心臟衰竭治療趨勢系列三:Cellular cardiomyoplasty(細胞心肌成型術)

Cellular cardiomyoplasty consists of cell implantation to grow of new muscle fibers in the damaged myocardium that potentially may contribute to the contractile performance of the heart। In adults, myocardium can not repair after infarction due to the absence of stem cells। Thus, the injury is irreversible For this reason, cell transplantation strategies for heart failure have been designed to replace damaged cells with cells that can perform cardiac work. Therefore, the aim of cellular cardiomyoplasty is the repair of injured myocardium by cell transplantation, either in ischemic or idiopathic cardiomyopathies. Cell types for cellular cardiomyoplasty Current possibilities in cell therapy for heart failure is the transplantation into the infarcted myocardium of: 1. CARDIOMYOCYTES: fetal or embryonic.2. ADULT CARDIOMYOCYTES.3. SKELETAL MYOBLASTS (SATELLITE CELLS).4. SMOOTH MUSCULAR CELLS.5. BONE MARROW STROMAL CELLS.6. UNDIFFERENTIATED BLOOD CELLS.7। CELL LINES (this approach can be related with oncogenic risks)। 心臟病突發會破壞心臟肌肉和血管，使心臟血液迴圈不暢。科學家長期以來都在尋找修復心肌的方法。一些專家認為，可以嘗試利用具有強大分化能力的幹細胞來進行此項工作。此前，科學家曾將從患者脊髓中提取的成熟幹細胞培育成心臟細胞，注入患者本人的心臟，並改善了他們心臟的血液迴圈。由於胚胎幹細胞的分化能力比成熟幹細胞更強，科學家們認為用胚胎幹細胞修復心肌的效果會更好。科學家此前曾利用老鼠的胚胎幹細胞成功修復了老鼠的心肌。為了證明這種方法對大型哺乳動物也適用，法國國家科研中心的科學家最近對患有心臟病的綿羊進行了實驗。他們首先誘發18頭綿羊突發心髒病，然後在實驗室中向老鼠胚胎幹細胞導入能夠使其分化成心臟細胞的生長因數。隨後，將經過處理的胚胎幹細胞注入其中9頭綿羊心髒受損的部位。實驗結果表明，胚胎幹細胞附著在綿羊心臟受損的部位元，成功地發育成心臟組織，接受幹細胞治療的綿羊左心室功能平均提升了10％。與此同時，未接受治療的綿羊左心室功能降低了6.6％。由於綿羊心臟大小已接近人類心臟，這項實驗的成功為利用胚胎幹細胞治療人類心臟病提供了經驗。 (資料來源：張景岳中醫藥研究中心　　所屬地區：法國 )