Cellular preconditioning and mesenchymal stem cell ferroptosis

In this editorial,we comment on the article published in the recent issue of the World Journal of Stem Cells.They focus on stem cell preconditioning to prevent ferroptosis by modulating the cystathionineγ-lyase/hydrogen sulfide(H_(2)S)pathway as a novel approach to treat vascular disorders,particularly pulmonary hypertension.Preconditioned stem cells are gaining popularity in regenerative medicine due to their unique ability to survive by resisting the harsh,unfavorable microenvironment of the injured tissue.They also secrete various paracrine factors against apoptosis,necrosis,and ferroptosis to enhance cell survival.Ferroptosis,a regulated form of cell death characterized by iron accumulation and oxidative stress,has been implicated in various pathologies encompassing dege-nerative disorders to cancer.The lipid peroxidation cascade initiates and sustains ferroptosis,generating many reactive oxygen species that attack and damage multiple cellular structures.Understanding these intertwined mechanisms provi-des significant insights into developing therapeutic modalities for ferroptosis-related diseases.This editorial primarily discusses stem cell preconditioning in modulating ferroptosis,focusing on the cystathionase gamma/H_(2)S ferroptosis pathway.Ferroptosis presents a significant challenge in mesenchymal stem cell(MSC)-based therapies;hence,the emerging role of H_(2)S/cystathionase gamma/H_(2) S signaling in abrogating ferroptosis provides a novel option for therapeutic intervention.Further research into understanding the precise mechanisms of H_(2)S-mediated cytoprotection against ferroptosis is warranted to enhance the thera-peutic potential of MSCs in clinical settings,particularly vascular disorders.

Priming mesenchymal stem cells to develop “super stem cells”

The stem cell pre-treatment approaches at cellular and sub-cellular levels encompass physical manipulation of stem cells to growth factor treatment,genetic manipulation,and chemical and pharmacological treatment,each strategy having advantages and limitations.Most of these pre-treatment protocols are non-combinative.This editorial is a continuum of Li et al’s published article and Wan et al’s editorial focusing on the significance of pre-treatment strategies to enhance their stemness,immunoregulatory,and immunosuppressive properties.They have elaborated on the intricacies of the combinative pre-treatment protocol using pro-inflammatory cytokines and hypoxia.Applying a well-defined multi-pronged combinatorial strategy of mesenchymal stem cells(MSCs),pre-treatment based on the mechanistic understanding is expected to develop“Super MSCs”,which will create a transformative shift in MSC-based therapies in clinical settings,potentially revolutionizing the field.Once optimized,the standardized protocols may be used with slight modifications to pre-treat different stem cells to develop“super stem cells”with augmented stemness,functionality,and reparability for diverse clinical applications with better outcomes.

High glucose microenvironment and human mesenchymal stem cell behavior

High glucose(HG)culture conditions in vitro and persistent exposure to hyperglycemia in diabetes patients are detrimental to stem cells,analogous to any other cell type in our body.It interferes with diverse signaling pathways,i.e.mammalian target of rapamycin(mTOR)-phosphoinositide 3-kinase(PI3K)-Akt signaling,to impact physiological cellular functions,leading to low cell survival and higher cell apoptosis rates.While elucidating the underlying mechanism responsible for the apoptosis of adipose tissue-derived mesenchymal stem cells(MSCs),a recent study has shown that HG culture conditions dysregulate mTORPI3K-Akt signaling in addition to mitochondrial malfunctioning due to defective mitochondrial membrane potential(MtMP)that lowers ATP production.This organelle-level dysfunction energy-starves the cells and increases oxidative stress and ultrastructural abnormalities.Disruption of the mitochondrial electron transport chain produces an altered mitochondrial NAD+/NADH redox state as evidenced by a low NAD+/NADH ratio that primarily contributes to the reduced cell survival in HG.Some previous studies have also reported altered mitochondrial membrane polarity(causing hyperpolarization)and reduced mitochondrial cell mass,leading to perturbed mitochondrial homeostasis.The hostile microenvironment created by HG exposure creates structural and functional changes in the mitochondria,altering their bioenergetics and reducing their capacity to produce ATP.These are significant data,as MSCs are extensively studied for tissue regeneration and restoring their normal functioning in cell-based therapy.Therefore,MSCs from hyperglycemic donors should be cautiously used in clinical settings for cell-based therapy due to concerns of their poor sur-vival rates and increased rates of post engraftment proliferation.As hypergly-cemia alters the bioenergetics of donor MSCs,rectifying the loss of MtMP may be an excellent target for future research to restore the normal functioning of MSCs in hyperglycemic patients.

