In Cardiac Regeneration, it's Repair, not Replace

Recent clinical trial failures in cardiac stem cell therapies have been widely reported as raising more questions than answers in a field which already had many unknowns. But those questions themselves give rise to new strategies spurring the formation of start-ups like those profiled in this issue. While the new companies are ultimately addressing heart failure, they hope to intervene much earlier in the cascade of damage and remodeling, where turning up the body's natural healing responses a notch could help it repair the damage caused by myocardial infarction or ischemia. Many cardiac cell and gene therapy companies are returning to ischemic disease, a field in which, in recent years, the success of device-based revascularization techniques appeared to present a competitive hurdle to cell and gene therapies. Microvessel disease is emerging as a large market in which cell and gene therapies might have advantages over devices.