Current Status of Stem Cell Therapy and Nanofibrous Scaffolds in Cardiovascular Tissue Engineering

Regenerative medicine is an emerging technology in medical sciences that aims to use its two main components, cell therapy and tissue engineering, to overcome untreatable diseases. Despite considerable advances in medicine, cardiovascular diseases (CVDs) are the number one cause of heart failure and death worldwide. To overcome this problem, cell therapy and tissue engineering alone or in combination with each other can be a promising therapeutic approach for CVDs. Cell therapy, especially stem cell therapy, is being developed as an attractive therapeutic platform for treating heart-associated diseases. There are different sources of stem cells with varying potencies that utilize each of them and are associated with a variety of advantages and disadvantages. The purpose of cardiac tissue engineering is to replace or repair injured cardiac muscle and vasculature in the heart. In this study, we focus on the current state of preclinical and clinical data regarding cell therapy with pluripotent stem cells, multipotent stem cells, and progenitor cells as well as cell-free-based therapy with extracellular vesicles (EVs) such as exosomes. Another major focus has been on the cardiovascular tissue engineering using biodegradable natural/synthetic nanofibers made by electrospinning technique. Lay Summary Because cardiovascular diseases (CVDs) are the main cause of death worldwide, the need to identify effective treatment strategies for this group of diseases is inevitable. Regenerative medicine, as an emerging and promising technology, is applying stem cell therapy and tissue engineering to overcome various problems. To outline advances of regenerative medicine for treatment of CVDs, here, we focus on the current preclinical and clinical knowledge regarding the cell (pluripotent/multipotent stem cells and progenitor cells)-based and cell-free (using extracellular vesicles) therapies. Furthermore, we address the role of biodegradable natural/synthetic electrospun nanofibers in cardiovascular tissue engineering.