How to Make a Heart Valve: From Embryonic Development to Bioengineering of Living Valve Substitutes
How to Make a Heart Valve: From Embryonic Development to Bioengineering of Living Valve Substitutes
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DOI：
10.1101/cshperspect.a013912
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发表时间：
2014-11-01
影响因子：
5.4
通讯作者：
Luis de la Pompa, Jose
中科院分区：
文献类型：
--
作者：
MacGrogan, Donal;Luxan, Guillermo;Luis de la Pompa, Jose
心脏瓣膜疾病是全球健康不良和死亡的重要原因，瓣膜置换术仍然是高收入经济体中最常见的心脏干预措施之一。尽管外科治疗取得了重大进展，但长期治疗仍然不足，因为目前没有一种瓣膜替代品具有重塑、再生和原生结构生长的潜力。瓣膜的发育是由信号通路和环境因素的复杂相互作用协调的，当这些信号通路和环境因素受到干扰时，就会导致疾病。心瓣膜由心内膜垫发育而来，心内膜垫由上皮-间质转化（EMT）形成的瓣膜前体间质填充。间充质前体随后经历定向生长，其特征是细胞区隔化和结构化的细胞外基质（ECM）分层。从心脏瓣膜发展的研究中获得的知识正在推动对瓣膜生物力学和组织工程的探索，旨在创造具有天然形态和功能的新型瓣膜替代品。
Cardiac valve disease is a significant cause of ill health and death worldwide, and valve replacement remains one of the most common cardiac interventions in high-income economies. Despite major advances in surgical treatment, long-term therapy remains inadequate because none of the current valve substitutes have the potential for remodeling, regeneration, and growth of native structures. Valve development is coordinated by a complex interplay of signaling pathways and environmental cues that cause disease when perturbed. Cardiac valves develop from endocardial cushions that become populated by valve precursor mesenchyme formed by an epithelial-mesenchymal transition (EMT). The mesenchymal precursors, subsequently, undergo directed growth, characterized by cellular compartmentalization and layering of a structured extracellular matrix (ECM). Knowledge gained from research into the development of cardiac valves is driving exploration into valve biomechanics and tissue engineering directed at creating novel valve substitutes endowed with native form and function.