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• W2352809785 abstract "Central MessageRecent investigations have identified the epicardium as an important source of endogenous factors that can stimulate myocardial regeneration to repair injured muscle.See Articles page 345 and 570.See Editorial Commentary page 583. Recent investigations have identified the epicardium as an important source of endogenous factors that can stimulate myocardial regeneration to repair injured muscle. See Articles page 345 and 570. See Editorial Commentary page 583. The change in our understanding of the heart as a biologically senescent organ to an organ with regenerative potential has significantly evolved over recent years.1Bergmann O. Bhardwaj R.D. Bernard S. Zdunek S. Barnabe-Heider F. Walsh S. et al.Evidence for cardiomyocyte renewal in humans.Science. 2009; 324: 98-102Crossref PubMed Scopus (2308) Google Scholar Researchers now know that adult mammalian myocardium, including that in humans, contains a small pool of cardiac stem and progenitor cells that exhibit a capacity for myocardial regeneration that is clearly measurable, but insufficient to restore normal heart function after ischemic or other injury.1Bergmann O. Bhardwaj R.D. Bernard S. Zdunek S. Barnabe-Heider F. Walsh S. et al.Evidence for cardiomyocyte renewal in humans.Science. 2009; 324: 98-102Crossref PubMed Scopus (2308) Google Scholar What has largely been beyond the grasp of researchers is an understanding of the molecular pathways and signals involved in this phenomenon and how to effectively leverage the heart's regenerative potential to repair injured muscle. The use of exogenous sources of stem cells to replace or repair damaged heart muscle has been used as a strategy to stimulate myocardial regeneration in the absence of our complete understanding on how to best stimulate endogenous repair pathways. The elucidation of factors that activate the regenerative potential of adult mammalian hearts is of major scientific and therapeutic importance. Emerging data have elucidated several factors that mediate the effects of epicardium and endocardium that support proliferation and differentiation of cardiomyocytes, as well as enhance the development of mature physiologic properties.2Limana F. Capogrossi M.C. Germani A. The epicardium in cardiac repair: from the stem cell view.Pharmacol Ther. 2010; 129: 82-96Crossref PubMed Scopus (70) Google Scholar The epicardium has received particular attention in the past few years, with evolving data suggesting that it is not only a rich source of diffusible factors during development, but also it retains valuable paracrine functions in adults that are enhanced after injury and may even be a source of cardiopoietic cells capable of differentiation into vascular cells or cardiomyocytes.2Limana F. Capogrossi M.C. Germani A. The epicardium in cardiac repair: from the stem cell view.Pharmacol Ther. 2010; 129: 82-96Crossref PubMed Scopus (70) Google Scholar Menasché3Menasché P. The future of stem cells: Should be we keep the “stem” and skip the “cells”?.J Thorac Cardiovasc Surg. 2016; 152: 345-349Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar artfully provides a unique perspective of recent progress in the field that describes use of a epicardium-derived biologically active product, follistatin-like 1, in combination with a biological scaffold to support myocardial regeneration in mammals by stimulating cell entry and division of preexisting cardiomyocytes that resulted in improved cardiac function and survival in mouse and swine models of myocardial injury.4Wei K. Serpooshan V. Hurtado C. Diez-Cuñado M. Zhao M. Maruyama S. et al.Epicardial FSTL1 reconstitution regenerates the adult mammalian heart.Nature. 2015; 525: 479-485Crossref PubMed Scopus (335) Google Scholar Menasché3Menasché P. The future of stem cells: Should be we keep the “stem” and skip the “cells”?.J Thorac Cardiovasc Surg. 2016; 152: 345-349Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar outlines 3 important messages of the current research: appropriately identified factors can stimulate endogenous repair pathways in the heart, use of biomaterials to form a scaffold for cell regeneration may augment repair processes, and use of biomaterials may be an effective strategy to provide a scaffold for delivery of a combination of regenerative factors. Conceptually, the benefit of an exogenous stem cell source that acts through a paracrine mechanism with secretion of multiple factors important in the regenerative process may ultimately remain a successful strategy. It may be naïve to think that use of a single, isolated endogenous factor may be key to successful and efficient stimulation of endogenous myocardial repair pathways. The question remains: How best can we achieve therapeutic regeneration? Although this discovery of follistatin-like 1 is an exciting piece of the puzzle, much work still remains in identifying the multitude of factors necessary for efficient endogenous myocardial regeneration and how best to deliver these factors to an injured heart. The future of stem cells: Should we keep the “stem” and skip the “cells”?The Journal of Thoracic and Cardiovascular SurgeryVol. 152Issue 2PreviewThere is accumulating evidence that the cardioprotective effects of stem cells are predominantly mediated by the release of a blend of factors, possibly clustered into extracellular vesicles, which harness endogenous repair pathways. The clinical translation of this concept requires the identification of the cell-secreted signaling biomolecules and an appropriate transfer method. The study by Wei and colleagues has addressed these 2 requirements by showing that the epicardial delivery of a collagen patch loaded with the cardiokine follistatin-like 1 improved left ventricular function in animal models of myocardial infarction. Full-Text PDF Open ArchiveIntrinsic cardiac stem cells are essential for regenerationThe Journal of Thoracic and Cardiovascular SurgeryVol. 152Issue 2PreviewCell therapy for cardiac repair and regeneration has received increasing attention over the last 2 decades. After the concept was developed in the early 1990s, preclinical studies demonstrated that implanted cells were able to protect the heart from progressive dysfunction after a myocardial infarction (MI).1,2 Subsequent investigations showed that heart function can be restored after injury with a variety of cell types at different doses in models of cardiac abnormality. Since 2000, numerous clinical trials of cell therapy have been initiated. Full-Text PDF Open ArchiveEdaravone promotes activation of resident cardiac stem cells by transplanted mesenchymal stem cells in a rat myocardial infarction modelThe Journal of Thoracic and Cardiovascular SurgeryVol. 152Issue 2PreviewTo explore the effect of edaravone on bone marrow mesenchymal stem cells (BMSCs) transplanted to treat acute myocardial infarction (AMI) and the underlying mechanism. Full-Text PDF Open Archive" @default.
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• W2352809785 title "Endogenous myocardial regeneration: Evolving from the unknown to known" @default.
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