Contemporaryperspective on endogenous myocardial regeneration

• 作者: Dejan Milasinovic Werner Mohl
• 来源期刊: 世界干细胞杂志：英文版（电子版）
• 学科: 医学
• 关键词: CARDIAC regeneration CARDIAC development EMBRYONIC RECALL Pressure-controlled intermittentcoronary SINUS OCCLUSION Heart failure MYOCARDIALINFARCTION
• 年，卷（期）: 2015,（5）
• 页码范围: 793-805
• 页数: 13页
• 分类号: R

摘要

Considering the complex nature of the adult heart,it is no wonder that innate regenerative processes,while maintaining adequate cardiac function, fall shortin myocardial jeopardy. In spite of these enchaining limitations, cardiac rejuvenation occurs as well asrestricted regeneration. In this review, the backgroundas well as potential mechanisms of endogenousmyocardial regeneration are summarized. We presentand analyze the available evidence in three subsequentsteps. First, we examine the experimental researchdata that provide insights into the mechanisms andorigins of the replicating cardiac myocytes, includingcell populations referred to as cardiac progenitor cells（i.e. , c-kit＋ cells）. Second, we describe the role ofclinical settings such as acute or chronic myocardialischemia, as initiators of pathways of endogenousmyocardial regeneration. Third, the hitherto conductedclinical studies that examined different approachesof initiating endogenous myocardial regeneration infailing human hearts are analyzed. In conclusion, wepresent the evidence in support of the notion thatregaining cardiac function beyond cellular replacementof dysfunctional myocardium via initiation of innateregenerative pathways could create a new perspectiveand a paradigm change in heart failure therapeutics.Reinitiating cardiac morphogenesis by reintroducingdevelopmental pathways in the adult failing heart mightprovide a feasible way of tissue regeneration. Basedon our hypothesis ＂embryonic recall＂, we present firstsupporting evidence on regenerative impulses in themyocardium, as induced by developmental processes.