Cell delivery in cardiac regenerative therapy

There is a growing interest in the clinical application of stem cells as a novel therapeutic approach for treatment of myocardial infarction and prevention of subsequent heart failure. Transplanted stem cells improve cardiac functions through multiple mechanisms, which include but are not limited to promoting angiogenesis, replacing dead cardiomyocytes, modulating cardiac remodeling. Most of the results obtained so far are exciting and very promising, spawning an increasing number of clinical trials recently. However, many problems still remain to be resolved such as the best delivery method for transplantation of cells to the injured myocardium and the issue of how to optimize the delivery of targeted cells is of exceptional clinical relevance. In this review, we focus on the different delivery strategies in cardiac regenerative therapy, as well as provide a brief overview of current clinical trials utilizing cell-based therapy in patients with ischemic heart disease.

Stem cell delivery strategies in cardiac regenerative therapy. A: Intravenous infusion of stem cells; B: surgical direct myocardial injection or injection of engineered stem cells; C: catheter based intracoronary artery infusion, retrograde coronary venous infusion, and catheter-based direct myocardial injection, D: engineered myocardial patch or cell sheet transplantation.Figure optionsDownload as PowerPoint slideHighlights
• We make a critical appraisal of different stem cell delivery methods in cardiac regenerative therapy.
• Remaining hurdles of cell delivery methods.
• Advantages and limitations of stem cell delivery methods.