Perinatal Institute, Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Center for Stem Cell and Organoid Medicine, CuSTOM, Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, OH, United States.
Department of Oral Biology, University at Buffalo, The State University of New York, Buffalo, NY, United States; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University at Buffalo, The State University of New York, Buffalo, NY, United States; Cell, Gene and Tissue Engineering Center, University at Buffalo, The State University of New York, Buffalo, NY, United States.
Semin Perinatol. 2023 Apr;47(3):151729. doi: 10.1016/j.semperi.2023.151729. Epub 2023 Mar 11.
Neonatal lung and heart diseases, albeit rare, can result in poor quality of life, often require long-term management and/or organ transplantation. For example, Congenital Heart Disease (CHD) is one of the most common type of congenital disabilities, affecting nearly 1% of the newborns, and has complex and multifactorial causes, including genetic predisposition and environmental influences. To develop new strategies for heart and lung regeneration in CHD and neonatal lung disease, human induced pluripotent stem cells (hiPSCs) provide a unique and personalized platform for future cell replacement therapy and high-throughput drug screening. Additionally, given the differentiation potential of iPSCs, cardiac cell types such as cardiomyocytes, endothelial cells, and fibroblasts and lung cell types such Type II alveolar epithelial cells can be derived in a dish to study the fundamental pathology during disease progression. In this review, we discuss the applications of hiPSCs in understanding the molecular mechanisms and cellular phenotypes of CHD (e.g., structural heart defect, congenital valve disease, and congenital channelopathies) and congenital lung diseases, such as surfactant deficiencies and Brain-Lung-Thyroid syndrome. We also provide future directions for generating mature cell types from iPSCs, and more complex hiPSC-based systems using three-dimensional (3D) organoids and tissue-engineering. With these potential advancements, the promise that hiPSCs will deliver new CHD and neonatal lung disease treatments may soon be fulfilled.
新生儿肺部和心脏疾病虽然罕见,但会导致生活质量下降,往往需要长期管理和/或器官移植。例如,先天性心脏病(CHD)是最常见的先天性残疾之一,影响近 1%的新生儿,其病因复杂且具有多因素性,包括遗传易感性和环境影响。为了针对 CHD 和新生儿肺部疾病开发新的心肺再生策略,人诱导多能干细胞(hiPSC)为未来的细胞替代治疗和高通量药物筛选提供了独特而个性化的平台。此外,鉴于 iPSC 的分化潜力,可以在体外衍生出心脏细胞类型,如心肌细胞、内皮细胞和成纤维细胞,以及肺细胞类型,如 II 型肺泡上皮细胞,以研究疾病进展过程中的基本病理学。在这篇综述中,我们讨论了 hiPSC 在理解 CHD(例如结构性心脏缺陷、先天性瓣膜病和先天性通道病)和先天性肺部疾病(如表面活性剂缺乏和脑-肺-甲状腺综合征)的分子机制和细胞表型中的应用。我们还提供了从 iPSC 产生成熟细胞类型的未来方向,以及使用三维(3D)类器官和组织工程构建更复杂的 hiPSC 系统的未来方向。随着这些潜在进展,hiPSC 有望为 CHD 和新生儿肺部疾病治疗带来新的希望。