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Regenerating Damaged Myocardium: A Review of Stem-Cell Therapies for Heart Failure
Dihan Fan1,2, Hanrong Wu1,2, Kaichao Pan3
1Psychiatric Genetics Group, McGill University, Montreal, QC H4H 1R3, Canada.
Insights
Cardiovascular disease leads to cardiac myocyte death. This review explores stem cells, particularly induced-pluripotent stem cells (iPSCs), and cardiac fibroblast transdifferentiation for myocardial repair.
Area of Science:
- Cardiovascular Research
- Regenerative Medicine
- Stem Cell Biology
Background:
- Cardiovascular disease (CVD) is a leading global cause of mortality.
- Cardiac myocyte death is a key pathological process in heart diseases like myocardial infarction.
- Replacing fibrotic scar tissue with functional myocardium is a major research goal.
Purpose of the Study:
- To review somatic stem and progenitor cells for myocardial regeneration.
- To focus on pluripotent stem cells (PSCs), especially induced-pluripotent stem cells (iPSCs), as a promising cardiomyocyte source.
- To discuss direct cardiomyocyte generation from cardiac fibroblasts (transdifferentiation) for in-situ repair.
Main Methods:
- Review of early somatic stem/progenitor cell investigations.
- Focus on pluripotent stem cells (PSCs) and induced-pluripotent stem cells (iPSCs).
- Description of transdifferentiation strategies from cardiac fibroblasts.
Main Results:
- Somatic stem/progenitor cells were early candidates for regenerative therapy.
- Pluripotent stem cells, particularly iPSCs, show significant promise for therapeutic cardiomyocytes and drug testing.
- Transdifferentiation offers a potential in-situ source of cardiomyocytes from endogenous fibroblasts.
Conclusions:
- Induced-pluripotent stem cells (iPSCs) are a leading candidate for generating cardiomyocytes for therapy and drug discovery.
- Transdifferentiation of cardiac fibroblasts presents a novel strategy for in-situ myocardial repair.
- Future research directions include optimizing cell-based therapies and transdifferentiation techniques for cardiovascular regeneration.
Abstract:
Cardiovascular disease (CVD) is one of the contributing factors to more than one-third of human mortality and the leading cause of death worldwide. The death of cardiac myocyte is a fundamental pathological process in cardiac pathologies caused by various heart diseases, including myocardial infarction. Thus, strategies for replacing fibrotic tissue in the infarcted region with functional myocardium have long been a goal of cardiovascular research. This review begins by briefly discussing a variety of somatic stem- and progenitor-cell populations that were frequently studied in early investigations of regenerative myocardial therapy and then focuses primarily on pluripotent stem cells (PSCs), especially induced-pluripotent stem cells (iPSCs), which have emerged as perhaps the most promising source of cardiomyocytes for both therapeutic applications and drug testing. We also describe attempts to generate cardiomyocytes directly from cardiac fibroblasts (i.e., transdifferentiation), which, if successful, may enable the pool of endogenous cardiac fibroblasts to be used as an in-situ source of cardiomyocytes for myocardial repair.
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