MESENCHYMAL STEM CELLS IN CARDIOVASCULAR PHARMACOTHERAPY: MECHANISMS, CLINICAL APPLICATIONS, AND FUTURE PERSPECTIVES

Mesenchymal stem cells (MSCs) have emerged as a promising therapeutic strategy in cardiovascular pharmacotherapy due to their immunomodulatory, regenerative, and angiogenic properties.Unlike conventional pharmacological treatments that primarily target symptoms, MSCs offer a disease-modifying approach by addressing the underlying pathophysiological mechanisms of cardiovascular diseases.This review explores the pharmacological mechanisms of MSC therapy, emphasising their role in paracrine signalling, cytokine modulation, angiogenesis, and myocardial regeneration.MSCs exert their effects predominantly through the secretion of growth factors, extracellular vesicles (EVs), and exosomes, influencing cardiomyocyte survival, vascular repair, and immune regulation.Clinical and preclinical studies suggest that MSC therapy can improve left ventricular function, reduce infarct size, and enhance myocardial perfusion, particularly in ischemic heart disease (IHD) and congestive heart failure (CHF).However, challenges remain regarding optimal cell delivery methods, patient selection, and long-term safety.As research advances, further large-scale clinical trials and genetic or pharmacological enhancements of MSCs will be critical for refining their clinical applications and integration into standard cardiovascular therapy. RezumatCelulele stem mezenchimale (MSC) reprezint o strategie terapeutic promitoare n farmacoterapia cardiovascular, datorit proprietilor imunomodulatoare, regenerative i angiogenice.Spre deosebire de tratamentele farmacologice convenionale, care au ca scop principal ameliorarea simptomelor, MSC-urile acioneaz asupra mecanismelor fiziopatologice care stau la baza afeciunilor cardiovasculare.Aceast articol examineaz mecanismele farmacologice ale terapiei cu MSC-uri, cu accent pe rolul acestora n semnalizarea paracrin, modularea citokinelor, angiogenez i regenerarea miocardic.Efectele terapeutice ale MSC-urilor se exercit n principal prin secreia de factori de cretere, vezicule extracelulare (EV) i exozomi, influennd astfel supravieuirea cardiomiocitelor, repararea vascular i reglarea rspunsului imun.Studiile clinice i preclinice sugereaz c terapia cu MSC-uri poate mbunti funcia ventricular stng, reduce riscul de infarct i crete perfuzia miocardic, n special n boala cardiac ischemic (IHD) i insuficiena cardiac congestiv (CHF).Totui, exist anumite provocri legate de metodele optime de administrare, selecia pacienilor i sigurana pe termen lung.