Department of Biomedical Engineering, Columbia University, New York, NY, USA.
Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
Expert Opin Drug Discov. 2024 Jul;19(7):827-840. doi: 10.1080/17460441.2024.2360420. Epub 2024 Jun 2.
Arrhythmias are disturbances in the normal rhythm of the heart and account for significant cardiovascular morbidity and mortality worldwide. Historically, preclinical research has been anchored in animal models, though physiological differences between these models and humans have limited their clinical translation. The discovery of human induced pluripotent stem cells (iPSC) and subsequent differentiation into cardiomyocyte has led to the development of new models of arrhythmias with the hope of a new pathway for both exploration of pathogenic variants and novel therapeutic discovery.
The authors describe the latest two-dimensional models of arrhythmias, several examples of the use of these models in drug development, and the role of gene editing when modeling diseases. They conclude by discussing the use of three-dimensional models in the study of arrythmias and the integration of computational technologies and machine learning with experimental technologies.
Human iPSC-derived cardiomyocytes models have significant potential to augment disease modeling, drug discovery, and toxicity studies in preclinical development. While there is initial success with modeling arrhythmias, the field is still in its nascency and requires advances in maturation, cellular diversity, and readouts to emulate arrhythmias more accurately.
心律失常是心脏正常节律的紊乱,是全球范围内导致重大心血管发病率和死亡率的原因。从历史上看,临床前研究主要以动物模型为基础,尽管这些模型与人类之间存在生理差异,限制了其临床转化。人类诱导多能干细胞(iPSC)的发现和随后向心肌细胞的分化,为心律失常的新模型的发展提供了可能,希望为探索致病变异和新的治疗发现开辟新途径。
作者描述了最新的心律失常二维模型,以及在药物开发中使用这些模型的几个实例,以及在疾病建模中基因编辑的作用。他们最后讨论了三维模型在心律失常研究中的应用以及计算技术和机器学习与实验技术的整合。
人类 iPSC 衍生的心肌细胞模型具有显著的潜力,可以增强临床前开发中的疾病建模、药物发现和毒性研究。虽然在心律失常建模方面取得了初步成功,但该领域仍处于起步阶段,需要在成熟度、细胞多样性和检测方面取得进展,以更准确地模拟心律失常。