Dose-Response Effects on LBP, Sleep, and Depression of Online Pre-Partum and Post-Partum Pilates-Based Programs

Purpose: Pilates-based programs can help pregnant women deal with the physical and psychological burden derived by major changes in their body. This study was designed to primarily test, in pregnant women, the dose-response and health effects of both pre-partum and post-partum, online Pilates-based program on weight control, low back pain (LBP) severity, sleep disturbances, mood and depression levels. Methods: A total of 136 pregnant women were screened for eligibility (low-risk pregnancy; aged 18-45 years; single pregnancy; 20-28-week gestational age, normal BMI). Participants completed an online Pilates-based program during pregnancy and after delivery, through an online platform guided by a Pilates, Yoga and Lagree certified instructor. Main outcomes (weight control, LBP disability, sleep quality, mood, and mental health) were assessed at baseline and at the completion of pre- and post-partum programs. Results: Regarding pre-partum, significant gains in weight were observed only in low- and intermediate-amount exercisers. Only high-amount exercisers did not display significant increase in LBP-related disability (+42.7%; p = .21) unlike low (+12.2%; p < .0001) and intermediate exercisers (+9.6%; p < .0001). Sleep disturbances increased significantly in low- (+24.3%; p = .005) but not in intermediate- (+4.6%; p = .50) and high-amount exercisers (-0.1%; p = .91). Regardless of the amount of exercise, depression scores improved in all groups. Following post-partum intervention (n = 40), only intermediate-amount exercisers showed significant reductions in sleep disturbances (-24.1%; p = .003) and depression (15.9%; p = .04). Conclusions: Approximately 270 min/week of an online Pilates-based program were needed to prevent LBP worsening, and sleep deterioration in pregnant women. A different pattern was outlined for those women resuming the Pilates-based intervention at post-partum, with 150 min/week emerging as the "dose" of exercise capable of inducing the largest improvements in LBP, sleep, and mood disturbances.

Forgetting how we ate: personalised nutrition and the strategic uses of history

Personalised nutrition (PN) has emerged over the past twenty years as a promising area of research in the postgenomic era and has been popularized as the new big thing out of molecular biology. Advocates of PN claim that previous approaches to nutrition sought general and universal guidance that applied to all people. In contrast, they contend that PN operates with the principle that "one size does not fit all" when it comes to dietary guidance. While the molecular mechanisms studied within PN are new, the notion of a personal dietary regime guided by medical advice has a much longer history that can be traced back to Galen's "On Food and Diet" or Ibn Sina's (westernized as Avicenna) "Canon of Medicine". Yet this history is either wholly ignored or misleadingly appropriated by PN proponents. This (mis)use of history, we argue helps to sustain the hype of the novelty of the proposed field and potential commodification of molecular advice that undermines longer histories of food management in premodern and non-Western cultures. Moreover, it elides how the longer history of nutritional advice always happened in a heavily moralized, gendered, and racialized context deeply entwined with collective technologies of power, not just individual advice. This article aims at offering a wider appreciation of this longer history to nuance the hype and exceptionalism surrounding contemporary claims.

Situating the Father: Strengthening Interdisciplinary Collaborations between Sociology, History and the Emerging POHaD Paradigm

(1) Background: Albeit the main focus remains largely on mothers, in recent years Developmental Origins of Health and Disease (DOHaD) scientists, including epigeneticists, have started to examine how a father's environment affects disease risk in children and argued that more attention needs to be given to father's health-related behaviors for their influence on offspring at preconception (i.e., sperm health) as well as paternal lifestyle influences over the first 1000 days. This research ushers in a new paternal origins of health and disease (POHaD) paradigm and is considered a welcome equalization to the overemphasis on maternal influences. Epigeneticists are excited by the possibilities of the POHaD paradigm but are also cautious about how to interpret data and avoid biased impression of socio-biological reality. (2) Methods: We review sociological and historical literatures on the intersection of gender, food and diet across different social and historical contexts to enrich our understanding of the father; (3) Results: Sociological and historical research on family food practices and diet show that there are no "fathers" in the abstract or vacuum, but they are differently classed, racialized and exist in socially stratified situations where choices may be constrained or unavailable. This confirms that epigeneticists researching POHaD need to be cautious in interpreting paternal and maternal dietary influences on offspring health; (4) Conclusions: We suggest that interdisciplinary approach to this new paradigm, which draws on sociology, history and public health, can help provide the social and historical context for interpreting and critically understanding paternal lifestyles and influences on offspring health.

