EMERGING ROLE OF CELLULAR THERAPY (STEM CELL THERAPY) IN CORONARY ARTERY DISEASE



Rakesh K. Sharma, M.D., University of Arkansas for Medical Sciences, Little Rock, AR, USA

The regenerative potential of stem cells offers an enormous impact on clinical applications in the management of cardiovascular diseases. There are multiple factors for success of cellular therapy for coronary artery disease or cardiomyopathy such as mode of delivery, retention of stem cells in ischemic tissue, microvascular plugging, bio-distribution, homing to ischemic tissues and paracrine function of stem cells. Atherosclerotic disease is associated with obstructive coronary artery disease and micro vascular dysfunction. While coronary artery interventions address the obstructive coronary artery disease, cellular therapy may improve the healing process in acute and chronic coronary artery disease at cellular level. Repair of damaged myocardial tissue occurs by virtue of proliferation of cells capable of restoring the injured tissue and regeneration and healing of a damaged tissue is critical to survival The ability of stem cells to repair tissue is dependent upon the intrinsic ability of tissues to proliferate such as embryonic stem cells giving rise to virtually any type of tissue. The ability to convert adult stem cells into pluripotent cells that resemble embryonic cells, and to transplant those in the desired organ for regenerative therapy is one of the goals of cellular therapy. This has lead to the exploration of innovative treatments for cardiovascular diseases. However one of the key concepts is homing of desired cell to the target injured tissue for enhancing the desirable paracrine function. The race is on to find an ideal stem cell, delivery strategies, retention of stem cells in target tissue and other factors for successful homing of such cells.