Mesenchymal stem cell therapy for heart disease.

Mesenchymal stem cells (MSC) are adult stem cells with capacity for self-renewal and multi-lineage differentiation. Initially described in bone marrow, MSC are also present in other organs and tissues. From a therapeutic perspective, facilitated by the ease of preparation and immunologic privilege, MSC are emerging as an extremely promising therapeutic agent for tissue regeneration and repair. Studies in animal models of myocardial infarction have demonstrated the ability of transplanted MSC to engraft and differentiate into cardiomyocytes and vasculature cells. Most importantly, engrafted MSC secrete a wide array of soluble factors that mediate beneficial paracrine effects and greatly contribute to cardiac repair. Together, these properties can be harnessed to both prevent and reverse remodeling in the ischemically injured ventricle. In proof-of-concept and phase I clinical trials, MSC therapy improved left ventricular function, induced reverse remodeling, and decreased scar size. This chapter reviews the current understanding of MSC biology and mechanism of action in cardiac repair of MSC therapy for cardiac disease.