A biosocial return to race? A cautionary view for the postgenomic era

Recent studies demonstrating epigenetic and developmental sensitivity to early environments, as exemplified by fields like the Developmental Origins of Health and Disease (DOHaD) and environmental epigenetics, are bringing new data and models to bear on debates about race, genetics, and society. Here, we first survey the historical prominence of models of environmental determinism in early formulations of racial thinking to illustrate how notions of direct environmental effects on bodies have been used to naturalize racial hierarchy and inequalities in the past. Next, we conduct a scoping review of postgenomic work in environmental epigenetics and DOHaD that looks at the role of race/ethnicity in human health (2000–2021). Although there is substantial heterogeneity in how race is conceptualized and interpreted across studies, we observe practices that may unwittingly encourage typological thinking, including: using DNA methylation as a novel marker of racial classification; neglect of variation and reversibility within supposedly homogenous racial groups; and a tendency to label and reify whole groups as pathologized or impaired. Even in the very different politico‐economic and epistemic context of contemporary postgenomic science, these trends echo deeply held beliefs in Western thinking which claimed that different environments shape different bodies and then used this logic to argue for essential differences between Europeans and non‐Europeans. We conclude with a series of suggestions on interpreting and reporting findings in these fields that we feel will help researchers harness this work to benefit disadvantaged groups while avoiding the inadvertent dissemination of new and old forms of stigma or prejudice.

The politics of environments before the environment: Biopolitics in the longue durée

Our understanding of body-world relations is caught in a curious contradiction. On one side, it is well established that many concepts that describe interaction with the outer world - 'plasticity' or 'metabolism'- or external influences on the body - 'environment' or 'milieu' - appeared with rise of modern science. On the other side, although premodern science lacked a unifying term for it, an anxious attentiveness to the power of 'environmental factors' in shaping physical and moral traits held sway in nearly all medical systems before and alongside modern Europe. In this article, I build on a new historiography on the policing of bodies and environments in medieval times and at the urban scale to problematize Foucault's claim about biopolitics as a modern phenomenon born in the European eighteenth-century. I look in particular at the collective usage of ancient medicine and manipulation of the milieu based on humoralist notions of corporeal permeability (Hippocrates, Galen, Ibn Sīnā) in the Islamicate and Latin Christendom between the 12th and the 15th century. This longer history has implications also for a richer genealogy of contemporary tropes of plasticity, permeability and environmental determinism beyond usual genealogies that take as a starting point the making of the modern body and EuroAmerican biomedicine.

Gender Beneath the Skull: Agency, Trauma and Persisting Stereotypes in Neuroepigenetics

Epigenetics stands in a complex relationship to issues of sex and gender. As a scientific field, it has been heavily criticized for disproportionately targeting the maternal body and reproducing deterministic views of biological sex (Kenney and Müller, 2017; Lappé, 2018; Richardson et al., 2014). And yet, it also represents the culmination of a long tradition of engaging with developmental biology as a feminist cause, because of the dispersal of the supposed 'master code' of DNA among wider cellular, organismic and ecological contexts (Keller, 1988). In this paper, we explore a number of tensions at the intersection of sex, gender and trauma that are playing out in the emerging area of neuroepigenetics - a relatively new subfield of epigenetics specifically interested in environment-brain relations through epigenetic modifications in neurons. Using qualitative interviews with leading scientists, we explore how trauma is conceptualized in neuroepigenetics, paying attention to its gendered dimensions. We address a number of concerns raised by feminist STS researchers in regard to epigenetics, and illustrate why we believe close engagement with neuroepigenetic claims, and neuroepigenetic researchers themselves, is a crucial step for social scientists interested in questions of embodiment and trauma. We argue this for three reasons: (1) Neuroepigenetic studies are recognizing the agential capacities of biological materials such as genes, neurotransmitters and methyl groups, and how they influence memory formation; (2) Neuroepigenetic conceptions of trauma are yet to be robustly coupled with social and anthropological theories of violence (Eliot, 2021; Nelson, 2021; Walby, 2013); (3) In spite of the gendered assumptions we find in neuroepigenetics, there are fruitful spaces - through collaboration - to be conceptualizing gender beyond culture-biology and nature-nurture binaries (Lock and Nguyen, 2010). To borrow Gravlee's (2009: 51) phrase, we find reason for social scientists to consider how gender is not only constructed, but how it may "become biology" via epigenetic and other biological pathways. Ultimately, we argue that a robust epigenetic methodology is one which values the integrity of expertise outside its own field, and can have an open, not empty mind to cross-disciplinary dialogue.

