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Updated: Jun 20, 2026
Generation of First Heart Field-like Cardiac Progenitors and Ventricular-like Cardiomyocytes from Human Pluripotent Stem Cells
Published on: June 19, 2018
Progenitor cell therapy for heart disease
Christine Gonzales1, Thierry Pedrazzini
1Experimental Cardiology Unit, Department of Medicine, University of Lausanne Medical School, CH-1011 Lausanne, Switzerland.
Insights
Identifying the best progenitor cells for cardiac repair remains challenging. While various cell types show promise, their cardiogenic potential and safety for heart regeneration therapy require further investigation.
Area of Science:
- Regenerative Medicine
- Cardiovascular Biology
- Stem Cell Therapy
Background:
- Cell transplantation is explored for myocardial repair, but the optimal progenitor cell source is undetermined.
- Bone marrow and endothelial progenitor cells have shown safety but controversial cardiogenic potential, likely mediating indirect benefits.
- Human embryonic stem cells offer abundant cardiomyocytes but pose teratoma, ethical, and rejection risks; induced pluripotent stem cells mitigate some issues but retain teratoma risk.
Purpose of the Study:
- To evaluate various cell types as potential cardiomyocyte sources for cardiac repair.
- To address the challenges and controversies surrounding the cardiogenic potential and clinical application of different progenitor cells.
- To explore the identification and isolation of cardiac progenitor cells and alternative regenerative strategies.
Main Methods:
- Review of current research on cell transplantation therapy for damaged myocardium.
- Analysis of the potential and limitations of bone marrow-derived cells, endothelial progenitor cells, human embryonic stem cells, induced pluripotent stem cells, and cardiac progenitor cells.
- Discussion of marker identification, cell stability, electromechanical coupling, and endogenous progenitor mobilization.
Main Results:
- The cardiogenic potential of bone marrow and endothelial progenitor cells is debated, with observed benefits likely indirect.
- Human embryonic stem cells and induced pluripotent stem cells offer differentiation potential but carry risks like teratoma formation and graft rejection.
- Accurate identification and isolation of cardiac progenitor cells remain problematic due to marker overlap with extracardiac progenitors.
Conclusions:
- No single progenitor cell type is definitively superior for cardiac repair; each has distinct advantages and significant limitations.
- Further research is needed to refine cell identification, control differentiation, ensure safety, and improve integration for effective cardiac regeneration.
- Mobilizing endogenous progenitors presents a promising complementary strategy to cell transplantation for promoting cardiac repair.
Abstract:
Many cell types are currently being studied as potential sources of cardiomyocytes for cell transplantation therapy to repair and regenerate damaged myocardium. The question remains as to which progenitor cell represents the best candidate. Bone marrow-derived cells and endothelial progenitor cells have been tested in clinical studies. These cells are safe, but their cardiogenic potential is controversial. The functional benefits observed are probably due to enhanced angiogenesis, reduced ventricular remodeling, or to cytokine-mediated effects that promote the survival of endogenous cells. Human embryonic stem cells represent an unlimited source of cardiomyocytes due to their great differentiation potential, but each step of differentiation must be tightly controlled due to the high risk of teratoma formation. These cells, however, confront ethical barriers and there is a risk of graft rejection. These last two problems can be avoided by using induced pluripotent stem cells (iPS), which can be autologously derived, but the high risk of teratoma formation remains. Cardiac progenitor cells have the advantage of being cardiac committed, but important questions remain unanswered, such as what is the best marker to identify and isolate these cells? To date the different markers used to identify adult cardiac progenitor cells also recognize progenitor cells that are outside the heart. Thus, it cannot be determined whether the cardiac progenitor cells identified in the adult heart represent resident cells present since fetal life or extracardiac cells that colonized the heart after cardiac injury. Developmental studies have identified markers of multipotent progenitors, but it is unknown whether these markers are specific for adult progenitors when expressed in the adult myocardium. Cardiac regeneration is dependent on the stability of the cells transplanted into the host myocardium and on the electromechanical coupling with the endogenous cells. Finally, the promotion of endogenous regenerative processes by mobilizing endogenous progenitors represents a complementary approach to cell transplantation therapy.
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