Overcoming the Roadblocks to Cardiac Cell Therapy Using Tissue Engineering

• Type of Material: Article
• Authors: Mounica Yanamandala, Montefiore Medical Center; Wuqiang Zhu, University of Alabama; Daniel J. Garry, University of Minnesota; Timothy Kamp, University of Wisconsin-Madison; Joshua M. Hare, University of Miami; Ho-wook Jun, University of Alabama; Young-sup Yoon, Emory University; Nenad Bursac, Duke University; Sumanth D. Prabhu, University of Alabama; Gerald W. Dorn, II, Washington University; Roberto Bolli, University of Louisville; Richard N. Kitsis, Montefiore Medical Center; Jianyi Zhang, University of Alabama
• Language: English
• Date: 2017-08-08
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 The Authors
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jacc.2017.06.012
• Title of Journal or Parent Work: Journal of the American College of Cardiology
• ISSN: 0735-1097
• Volume: 70
• Issue: 6
• Start Page: 766
• End Page: 775
• Grant/Funding Information: NIH Progenitor Cell Biology Consortium (grant HL099997)
• Keywords: CARDIOVASCULAR PROGENITOR CELLS; Life Sciences & Biomedicine; myocardial infarction; PLURIPOTENT STEM-CELLS; IN-VIVO; CARDIOMYOCYTE DIFFERENTIATION; stem cells; SINGLE-VENTRICLE PHYSIOLOGY; biocompatible materials; Science & Technology; LEFT-HEART SYNDROME; myocardium; BLASTOCYST COMPLEMENTATION; MYOCARDIAL-INFARCTION; Cardiac & Cardiovascular Systems; Cardiovascular System & Cardiology; heart failure; FUNCTIONAL CONSEQUENCES; CARDIOSPHERE-DERIVED CELLS
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Pharmacology; Engineering, Biomedical

Abstract

Transplantations of various stem cells or their progeny have repeatedly improved cardiac performance in animal models of myocardial injury; however, the benefits observed in clinical trials have been generally less consistent. Some of the recognized challenges are poor engraftment of implanted cells and, in the case of human cardiomyocytes, functional immaturity and lack of electrical integration, leading to limited contribution to the heart's contractile activity and increased arrhythmogenic risks. Advances in tissue and genetic engineering techniques are expected to improve the survival and integration of transplanted cells, and to support structural, functional, and bioenergetic recovery of the recipient hearts. Specifically, application of a prefabricated cardiac tissue patch to prevent dilation and to improve pumping efficiency of the infarcted heart offers a promising strategy for making stem cell therapy a clinical reality.