Very small embryonic-like stem cells (VSELs)—A new promising candidate for use in cardiac regeneration

In recent years, stem cell-based therapy has been given increased attention in terms of its potential contribution to cardiac regeneration and repair, after acute myocardial infarction (AMI). The published studies have identified many kinds of stem cells with the ability to regenerate and repair damaged myocardium after AMI. These include embryonic stem cells (ESCs), mesenchymal stem cells (MSCs), multipotent adult progenitor cells, unrestricted somatic stem cells, etc. More recently, very small embryonic-like stem cells (VSELs) were identified from murine, as a population of very small CXCR4+ Lin− CD45− cells and from human, as a population of very small CD34+ CD133+ CXCR4+ Lin− CD45− cells. These cells exhibit beneficial effects on improving cardiac function and attenuating cardiac remodeling after AMI. However, the mechanisms underlying the benefits associated with VSELs therapy, in cardiac regeneration and repair, remain poorly understood. This review summarizes the current studies on cardiac repair with VSELs after AMI, and discusses the potential mechanisms and implications of these cells in cardiac repair.

Research highlights▶ Very small embryonic-like stem cells (VSELs) were able to differentiate into all three germ-layer lineages in vitro cultures. ▶ Transplantation of VSELs could attenuate left ventricular dysfunction and remodeling after myocardial infarction. ▶ VSELs are more suitable to intracoronary infusion compared with other PSCs derived from bone marrow due to their small size. ▶ VSELs will bring exciting new therapeutic alternatives for cardiac regeneration and repair.