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Handbook of Cardiovascular Cell Transplantation FREE TO VIEW

N. Sathish Babu, MD, MS
Chest. 2005;127(6):2302-2303. doi:10.1378/chest.127.6.2302
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By Nicholas N. Kipshidze and Patrick W. Serruys, eds. London, UK: Martin Dunitz, an imprint of the Taylor & Francis Group, 2004; 448 pp; $136

The Handbook of Cardiovascular Cell Transplantation is a multiauthored text that uses an interdisciplinary approach to cover the exciting topic of cardiovascular cell transplantation. The book includes up-to-date information on experimental studies and first clinical trials using a number of different cell types to repair damaged myocardium and coronary vessels, and to induce angiogenesis.

This comprehensive book contains 29 chapters, the first of which sets the stage by detailing the underlying principles of the techniques covered in subsequent chapters. The following chapters focus on the use of marrow stromal cells as donor cells, IV transplantation of exogenous endothelial progenitor cells that incorporate into foci of neovascularization, and transplantation of fetal and neonatal cardiomyocytes into an experimental myocardial infarct model. An entire chapter focuses on describing the unique properties of human embryonic stem cells, and the establishment of a reproducible cardiomyocyte differentiating system using these cell lines. Five chapters describe the role of cardiac fibroblasts, utilization of autologous satellite cells, and strategies for using stem cells in cardiac regeneration and in myocardial infarction. Various approaches to the preparation, manipulation, and delivery of skeletal myogenic precursor cells for optimal function in the heart are described. Three chapters describe the angiogenic effects of endothelial precursor cells and methods for augmenting vascular bed neovascularization and improving cardiac function by preventing loss of hypertrophied, but otherwise viable, cardiac myocytes. Also covered is autologous endothelial cell transplantation, which delivers both the cellular substrate and the specific signaling factors necessary to effect significant and sustained myocardial revascularization in experimental models.

Additional chapters summarize the animal studies and the very preliminary clinical experience with bone marrow-derived cells aimed at enhancing myocardial tissue perfusion, and cellular cardiomyoplasty, a technique using autologous skeletal muscle-derived myoblasts. The former technique has resulted in improved systolic function of the hibernating myocardium thought to be related to implanted bone marrow mononuclear cells, and the latter procedure has resulted in advantageous changes in left ventricular function as assessed by changes in rate of rise in left ventricular pressure, sonomicrometry, and echocardiography. These cell-based investigational therapies for ischemic heart disease appear to be safe and feasible, with studies suggesting that a combination of stem cell and myoblast therapy (sequentially or in concert) may be needed depending on the stage and associated symptoms of the myocardial disease.

Four chapters describe a set of subjects that are unrelated to each other or the rest of the book. The first describes the genetic transformation of cardiomyocytes in vivo to become regenerative heterokaryons through myoblast genome transfer, which may constitute the ultimate in heart repair. The next chapter outlines the first human study of skeletal myoblast transplantation in the United States. The third chapter describes the significant therapeutic potential of adipose stromal cells containing a mixture of pluripotent and lineage-committed cells for patients with cardiovascular disease, and the last chapter explains intramyocardial gene and cellular delivery for myocardial angiogenesis and regeneration in experimental models. There are two chapters that emphasize the coronary venous system for biological interventions: transvenous intramyocardial injections requiring lesser injection volumes and cell counts could potentially limit systemic side effects. The last four chapters deal with perivascular endothelial cell and small-vessel graft tissue engineering, a means to evolve a living stent that contains active cellular material that could be a solution to a myriad of vascular biological problems. Also described is endoluminal transplantation of endothelial cells, which promotes and accelerates re-endothelialization in the injured vessel using autologous endothelial cell fibrin matrix. This technique seems to have substantial potential in preventing restenosis in animal models.

No significant deficiencies were found in this book. The multiauthored approach allows experts in various aspects of cardiovascular cell transplantation to present their insights. The text is well written, easy to understand, and concise. Clear illustrations enhance the reader’s understanding of the topics. Each chapter stands alone and can be read independently, with little repetition of material between chapters.

Although myoblast transplantation into the heart has been proven to be feasible in animal models of cardiovascular disease, many questions remain to be answered. The emphasis on the heterogeneity of cardiovascular disease and the optimal timing of myoblast injection and the arrhythmic potential of the injected cells is understandable and studied frequently in large preclinical animal models. The chapters on endothelial tissue engineering provide much in the way of thought-provoking information. The schematic drawings and scanning electron microscope photographs are extremely worthwhile. The majority of the references are within the last 4 years, making this book remarkably up to date in this rapidly expanding field. The authors also discuss recent unpublished data, further enhancing the future relevance of this textbook. The stimulating material on endothelial cell tissue engineering presents perspectives on future applications that may well be right around the corner. The chapters on recent advances in cardiac cell and gene transfer techniques offer the potential for new therapeutic strategies in the treatment of inherited and acquired heart diseases.

The Handbook of Cardiovascular Cell Transplantation can be used by researchers and clinicians to obtain a comprehensive review of the current accomplishments and limitations of cardiovascular cell transplantation. First and foremost, however, it seems designed for cardiovascular basic science and clinical research investigators in the academic, pharmaceutical, and biotechnology sectors.




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