Transplantation of Human Pluripotent Stem Cell-Derived Cardiomyocytes for Cardiac Regenerative Therapy.

Transplantation of Human Pluripotent Stem Cell-Derived Cardiomyocytes for Cardiac Regenerative Therapy.
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DOI:
10.3389/fcvm.2021.707890
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发表时间:
2021
影响因子:
3.6
通讯作者:
Mei Y
Mei Y
中科院分区:
医学3区
文献类型:
--
作者:
Silver SE;Barrs RW;Mei Y

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心血管疾病是世界范围内主要的死亡原因,并承担着巨大的经济负担。晚期心力衰竭通常需要全心脏移植;然而,由于供体短缺和终身免疫抑制,替代心脏再生疗法的需求很高。人类多能干细胞(HPSCs),包括人类胚胎干细胞和诱导的多能干细胞,已经成为一种可供移植的人类心肌细胞来源。几种哺乳动物心脏损伤模型的最新进展为hPSC来源的心肌细胞(hPSC-CM)的治疗潜力提供了强有力的证据,显示了其与宿主心肌组织机电结合的能力,并促进了功能恢复。在这篇综述中,我们将讨论hPSC-CM分化和移植策略的最新进展。我们将强调hPSC-CMS促进心脏修复的机制,回顾成功移植hPSC-CMS的主要挑战,并提出正在探索的解决这些局限性的方案。我们最后讨论了hPSC-CMS的临床应用,包括临床翻译的障碍,目前的临床试验,以及hPSC-CM移植的未来前景。
Cardiovascular disease is the leading cause of death worldwide and bears an immense economic burden. Late-stage heart failure often requires total heart transplantation; however, due to donor shortages and lifelong immunosuppression, alternative cardiac regenerative therapies are in high demand. Human pluripotent stem cells (hPSCs), including human embryonic and induced pluripotent stem cells, have emerged as a viable source of human cardiomyocytes for transplantation. Recent developments in several mammalian models of cardiac injury have provided strong evidence of the therapeutic potential of hPSC-derived cardiomyocytes (hPSC-CM), showing their ability to electromechanically integrate with host cardiac tissue and promote functional recovery. In this review, we will discuss recent developments in hPSC-CM differentiation and transplantation strategies for delivery to the heart. We will highlight the mechanisms through which hPSC-CMs contribute to heart repair, review major challenges in successful transplantation of hPSC-CMs, and present solutions that are being explored to address these limitations. We end with a discussion of the clinical use of hPSC-CMs, including hurdles to clinical translation, current clinical trials, and future perspectives on hPSC-CM transplantation.
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