From Genes to Regenerative Medicine Approaches in Development

Coronary artery disease (CAD) persists as a leading causeof morbidity and mortality in the industrialized world. Patients with myocardial damage who have not adequately responded to medical therapy and revascularization may, if eligible, be treated by surgical ventricular restoration, ven-tricular assist devices, and, ultimately, by transplantation. Although these treatments can extend the lives of some patients, they can only be offered to a minority of affected patients and remain “mechanical ” in that they do not biolog-ically address the functional deficit of the heart. This has led to great interest in cell replacement strategies, with the goal of safely and effectively restoring perfusion and/or contractility to ischemic, stunned, hibernating, or scarred myocardium. A number of clinical trials in cell therapy have been performed, most of them using simpler approaches such as the transplan-tation of unselected bone marrow mononuclear cells. Recen