Combining Pluripotent stem cell-based therapies and bioengineering strategies for Cardiac regeneration
Circa 2020, immortality of the heart with heart regeneration.
Worldwide, cardiovascular diseases are the leading cause of death and morbidity. Numerous studies have been carried out to date in order to develop treatment options that can prevent the progression these pathologies. Despite the progress made over the past decade, current treatments are still hindered by a poor translation of their clinical applications. This is due to the limited capacity of cardiac tissue to regenerate. After an ischaemic injury, fibrotic scarring occurs, which interferes with the mechanical and electrical functions. The ability of the body to heal after an ischaemic insult depends on multiple molecular pathways and cellular pathways. An imbalance between these pathways can lead to adverse remodeling and heart failure. Over the last 20 years, a new chapter in regenerative medicine was opened with the discovery and use of induced pluripotent cells (iPSCs). These cells have the same characteristics as embryonic stem (ESCs), however, they are generated using patient-specific somatic cell lines. This overcomes the ethical restrictions associated with ESCs and provides an autologous human source of cells. iPSCs can also differentiate into cardiomyocytes. This means that they have a real regenerative capacity for future clinical uses. Cell-based therapies can cause adverse effects on the failing heart due to their poor grafting. In the past few years, bioengineering technology has focused on improving the survival and functionality of CMs derived from iPSCs. Combining these two fields has sparked the development of three-dimensional (3D), cell-based structures and organoids that mimic more realistically the in vivo behavior of cells. In the same vein, recent research has shown that the ability to convert fibroblasts directly into CMs is a promising approach for in situ cardiac repair. This review provides an overview of recent advances in the use of pluripotent cells and tissue engineering for therapeutically-relevant cardiac regenerative methods. We also highlight limitations and future prospects for their clinical application.
Worldwide, cardiovascular diseases are the leading cause of death and morbidity. They account for 31 percent of all deaths. (Organization W 2016). Myocardial Infarction (MI), also known as a heart attack, is characterized by the necrosis or death of cardiac tissue caused by the obstruction of coronary arteries. This condition reduces the oxygen and nutrients delivered to the heart irrevocably (Thygesen, et. al., 2007). Although there are many effective treatments, such as surgical approaches to treat cardiac disorders like valvular and artery disease, the available therapeutic treatment for damaged myocardium is still very limited. After an ischaemic injury, fibrotic scarring occurs, which interferes with the mechanical and electrical functions.