Skip to main content
Erschienen in: Die Innere Medizin 9/2008

01.09.2008 | Schwerpunkt

Stammzelltherapie nach akutem Myokardinfarkt

verfasst von: Dr. M. Brehm, E. Darrelmann, B.E. Strauer

Erschienen in: Die Innere Medizin | Ausgabe 9/2008

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die therapeutischen Erfolge auf dem Gebiet der Stammzellforschung eröffnen einer Vielzahl an kardiovaskulären Erkrankungen neue Behandlungsmöglichkeiten, insbesondere mit dem Ziel, die Entwicklung einer Herzinsuffizienz auf dem Boden eines akuten Myokardinfarkts oder einer chronisch ischämischen koronaren Herzkrankheit zu verhindern. Derzeit wird intensiv die Anwendung von Stammzellen (Knochenmarkstammzellen) und Progenitorzellen (endotheliale Progenitorzellen) zur funktionellen Restitution der Herzfunktion nach Infarkt bzw. bei myokardialer Ischämie untersucht, wobei unterschiedliche Applikationswege wie die intrakoronare, transendokardiale und intramyokardiale Injektion angewendet werden. In klinischen Studien konnte sich das Konzept der Myokardregeneration nach Anwendung autologer Stammzellen bzw. Progenitorzellen nach akutem Myokardinfarkt umsetzen lassen. Die Mehrzahl der kontrollierten und randomisierten Studien sowie mehrere Metaanalysen bestätigen die klinisch-therapeutische Relevanz der intrakoronaren Stammzellapplikation nach Herzinfarkt mit positiven Einfluss der adulten Stammzellen oder Progenitorzellen auf Mortalität und Morbidität der Patienten mit eingeschränkter Herzleistung nach akutem Herzinfarkt.
Literatur
1.
Zurück zum Zitat Abdel-Latif A, Bolli R, Tleyjeh IM et al. (2007) Adult bone marrow-derived cells for cardiac repair: a systematic review and meta-analysis. Arch Intern Med 167: 989–997PubMedCrossRef Abdel-Latif A, Bolli R, Tleyjeh IM et al. (2007) Adult bone marrow-derived cells for cardiac repair: a systematic review and meta-analysis. Arch Intern Med 167: 989–997PubMedCrossRef
2.
Zurück zum Zitat Anversa P, Kajstura J, Nadal-Ginard B, Leri A (2003) Primitive cells and tissue regeneration. Circ Res 92: 579–582PubMedCrossRef Anversa P, Kajstura J, Nadal-Ginard B, Leri A (2003) Primitive cells and tissue regeneration. Circ Res 92: 579–582PubMedCrossRef
3.
Zurück zum Zitat Asahara T, Murohara T, Sullivan A et al. (1997) Isolation of putative progenitor endothelial cells for angiogenesis. Science 275: 964–967PubMedCrossRef Asahara T, Murohara T, Sullivan A et al. (1997) Isolation of putative progenitor endothelial cells for angiogenesis. Science 275: 964–967PubMedCrossRef
4.
Zurück zum Zitat Assmus B, Schachinger V, Teupe C et al. (2002) Transplantation of Progenitor Cells and Regeneration Enhancement in Acute Myocardial Infarction (TOPCARE-AMI). Circulation 106: 3009–3017PubMedCrossRef Assmus B, Schachinger V, Teupe C et al. (2002) Transplantation of Progenitor Cells and Regeneration Enhancement in Acute Myocardial Infarction (TOPCARE-AMI). Circulation 106: 3009–3017PubMedCrossRef
5.
Zurück zum Zitat Badorff C, Brandes RP, Popp R et al. (2003) Transdifferentiation of blood-derived human adult endothelial progenitor cells into functionally active cardiomyocytes. Circulation 107: 1024–1032PubMedCrossRef Badorff C, Brandes RP, Popp R et al. (2003) Transdifferentiation of blood-derived human adult endothelial progenitor cells into functionally active cardiomyocytes. Circulation 107: 1024–1032PubMedCrossRef
6.
Zurück zum Zitat Beltrami AP, Barlucchi L, Torella D et al. (2003) Adult cardiac stem cells are multipotent and support myocardial regeneration. Cell 114: 763–776PubMedCrossRef Beltrami AP, Barlucchi L, Torella D et al. (2003) Adult cardiac stem cells are multipotent and support myocardial regeneration. Cell 114: 763–776PubMedCrossRef
