Introduction

Since bone marrow-derived mesenchymal stem cells (MSCs) were discovered to have differentiative plasticity, great interest has been attracted on their potential therapeutic applications [1, 2]. There is increasing evidence indicating the therapeutic benefit of MSC transplantation in various disorders that are characterized by cell injury or cell loss, such as brain traumatic injury, stroke [3], Parkinson's disease [4], liver disease [5] as well as myocardial infarction [6,7]. In a recent multicenter clinical trial on acute myocardial infarction (AMI), Schachinger et al [8] reported an absolute improvement in the left ventricular ejection fraction (LVEF) with intracoronary infusion of BMC. By contrast, similar application of autologous BMC failed to show significant LVEF improvement in a smaller scale trial [9]. In another randomized, crossover clinical trial on chronic ischemic heart disease, Assmus et al [7] compared the efficacy of progenitor cells from different sources. Bone marrow-derived progenitor cell showed greater therapeutic benefit than the cells derived from circulating blood. Since total mononuclear cells isolated from density separation were used in all above mentioned clinical studies, the heterogeneous cell population was most likely the reason that apparently similar protocols yielded disparate outcomes. Rosenzweig [10] described this as "mixed results from mixed cells". In the present report, purified and characterized bone marrow-derived mesenchymal stem cells (MSCs) were autotransplanted into an AMI patient through a combined procedure, i.e., primary intracoronary infusion and secondary intravenous boost. Myocardial perfusion and cardiac function were assessed before and after cell therapy. The patient was regularly followed up for six months after cell transplantation. The therapeutic benefit was observed in both myocardial perfusion and cardiac function.

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