Enhancing the functionality of mesenchymal stem cells:An attractive treatment strategy for metabolic dysfunction-associated steatotic liver disease?

The intrinsic heterogeneity of metabolic dysfunction-associated fatty liver disease(MASLD)and the intricate pathogenesis have impeded the advancement and clinical implementation of therapeutic interventions,underscoring the critical demand for novel treatments.A recent publication by Li et al proposes mesenchymal stem cells as promising effectors for the treatment of MASLD.This editorial is a continuum of the article published by Jiang et al which focuses on the significance of strategies to enhance the functionality of mesenchymal stem cells to improve efficacy in curing MASLD,including physical pretreatment,drug or chemical pretreatment,pretreatment with bioactive substances,and genetic engineering.

Effects of ursolic acid and oleanolic acid on human colon carcinoma cell line HCT15

AIM: Ursolic acid (UA) and oleanolic acid (OA) are triperpene acids having a similar chemical structure and are distributed wildly in plants all over the world. In recent years, it was found that they had marked anti-tumor effects. There is little literature currently available regarding their effects on colon carcinoma cells. The present study was designed to investigate their inhibitory effects on human colon carcinoma cell line HCT15. METHODS: HCT15 cells were cultured with different drugs. The treated cells were stained with hematoxylin-eosin and their morphologic changes observed under a light microscope. The cytotoxicity of these drugs was evaluated by tetrazolium dye assay. Cell cycle analysis was performed by flow cytometry (FCM). Data were expressed as means +/-SEM and Analysis of variance and Student' t-test for individual comparisons. RESULTS: Twenty-four to 72 h after UA or OA 60 micromol/L treatment, the numbers of dead cells and cell fragments were increased and most cells were dead at the 72nd hour. The cytotoxicity of UA was stronger than that of OA. Seventy-eight hours after 30 micromol/L of UA or OA treatment, a number of cells were degenerated, but cell fragments were rarely seen. The IC(50) values for UA and OA were 30 and 60 micromol/L, respectively. Proliferation assay showed that proliferation of UA and OA-treated cells was slightly increased at 24h and significantly decreased at 48 h and 60 h, whereas untreated control cells maintained an exponential growth curve. Cell cycle analysis by FCM showed HCT15 cells treated with UA 30 and OA 60 for 36 h and 72 h gradually accumulated in G(0)/G(1) phase (both drugs P【0.05 for 72 h), with a concomitant decrease of cell populations in S phase (both drugs P【0.01 for 72 h) and no detectable apoptotic fraction. CONCLUSION: UA and OA have significant anti-tumor activity. The effect of UA is stronger than that of OA. The possible mechanism of action is that both drugs have an inhibitory effect on tumor cell proliferation through cell-cycle arrest.

