Prospects for the use of mesenchymal stromal cells in the treatment of dilated cardiomyopathy

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Abstract

This review discusses the mechanisms underlying the therapeutic effects and the clinical prospects of mesenchymal stromal cell (MSC) transplantation in dilated cardiomyopathy. The development of dilated cardiomyopathy is based on a complex interplay of multiple etiological factors and mechanisms. This condition is characterized by high prevalence, unfavorable prognosis, and substantial mortality, highlighting the need for innovative treatment methods. In dilated cardiomyopathy, mesenchymal stromal cells exert multifaceted effects on the injured myocardium, primarily through paracrine secretion of cytoprotective, immunomodulatory, proangiogenic, and antifibrotic factors; suppression of oxidative stress; and restoration of cardiomyocyte energy metabolism. Preclinical and clinical studies have demonstrated the ability of mesenchymal stromal cells to improve cardiac contractile function and patients’ quality of life. Sustained long-term benefits have been reported, with allogeneic cells showing greater therapeutic potential and a lower incidence of complications compared with autologous cells. To enhance the efficacy of MSC transplantation and facilitate its broader implementation in clinical practice, several challenges must be addressed, including optimization of cell sources, delivery methods, and strategies to improve cell survival within the hostile myocardial microenvironment. In this context, genetic modification of mesenchymal stromal cells aimed at enhancing their cardioprotective and regenerative properties represents a promising approach to improving outcomes in patients with dilated cardiomyopathy.

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About the authors

Zekhra E. Mirzezade

The First Sechenov Moscow State Medical University

Email: zehra.mirzezade2006@gmail.com
ORCID iD: 0009-0000-8229-0184
SPIN-code: 6987-6342
Russian Federation, Moscow

Olga V. Payushina

The First Sechenov Moscow State Medical University

Author for correspondence.
Email: payushina@mail.ru
ORCID iD: 0000-0001-8467-0623
SPIN-code: 3854-7256

Dr. Sci. (Biology), Associate Professor

Russian Federation, Moscow

Dibakhan A. Tsomartova

The First Sechenov Moscow State Medical University

Email: dtsomartova@mail.ru
ORCID iD: 0000-0002-1381-0200
SPIN-code: 4644-5171

MD, Dr. Sci. (Medicine), Associate Professor

Russian Federation, Moscow

Yelizaveta V. Chereshneva

The First Sechenov Moscow State Medical University

Email: yelizaveta.new@mail.ru
ORCID iD: 0000-0002-1046-6336
SPIN-code: 5567-4358

MD, Cand. Sci. (Medicine), Associate Professor

Russian Federation, Moscow

Nataliya L. Kartashkina

The First Sechenov Moscow State Medical University

Email: knlmma@mail.ru
ORCID iD: 0000-0003-4648-9027
SPIN-code: 8123-7801

MD, Cand. Sci. (Medicine), Associate Professor

Russian Federation, Moscow

Elina S. Tsomartova

The First Sechenov Moscow State Medical University

Email: elina.tsomartova@gmail.com
ORCID iD: 0000-0002-8581-338X
SPIN-code: 8957-3308

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Svetlana A. Kosobutskaya

The First Sechenov Moscow State Medical University

Email: fotinia78@mail.ru
ORCID iD: 0000-0002-5484-9574
SPIN-code: 2589-3752

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

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2. Fig. 1. Pathogenesis of dilated cardiomyopathy and potential therapeutic targets of mesenchymal stromal cells (МСК).

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