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The use of stem cells in cardiovascular therapy as a potential solution for heart failure, discussing historical evidence, different types of stem cells, and their limitations and benefits. It also covers the goals of cell therapy in failing hearts and the challenges that remain.
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THE PROBLEM :
Historical Evidence – The basis
Ideal cell replacement Ultrastructural integratian Good functional improvement of LV
Limited source / ethics Immunogenicity Ischemia sensitivity
Note: Day 5 Human blastocyst inner cell mass Differentiation Early stage : Pacemaker cells Intermediate : Myocardial cell Late : Nodal, His purkinjee cells
Hemapoeitic Stem cells T-2% Endothelial Progenitor cells <0.05% (Stromal stem cells) (Lin – c Kit (+ve) ; AC 133+) Transplantation (^) HEART Translocation (Endogenous stem cell mobilization) CARDIOMYOCYTES Endothelium sm cells G – CSF GM - CSF CD 34+
Ischemia ; Hypoxia Cytokines Increased vascular permeability V CAM I CAM VEGF – 2 GCSF SDF – Increased MMP 9
G.B. Shaw