpoints did not reach statistical significance, there were reports of improved ischemic area, functional capacity, symptoms, and contractility in patients treated with ADSCs.

Conclusions

The findings from our review suggest that ADSC therapy is generally safe for patients with ischemic heart disease. However, further investigation is warranted to confirm its efficacy, particularly with larger clinical trials and in specific conditions where improvements in microcirculation may have a notable impact on clinical outcomes.

Read Full Article

ABC

Editorial

Decellularization of Human Pericardium with Potential Application in Regenerative Medicine

Estela de Oliveira Lima et al. Adriana Camargo Ferrasi Andreas Kaasi

Regenerative medicine is an interdisciplinary branch of the biomedical sciences that is showing, through the transposition of basic research into the clinic, great potential for therapeutic application, and the field is consequently becoming an important frontman for Translational Medicine. The essence of regenerative medicine consists of the repair or replacement of tissues and organs in which there is structural and functional deficiency. With a view of achieving this objective, several approaches have been proposed, including therapies that include genes, cells, biologic and synthetic scaffolds, which may or may not take part of a tissue engineering strategy. When dealing with synthetic scaffolds, it is possible to manipulate and control structural and mechanical properties, nonetheless, it is not possible to guarantee the same functional capacity as natural tissue. In addition, one of the great challenges is minimizing the risk of immunogenic reactions triggered by the repair scaffold’s composition. Owing to the challenges associated with the reestablishment on a functional and structural level of the cell microenvironment, the interest in scaffolds based on natural extracellular matrix (ECM) has increased considerably.

With a view of obtaining a biomaterial closely approximating tissues or organs having suffered damage, be it structural or functional, yet at the same time presenting safety from an immunological point of view, a new technology for clinical applications of ECM has been proposed – the decellularization of tissues and organs from human or animal donors. This technology makes use of physical, chemical and/or biochemical methods to eliminate cells from the target tissue/organ, be it xenogeneic or allogeneic, whose antigens represent an elevated risk of immunogenic reaction. The process seeks to ensure immunologic safety and the preservation of basic structural and functional components of the ECM, such as proteins, collagen and glycosaminoglycans (GAGs). The end product is a three-dimensional ECM scaffold with analogous shape to the original tissue, with preserved ultrastructural architecture and with greater biocompatibility and potential of tissue regeneration when compared to synthetic scaffolds.

[…]