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Brain & Heart Stem cells in cardiovascular disease

Figure 2. Improving the targeted transplantation of stem cells through in vitro differentiation: improving survival rates and adaptation within 3D cardiac
environments in tissue engineering and the significant role of exosome utilization. Image created by the authors.
clinical safety. Genomic instability during reprogramming factors can affect cell development, the laboratory provides
raises concerns, making ESCs the preferred choice for now controlled environments to guide differentiation. All
until more stable reprogramming methods are developed. pluripotent cells, including VSELs, can be predifferentiated
5
MSCs are widely used in cardiac research due to their to align with specific therapeutic goals, thereby improving
potential. Optimizing the isolation and expansion of their engraftment and therapeutic potential. 23,24,27 For
VSELs is also important, because banking hUCB-VSELs instance, Szaraz et al. found that human umbilical cord
27
could create a valuable cell reservoir for treating congenital perivascular cells formed contracting clusters within
or acquired heart diseases. a week when cocultured on cardiac feeder layers, thus

Major challenges for transplanted stem cells include addressing low survival rates post-transplantation due
24
minimizing apoptosis, oxidative stress, and inflammation to leakage, ischemic conditions, or oxidative stress.
that can result in cell death and cardiac complications. Furthermore, exosomes from failing hearts exhibit
Efforts must focus on improving cell survival, angiogenesis, diminished cardioprotective properties compared with
and cardiac function to support the damaged myocardium. those from healthy hearts, emphasizing the need for ex vivo
It is also important for transplanted cells to survive, improvements to stem cell function. 22
integrate properly, and receive appropriate electrical and The stem cell secretome is pivotal in therapies,
mechanical signals to develop into functional heart cells. comprising proteins, nucleic acids, lipids, and extracellular
There are also challenges related to exosomes, such as vesicles (EVs). EVs, categorized by size and origin,
specificity, dosing, and target binding. include exosomes, mRNAs, microRNAs, and non-
A major challenge with undifferentiated stem cells coding RNAs, all of which are essential for intercellular
is their tendency to differentiate into various cell types communication. 24,28 Exosomes, involved in processes such
in vivo, resulting in poor cardiomyogenic outcomes. as immune modulation and differentiation, demonstrate
Predifferentiating them toward a cardiomyogenic lineage potential for cardiac regeneration. For instance, Farahzadi
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in vitro significantly improves their efficacy. Unlike et al. demonstrated that injecting MSC-derived exosomes
in vivo conditions, where oxidative stress and unpredictable into mice shortly before cardiac reperfusion significantly

Volume 2 Issue 4 (2024) 7 doi: 10.36922/bh.4521