Dry eye disease treatment: the role of tear substitutes, their future, and an updated classification

OBJECTIVE

The aim of this review is to summarize the results of a consensus meeting held by a group of experts in dry eye disease (DED) to discuss the importance of tear substitutes in the treatment of DED. The meeting focused especially on the main characteristics of lacrimal substitutes, the development of in vitro models to investigate DED pathophysiology and treatment, the importance of conducting rigorous clinical trials, the requirements of the upcoming European Legislation on medical devices, the advances in the formulation of safer preservatives, the peculiarities of treatment in younger subjects, and the importance of an updated terminology for lacrimal substitutes.

MATERIALS AND METHODS

A literature search was conducted using MEDLINE, with different combinations of pertinent keywords, depending on the subject under discussion, such as "dry eye disease"; "tear substitutes"; "in vitro models"; "ocular surface"; "clinical trials"; "European Regulation"; "preservatives" "younger patients". Also, each author included in the discussion selected articles from their personal library. Using a consensus-based method called nominal group technique to reach a conclusion and proposal for a new classification of eye drops used to improve the tear film and ocular surface epithelia, the experts also conducted a round table meeting.

RESULTS

The new terms proposed by the authors are "wetting agents", "multiple-action tear substitutes" or "ocular surface modulators". The new classification is needed to distinguish eye drops used to improve the tear film and ocular surface epithelia, in line with the new definition of DED, which recognizes the loss of ocular homeostasis, and the creation of a vicious circle of chronic inflammation and ocular damage as fundamental aspects of DED pathophysiology.

CONCLUSIONS

Although tear substitutes have been historically used to provide eye lubrication to the ocular surface, recent advances in the pathophysiology of dry eye disease (DED) clarified that treatment should not just focus on tear film quality or quantity, but address the loss of homeostasis of the ocular surface, blocking the vicious circle of chronic inflammation and ocular damage. Given the scant comparative evidence on tear substitutes currently on the market, further studies should focus on developing new agents, considering the advantages provided by in vitro models, importance of conducting rigorous clinical trials, availability of less harmful preservatives and obligations related to the new European legislation on medical devices. Based on the discussion of these topics, a group of experts held a consensus meeting to identify new and more appropriate terms for different tear substitutes. The proposed terms are wetting agents, multiple-action tear substitutes and ocular surface modulators. Regardless of the agent used, it is important to note that tear substitutes represent one of many options for DED treatment, which should not overlook the psychological aspects of the disease and the peculiarities of younger subjects, who seem to have a higher risk for DED, possibly related to digital devices excessive use.

A short term treatment with a Mek1/2 inhibitor promotes myocardial arteriogenesis and perfusion in vivo: focus on cardiac mural cells

Background

Arteriogenesis is crucial for heart recovery after ischaemia, but cellular and molecular mechanisms able to foster this phenomenon are still poorly characterised.

Purpose

To discover novel pro-arteriogenic approaches by exploiting cardiac mural cells endowed with arteriogenic capacity: pericytes (PCs) and vascular smooth muscle cells (VSMCs).

