Strategies for Cytokine Modification and Stem Cell Mobilization for Acute Myocardial Infarction.

Previous dogma held that an acute myocardial infarction (MI) resulted in absolute death of the involved myocardium and could only be modulated by reperfusion therapy. Recent data demonstrating the presence of a natural repair process stimulated by the release of chemokines in response to injury have challenged that belief. Unfortunately, this natural repair mechanism occurs at a rate that precludes any meaningful recovery of myocardial tissue and function. The feasibility of myocardial repair/regeneration has been demonstrated through delivery of either exogenously expanded stem cells or endogenously mobilized stem cells expanded by growth factors (i.e., granulocyte-colony-stimulating factor). Although data regarding the use of various growth factors in order to attenuate the extent of damage or facilitate repair of injured myocardium remain limited, the early experiences have suggested safety. From these data, one may envision a potential therapeutic strategy that augments the naturally occurring repair process early following a MI through mobilization of stem cells that will minimize damage and limit the dysfunction for a substantial proportion of patients. [ABSTRACT FROM AUTHOR]