Cardiac Cell Therapy 3.0

Cardiac cell therapy (CCT) holds great promise as a regenerative medicine approach for the treatment of cardiovascular diseases (CVDs). The first generation of CCTs tested various adult cell types, including skeletal myoblasts, bone marrow (BM)–derived mesenchymal stem cells (MSCs), and cardiac progenitor cells (CPCs). More recently, the advent of induced pluripotent stem cells (PSCs) led to the much-anticipated second generation of CCTs with bona fide, PSC-derived CPCs and cardiomyocytes. The bad news is that, to date, both adult and PSC-based CCTs have failed to meet their promise of directly remuscularizing and repairing the heart to a therapeutically meaningful extent. The good news is that some cell types clearly demonstrate encouraging results in terms of efficacy and safety and, more importantly, reveal a previously underestimated key role of CCT, to indirectly promote repair by regulating mechanisms of endogenous cardiac regeneration in the host.