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Stem/Progenitor-Cell-Based Approach for Restenosis after Percutaneous Coronary Intervention: Application of Bone Marrow Progenitors and Future Perspectives

Yoshitaka Iso, Takuya Watanabe, Makoto Shoji and Hiroshi Suzuki

Endothelial dysfunction and cell loss are prominent features of cardiovascular disease. Endothelial damage is a critical trigger of restenosis after percutaneous coronary angioplasty or stent implantation. Consequently, rapid re-endothelialization is essential for restoring normal vascular function and regulating neointimal hyperplasia. Bone-marrow-derived cell therapy has emerged as a therapeutic option for the treatment of ischemic cardiovascular diseases by virtue of its effects in enhancing endothelial capillary growth and collateral formation. It remains to be seen whether this cell therapy is also effective for the treatment of restenosis, but evidence suggests that it may be. Bone marrow stem/progenitor cells promote endothelialization and modulate immune response, processes that can lead to vascular repair after injury. Given the increased concern over late thrombosis after drug-eluting stents, therapeutic re-endothelialization by the bone marrow stem/progenitor cells seems both attractive and promising. In this review we focus on the therapeutic potential of endothelial progenitors and mesenchymal stem cells from bone marrow for the prevention of restenosis after coronary intervention. We describe the current status of this nascent therapy and perspectives on where it may lead in the future.