Overexpression of heme oxygenase-1 protects smooth muscle cells against oxidative injury and inhibits cell proliferation

To investigate whether the expression of exogenous heme oxygenase-1 (HO-1) gene within vascular smooth muscle cells (VSMC) could protect the cells from free radical attack and inhibit cell proliferation, we established an in vitro transfection of human HO-1 gene into rat VSMC mediated by a retroviral vector. The results showed that the profound expression of HO-1 protein as well as HO activity was 1.8- and 2.0-fold increased respectively in the transfected cells compared to the non-transfected ones. The treatment of VSMC with different concentrations of H2O2 led to the remarkable cell damage as indicated by survival rate and LDH leakage. However, the resistance of the HO-1 transfected VSMC against H2O2 was significantly raised. This protective effect was dramatically diminished when the transfected VSMC were pretreated with ZnPP-IX, a specific inhibitor of HO, for 24 h. In addition, we found that the growth potential of the transfected cells was significantly inhibited directly by increased activity of HO-1, and this effect might be related to decreased phosphorylation of MAPK. These results suggest that the overexpression of introduced hHO-1 is potentially able to reduce the risk factors of atherosclerosis, partially due to its cellular protection against oxidative injury and to its inhibitory effect on cellular proliferation.

Macrophage depletion and Schwann cell transplantation reduce cyst size after rat contusive spinal cord injury

Schwann cell transplantation is a promising therapy for the treatment of spinal cord injury（SCI） and is currently in clinical trials.In our continuing efforts to improve Schwann cell transplantation strategies,we sought to determine the combined effects of Schwann cell transplantation with macrophage depletion.Since macrophages are major inflammatory contributors to the acute spinal cord injury,and are the major phagocytic cells,we hypothesized that transplanting Schwann cells after macrophage depletion will improve cell survival and integration with host tissue after SCI.To test this hypothesis,rat models of contusive SCI at thoracic level 8 were randomly subjected to macrophage depletion or not.In rat subjected to macrophage depletion,liposomes filled with clodronate were intraperitoneally injected at 1,3,6,11,and 18 days post injury.Rats not subjected to macrophage depletion were intraperitoneally injected with liposomes filled with phosphate buffered saline.Schwann cells were transplanted 1 week post injury in all rats.Biotinylated dextran amine（BDA） was injected at thoracic level 5 to evalute axon regeneration.The Basso,Beattie,and Bresnahan locomotor test,Gridwalk test,and sensory test using von Frey filaments were performed to assess functional recovery.Immunohistochemistry was used to detect glial fibrillary acidic protein,neurofilament,and green fluorescent protein（GFP）,and also to visulize BDA-labelled axons.The GFP labeled Schwann cell and cyst and lesion volumes were quantified using stained slides.The numbers of BDA-positive axons were also quantified.At 8 weeks after Schwann cell transplantation,there was a significant reduction in cyst and lesion volumes in the combined treatment group compared to Schwann cell transplantation alone.These changes were not associated,however,with improved Schwann cell survival,axon growth,or locomotor recovery.Although combining Schwann cell transplantation with macrophage depletion does improve histopathology of the injury site,the effect on axon growth and behavioral recovery appears no better than what can be achieved with Schwann cell transplants alone.

Long noncoding RNA HAND2-AS1 re duce d the viability of hepatocellular carcinoma via targeting microRNA-300/SOCS5 axis

Background:Hepatocellular carcinoma(HCC)is one of the most prevalent human cancers with high mortality.Long non-coding RNA heart and neural crest derivatives expressed 2 anti-sense 1(HAND2-AS1)is down-regulated in several cancers including HCC,yet the precise mechanisms how HAND2-AS1 regulates cell survival in HCC remains poorly understood.Methods:The expression levels of HAND2-AS1 and miR-300 were measured using quantitative real-time PCR.The protein levels of suppressor of cytokine signaling 5(SOCS5),Bcl-2,Bax and cleaved caspase-3 were determined by Western blot.Cell viability and cell proliferation were assessed using cell counting kit-8 and clone formation assay,respectively.Cell apoptosis was detected using flow cytometry.The interactions between HAND2-AS1 and miR-300,miR-300 and SOCS5 were validated using luciferase reporter assay.Results:HAND2-AS1 was down-regulated in HCC tissues and cell lines,and the expression level of HAND2-AS1 was positively correlated to patient survival.HAND2-AS1 over-expression reduced viability and proliferation in HCC cells.Elevated HAND2-AS1 level induced apoptosis in HCC cells,accompanied with increased Bax and cleaved caspase-3 levels and decreased Bcl-2 level.We also validated that HAND2-AS1 acted as a sponge of miR-300,and there was a negative correlation between expression levels of HAND2-AS1 and miR-300 in HCC tissues.Furthermore,we found that SOCS5 was a downstream target of miR-300.In addition,miR-300 mimics abolished HAND2-AS1-mediated inhibition of cell viability and proliferation.miR-300 mimics also reversed the HAND2-AS1-induced apoptosis in HCC cells.Conclusion:lncRNA HAND2-AS1 inhibits proliferation in HCC through regulating miR-300/SOCS5 axis.

