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blood-derived MNCs are possibly a feasible clinical application compared with MSCs because a cell-processing center is unnecessary for preparing MNCs (Figure). F or decades, several autologous cells have been considered as candidates for a cell-based strategy to rescue and repair damaged tissue in cardiovascular disease.1 Mesenchymal stem cells (MSCs), which were discovered on culture plates in 1970 as a rare population of progenitor cells in the bone marrow,2 may be one of the candidates. MSCs are capable of not only replicating as undifferentiated cells, but also differentiating into bone, muscle, adipose, endothelial cells, smooth muscle cells, and cardiomyocytes. Expressing CD73, CD90, and CD105, and lacking CD34, CD45, HLA-DR, CD14 or CD11b, CD79a, or CD19 on the cell surface are needed to define the cells as MSCs.3 It is currently considered that MSCs originate not only in bone marrow but also in adipose tissue, gut, lung, liver, dental pulp, heart, and so on.3 In animals, injected MSCs have been reported to play roles in cardioprotection, neovascularization, antifibrosis, and stimulation of endogenous cardiac stem cell proliferation and differentiation.3 Recently, transendocardial injection of MSCs into patients with left ventricular dysfunction caused by chronic ischemic cardiomyopathy has reduced the infarct size and improved the myocardial function regionally.4 However, a cell-processing center, which entails huge cost to build and maintain, is crucial for preparing MSCs, suggesting difficulties in their clinical application (Figure). Endothelial progenitor cells (EPCs), which were identified in 1997 as a population of hematopoietic cells circulating in the peripheral blood,5 may also be a candidate. EPCs are capable of differentiating into mature endothelial cells in vitro and playing roles in neovascularization of ischemic tissues and re-endothelialization of injured vessels in vivo,6,7 suggesting progeny of hemangioblasts. EPCs are generally cultured from bone marrowand peripheral blood-derived mononuclear cells (MNCs). Expressing CD133, CD34, VEGF-receptor 2 (KDR/Flk-1), and low intensity CD45 (CD45dim) on the cell surface is widely acceptable to define cultured or non-cultured MNCs as EPCs;8 however, the method for identification and characterization of EPCs is still controversial. Nevertheless, injections of bone marrowand peripheral blood-derived MNCs, which are phenotypically defined as EPCs, have improved the clinical condition in patients with ischemic coronary artery disease and peripheral artery disease.7,9 Bone marrowand peripheral Article p ????

Mesoangioblasts ― A Newcomer in Cell-Based Treatment Strategy for Cardiovascular Disease? ―