7.
Zurück zum Zitat Braunwald E, Pfeffer MA (1991) Ventricular enlargement and remodeling following acute myocardial infarction: mechanisms and management. Am J Cardiol 68: 1D–6DPubMedCrossRef Braunwald E, Pfeffer MA (1991) Ventricular enlargement and remodeling following acute myocardial infarction: mechanisms and management. Am J Cardiol 68: 1D–6DPubMedCrossRef
8.
Zurück zum Zitat Brehm M, Zeus T, Strauer BE (2002) Stem cells – clinical application and perspectives. Herz 27: 611–620PubMedCrossRef Brehm M, Zeus T, Strauer BE (2002) Stem cells – clinical application and perspectives. Herz 27: 611–620PubMedCrossRef
9.
Zurück zum Zitat Burt RK, Loh Y, Pearce W et al. (2008) Clinical applications of blood-derived and marrow-derived stem cells for nonmalignant diseases. JAMA 299: 925–936PubMedCrossRef Burt RK, Loh Y, Pearce W et al. (2008) Clinical applications of blood-derived and marrow-derived stem cells for nonmalignant diseases. JAMA 299: 925–936PubMedCrossRef
10.
Zurück zum Zitat Chen SL, Fang WW, Ye F et al. (2004) Effect on left ventricular function of intracoronary transplantation of autologous bone marrow mesenchymal stem cell in patients with acute myocardial infarction. Am J Cardiol 94: 92–95PubMedCrossRef Chen SL, Fang WW, Ye F et al. (2004) Effect on left ventricular function of intracoronary transplantation of autologous bone marrow mesenchymal stem cell in patients with acute myocardial infarction. Am J Cardiol 94: 92–95PubMedCrossRef
11.
Zurück zum Zitat Condorelli G, Borello U, De Angelis L et al. (2001) Cardiomyocytes induce endothelial cells to trans-differentiate into cardiac muscle: implications for myocardium regeneration. Proc Natl Acad Sci U S A 98: 10733–10738PubMedCrossRef Condorelli G, Borello U, De Angelis L et al. (2001) Cardiomyocytes induce endothelial cells to trans-differentiate into cardiac muscle: implications for myocardium regeneration. Proc Natl Acad Sci U S A 98: 10733–10738PubMedCrossRef
12.
Zurück zum Zitat Dib N, Taylor DA, Diethrich EB (2006) Stem cell therapy and tissue engineering for cardiovascular repair. Springer, Berlin Heidelberg New York, ISBN-13: 978-0387-25788-4 Dib N, Taylor DA, Diethrich EB (2006) Stem cell therapy and tissue engineering for cardiovascular repair. Springer, Berlin Heidelberg New York, ISBN-13: 978-0387-25788-4
13.
Zurück zum Zitat Dietel M, Dudenhausen J, Suttorp N (Hrsg) (2002) Harrisons Innere Medizin, 15. Aufl. ABW Wissenschaftsverlag, Berlin Dietel M, Dudenhausen J, Suttorp N (Hrsg) (2002) Harrisons Innere Medizin, 15. Aufl. ABW Wissenschaftsverlag, Berlin
14.
Zurück zum Zitat Drexler H, Hornig B (1999) Endothelial dysfunction in human disease. J Mol Cell Cardiol 31: 51–60PubMedCrossRef Drexler H, Hornig B (1999) Endothelial dysfunction in human disease. J Mol Cell Cardiol 31: 51–60PubMedCrossRef
15.
Zurück zum Zitat Engelmann MG, Theiss HD, Hennig-Theiss C et al. (2006) Autologous bone marrow stem cell mobilization induced by granulocyte colony-stimulating factor after subacute ST-segment elevation myocardial infarction undergoing late revascularization: final results from the G-CSF-STEMI (Granulocyte Colony-Stimulating Factor ST-Segment Elevation Myocardial Infarction) trial. J Am Coll Cardiol 48: 1712–1721PubMedCrossRef Engelmann MG, Theiss HD, Hennig-Theiss C et al. (2006) Autologous bone marrow stem cell mobilization induced by granulocyte colony-stimulating factor after subacute ST-segment elevation myocardial infarction undergoing late revascularization: final results from the G-CSF-STEMI (Granulocyte Colony-Stimulating Factor ST-Segment Elevation Myocardial Infarction) trial. J Am Coll Cardiol 48: 1712–1721PubMedCrossRef
16.
