{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:47:56Z","timestamp":1790837276041,"version":"4.1.0"},"reference-count":33,"publisher":"EDP Sciences","license":[{"start":{"date-parts":[[2016,11,21]],"date-time":"2016-11-21T00:00:00Z","timestamp":1479686400000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/www.edpsciences.org\/en\/authors\/copyright-and-licensing"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med Sci (Paris)"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:p>L\u2019insuffisance cardiaque est un probl\u00e8me majeur de sant\u00e9 publique et diff\u00e9rentes approches de th\u00e9rapie cellulaire sont exp\u00e9riment\u00e9es pour am\u00e9liorer la fonction de myocardes d\u00e9faillants. De nombreux types cellulaires ont \u00e9t\u00e9 utilis\u00e9s (myoblastes squelettiques, cellules h\u00e9matopo\u00ef\u00e9tiques, endoth\u00e9liales ou m\u00e9senchymateuses, cellules d\u2019origine cardiaque\u2026), plus souvent dans des indications d\u2019insuffisance post-isch\u00e9mique que de cardiomyopathie dilat\u00e9e g\u00e9n\u00e9tique. Il est en effet plus ais\u00e9 de cibler une zone de r\u00e9paration localis\u00e9e que l\u2019ensemble du tissu myocardique. De nombreux essais cliniques ont fait \u00e9tat de r\u00e9sultats fonctionnels de faibles ampleurs mais encourageants, dont l\u2019interpr\u00e9tation est souvent limit\u00e9e par la taille des cohortes et les variabilit\u00e9s biologiques li\u00e9es aux patients et aux candidats cellulaires. Ces essais ont aussi mis en lumi\u00e8re des m\u00e9canismes d\u2019action inattendus, qui changent les concepts et m\u00e9thodologies de traitement. En effet, les b\u00e9n\u00e9fices proviendraient de s\u00e9cr\u00e9tions de facteurs trophiques, plut\u00f4t que d\u2019une int\u00e9gration structurale des cellules au sein du myocarde. Par cons\u00e9quent, les nouvelles g\u00e9n\u00e9rations d\u2019essais visent \u00e0 accro\u00eetre la taille et l\u2019homog\u00e9n\u00e9it\u00e9 des cohortes de patients afin d\u2019am\u00e9liorer la puissance statistique. Par ailleurs, des \u00e9tudes misent sur l\u2019accompagnement et\/ou le conditionnement des cellules \u00e0 l\u2019aide de biomat\u00e9riaux et\/ou de cocktails de cytokines, en vue d\u2019am\u00e9liorer leur survie et leur fonctionnement. En parall\u00e8le, de nombreuses recherches en bio-ing\u00e9nierie s\u2019int\u00e9ressent au soutien des cellules, au maintien de la structure du myocarde, \u00e0 la fabrication <jats:italic>ex vivo<\/jats:italic> de tissu cardiaque de substitution, et finalement \u00e0 la possibilit\u00e9 de remplacer les cellules par leurs produits actifs de s\u00e9cr\u00e9tion. Plusieurs dispositifs devraient \u00e9merger de ces recherches, dont le choix sera guid\u00e9 par l\u2019indication m\u00e9dicale.<\/jats:p>","DOI":"10.1051\/medsci\/201632s209","type":"journal-article","created":{"date-parts":[[2016,11,21]],"date-time":"2016-11-21T07:34:07Z","timestamp":1479713647000},"page":"30-39","source":"Crossref","is-referenced-by-count":5,"special_numbering":"Hors s\u00e9rie n\u00b02","title":["Th\u00e9rapies cellulaires des 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