Клинические исследования клеточной терапии повреждений миокарда

Клинические исследования клеточной терапии повреждений миокарда

Автор: А.Г. Попандопуло, М.В. Солопов, В.В. Турчин, В.В. Буше

Журнал: Патология кровообращения и кардиохирургия @journal-meshalkin

Рубрика: Обзоры

Статья в выпуске: 2 т.26, 2022 года.

Бесплатный доступ

Высокая смертность от сердечных заболеваний требует разработки новых терапевтических подходов. Традиционные методы лечения могут обеспечить компенсирующий эффект, улучшить качество жизни пациента, но не устранить потерю миокарда. Доклинические исследования свидетельствуют, что трансплантация стволовых и прогениторных клеток способна стимулировать регенерацию сердечной ткани. В обзоре рассматриваются клинические исследования терапии повреждений миокарда с использованием региональных стволовых клеток, прогениторных клеток и клеток, дифференцированных из эмбриональных стволовых клеток/индуцированных плюрипотентных стволовых клеток. Результаты этих работ подтвердили безопасность и доступность клеточной терапии повреждений миокарда. Однако недостаточная изученность механизмов действия трансплантируемых клеток на миокард и быстрое развертывание клинических исследований, инициированных успехами доклинических испытаний, позволили наблюдать в лучшем случае лишь умеренный терапевтический эффект. В исследованиях с использованием региональных стволовых клеток не удалось достоверно подтвердить их способность дифференцироваться в кардиомиоциты и интегрироваться в миокард, а наблюдаемые улучшения работы сердца связывают с паракринной передачей сигналов. Для восстановления утраченного миокарда более подходящими являются кардиальные производные эмбриональных стволовых клеток/индуцированных плюрипотентных стволовых клеток, но так как количество клинических испытаний с этими типами клеток пока невелико, требуются дополнительные исследования для подтверждения их безопасности и эффективности. При разработке дизайна будущих клинических испытаний клеточной терапии необходимо строго учитывать механизм действия клеток, патофизиологию заболевания и подбирать оптимальный набор конечных точек. Необходимо развивать персонализированную клеточную терапию, которая предполагает выбор источника клеток и пути введения на основе индивидуальных характеристик пациента. Рост числа клинических исследований и активное изучение механизмов действия трансплантируемых клеток на поврежденный миокард позволяют предполагать, что данный тип клеточной терапии может в ближайшем будущем войти в клиническую практику.

Еще

Кардиальные производные эмбриональных стволовых клеток/индуцированных плюрипотентных стволовых клеток, клеточная терапия, клиническое испытание, миокард, региональные стволовые клетки

Короткий адрес: https://sciup.org/142232020

IDR: 142232020   |   DOI: 10.21688/1681-3472-2022-2-17-29

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