The future of stem cells: Should we keep the “stem” and skip the “cells”?

• Published in: The Journal of thoracic and cardiovascular surgery Vol. 152; no. 2; pp. 345 - 349
• Main Author: Menasché, Philippe, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2016
• Subjects: Animals; biomaterials; Cardiothoracic Surgery; Cardiovascular Agents - administration & dosage; Cardiovascular Agents - metabolism; Diffusion of Innovation; Drug Carriers; Follistatin-Related Proteins - administration & dosage; Follistatin-Related Proteins - metabolism; Heart Diseases - metabolism; Heart Diseases - pathology; Heart Diseases - physiopathology; Heart Diseases - therapy; heart failure; Humans; Myocardium - metabolism; Myocardium - pathology; paracrine signaling effects by; Phenotype; Recovery of Function; Regeneration; Regenerative Medicine - methods; Signal Transduction; Stem Cell Transplantation - adverse effects; Stem Cell Transplantation - methods; Stem Cell Transplantation - trends; stem cells; Stem Cells - metabolism; Treatment Outcome; heart failure; stem cells; paracrine signaling effects by; cardiokine follistatin-like 1; biomaterials; Fstl-1
• ISSN: 0022-5223; 1097-685X
• DOI: 10.1016/j.jtcvs.2016.02.058

Abstract There 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. Beyond the choice of the factor and its vehicle, these data may open a new therapeutic path whereby the functionalization of biomaterials by bioactive compounds could successfully substitute for the current cell transplantation–based strategy.