Department of Physiology, Technion, Haifa, Israel; The Rappaport Family Institute, Technion, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel; The Sohnis and Forman Families Stem Cell Center, Technion, Haifa, Israel.
Can J Cardiol. 2014 Nov;30(11):1279-87. doi: 10.1016/j.cjca.2014.06.023. Epub 2014 Jul 2.
Human embryonic stem cells (hESCs) and human induced pluripotent stem cells (hiPSCs) have the capacity to differentiate into any specialized cell type, including cardiomyocytes. Therefore, hESC-derived and hiPSC-derived cardiomyocytes (hESC-CMs and hiPSC-CMs, respectively) offer great potential for cardiac regenerative medicine. Unlike some organs, the heart has a limited ability to regenerate, and dysfunction resulting from significant cardiomyocyte loss under pathophysiological conditions, such as myocardial infarction (MI), can lead to heart failure. Unfortunately, for patients with end-stage heart failure, heart transplantation remains the main alternative, and it is insufficient, mainly because of the limited availability of donor organs. Although left ventricular assist devices are progressively entering clinical practice as a bridge to transplantation and even as an optional therapy, cell replacement therapy presents a plausible alternative to donor organ transplantation. During the past decade, multiple candidate cells were proposed for cardiac regeneration, and their mechanisms of action in the myocardium have been explored. The purpose of this article is to critically review the comprehensive research involving the use of hESCs and hiPSCs in MI models and to discuss current controversies, unresolved issues, challenges, and future directions.
人类胚胎干细胞(hESCs)和人类诱导多能干细胞(hiPSCs)具有分化为任何特化细胞类型的能力,包括心肌细胞。因此,hESC 衍生和 hiPSC 衍生的心肌细胞(hESC-CMs 和 hiPSC-CMs)为心脏再生医学提供了巨大的潜力。与某些器官不同,心脏的再生能力有限,在生理病理条件下,如心肌梗死(MI),大量心肌细胞丧失会导致心力衰竭。不幸的是,对于终末期心力衰竭患者,心脏移植仍然是主要的替代方法,但心脏移植供体器官的有限可用性是一个主要的限制因素。尽管左心室辅助设备作为移植的桥梁,甚至作为一种可选的治疗方法,逐渐进入临床实践,但细胞替代疗法为供体器官移植提供了一种合理的替代方案。在过去的十年中,已经提出了多种候选细胞用于心脏再生,并且已经探索了它们在心肌中的作用机制。本文旨在批判性地回顾使用 hESCs 和 hiPSCs 在 MI 模型中的综合研究,并讨论当前的争议、未解决的问题、挑战和未来的方向。
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