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[ACC2012]心力衰竭治疗进展——Marvin A. Konstam教授专访
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作者:MarvinA.Konstam 编辑:国际循环网 时间:2012/3/25 18:38:54    加入收藏

 标签:专家访谈(专题)  关键字:Marvin A. Konstam 心力衰竭 干细胞 肾脏交感神经系统 

 

 

 

 Marvin A. Konstam  Tufts大学医学院教授,美国心力衰竭学会(Heart Failure Society of America)前主席

 

  <International Circulation>: The FOCUS study was presented today regarding the introduction of stem cells to hearts as a treatment for heart failure. This showed a 2.7% recovery of ejection fraction in people who received stem cells. The use of stem cells for treating heart failure, at least in China, is something we are very excited about. What is your view of stem cell treatment right now?

  《国际循环》:今天展示的FOCUS研究是关于将干细胞引入心脏来恢复射血功能的。其结果显示接受干细胞治疗的患者的射血分数可提高2.7%。至少在中国,用干细胞来治疗心力衰竭是令人感到兴奋的。您对干细胞治疗有何看法?
  Dr Konstam: The concept is extremely exciting. Obviously, the idea that you can take scarred or dysfunctional myocardium and implant it with viable cells and take the place of the defunct myocardium, is very exciting. There are many people working on this. There are some early encouraging findings, but, if you look at the findings to-date, they have not been blockbusting. There have been studies that have shown modest improvement in ejection fraction for example with stem cell implants derived from different places, implanted in different ways, implanted in different locations and in different populations. There is a lot of variability. Looking at it in aggregate, I would say that there have been favorable results but they have been pretty modest. Secondly, it has not been clear to me, in how many of these situations, if any, the stem cells that are taken up (and it is clear that they are being taken up) are they actually contracting. Most people in fact, do not believe that, in most of these cases, these cells are functioning as truly functional myocytes. Now that begs the question,  what is going on? There is a lot of interest in the possibility that these are paracrine effects, for example, where these cells are secreting substances that are having favorable downstream effects on their surroundings. But there is a lot of work going on and a lot of smart people working on this. There is a lot of interest in novel approaches to harvesting and selecting the cells most likely to differentiate into myocytes and novel ways of introducing these cells. I am still pretty hopeful that something positive is going to come of it.

心力衰竭的干细胞治疗

    所谓心力衰竭的干细胞治疗就是将多能干细胞植入存在疤痕或功能失调的心肌中来改善心肌功能,其作用机理可能是移植的干细胞能够通过分泌一些物质对周围心肌产生有利的下游效应,但不同来源、不同方式、不同部分以及不同人群的干细胞移植对射血分数的改善效果存在很大的变异性。我认为干细胞治疗虽然取得了可喜的结果,但并不认为其在短期内能够实现。 

  <International Circulation>: This may well be the future, but it is not the present in the treatment of heart failure.

  《国际循环》:这可能是心力衰竭治疗的未来趋势,但目前尚不成熟。
  Dr Konstam: If you were a patient today with heart failure, I don’t think you should get very excited that cell transplants will provide enormous benefits.

  Dr Konstam:如果你现在是一名心力衰竭患者,我认为你不应该对细胞移植能够带来巨大的获益抱有过多的希望。


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