Modulation of cell physiology under hypoxia in pancreatic cancer

In solid tumors,the development of vasculature is,to some extent,slower than the proliferation of the different types of cells that form the tissue,both cancer and stroma cells.As a consequence,the oxygen availability is compromised and the tissue evolves toward a condition of hypoxia.The presence of hypoxia is variable depending on where the cells are localized,being less extreme at the periphery of the tumor and more severe in areas located deep within the tumor mass.Surprisingly,the cells do not die.Intracellular pathways that are critical for cell fate such as endoplasmic reticulum stress,apoptosis,autophagy,and others are all involved in cellular responses to the low oxygen availability and are orchestrated by hypoxia-inducible factor.Oxidative stress and inflammation are critical conditions that develop under hypoxia.Together with changes in cellular bioenergetics,all contribute to cell survival.Moreover,cell-to-cell interaction is established within the tumor such that cancer cells and the microenvironment maintain a bidirectional communication.Additionally,the release of extracellular vesicles,or exosomes,represents short and long loops that can convey important information regarding invasion and metastasis.As a result,the tumor grows and its malignancy increases.Currently,one of the most lethal tumors is pancreatic cancer.This paper reviews the most recent advances in the knowledge of how cells grow in a pancreatic tumor by adapting to hypoxia.Unmasking the physiological processes that help the tumor increase its size and their regulation will be of major relevance for the treatment of this deadly tumor.

Abnormal lipid synthesis as a therapeutic target for cancer stem cells

Cancer stem cells(CSCs)comprise a subpopulation of cancer cells with stem cell properties,which exhibit the characteristics of high tumorigenicity,self-renewal,and tumor initiation and are associated with the occurrence,metastasis,therapy resistance,and relapse of cancer.Compared with differentiated cells,CSCs have unique metabolic characteristics,and metabolic reprogramming contributes to the self-renewal and maintenance of stem cells.It has been reported that CSCs are highly dependent on lipid metabolism to maintain stemness and satisfy the requirements of biosynthesis and energy metabolism.In this review,we demonstrate that lipid anabolism alterations promote the survival of CSCs,including de novo lipogenesis,lipid desaturation,and cholesterol synthesis.In addition,we also emphasize the molecular mechanism underlying the relationship between lipid synthesis and stem cell survival,the signal transduction pathways involved,and the application prospect of lipid synthesis reprogramming in CSC therapy.It is demonstrated that the dependence on lipid synthesis makes targeting of lipid synthesis metabolism a promising therapeutic strategy for eliminating CSCs.Targeting key molecules in lipid synthesis will play an important role in anti-CSC therapy.

