Регенеративная Кардиология: Потенциал Стволовых Клеток

Abstract

Cardiovascular diseases (CVDs) remain a leading cause of morbidity and mortality worldwide, despite advancements in traditional treatments that often fail to restore damaged cardiac tissue. The adult myocardium has a limited regenerative capacity, leading to the replacement of damaged cardiomyocytes with fibrotic scar tissue and progressive heart failure. Regenerative medicine, particularly stem cell therapy, represents an innovative approach aimed at restoring myocardial structure and function. This article provides a comprehensive analysis of current achievements and challenges in regenerative cardiology, focusing on the potential of various stem cell types. It examines mesenchymal stem cells (MSCs), known for their immunomodulatory and paracrine effects that promote angiogenesis, reduce apoptosis, and mitigate fibrosis. The application of induced pluripotent stem cells (iPSCs) and their derivatives is discussed, highlighting their pluripotency and ability to differentiate into cardiomyocytes, opening avenues for personalized therapy. Direct reprogramming of fibroblasts into cardiomyocytes is also addressed as a method that eliminates the risk of teratoma formation. Various cell delivery methods are explored, including intracoronary, intramyocardial, and intravenous administration, as well as the use of biomaterials to enhance cell survival. Key clinical trial results are presented, confirming the safety of cell therapy but indicating a moderate effect and the need for further protocol optimization. Challenges such as arrhythmogenesis and teratoma risks, the need for standardization, improved cell survival, development of hypoimmunogenic lines, and regulatory framework establishment are discussed. The importance of international cooperation and investment for implementing cell technologies in countries like Uzbekistan is emphasized.