Zurück zum Zitat Fernández-Avilés F, San Román JA, García-Frade J et al. (2004) Experimental and clinical regenerative capability of human bone marrow cells after myocardial infarction. Circ Res 95: 742–748PubMedCrossRef Fernández-Avilés F, San Román JA, García-Frade J et al. (2004) Experimental and clinical regenerative capability of human bone marrow cells after myocardial infarction. Circ Res 95: 742–748PubMedCrossRef
17.
Zurück zum Zitat Fuchs S, Weisz G, Kornowski R (2002) Catheter-based autologous bone marrow myocardial injection in no-option patients with advanced coronary artery disease: a feasibility and safety study. Circulation 106 (Suppl II): II655–II656CrossRef Fuchs S, Weisz G, Kornowski R (2002) Catheter-based autologous bone marrow myocardial injection in no-option patients with advanced coronary artery disease: a feasibility and safety study. Circulation 106 (Suppl II): II655–II656CrossRef
18.
Zurück zum Zitat Hill JM, Zalos G, Halcox JP et al. (2003) Circulating endothelial progenitor cells, vascular function, and cardiovascular risk. N Engl J Med 348: 593–600PubMedCrossRef Hill JM, Zalos G, Halcox JP et al. (2003) Circulating endothelial progenitor cells, vascular function, and cardiovascular risk. N Engl J Med 348: 593–600PubMedCrossRef
19.
Zurück zum Zitat Hombach V, Koenig W, Kochs M (2001) Akuter Herzinfarkt: Epidemiologie und Prähospitalphase. Internist 42: 649–658PubMedCrossRef Hombach V, Koenig W, Kochs M (2001) Akuter Herzinfarkt: Epidemiologie und Prähospitalphase. Internist 42: 649–658PubMedCrossRef
20.
Zurück zum Zitat Hristov M, Heussen N, Schober A, Weber C (2006) Intracoronary infusion of autologous bone marrow cells and left ventricular function after acute myocardial infarction: a meta-analysis. J Cell Mol Med 10: 727–733PubMedCrossRef Hristov M, Heussen N, Schober A, Weber C (2006) Intracoronary infusion of autologous bone marrow cells and left ventricular function after acute myocardial infarction: a meta-analysis. J Cell Mol Med 10: 727–733PubMedCrossRef
21.
Zurück zum Zitat Janssens S, Dubois C, Bogaert J et al. (2006) Autologous bone marrow-derived stem-cell transfer in patients with ST-segment elevation myocardial infarction: double-blind, randomised controlled trial. Lancet 367: 113–121PubMedCrossRef Janssens S, Dubois C, Bogaert J et al. (2006) Autologous bone marrow-derived stem-cell transfer in patients with ST-segment elevation myocardial infarction: double-blind, randomised controlled trial. Lancet 367: 113–121PubMedCrossRef
22.
Zurück zum Zitat Kehat I, Kenyagin-Karsenti D, Snir M et al. (2001) Human embryonic stem cells can differentiate into myocytes with structural and functional properties of cardiomyocytes. J Clin Invest 108: 407–414PubMed Kehat I, Kenyagin-Karsenti D, Snir M et al. (2001) Human embryonic stem cells can differentiate into myocytes with structural and functional properties of cardiomyocytes. J Clin Invest 108: 407–414PubMed
23.
Zurück zum Zitat Kocher AA, Schuster MD, Szabolcs MJ et al. (2001) Neovascularization of ischemic myocardium by human bone-marrow-derived angioblasts prevents cardiomyocyte apoptosis, reduces remodeling and improves cardiac function. Nat Med 7: 430–436PubMedCrossRef Kocher AA, Schuster MD, Szabolcs MJ et al. (2001) Neovascularization of ischemic myocardium by human bone-marrow-derived angioblasts prevents cardiomyocyte apoptosis, reduces remodeling and improves cardiac function. Nat Med 7: 430–436PubMedCrossRef
24.
Zurück zum Zitat Lipinski MJ, Giuseppe GL, Biondi-Zoccai et al. (2007) Impact of intracoronary cell therapy on left ventrikular function in the setting of myocardial infarction. J Am Coll Cardiol 50: 1761–1767PubMedCrossRef Lipinski MJ, Giuseppe GL, Biondi-Zoccai et al. (2007) Impact of intracoronary cell therapy on left ventrikular function in the setting of myocardial infarction. J Am Coll Cardiol 50: 1761–1767PubMedCrossRef