Methods and results

We derived human and murine CD31neg CD34pos cardiac PCs (cPCs) from myocardial samples of adult subjects and confirmed the pericyte phenotype and function in vitro. We discovered that the withdrawal of EGF and bFGF from the culture media induces the differentiation of cPCs into contractile VSMCs. Molecular investigations of pathways associated with the two factors showed that the Mek1/2-Erk1/2 signalling exerts an inhibitory transcriptional control on contractile VSMC genes. Screening of compounds able to interfere with this pathway revealed that PD0325901 – a potent Mek1/2 inhibitor (MeKi) tested in clinical trials for the treatment of cancer – activates the VSMC phenotype in cPCs. We observed a similar effect on coronary artery VSMCs. Next, we interrogated the effect of PD0325901 on cardiac arteriogenesis in vivo. Adult C57BL6/J mice were given the MeKi 10 mg/kg/day or vehicle (DMSO), orally for 14 days (n=11/group). At the endpoint, echocardiographic evaluation of left ventricle (LV) function and dimensions (n=6/group) showed no difference in comparison with the respective baseline in both groups. Effective inhibition of Mek1/2 in the heart of PD-treated mice was confirmed by the reduced immunostaining for the phosphorylated form of Erk1/2. The MeKi cardiotoxicity was ruled out by assessment of cardiomyocytes and vascular cells apoptosis (Tunel) and plasmatic levels of cTn-I. Histological analyses of the hearts (n=5/group) showed an increase in small arterioles (diameter &lt;20μm) density in the LV of PD-mice compared with the DMSO group (16.4 vs 11.7 art/mm2). No change was observed for the capillary density. The drug promoted the maturation of VSMCs within both small and large (&gt;20μm) arterioles, as shown by the higher ratio between the areas of the vascular wall occupied by the mature contractile marker SM myosin heavy chain and the synthetic/early contractile marker alpha-SM actin (αSMA). The PD treatment reduced the fraction of small arterioles covered with a CD34pos layer (53% vs 70% of total arterioles), along with a lower ratio between the areas occupied by adventitial CD34pos cells and αSMApos VSMCs, suggesting a contribution of cPCs to the arteriolar remodelling. Last, the drug improved the LV myocardial perfusion in the PD- vs the DMSO-group (6.8 vs 5.3 ml/min/g of LV tissue, n=6/group).

Conclusions

We show that a short treatment with a Mek1/2 inhibitor stimulates myocardial arteriogenesis and perfusion without either inducing cardiotoxicity or deteriorating heart function. This may be a novel, intriguing approach to promote therapeutic arteriogenesis.

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): British Heart Foundation Centre for Vascular Regeneration II

"It's Never Too Early": Preconception Care and Postgenomic Models of Life

In this article, we are concerned with the expanded public health interest in the "preconception period" as a window of opportunity for intervention to improve long-term population health outcomes. While definitions of the "preconception period" remain vague, new classifications and categories of life are becoming formalized as biomedicine begins to conduct research on, and suggest intervention in, this undefined and potentially unlimited time before conception. In particular, we focus on the burgeoning epidemiological interest in epigenetics and Developmental Origins of Health and Disease (DOHaD) research as simultaneously a theoretical spyglass into postgenomic biology and a catalyst toward a public health focus on preconception care. We historicize the notion that there are long-term implications of parental behaviors before conception, illustrating how, as Han and Das have noted, "newness comes to be embedded in older forms even as it transforms them" (Han and Das, 2015, p. 2). We then consider how DOHaD frameworks justify a number of fragmented claims about preconception by making novel evidentiary assertions. Engaging with the philosophy of Georges Canguilhem, we examine the relationship between reproductive risk and revised understandings of biological permeability, and discuss some of the epistemic and political implications of emerging claims in postgenomics.

Physician experts in diabetes are natural team leaders for managing diabetic patients with foot complications. A position statement from the Italian diabetic foot study group

Diabetic foot syndrome (DFS) is a complex disease. The best outcomes are reported with the multi-disciplinary team (MDT) approach, where each member works collaboratively according to his/her expertise. However, which health provider should act as the team leader (TL) has not been determined. The TL should be familiar with the management of diabetes, related complications and comorbidities. He/she should be able to diagnose and manage foot infections, including prompt surgical treatment of local lesions, such as abscesses or phlegmons, in an emergent way in the first meeting with the patient. According to the Organization for Economic Co-operation and Development (OECD) reports, Italy is one of countries with a low amputation rate in diabetic patients. Many factors might have contributed to this result, including 1)the special attention directed to diabetes by the public health system, which has defined diabetes as a "protected disease", and accordingly, offers diabetic patients, at no charge, the best specialist care, including specific devices, and 2)the presence of a network of diabetic foot (DF) clinics managed by diabetologists with medical and surgical expertise. The health care providers all share a "patient centred model" of care, for which they use their internal medicine background and skills in podiatric surgery to manage acute or chronic needs in a timely manner. Therefore, according to Italian experiences, which are fully reported in this document, we believe that only a skilled diabetologist/endocrinologist should act as a TL. Courses and university master's degree programmes focused on DF should guarantee specific training for physicians to become a TL.

Does REM sleep behavior disorder change in the progression of Parkinson's disease?

