Living biodrugs and how tissue source influences mesenchymal stem cell therapeutics for heart failure

Table 1 Advantages and disadvantages of mesenchymal stem cell therapy

MSC therapies	Comparison
Advantages	MSCs can be sourced from various tissues, including bone marrow, adipose tissue, and umbilical cord, providing multiple options for therapy
	MSCs have immunomodulatory properties, which can reduce inflammation and fibrosis, promoting tissue regeneration
	UC-MSCs are easily accessible, have reduced cellular senescence, and do not raise ethical concerns
	MSCs exhibit paracrine effects that contribute to cardiac repair and functional improvement, even without direct differentiation into cardiomyocytes
Disadvantages	The therapeutic efficacy may be limited by low cell engraftment and survival within myocardial tissue
	Clinical trials, such as those using BM-MSCs, have shown variable outcomes, with some failing to achieve significant improvements in heart failure patients
	Delivery methods, such as multiple intraventricular injections, can pose challenges and may lead to inconsistent results or myocardial damage
	Factors like cell dosing, delivery techniques, and heterogeneous myocardial environments can affect the overall success of the therapy

MSC: Mesenchymal stem cell.