25.
Zurück zum Zitat Lunde K, Solheim S, Aakhus S et al. (2006) Intracoronary injection of mononuclear bone marrow cells in acute myocardial infarction. N Engl J Med 355: 1199–1209PubMedCrossRef Lunde K, Solheim S, Aakhus S et al. (2006) Intracoronary injection of mononuclear bone marrow cells in acute myocardial infarction. N Engl J Med 355: 1199–1209PubMedCrossRef
26.
Zurück zum Zitat Meyer GP, Wollert KC, Lotz J et al. (2006) Intracoronary bone marrow cell transfer after myocardial infarction: eighteen months‘ follow-up data from the randomized, controlled BOOST (BOne marrow transfer to enhance ST-elevation infarct regeneration) trial. Circulation 113: 1287–1294PubMedCrossRef Meyer GP, Wollert KC, Lotz J et al. (2006) Intracoronary bone marrow cell transfer after myocardial infarction: eighteen months‘ follow-up data from the randomized, controlled BOOST (BOne marrow transfer to enhance ST-elevation infarct regeneration) trial. Circulation 113: 1287–1294PubMedCrossRef
27.
Zurück zum Zitat Murry EM, Loren JF, Menasche F, Menasche P (2005) Cell-based cardiac repair: reflection at the 10 year point. Circulation 112: 3174–3183PubMedCrossRef Murry EM, Loren JF, Menasche F, Menasche P (2005) Cell-based cardiac repair: reflection at the 10 year point. Circulation 112: 3174–3183PubMedCrossRef
28.
Zurück zum Zitat Orlic D, Kajstura J, Chimenti S et al. (2001) Bone marrow cells regenerate infarcted myocardium. Nature 410: 701–705PubMedCrossRef Orlic D, Kajstura J, Chimenti S et al. (2001) Bone marrow cells regenerate infarcted myocardium. Nature 410: 701–705PubMedCrossRef
29.
Zurück zum Zitat Orlic D, Kajstura J, Chimenti S et al. (2001) Mobilized bone marrow cells repair the infarcted heart, improving function and survival. Proc Natl Acad Sci U S A 98: 10344–10349PubMedCrossRef Orlic D, Kajstura J, Chimenti S et al. (2001) Mobilized bone marrow cells repair the infarcted heart, improving function and survival. Proc Natl Acad Sci U S A 98: 10344–10349PubMedCrossRef
30.
Zurück zum Zitat Pfeffer MA, Braunwald E (1990) Ventricular remodeling after myocardial infarction. Experimental observations and clinical implications. Circulation 81: 1161–1172PubMed Pfeffer MA, Braunwald E (1990) Ventricular remodeling after myocardial infarction. Experimental observations and clinical implications. Circulation 81: 1161–1172PubMed
31.
Zurück zum Zitat Schächinger V, Erbs S, Elsässer A et al. REPAIR-AMI Investigators (2006) Intracoronary bone marrow-derived progenitor cells in acute myocardial infarction. N Engl J Med 355: 1210–1221PubMedCrossRef Schächinger V, Erbs S, Elsässer A et al. REPAIR-AMI Investigators (2006) Intracoronary bone marrow-derived progenitor cells in acute myocardial infarction. N Engl J Med 355: 1210–1221PubMedCrossRef
32.
Zurück zum Zitat Schächinger V, Erbs S, Elsässer A et al. REPAIR-AMI Investigators (2006) Improved clinical outcome after intracoronary administration of bone-marrow-derived progenitor cells in acute myocardial infarction: final 1-year results of the REPAIR-AMI trial. Eur Heart J 27: 2775–2783PubMedCrossRef Schächinger V, Erbs S, Elsässer A et al. REPAIR-AMI Investigators (2006) Improved clinical outcome after intracoronary administration of bone-marrow-derived progenitor cells in acute myocardial infarction: final 1-year results of the REPAIR-AMI trial. Eur Heart J 27: 2775–2783PubMedCrossRef
33.