OBJECTIVES/BACKGROUND

Rapid eye movement (REM) Sleep Behavior Disorder (RBD) in Parkinson's disease (PD) may be associated with a malignant phenotype. Despite its prognostic value, little is known about the time course of RBD in PD. In this study, we aimed to ascertain whether or not RBD is a stable feature in PD. In this study, we prospectively evaluated clinical and neurophysiological features of RBD, including REM Sleep Without Atonia (RSWA), in PD patients with RBD at baseline and after three years then assessed whether the changes in measures of RSWA parallel the progression of PD.

PATIENTS/METHODS

In sum, 22 (17M, mean age 64.0 ± 6.9 years) moderate-to-advanced PD patients (mean PD duration at baseline:7.6±4.8 years) with RBD, underwent a video-polysomnography (vPSG) recording and clinical and neuropsychological assessment at baseline and after three years.

RESULTS

At follow-up, the self-assessed frequency of RBD symptoms increased in six patients, decreased in six and remained stable in 10, while RSWA measures significantly increased in all subjects. At follow-up, patients showed worse H&Y stage (p = 0.02), higher dopaminergic doses (p = 0.05) and they performed significantly worse in phonetic and semantic fluency tests (p = 0.02; p = 0.04). Changes in RSWA correlated significantly with the severity in levodopa-induced dyskinesia (r = 0.61,p = 0.05) and motor fluctuation (r = 0.54,p = 0.03) scores, and with the worsening of executive functions (r = 0.78,p = 0.001) and visuo-spatial perception (r = -0.57,p = 0.04).

CONCLUSION

Despite the subjective improvement of RBD symptoms in one-fourth of PD patients, all RSWA measures increased significantly at follow-up, and their changes correlated with the clinical evolution of motor and non-motor symptoms. RBD is a long-lasting feature in PD and RSWA is a marker of the disease's progression.

P4163Long term comparison between homograft vs stented bio-prostheses for pulmonary valve replacement in tetralogy of Fallot patients

Background

Tetralogy of Fallot (TOF) repair results in long term chronic pulmonary regurgitation requiring pulmonary valve replacement (PVR). Homograft and stented bio-prosthesis are currently used for PVR but whether one should be considered superior to another remains unknown.

Aim

To compare echocardiographic and clinical outcomes after PVR with Homograft vs stented bioprosthesis in patients with previous TOF repair.

Methods

137 patients who underwent PVR with stented bioproshesis were compared with 80 patients who received an homograft using Mixed linear model and multivariate Cox regression.

Results

Homograft were associated with a significantly lower transpulmonary gradient postoperatively (P=0.04) and after a mean follow-up 6 years (table). Homograft were associated with a significantly lower risk of reintervention (HR 0.24; 95% CI 0.07–0.85, p=0.026) while long term mortality was comparable between the two groups (P=0.1).

Echocardiographic findings BIO HOMOGRAFT P N 137 80 Preoperatively   TV regurgitation (mean, sd) 1.80 (0.63) 1.94 (0.81) 0.353   TV regurgitation pressure drop (mean,sd) 35.15 (15.49) 45.34 (25.24) 0.009   PV regurgitation (mean,sd) 3.63 (0.52) 3.34 (0.64) 0.004   PV systolic peak gradient (mean, sd) 25.07 (17.05) 30.68 (21.70) 0.138 Early postoperatively   TV regurgitation (mean,sd) 1.52 (0.54) 1.54 (0.55) 0.858   TV regurgitation pressure drop (mean,sd) 30.10 (13.82) 29.13 (13.98) 0.733   PV regurgitation (mean,sd) 1.50 (0.54) 1.64 (0.53) 0.224   PV systolic peak gradient (mean,sd) 24.05 (11.10) 20.16 (14.19) 0.045 Latest follow_up   TV regurgitation (mean,sd) 1.63 (0.61) 1.83 (0.80) 0.195   TV regurgitation pressure drop (mean,sd) 37.46 (18.84) 32.58 (13.47) 0.233   PV regurgitation (mean,sd) 2.06 (0.77) 2.07 (0.94) 0.982   PV systolic peak gradient (mean,sd) 32.22 (18.17) 21.25 (13.47) 0.001 TAPSE: Tricuspid annular plane systolic excursion; TV: tricuspid valve; PV: pulmonary valve.

PV re-intervention

Conclusions

When compared to stented bio-prostheses, homografts were associated better early and late hemodynamic profile and a significantly lower risk of re-intervention. Homograft should be considered the first choice in patients undergoing PVR after TOF repair.