Construction of a plasmid for human brain-derived neurotrophic factor and its effect on retinal pigment epithelial cell viability

Several studies have investigated the protective functions of brain-derived neurotrophic factor（BDNF） in retinitis pigmentosa. However, a BDNF-based therapy for retinitis pigmentosa is not yet available. To develop an efficient treatment for fundus disease, an eukaryotic expression plasmid was generated and used to transfect human 293 T cells to assess the expression and bioactivity of BDNF on acute retinal pigment epithelial-19（ARPE-19） cells, a human retinal epithelial cell line. After 96 hours of co-culture in a Transwell chamber, ARPE-19 cells exposed to BDNF secreted by 293 T cells were more viable than ARPE-19 cells not exposed to secreted BDNF. Western blot assay showed that Bax levels were downregulated and that Bcl-2 levels were upregulated in human ARPE-19 cells exposed to BDNF. Furthermore, 293 T cells transfected with the BDNF gene steadily secreted the protein. The powerful anti-apoptotic function of this BDNF may be useful for the treatment of retinitis pigmentosa and other retinal degenerative diseases.

A Meta-analysis Reveals Prognostic Role of Programmed Death Ligand-1 in Asian Patients with Non-small Cell Lung Cancer

Accumulating studies explored the clinicopathologic and prognostic value of programmed death ligand-1（PD-L1） in non-small cell lung cancer（NSCLC）, but the results were controversial. We therefore conducted a meta-analysis to evaluate the predictive role of PD-L1 in NSCLC patients. We systematically collected relevant studies from Pub Med, Embase, Web of Science and China National Knowledge Infrastructure. The pooled hazard ratios（HRs） with 95% confidence intervals（CIs） for overall survival（OS）, and odd ratios（ORs） with 95% CIs for clinicopathologic factors were calculated. A total of 15 studies involving 3605 patients were included in this meta-analysis. The results showed no prognostic role of PD-L1 in the whole patients（HR=1.60, 95% CI： 0.88–2.89, P=0.123）. Subgroup analysis showed that PD-L1 was associated with decreased OS in Asian patients（HR=2.00, 95% CI： 1.55–2.57, P〈0.001）. Among all the clinicopathologic factors, PD-L1 overexpression was significantly in relevance with poor tumor cell differentiation（HR=1.84, 95% CI： 1.49–2.28, P〈0.001）, late stage（HR=1.21, 95% CI： 1.02–1.43, P=0.026） and anaplastic lymphoma kinase（ALK） translocation（HR=2.63, 95% CI： 1.08–6.40, P=0.034）, but not with other factors. In conclusion, our meta-analysis demonstrated that PD-L1 has a prognostic role in Asian patients with NSCLC.

Protective effect of insulin and glucose at different concentrations on penicillin-induced astrocyte death on the primer astroglial cell line

Astrocytes perform many functions in the brain and spinal cord.Glucose metabolism is important for astroglial cells and astrocytes are the only cells with insulin receptors in the brain.The common antibiotic penicillin is also a chemical agent that causes degenerative effect on neuronal cell.The aim of this study is to show the effect of insulin and glucose at different concentrations on the astrocyte death induced by penicillin on primer astroglial cell line.It is well known that intracranial penicillin treatment causes neuronal cell death and it is used for experimental epilepsy model commonly.Previous studies showed that insulin and glucose might protect neuronal cell in case of proper concentrations.But,the present study is about the effect of insulin and glucose against astrocyte death induced by penicillin.For this purpose,newborn rat brain was extracted and then mechanically dissociated to astroglial cell suspension and finally grown in culture medium.Clutters were maintained for 2 weeks prior to being used in these experiments.Different concentrations of insulin（0,1,3 nM）and glucose（0,3,30 mM）were used in media without penicillin and with 2 500μM penicillin.Penicillin decreased the viability of astroglial cell seriously.The highest cell viability appeared in medium with 3 nM insulin and 3 mM glucose but without penicillin.However,in medium with penicillin,the best cell survival was in medium with 1 nM insulin but without glucose. We concluded that insulin and glucose show protective effects on the damage induced by penicillin to primer astroglial cell line.Interestingly,cell survival depends on concentrations of insulin and glucose strongly.The results of this study will help to explain cerebrovascular pathologies parallel to insulin and glucose conditions of patient after intracranial injuries.

