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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Aug 26, 2015; 7(8): 454-465
Published online Aug 26, 2015. doi: 10.4330/wjc.v7.i8.454
Adipose tissue-derived stem cells as a therapeutic tool for cardiovascular disease
Etsu Suzuki, Daishi Fujita, Masao Takahashi, Shigeyoshi Oba, Hiroaki Nishimatsu
Etsu Suzuki, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki 216-8512, Japan
Daishi Fujita, Masao Takahashi, Shigeyoshi Oba, the Department of Internal Medicine, Faculty of Medicine, University of Tokyo, Tokyo 113-8655, Japan
Hiroaki Nishimatsu, the Department of Urology, Faculty of Medicine, University of Tokyo, Tokyo 113-8655, Japan
Author contributions: Suzuki E, Fujita D, Takahashi M, Oba S and Nishimatsu H contributed to this paper.
Conflict-of-interest statement: There exist no conflicts of interest in this study.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Etsu Suzuki, MD, PhD, Institute of Medical Science, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki 216-8512, Japan. esuzuki-tky@umin.ac.jp
Received: May 11, 2015
Peer-review started: May 11, 2015
First decision: June 3, 2015
Revised: June 15, 2015
Accepted: June 18, 2015
Article in press: June 19, 2015
Published online: August 26, 2015
Processing time: 108 Days and 2.1 Hours
Abstract

Adipose tissue-derived stem cells (ADSCs) are adult stem cells that can be easily harvested from subcutaneous adipose tissue. Many studies have demonstrated that ADSCs differentiate into vascular endothelial cells (VECs), vascular smooth muscle cells (VSMCs), and cardiomyocytes in vitro and in vivo. However, ADSCs may fuse with tissue-resident cells and obtain the corresponding characteristics of those cells. If fusion occurs, ADSCs may express markers of VECs, VSMCs, and cardiomyocytes without direct differentiation into these cell types. ADSCs also produce a variety of paracrine factors such as vascular endothelial growth factor, hepatocyte growth factor, and insulin-like growth factor-1 that have proangiogenic and/or antiapoptotic activities. Thus, ADSCs have the potential to regenerate the cardiovascular system via direct differentiation into VECs, VSMCs, and cardiomyocytes, fusion with tissue-resident cells, and the production of paracrine factors. Numerous animal studies have demonstrated the efficacy of ADSC implantation in the treatment of acute myocardial infarction (AMI), ischemic cardiomyopathy (ICM), dilated cardiomyopathy, hindlimb ischemia, and stroke. Clinical studies regarding the use of autologous ADSCs for treating patients with AMI and ICM have recently been initiated. ADSC implantation has been reported as safe and effective so far. Therefore, ADSCs appear to be useful for the treatment of cardiovascular disease. However, the tumorigenic potential of ADSCs requires careful evaluation before their safe clinical application.

Keywords: Adipose tissue-derived stem cells; Cardiovascular disease; Acute myocardial infarction; Ischemic cardiomyopathy; Hindlimb ischemia; Stroke

Core tip: Adipose tissue-derived stem cells (ADSCs) have been used for the treatment of cardiovascular disease with the efficacy of ADSC implantation demonstrated in animal models. However, the mechanisms underlying the capacity of ADSCs for regenerating the cardiovascular system remain controversial. ADSCs may differentiate into blood vessels and cardiomyocytes, fuse with other cell types, obtaining the characteristics of those cells, and secrete paracrine factors that have proangiogenic and/or antiapoptotic activities. This review also discusses recently initiated clinical trials using autologous ADSCs.