Ou Dong-Bo, Lang Hong-Juan, Chen Rui, Liu Xiong-Tao, Zheng Qiang-Sun
Department of Cardiology and Arrhythmologic Center, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
Bioessays. 2009 Feb;31(2):246-52. doi: 10.1002/bies.200800179.
Biological pacemakers can be achieved by various gene-based and cell-based approaches. Embryonic stem cells (ESCs)-derived pacemaker cells might be the most promising way to form biological pacemakers, but there are challenges as to how to control the differentiation of ESCs and to overcome the neoplasia, proarrhythmia, or immunogenicity resulting from the use of ESCs. As a potential approach to solve these difficult problems, tissue-engineering techniques may provide a precise control on the different cell components of multicellular aggregates and the forming of a construct with-defined architectures and functional properties. The combined interactions between ESC-derived pacemaker cells, supporting cells, and matrices may completely reproduce pacemaker properties and result in a steady functional unit to induce rhythmic electrical and contractile activities. As ESCs have a high capability for self-renewal, proliferation, and potential differentiation, we hypothesize that ESCs can be used as a source of pacemaker cells for tissue-engineering applications and the ambitious goal of biological cardiac pacemakers may ultimately be achieved with ESCs via tissue-engineering technology.
生物起搏器可通过多种基于基因和基于细胞的方法实现。胚胎干细胞（ESC）衍生的起搏细胞可能是形成生物起搏器最有前景的方式，但在如何控制ESC的分化以及克服使用ESC导致的肿瘤形成、心律失常或免疫原性方面存在挑战。作为解决这些难题的一种潜在方法，组织工程技术可以对多细胞聚集体的不同细胞成分进行精确控制，并形成具有明确结构和功能特性的构建体。ESC衍生的起搏细胞、支持细胞和基质之间的联合相互作用可能完全重现起搏器特性，并产生一个稳定的功能单元以诱导节律性电活动和收缩活动。由于ESC具有高度的自我更新、增殖和潜在分化能力，我们假设ESC可作为组织工程应用中起搏细胞的来源，并且通过组织工程技术最终可能借助ESC实现生物心脏起搏器这一宏伟目标。
