Abstract
Mesenchymal stem cells (MSCs) are a safe and promising biologic therapeutic for promoting tissue repair in ischemic and non-ischemic heart disease. The mechanisms underlying the salutary effects of MSCs include multilineage differentiation potential, immunomodulatory effect, anti-fibrotic effect, and stimulation of neovascularization and endogenous progenitor cell proliferation and differentiation. The immune-evasive properties of MSCs permit their use in allogeneic therapy, which offers the benefit of immediate availability and the appropriate number of cells. A growing number of clinical trials support the notion that both autologous and allogeneic MSC therapy is safe and has the capacity for repair of the myocardium. Studies are underway to determine the best tissue source of MSCs and the optimal number of cells, route(s) of delivery, and timing of the intervention. In addition, combination stem cell therapy is emerging as a strategy to improve the therapeutic potential of MSCs.