Center of Cardiovascular Research, Mount Sinai School of Medicine, New York, NY 10029, USA.
Gene Ther. 2012 Jun;19(6):588-95. doi: 10.1038/gt.2012.33.
Normal rhythms originate in the sino-atrial node, a specialized cardiac tissue consisting of only a few thousands of nodal pacemaker cells. Malfunction of pacemaker cells due to diseases or aging leads to rhythm generation disorders (for example, bradycardias and sick-sinus syndrome (SSS)), which often necessitate the implantation of electronic pacemakers. Although effective, electronic devices are associated with such shortcomings as limited battery life, permanent implantation of leads, lead dislodging, the lack of autonomic responses and so on. Here, various gene- and cell-based approaches, with a particular emphasis placed on the use of pluripotent stem cells and the hyperpolarization-activated cyclic nucleotide-gated-encoded pacemaker gene family, that have been pursued in the past decade to reconstruct bio-artificial pacemakers as alternatives will be discussed in relation to the basic biological insights and translational regenerative potential.
正常节律源自窦房结，这是一种特殊的心脏组织，仅由几千个节细胞组成。起搏细胞因疾病或衰老而发生功能障碍会导致节律产生障碍（例如，心动过缓和病态窦房结综合征（SSS）），这通常需要植入电子起搏器。尽管电子设备有效，但它们也存在一些缺点，如电池寿命有限、导线永久植入、导线移位、缺乏自主反应等。在这里，我们将讨论过去十年中为重建生物人工起搏器而采用的各种基于基因和细胞的方法，特别是利用多能干细胞和超极化激活环核苷酸门控编码起搏基因家族的方法，以及这些方法的基本生物学见解和转化再生潜力。
