The ideal candidate donor cell for myocardial reconstitution is an autologous cell that can be easily obtained and that, once placed into the myocardium, homes to the lesion, has a robust replication capacity with a low risk of neoplastic transformation, and differentiates into normal myocardium. Most adult mammalian tissues contain a population of multipotent undifferentiated cells with the characteristics of stem cells. These cells, under the appropriate conditions, are able to reconstitute all the cell types of the tissue of origin. Surprisingly, several of these putative stem cells exhibited an unsuspected degree of plasticity and were shown to be able to differentiate in cell types other than those in the tissue of origin. An effort has to be made to identify the best cellular target for new therapeutic approaches. Primitive cells with properties of stem cells are present in the myocardium, either as a resident population of embryonic origin or as a blood-born population that continuously seeds the tissue. The present work suggests that cardiac resident mesenchymal- like stem cells (C-MSCs) are a promising candidate for novel, cell-based treatment of the damaged heart.
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