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Archives of cardiovascular diseases
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le jeudi 12 mars 2020
Doi : 10.1016/j.acvd.2020.01.002
Received : 27 December 2019 ;  accepted : 8 January 2020
Cardiac cell therapy: Current status, challenges and perspectives
Thérapie cellulaire cardiaque : état des lieux, défis et perspectives
 

Philippe Menasché a, b,
a Département de chirurgie cardiovasculaire, hôpital Européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France 
b Université de Paris, INSERM, PARCC, 75015 Paris, France 

*Corresponding author.
Graphical abstract

Cardiac cell therapy, illustrating cell type, mode of delivery and mechanism of action. CSC: cardiac stem cells; IV: intravenous; MI: myocardial infarction; MNC: mononuclear cells; MOA: mechanism of action; MSC: mesenchymal stromal cells; PSC: pluripotent stem cells.

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Summary

Although the initial clinical trials of cardiac cell therapy have failed to demonstrate unequivocal clinical benefits, the accumulation of preclinical data gathered in parallel can now help us to understand the main causes of failures, while providing mechanistic insights that may be leveraged to improve the outcomes of subsequent clinical studies using cells or their secreted products. This review briefly describes the current status of clinical trials, discusses the potential mechanisms of action of the grafted cells, and the impact of this knowledge on the design of future studies, and finally draws some perspectives.

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Résumé

Bien que les premiers essais de thérapie cellulaire cardiaque n’aient pas démontré un bénéfice clinique indiscutable, l’accumulation des données non cliniques acquises en parallèle permet aujourd’hui de mieux comprendre les causes de ces échecs et apporte des informations de nature mécanistique dont l’exploitation devrait permettre d’améliorer les résultats des futurs essais, qu’ils utilisent les cellules ou leurs produits de sécrétion. Cette revue décrit brièvement les principales études, discute les mécanismes d’action présumés des cellules greffées et l’impact que leur connaissance a sur le schéma des futurs essais avant de conclure sur les perspectives.

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Keywords : Stem cells, Heart failure, Extracellular vesicles, Tissue engineering

Mots clés : Cellules souches, Insuffisance cardiaque, Vésicules extracellulaires, Ingénierie tissulaire

Abbreviations : ESC, hESC, HLA, MSC, PSC




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