Zurück zum Zitat Shamblott MJ, Axelman J, Wang S et al. (1998) Derivation of pluripotent stem cells from cultured human primordial germ cells. Proc Natl Acad Sci U S A 95: 13726–13731PubMedCrossRef Shamblott MJ, Axelman J, Wang S et al. (1998) Derivation of pluripotent stem cells from cultured human primordial germ cells. Proc Natl Acad Sci U S A 95: 13726–13731PubMedCrossRef
34.
Zurück zum Zitat Stamm C, Westphal B, Kleine HD et al. (2003) Autologous bone-marrow stem-cell transplantation for myocardial regeneration. Lancet 361: 45–46PubMedCrossRef Stamm C, Westphal B, Kleine HD et al. (2003) Autologous bone-marrow stem-cell transplantation for myocardial regeneration. Lancet 361: 45–46PubMedCrossRef
35.
Zurück zum Zitat Strauer BE, Brehm M, Zeus T et al. (2001) Intrakoronare, humane autologe Stammzelltransplantation zur Myokardregeneration nach Herzinfarkt. Dtsch Med Wochenschr 126: 932–938PubMedCrossRef Strauer BE, Brehm M, Zeus T et al. (2001) Intrakoronare, humane autologe Stammzelltransplantation zur Myokardregeneration nach Herzinfarkt. Dtsch Med Wochenschr 126: 932–938PubMedCrossRef
36.
Zurück zum Zitat Strauer BE, Brehm M, Zeus T et al. (2002) Repair of infarcted myocardium by autologous intracoronary mononuclear bone marrow cell transplantation in humans. Circulation 106: 1913–1918PubMedCrossRef Strauer BE, Brehm M, Zeus T et al. (2002) Repair of infarcted myocardium by autologous intracoronary mononuclear bone marrow cell transplantation in humans. Circulation 106: 1913–1918PubMedCrossRef
37.
38.
Zurück zum Zitat Thomson JA, Itskovitz-Eldor J, Shapiro SS et al. (1998) Embryonic stem cell lines derived from human blastocysts. Science 282: 1145–1147PubMedCrossRef Thomson JA, Itskovitz-Eldor J, Shapiro SS et al. (1998) Embryonic stem cell lines derived from human blastocysts. Science 282: 1145–1147PubMedCrossRef
39.
Zurück zum Zitat Van de Werf F, Ardissino D, Betriu A et al.; Task Force on the Management of Acute Myocardial Infarction of the European Society of Cardiology (2003) Management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 24: 28–66 Van de Werf F, Ardissino D, Betriu A et al.; Task Force on the Management of Acute Myocardial Infarction of the European Society of Cardiology (2003) Management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 24: 28–66
40.
Zurück zum Zitat Velazquez EJ, Francis GS, Armstrong PW et al.; VALIANT Registry (2004) An international perspective on heart failure and left ventricular systolic dysfunction complicating myocardial infarction: the VALIANT Registry. Eur Heart J 25: 1911–1919PubMedCrossRef Velazquez EJ, Francis GS, Armstrong PW et al.; VALIANT Registry (2004) An international perspective on heart failure and left ventricular systolic dysfunction complicating myocardial infarction: the VALIANT Registry. Eur Heart J 25: 1911–1919PubMedCrossRef
41.
Zurück zum Zitat Wollert KC, Meyer GP, Lotz J et al. (2004) Intracoronary autologous bone-marrow cell transfer after myocardial infarction: the BOOST randomised controlled clinical trial. Lancet 364: 141–148PubMedCrossRef Wollert KC, Meyer GP, Lotz J et al. (2004) Intracoronary autologous bone-marrow cell transfer after myocardial infarction: the BOOST randomised controlled clinical trial. Lancet 364: 141–148PubMedCrossRef
Metadaten
Titel
Stammzelltherapie nach akutem Myokardinfarkt
verfasst von
Dr. M. Brehm
E. Darrelmann
B.E. Strauer
Publikationsdatum
01.09.2008
Verlag
Springer-Verlag
Erschienen in
Die Innere Medizin / Ausgabe 9/2008
Print ISSN: 2731-7080
Elektronische ISSN: 2731-7099
DOI
https://doi.org/10.1007/s00108-008-2079-y

Weitere Artikel der Ausgabe 9/2008

Die Innere Medizin 9/2008 Zur Ausgabe

Mitteilungen des BDI

Mitteilungen des BDI

CME Weiterbildung • Zertifizierte Fortbildung

Pankreaskarzinom

Einführung zum Thema

Der akute Herzinfarkt

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.