Pleckstrin Homology-Like Domain, Family A, Member 1 (PHLDA1): A Multifaceted Cell Survival Factor that Drives Metabolic Disease

Pleckstrin homology-like domain, family A, member 1 (PHLDA1) is a multifaceted intracellular protein belonging to the evolutionarily conserved pleckstrin homology-related domain family. Its murine homologue, T-cell death-associated 51 (TDAG51) gene, was initially discovered for its role in activation-induced apoptosis in T-cell hybridomas. In recent years, PHLDA1 has received increased attention due to its association with obesity, fatty liver disease, diabetes, atherosclerosis, and cancer. Accumulating evidence also supports its role in endoplasmic reticulum stress signaling pathways as a crucial mediator of apoptosis, autophagy, and cell proliferation. In this review, the current knowledge of PHLDA1 gene and protein regulation, localization, and function is summarized. This review highlights the pro- and anti-apoptotic roles of PHLDA1 that contribute to vast array of metabolic diseases.

The effects of 2-Bromopropane on Viability and TestosteroneProduction Ability of Rat Leydig Cells in Primary Culture

Epidemiological surveys and animal experiments have shown that 2-bromopropane induces oligozoospermia in exposed workers and inhibits spermatogensis in laborratory animals. However, themechanism by which 2-bromopropane exerts its effects is unknown. To this end, we examined the formation of testosterone by the Leydig cells and their survival of these cells in the Presence of differ-ent concentrations of 2-bromopropane in vitro. Leydig cells were isolated following vascular Perfu-sion, enzymatic dissociation and Percoll gradient centrifugation techniques. The cells were cultured in culture dishes. After 8 h, different cultures were exposed to 2-bromopropane at concentrations of 0.01 mmol/L, 0.10 mmol/L and 1.00 mmol/L. In order to stimulate Leydig cells to secrete testos-terone, human chorionic gonadotropin (hCG) was also added. Cell viability was determined using the trypan blue dye exclusion test and cell numbers were counted by hemocytometer. Testosterone secretion was detected by radioimmunoassay. The cell viability decreased after exposure to 2-bromo-propane in a dose-dependent way, but no morphological change was observed. The cell number de-creased in the 2-bromopropane-treated cultures. The secretion of testosterone did not manifest de -tectable changes in the culture treated with 0.10 mmol/L and 0.01 mmol/L of 2-bromopropane;however, it decreased significantly (P < 0. 02) in the Presence of 1.00 mmol/L. Therefore, ourresults strongly suggest that 2-bromopropane may exert its cytotoxic effects on heydig cells in vitro.We speculate that the decrease in the numbers of Leydig cells caused by 2-bromopropane was medi-ated by a feedback mechanism resulting from a lower testosterone concentration.

Minibrain-related kinase/dual-specificity tyrosine-regulated kinase 1B implication in stem/cancer stem cells biology

Dual-specificity tyrosine phosphorylation-regulated kinase 1B(DYRK1B),also known as minibrain-related kinase(MIRK)is one of the best functionally studied members of the DYRK kinase family.DYRKs comprise a family of protein kinases that are emerging modulators of signal transduction pathways,cell proliferation and differentiation,survival,and cell motility.DYRKs were found to participate in several signaling pathways critical for development and cell homeostasis.In this review,we focus on the DYRK1B protein kinase from a functional point of view concerning the signaling pathways through which DYRK1B exerts its cell type-dependent function in a positive or negative manner,in development and human diseases.In particular,we focus on the physiological role of DYRK1B in behavior of stem cells in myogenesis,adipogenesis,spermatogenesis and neurogenesis,as well as in its pathological implication in cancer and metabolic syndrome.Thus,understanding of the molecular mechanisms that regulate signaling pathways is of high importance.Recent studies have identified a close regulatory connection between DYRK1B and the hedgehog(HH)signaling pathway.Here,we aim to bring together what is known about the functional integration and cross-talk between DYRK1B and several signaling pathways,such as HH,RAS and PI3K/mTOR/AKT,as well as how this might affect cellular and molecular processes in development,physiology,and pathology.Thus,this review summarizes the major known functions of DYRK1B kinase,as well as the mechanisms by which DYRK1B exerts its functions in development and human diseases focusing on the homeostasis of stem and cancer stem cells.

