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Assessing Stem Cell DNA Integrity for Cardiac Cell Therapy
Published on: January 25, 2019
Heart regeneration for clinical application update 2016: from induced pluripotent stem cells to direct cardiac
1Department of Clinical and Molecular Cardiovascular Research, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Insights
Direct cardiac reprogramming offers a promising alternative to stem cell therapies for cardiovascular disease. This method converts fibroblasts directly into cardiomyocytes, bypassing risks associated with induced pluripotent stem cells.
Area of Science:
- Cardiovascular Research
- Regenerative Medicine
- Stem Cell Biology
Background:
- Cardiovascular disease is a leading cause of mortality with limited therapeutic options.
- Myocardial injury leads to fibroblast proliferation, fibrosis, and heart failure.
- Terminally differentiated cardiomyocytes exhibit poor regenerative capacity, necessitating cardiac regenerative therapies.
Purpose of the Study:
- To review recent advancements in stem cell and direct cardiac reprogramming strategies.
- To explore the potential of these methods for cardiovascular regenerative medicine.
- To summarize trends in induced pluripotent stem cells (iPS cells) and partial reprogramming.
Main Methods:
- Review of current literature on stem cell differentiation and direct reprogramming.
- Analysis of iPS cell generation and partial reprogramming strategies.
- Examination of direct cardiac reprogramming techniques from fibroblasts.
Main Results:
- Direct reprogramming of fibroblasts into cardiomyocytes bypasses the need for iPS cell generation.
- Multiple cardiac reprogramming pathways have been identified.
- Recent advances show promise for direct cardiac reprogramming in cardiovascular applications.
Conclusions:
- Direct cardiac reprogramming presents a viable alternative to iPS cell-based therapies.
- Further research is needed to optimize direct reprogramming for clinical use.
- This approach holds significant potential for treating heart failure and other cardiovascular conditions.
Abstract:
Cardiovascular disease remains a major cause of death for which current therapeutic regimens are limited. Following myocardial injury, endogenous cardiac fibroblasts, which account for more than half of the cells in the heart, proliferate and synthesize extracellular matrix, leading to fibrosis and heart failure. As terminally differentiated cardiomyocytes have little regenerative capacity following injury, the development of cardiac regenerative therapy is highly desired. Embryonic stem and induced pluripotent stem (iPS) cells are promising tools for regenerative medicine. However, these stem cells demonstrate variable cardiac differentiation efficiency and tumorigenicity, which must be resolved prior to clinical regenerative applications. Until the last decade, an established theory was that cardiomyocytes could only be produced from fibroblasts through iPS cell generation. In 2010, we first reported cardiac differentiation from fibroblasts by direct reprogramming, and we demonstrated that various cardiac reprogramming pathways exist. This review summarizes the latest trends in stem cell and regenerative research regarding iPS cells, a partial reprogramming strategy, and direct cardiac reprogramming. We also examine the many recent advances in direct cardiac reprogramming and explore the suitable utilization of these methods for regenerative medicine in the cardiovascular field.
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