Thomas Dilip, Choi Suji, Alamana Christina, Parker Kevin Kit, Wu Joseph C
Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA (D.T., C.A., J.C.W.).
Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.T., C.A., J.C.W.).
Circ Res. 2022 Jun 10;130(12):1780-1802. doi: 10.1161/CIRCRESAHA.122.320305. Epub 2022 Jun 9.
An ensemble of in vitro cardiac tissue models has been developed over the past several decades to aid our understanding of complex cardiovascular disorders using a reductionist approach. These approaches often rely on recapitulating single or multiple clinically relevant end points in a dish indicative of the cardiac pathophysiology. The possibility to generate disease-relevant and patient-specific human induced pluripotent stem cells has further leveraged the utility of the cardiac models as screening tools at a large scale. To elucidate biological mechanisms in the cardiac models, it is critical to integrate physiological cues in form of biochemical, biophysical, and electromechanical stimuli to achieve desired tissue-like maturity for a robust phenotyping. Here, we review the latest advances in the directed stem cell differentiation approaches to derive a wide gamut of cardiovascular cell types, to allow customization in cardiac model systems, and to study diseased states in multiple cell types. We also highlight the recent progress in the development of several cardiovascular models, such as cardiac organoids, microtissues, engineered heart tissues, and microphysiological systems. We further expand our discussion on defining the context of use for the selection of currently available cardiac tissue models. Last, we discuss the limitations and challenges with the current state-of-the-art cardiac models and highlight future directions.
在过去几十年里,已经开发出了一系列体外心脏组织模型,以采用简化论方法帮助我们理解复杂的心血管疾病。这些方法通常依赖于在培养皿中重现单个或多个与临床相关的终点,这些终点可指示心脏病理生理学。生成与疾病相关且针对患者的人类诱导多能干细胞的可能性,进一步提升了心脏模型作为大规模筛选工具的效用。为了阐明心脏模型中的生物学机制,以生化、生物物理和机电刺激的形式整合生理线索以实现所需的组织样成熟度以进行稳健的表型分析至关重要。在这里,我们回顾了定向干细胞分化方法的最新进展,这些方法可衍生出广泛的心血管细胞类型,以便在心脏模型系统中进行定制,并研究多种细胞类型中的疾病状态。我们还强调了几种心血管模型(如心脏类器官、微组织、工程心脏组织和微生理系统)开发方面的最新进展。我们进一步扩展了关于确定使用背景以选择当前可用心脏组织模型的讨论。最后,我们讨论了当前最先进的心脏模型的局限性和挑战,并突出了未来的方向。