A Novel Strategy For The Treatment Of Ischemic Heart Disease: Mesenchymal Stem Cells Mediated Vascular Endothelial Growth Factor Gene Transfer

Background Despite advances in revascularization techniques, treatment of ischemic heart disease (IHD) remains a challenge. Commonly adopted approaches for therapeutic angiogenesis include protein therapy using direct introduction of recombinant cytokines and gene therapy based on the delivery of gene encoding for one or more angiogenic factors. Among these angiogenic factors, the better documented are the vascular endothelial growth factor (VEGF) isoforms due to their pivotal role in angiogenesis. In addition to its angiogenic effect, VEGF may provide myocardial protection against ischemic injury. A more recent progress along these two basic strategies is to achieve angiogenesis through transplantation of cells. Mesenchymal stem cells (MSCs) derived from marrow stroma are pluripotent and have the ability to differentiate into several cell types including cardiomyocytes, and endothelial cells. Myoblast mediated angiogenic gene transfer may achieve concurrently both myogenesis and angiogenesis in infarcted myocardium and skeletal muscle, and therefore it is being studied as a potential alternative strategy for the treatment of IHD.