Allogeneic mesenchymal precursor cells (MPCs): an innovative approach to treating advanced heart failure

ABSTRACT

Introduction: Over 37 million people worldwide are living with Heart Failure (HF). Advancements in medical therapy have improved mortality primarily by slowing the progression of left ventricular dysfunction and debilitating symptoms. Ultimately, heart transplantation, durable mechanical circulatory support (MCS), or palliative care are the only options for patients with end-stage HF. Regenerative therapies offer an innovative approach, focused on reversing myocardial dysfunction and restoring healthy myocardial tissue. Initial clinical trials using autologous (self-donated) bone marrow mononuclear cells (BMMCs) demonstrated excellent safety, but only modest efficacy. Challenges with autologous stem cells include reduced quality and efficacy with increased patient age. The use of allogeneic mesenchymal precursor cells (MPCs) offers an “off the shelf” therapy, with consistent potency and less variability than autologous cells.

Areas covered: Preclinical and initial clinical trials with allogeneic MPCs have been encouraging, providing the support for a large ongoing Phase III trial—DREAM-HF. We provide a comprehensive review of preclinical and clinical data supporting MPCs as a therapeutic option for HF patients.

Expert opinion: The current data suggest allogeneic MPCs are a promising therapy for HF patients. The results of DREAM-HF will determine whether allogeneic MPCs can decrease major adverse clinical events (MACE) in advanced HF patients.

KEYWORDS:

• Heart failure
• intramyocardial injection
• mesenchymal precursor cell
• mesenchymal progenitor cell
• myocardial regeneration
• stem cells
• therapeutic biologics
• tissue therapy

Declaration of interest

D Chang and T Henry are principle investigators for DREAM-HF trial at Cedars-Sinai. T Henry is the principle investigator for the AMICI trial. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper has no funding.