A Postgenomic Body: Histories, Genealogy, Politics

This article sets the stage for a genealogy of the postgenomic body. It starts with the current transformative views of epigenetics and microbiomics to offer a more pluralistic history in which the ethical problem of how to live with a permeable body - that is plasticity as a form of life - is pervasive in traditions pre-dating and coexisting with modern biomedicine (particularly humoralism in its several ramifications). To challenge universalizing narratives, I draw on genealogical method to illuminate the unequal distribution of plasticity across gender and ethnic groups. Finally, after analysing postgenomics as a different thought-style to genomics, I outline some of its implications for notions of plasticity. I argue that postgenomic plasticity is neither a modernistic plasticity of instrumental control of the body nor a postmodernist celebration of endless potentialities. It is instead closer to an alter-modernistic view that disrupts clear boundaries between openness and determination, individual and community.

Amino acid and hyaluronic acid mixtures differentially regulate extra cellular matrix genes in cultured human fibroblasts

The aim of this screening study was to evaluate the efficacy of different proprietary mixtures of amino acid and hyaluronic acid (HA) in stimulating the production of extracellular matrix (ECM) components, particularly the neo-synthesis of elastin, and in promoting a more efficient deposition of elastic fibres (elastogenesis), while at the same time maintaining the stimulation of collagen. The study has allowed identification of the optimal ratios between the amino acids (AA) for the production of collagen and elastin. Human primary dermal fibroblasts from a 44-year-old female donor were used as a test system in an experimental design based on the evaluation of the expression of relevant ECM genes using a transcriptomic dynamic approach. The expression of ECM genes was evaluated by RTqPCR from 24 to 120 hours in the presence of the test items. Moreover, the production of ECM proteins was verified by Western blot analysis after a 120 h treatment period. In addition to elastin, collagen IV, a fundamental structural component of the basal lamina responsible for epithelial and connective tissue anchoring, was analysed as potential target for the modulation of ECM protein production by human fibroblast. The first phase of the study demonstrated that alanine and valine are essential to promote production of elastin, of which they are important constituents. The second phase of the study, which was conducted to clarify the interactions between the different clusters of AA, demonstrated that it is necessary to choose a mixture that contains specific amounts of amino acids of both proteins, collagen and elastin, to give a significant response and a significant production of both. This also proves the existence of a ratio between the 2 clusters (AA elastin/AA collagen) that guarantees an adequate and balanced response to gene expression and production by fibroblasts, collagen and elastin. The study has allowed identification of the optimal ratios between the AA for the production of collagen and elastin.

Transgenerational epigenetic inheritance and social responsibility: perspectives from the social sciences

Research in environmental epigenetics explores how environmental exposures and life experiences such as food, toxins, stress or trauma can shape trajectories of human health and well-being in complex ways. This perspective resonates with social science expertise on the significant health impacts of unequal living conditions and the profound influence of social life on bodies in general. Environmental epigenetics could thus provide an important opportunity for moving beyond long-standing debates about nature versus nurture between the disciplines and think instead in 'biosocial' terms across the disciplines. Yet, beyond enthusiasm for such novel interdisciplinary opportunities, it is crucial to also reflect on the scientific, social and political challenges that a biosocial model of body, health and illness might entail. In this paper, we contribute historical and social science perspectives on the political opportunities and challenges afforded by a biosocial conception of the body. We will specifically focus on what it means if biosocial plasticity is not only perceived to characterize the life of individuals but also as possibly giving rise to semi-stable traits that can be passed on to future generations. That is, we will consider the historical, social and political valences of the scientific proposition of transgenerational epigenetic inheritance. The key question that animates this article is if and how the notion of transgenerational epigenetic inheritance creates new forms of responsibilities both in science and in society. We propose that, ultimately, interdisciplinary conversation and collaboration is essential for responsible approaches to transgenerational epigenetic inheritance in science and society.

Resident cells of the myocardium: more than spectators in cardiac injury, repair and regeneration

Multiple resident cell types contribute to maintaining the structure and physiological function of the heart over the life course. Cardiomyocyte proliferation supports scar free regeneration in the neonatal heart following injury, but a lower rate of proliferation in the adult necessitates replacement by a collagen scar to maintain ventricular integrity. In this short review we discuss recent studies that have identified novel roles for non-myocyte resident cells and the extracellular matrix in supporting repair, as well as cardiomyocyte and vascular regeneration, following myocardial infarction.