He Xingyu, Good Angela, Kalou Wael, Ahmad Waqas, Dutta Suchandrima, Chen Sophie, Lin Charles Noah, Chella Krishnan Karthickeyan, Fan Yanbo, Huang Wei, Liang Jialiang, Wang Yigang
Department of Pathology and Laboratory Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA.
Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA.
Cells. 2024 Dec 18;13(24):2098. doi: 10.3390/cells13242098.
Cardiovascular diseases resulting from myocardial infarction (MI) remain a leading cause of death worldwide, imposing a substantial burden on global health systems. Current MI treatments, primarily pharmacological and surgical, do not regenerate lost myocardium, leaving patients at high risk for heart failure. Engineered heart tissue (EHT) offers a promising solution for MI and related cardiac conditions by replenishing myocardial loss. However, challenges like immune rejection, inadequate vascularization, limited mechanical strength, and incomplete tissue maturation hinder clinical application. The discovery of human-induced pluripotent stem cells (hiPSCs) has transformed the EHT field, enabling new bioengineering innovations. This review explores recent advancements and future directions in hiPSC-derived EHTs, focusing on innovative materials and fabrication methods like bioprinting and decellularization, and assessing their therapeutic potential through preclinical and clinical studies. Achieving functional integration of EHTs in the heart remains challenging due to the need for synchronized contraction, sufficient vascularization, and mechanical compatibility. Solutions such as genome editing, personalized medicine, and AI technologies offer promising strategies to address these translational barriers. Beyond MI, EHTs also show potential in treating ischemic cardiomyopathy, heart valve engineering, and drug screening, underscoring their promise in cardiovascular regenerative medicine.
心肌梗死（MI）引发的心血管疾病仍是全球主要死因，给全球卫生系统带来沉重负担。目前针对MI的治疗方法主要是药物治疗和手术治疗，无法使受损心肌再生，导致患者面临心力衰竭的高风险。工程化心脏组织（EHT）通过补充心肌损失，为MI及相关心脏疾病提供了一个有前景的解决方案。然而，免疫排斥、血管化不足、机械强度有限和组织成熟不完全等挑战阻碍了其临床应用。人类诱导多能干细胞（hiPSC）的发现改变了EHT领域，推动了新的生物工程创新。本文综述探讨了hiPSC来源的EHT的最新进展和未来方向，重点关注生物打印和去细胞化等创新材料和制造方法，并通过临床前和临床研究评估其治疗潜力。由于需要同步收缩、充足的血管化和机械兼容性，实现EHT在心脏中的功能整合仍然具有挑战性。基因组编辑、个性化医疗和人工智能技术等解决方案为克服这些转化障碍提供了有前景的策略。除了MI，EHT在治疗缺血性心肌病、心脏瓣膜工程和药物筛选方面也显示出潜力，凸显了其在心血管再生医学中的前景。
