Jarrell Dillon K, Vanderslice Ethan J, VeDepo Mitchell C, Jacot Jeffrey G
Jacot Laboratory for Pediatric Regenerative Medicine, Department of Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
Front Cardiovasc Med. 2020 Oct 15;7:586261. doi: 10.3389/fcvm.2020.586261. eCollection 2020.
Heart disease is the leading cause of death in the United States among both adults and infants. In adults, 5-year survival after a heart attack is <60%, and congenital heart defects are the top killer of liveborn infants. Problematically, the regenerative capacity of the heart is extremely limited, even in newborns. Furthermore, suitable donor hearts for transplant cannot meet the demand and require recipients to use immunosuppressants for life. Tissue engineered myocardium has the potential to replace dead or fibrotic heart tissue in adults and could also be used to permanently repair congenital heart defects in infants. In addition, engineering functional myocardium could facilitate the development of a whole bioartificial heart. Here, we review and compare and myocardial tissue engineering strategies. In the context of this comparison, we consider three challenges that must be addressed in the engineering of myocardial tissue: recapitulation of myocardial architecture, vascularization of the tissue, and modulation of the immune system. In addition to reviewing and analyzing current progress, we recommend specific strategies for the generation of tissue engineered myocardial patches for heart regeneration and repair.
在美国，心脏病是成年人和婴儿死亡的主要原因。对于成年人而言，心脏病发作后的5年生存率低于60%，而先天性心脏缺陷是活产婴儿的头号杀手。问题在于，即使是新生儿，心脏的再生能力也极其有限。此外，合适的供体心脏用于移植供不应求，且需要接受者终身使用免疫抑制剂。组织工程化心肌有潜力替代成体中死亡或纤维化的心脏组织，也可用于永久性修复婴儿的先天性心脏缺陷。此外，构建功能性心肌可推动全生物人工心脏的发展。在此，我们综述并比较心肌组织工程策略。在这种比较的背景下，我们考虑心肌组织工程中必须解决的三个挑战：心肌结构的重现、组织的血管化以及免疫系统的调节。除了综述和分析当前进展外，我们还推荐用于生成组织工程化心肌补片以进行心脏再生和修复的具体策略。
