Recent advances and future prospects in direct cardiac reprogramming

Yifang Xie1,2, Ben Van Handel3, Li Qian1,2

  • 1McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

PubMed

Insights

Direct cardiac reprogramming converts fibroblasts into cardiomyocyte-like cells (iCMs) to repair heart damage. This review covers reprogramming methods, mechanisms, and challenges for clinical use.

Area of Science:

  • Cardiovascular Research
  • Regenerative Medicine
  • Molecular Biology

Background:

  • Cardiovascular disease is a major global health issue.
  • Limited regeneration of cardiomyocytes after myocardial infarction leads to heart failure.
  • Direct cardiac reprogramming offers a potential therapeutic strategy to replace lost cardiomyocytes.

Purpose of the Study:

  • To review cardiac reprogramming cocktails for generating induced cardiomyocyte-like cells (iCMs).
  • To explore mechanistic studies on barriers and facilitators of cardiac reprogramming.
  • To discuss recent advances, including single-cell '-omics' research, and obstacles to clinical translation.

Main Methods:

  • Review of literature on cardiac reprogramming cocktails (transcription factors, microRNAs, small molecules).
  • Analysis of mechanistic studies investigating reprogramming processes.
  • Examination of single-cell '-omics' data for insights into iCM generation.

Main Results:

  • Various reprogramming cocktails effectively generate iCMs from cardiac fibroblasts.
  • Mechanistic studies reveal key factors influencing reprogramming efficiency.
  • Single-cell '-omics' technologies provide high-resolution insights into cellular transitions during reprogramming.

Conclusions:

  • Direct cardiac reprogramming is a promising strategy for treating heart failure.
  • Understanding reprogramming mechanisms and barriers is crucial for optimizing iCM generation.
  • Overcoming obstacles is essential for the clinical application of cardiac reprogramming therapies.

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