Convergence and Complexity in Cardiac Regeneration

In heart failure, companies with expertise in gene or cell biology, or percutaneous delivery devices, see the first application where regenerative medicine could finally realize its promise. The enormous patient population, the high mortality of the disease, and the economics of treating it today provide a multi-billion dollar opportunity for which it's worth braving the complexity of cell therapy for tissue repair. Indeed, first-generation autologous heart cell therapies involve many different types of expertise resident in companies with different mindsets. Unknowns dog every component of the therapies on the level of basic biology. Still to be worked out: the right cell types; the optimal delivery route and device; when and at what dose cells should be administered, and in combination with which genes or drugs. Nevertheless, the great need in heart failure keeps companies dedicated to cardiac regeneration therapies. And as the cell therapy developers reveal new discoveries about the innate regenerative powers of the heart, drug developers are starting to move in, promising a much simpler approach than the combination products presently in the works.