Quercetin and Rutin Affect the Survival and Proliferation of Human Skin-Derived Multipotent Mesenchymal Stromal Cells

Flavonoids are phenolic compounds with biological and pharmacological properties, such as antioxidant and antiviral effects. In the present work, we evaluated the effect of the flavonoids quercetin and rutin in human SD-MSCs （skin-derived-multipotent mesenchymal stromal cells）. Cultured SD-MSCs were exposed to different concentrations of flavonoids （80 to 320 μM） for 2 days in vitro. Cell viability was assessed by MTT assay and cell proliferation by BrdU staining. Cell death was quantified by the analysis of picnotic nuclei. In this paper, we demonstrated for the first time that both quercetin and rutin affect the viability of SD-MSCs, although high concentrations of quercetin （320 μM） promoted increased values of picnoctic nuclei. Quercetin treatment increased cell proliferation and, in contrast, rutin in the same concentration decreased these values. Our results may aid the comprehension of flavonoids effect in SD-MSCs. However, a better understanding of the mechanisms involving flavonoids and SD-MSCs interactions are necessary.

A role for mitogen-activated protein kinase phosphatase 1(MKP1) in neural cell development and survival

The mitogen-activated protein kinase（MAPK）pathways are a group of conserved intracellular signalling pathways present in most cells including neurons and glia.These pathways respond to a variety of stimuli including growth factors,cytokines and oxidative stress to generate appropriate cellular responses such as modulation of gene expression,cell proliferation,differentiation and survival as well as the stress response（Korhonen and Moilanen,2014）.

Experimental study of the effect of adipose stromal vascular fraction cells on the survival rate of fat transplantation

Objective To investigate the effect of adipose stromal vascular fraction cells(SVFs)on the survival rate of fat ransplantation.Methods 0.5mL autologous fat tissue was mixed with: ① DiI-labeled autologous SVFs (Group A);②

The role and modulation of autophagy in experimental models of myocardial ischemia-reperfusion injury

A physiological sequence called autophagy qualitatively determines cellular viability by removing protein aggregates and damaged cyto-plasmic constituents, and contributes significantly to the degree of myocardial ischemia-reperfusion （I/R） injury. This tightly orchestrated cata-bolic cellular‘housekeeping’ process provides cells with a new source of energy to adapt to stressful conditions. This process was first described as a pro-survival mechanism, but increasing evidence suggests that it can also lead to the demise of the cell. Autophagy has been implicated in the pathogenesis of multiple cardiac conditions including myocardial I/R injury. However, a debate persists as to whether autophagy acts as a protec-tive mechanism or contributes to the injurious effects of I/R injury in the heart. This controversy may stem from several factors including the va-riability in the experimental models and species, and the methodology used to assess autophagy. This review provides updated knowledge on the modulation and role of autophagy in isolated cardiac cells subjected to I/R, and the growing interest towards manipulating autophagy to increase the survival of cardiac myocytes under conditions of stress-most notably being I/R injury. Perturbation of this evolutionarily conserved intracellular cleansing autophagy mechanism, by targeted modulation through, among others, mammalian target of rapamycin （mTOR） inhibitors, adenosine monophosphate-activated protein kinase （AMPK） modulators, calcium lowering agents, resveratrol, longevinex, sirtuin activators, the proapoptotic gene Bnip3, IP3 and lysosome inhibitors, may confer resistance to heart cells against I/R induced cell death. Thus, therapeutic ma-nipulation of autophagy in the challenged myocardium may benefit post-infarction cardiac healing and remodeling.