Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, RB, The Netherlands.
Stem Cells Transl Med. 2019 Jan;8(1):66-74. doi: 10.1002/sctm.18-0052. Epub 2018 Oct 9.
Until recently, in vivo and ex vivo experiments were the only means to determine factors and pathways involved in disease pathophysiology. After the generation of characterized human embryonic stem cell lines, human diseases could readily be studied in an extensively controllable setting. The introduction of human-induced pluripotent stem cells, a decade ago, allowed the investigation of hereditary diseases in vitro. In the field of cardiology, diseases linked to known genes have successfully been studied, revealing novel disease mechanisms. The direct effects of various mutations leading to hypertrophic cardiomyopathy, dilated cardiomyopathy, arrythmogenic cardiomyopathy, or left ventricular noncompaction cardiomyopathy are discovered as a result of in vitro disease modeling. Researchers are currently applying more advanced techniques to unravel more complex phenotypes, resulting in state-of-the-art models that better mimic in vivo physiology. The continued improvement of tissue engineering techniques and new insights into epigenetics resulted in more reliable and feasible platforms for disease modeling and the development of novel therapeutic strategies. The introduction of CRISPR-Cas9 gene editing granted the ability to model diseases in vitro independent of induced pluripotent stem cells. In addition to highlighting recent developments in the field of human in vitro cardiomyopathy modeling, this review also aims to emphasize limitations that remain to be addressed; including residual somatic epigenetic signatures induced pluripotent stem cells, and modeling diseases with unknown genetic causes. Stem Cells Translational Medicine 2019;8:66-74.
直到最近,体内和体外实验一直是确定疾病病理生理学相关因素和途径的唯一手段。在产生具有特征的人类胚胎干细胞系之后,人们可以在广泛可控的环境中轻松研究人类疾病。十年前,人类诱导多能干细胞的出现使得可以在体外研究遗传性疾病。在心脏病学领域,与已知基因相关的疾病已成功进行了研究,揭示了新的疾病机制。通过体外疾病建模,可以发现导致肥厚型心肌病、扩张型心肌病、心律失常性心肌病或左心室致密化不全性心肌病的各种突变的直接影响。研究人员目前正在应用更先进的技术来揭示更复杂的表型,从而建立更好地模拟体内生理学的最新模型。组织工程技术的不断改进和对表观遗传学的新见解为疾病建模和新型治疗策略的发展提供了更可靠和可行的平台。CRISPR-Cas9 基因编辑的引入使得可以在不依赖诱导多能干细胞的情况下在体外模拟疾病。除了强调体外人类心肌病建模领域的最新进展外,本文还旨在强调仍需解决的局限性;包括诱导多能干细胞中残留的体细胞表观遗传特征,以及对未知遗传原因的疾病进行建模。《干细胞转化医学》2019 年;8:66-74。