The Mechanisms of Cell Therapy for Clinical Investigations: An Urgent Need for Large-Animal Models
Evidence from experiments performed in animal models and from early-stage clinical trials demonstrate that the contractile performance of hearts with severe ischemic injury can be improved by transplanting a variety of cell types into the injured heart.1-5 As a result of these investigations progenitor cells have emerged as a promising therapeutic agent both for limiting postinfarction left-ventricular (LV) remodeling and for improving cardiac performance in hearts with severe LV dysfunction secondary to other diseases, such as dilated cardiomyopathy and concentric LV hypertrophy. 6, 7 Some of the most encouraging clinical results were obtained in the SCIPIO trial 4, which investigated the use of autologous cardiac progenitor cells (CPCs) in patients with severe LV dysfunction undergoing coronary artery bypass graft surgery. Although the small patient population and open-label design preclude definitive mechanistic conclusions, CPCs infusion was associated with significant improvements in LV ejection fraction from before treatment to 4 months afterward, and even greater improvement was observed at 12 months. These and other promising results could soon lead to the initiation of more definitive, large-scale, phase 2 clinical trials.
- Received June 6, 2013.
- Accepted June 7, 2013.