Regenerating the heart using human embryonic stem cells--from cell to bedside.
The adult human heart has limited regenerative capacity and, therefore, functional restoration of the damaged heart presents a great challenge. Despite the progress achieved in the pharmacological and surgical treatment of degenerative myocardial diseases, they are still considered a major cause of morbidity and mortality in the western world. Repopulation of the damaged heart with cardiomyocytes represents a novel conceptual therapeutic paradigm but is hampered by the lack of sources for human cardiomyocytes. The recent derivation of pluripotent human embryonic stem cell lines may provide a solution for this cell sourcing problem. This review will focus on the derivation of the hESC lines, their mechanism of self-renewal, and their differentiation to cardiomyocytes. The possible signals and cues involved in the commitment and early differentiation of cardiomyocytes in this model will be discussed as well as the molecular, structural and electrophysiologic characteristics of the generated hESC-derived cardiomyocytes. Finally, the hurdles and challenges toward fully harnessing the potential clinical applications of these unique cells will be described.
Caspi
Oren
O
Research Laboratory for the Regeneration of Functional Myocardium, Department of Biophysics and Physiology, Rappaport Faculty of Medicine, Technion, Haifa, Israel. caspio@techunix.technion.ac.il
Gepstein
Lior
L
D000818:Animals; D006321:Heart / Q000196:embryology*; D006333:Heart Failure / Q000601:surgery*; D006801:Humans; D009206:Myocardium / Q000166:cytology*; D012038:Regeneration / Q000502:physiology*; D033581:Stem Cell Transplantation / Q000379:methods*; D016896:Treatment Outcome