Stem Cell Therapy for Acute Myocardial Infarction and Heart Failure-Past, Present and Future

幹細胞治療在急性心肌梗塞以及心臟衰竭的應用－過去，現在，未來

郭顯宗(Sheing-Tsung Kuo) ； 曾淵如(Yung-Zu Tseng)

《內科學誌》 20卷1期 (2009/02) Pp. 1-18

https://doi.org/10.6314/JIMT.2009.20(1).01

摘要

急性心肌梗塞後的心臟衰竭已變成台灣人民健康的一大隱憂。隨著越來越多的病患從急性梗塞中存活，這些慢性缺血性心衰竭病患的照護，已造成政府極大的醫療負擔。在最近數十年裡，除了傳統藥物治療如乙型阻斷劑(β-blockers)、血管張力素轉換抑制劑(ACEIs)、冠狀動脈氣球擴張術及支架植入以及外科手術如左心室輔助器，冠狀動脈繞道手術或心臟移植，隨著幹細胞生物特性逐漸被了解以及近年來再生醫學蓬勃發展，幹細胞療法已成爲心肌梗塞和心臟衰竭的前瞻性療法。在本文我們將回顧文獻中有關幹細胞療法的背景、可能的機轉，各類幹細胞在人類及動物模式中使用的研究成果，以及幹細胞療法可能面臨的問題和將來的展望，期能增加臨床醫師對幹細胞在心血管疾病治療的瞭解。

並列摘要

Heart failure (HF) after acute myocardiac infraction (AMI) is becoming a major problem in Taiwan. Because of the increase of the aged population in Taiwan, many of whom survive AMI, the country spends much money on the health care of these patients suffering from ischemic heart failure. In recent decades, in addition to conventional therapies with β-blockers and angiotensin-converting enzyme inhibitors (ACEIs), percutaneous transluminal coronary angioplasty (PTCA) and stenting, or surgical therapies with left ventricular assist device (LVAD), coronary artery bypass grafting (CABG) and ultimately cardiac transplantation, stem cell therapy has emerged to be a promising therapeutic option as the biologic characteristics of various stem cells have been more clearly elucidated and much progress has been made in the field of regenerative medicine. In this article, we provide internists a brief review of the literature regarding the background of stem cell therapy, the proposed mechanisms, and the cell types that have been studied for the potential use of cellular therapy, both in animals and humans, as well as problems and future prospects for stem cell therapy. Several clinical trials of cornerstone significance are also reviewed.

並列關鍵字

Stem cells ； Acute myocardial infarction ； Heart failure ； Pluripotent ； Transdifferentiation ； Paracrine effect