Traitement de l'infarctus du myocarde chronique : contribution des cellules souches mésenchymateuses de moelle osseuse autologue

Abstract : Cellular therapy and tissue engineering are new strategies to be tested in the treatment of ischemic cardiopathy. In chronic infarction (MI) specifically, the possibility of rehabilitating a cicatricial zone using bone marrow mesenchymal stem cells (BMSC) as well as the feasibility of remodeling parietal ventricular architecture are especially discussed. The first part reviews the main concepts which have led to these new promising avenues of treatment. In the second part we present our work concerning (1) direct myocardial cellular injection via the epicardium in rats and in humans suffering from MI, and (2) direct epicardial surgical application of a tissular patch consisting of BMSC in a type I collagen network. The results show that direct cellular injection is responsible for an immediate non-specific inflammatory reaction. Nevertheless, the work also supports the notions that (1) BMSCs stimulate local angiogenesis on the basis of residual metabolic activity, and (2) the BMSC patch stimulates inverse ventricular remodeling in infarcted rats. The final part is devoted to a wider discussion of these results which are as yet too limited to hope to heal severe myocardial failure. However, despite the fact that these experiments do not confirm the cardiogenic potential of BMSCs, they do strongly hint at the possibility of using this methodology to invert the natural course of MI
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Juan Pablo Maureira. Traitement de l'infarctus du myocarde chronique : contribution des cellules souches mésenchymateuses de moelle osseuse autologue. Médecine humaine et pathologie. Université de Lorraine, 2012. Français. ⟨NNT : 2012LORR0411⟩. ⟨tel-01750417⟩

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