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Oh GC, Choi YJ, Park BW, Ban K, Park HJ. Are There Hopeful Therapeutic Strategies to Regenerate the Infarcted Hearts? Korean Circ J 2023; 53:367-386. [PMID: 37271744 DOI: 10.4070/kcj.2023.0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 04/26/2023] [Indexed: 06/06/2023] Open
Abstract
Ischemic heart disease remains the primary cause of morbidity and mortality worldwide. Despite significant advancements in pharmacological and revascularization techniques in the late 20th century, heart failure prevalence after myocardial infarction has gradually increased over the last 2 decades. After ischemic injury, pathological remodeling results in cardiomyocytes (CMs) loss and fibrosis, which leads to impaired heart function. Unfortunately, there are no clinical therapies to regenerate CMs to date, and the adult heart's limited turnover rate of CMs hinders its ability to self-regenerate. In this review, we present novel therapeutic strategies to regenerate injured myocardium, including (1) reconstruction of cardiac niche microenvironment, (2) recruitment of functional CMs by promoting their proliferation or differentiation, and (3) organizing 3-dimensional tissue construct beyond the CMs. Additionally, we highlight recent mechanistic insights that govern these strategies and identify current challenges in translating these approaches to human patients.
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Affiliation(s)
- Gyu-Chul Oh
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Yeon-Jik Choi
- Division of Cardiology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Bong-Woo Park
- Department of Biomedicine & Health Sciences, The Catholic University of Korea, Seoul, Korea
| | - Kiwon Ban
- Department of Biomedical Sciences, City University of Hong Kong, Kowloon, Hong Kong.
| | - Hun-Jun Park
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
- Department of Biomedicine & Health Sciences, The Catholic University of Korea, Seoul, Korea.
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Kobayashi H, Tohyama S, Kanazawa H, Ichimura H, Chino S, Tanaka Y, Suzuki Y, Zhao J, Shiba N, Kadota S, Narita K, Naito T, Seto T, Kuwahara K, Shiba Y, Fukuda K. Intracoronary transplantation of pluripotent stem cell-derived cardiomyocytes: Inefficient procedure for cardiac regeneration. J Mol Cell Cardiol 2023; 174:77-87. [PMID: 36403760 DOI: 10.1016/j.yjmcc.2022.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 11/08/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022]
Abstract
Advances in stem cell biology have facilitated cardiac regeneration, and many animal studies and several initial clinical trials have been conducted using human pluripotent stem cell-derived cardiomyocytes (PSC-CMs). Most preclinical and clinical studies have typically transplanted PSC-CMs via the following two distinct approaches: direct intramyocardial injection or epicardial delivery of engineered heart tissue. Both approaches present common disadvantages, including a mandatory thoracotomy and poor engraftment. Furthermore, a standard transplantation approach has yet to be established. In this study, we tested the feasibility of performing intracoronary administration of PSC-CMs based on a commonly used method of transplanting somatic stem cells. Six male cynomolgus monkeys underwent intracoronary administration of dispersed human PSC-CMs or PSC-CM aggregates, which are called cardiac spheroids, with multiple cell dosages. The recipient animals were sacrificed at 4 weeks post-transplantation for histological analysis. Intracoronary administration of dispersed human PSC-CMs in the cynomolgus monkeys did not lead to coronary embolism or graft survival. Although the transplanted cardiac spheroids became partially engrafted, they also induced scar formation due to cardiac ischemic injury. Cardiac engraftment and scar formation were reasonably consistent with the spheroid size or cell dosage. These findings indicate that intracoronary transplantation of PSC-CMs is an inefficient therapeutic approach.
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Affiliation(s)
- Hideki Kobayashi
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shugo Tohyama
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
| | - Hideaki Kanazawa
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Hajime Ichimura
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan; Department of Regenerative Science and Medicine, Shinshu University, Matsumoto, Japan
| | - Shuji Chino
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yuki Tanaka
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan; Department of Regenerative Science and Medicine, Shinshu University, Matsumoto, Japan
| | - Yota Suzuki
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan; Department of Regenerative Science and Medicine, Shinshu University, Matsumoto, Japan
| | - Jian Zhao
- Department of Regenerative Science and Medicine, Shinshu University, Matsumoto, Japan
| | - Naoko Shiba
- Department of Regenerative Science and Medicine, Shinshu University, Matsumoto, Japan
| | - Shin Kadota
- Institute for Biomedical Sciences, Shinshu University, Matsumoto, Japan; Department of Regenerative Science and Medicine, Shinshu University, Matsumoto, Japan
| | - Kazumasa Narita
- Department of Pharmacy, Shinshu University Hospital, Matsumoto, Japan; Department of Clinical Pharmacology and Therapeutics, Shinshu University Graduate School of Medicine, Matsumoto, Japan
| | - Takafumi Naito
- Department of Pharmacy, Shinshu University Hospital, Matsumoto, Japan; Department of Clinical Pharmacology and Therapeutics, Shinshu University Graduate School of Medicine, Matsumoto, Japan
| | - Tatsuichiro Seto
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Koichiro Kuwahara
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan; Institute for Biomedical Sciences, Shinshu University, Matsumoto, Japan
| | - Yuji Shiba
- Institute for Biomedical Sciences, Shinshu University, Matsumoto, Japan; Department of Regenerative Science and Medicine, Shinshu University, Matsumoto, Japan.
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
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Yessentayeva SY, Orakbay LZ, Adilhanova A, Yessimov N. Approaches to the use of stem cells in regenerative medicine. Anal Biochem 2022; 645:114608. [PMID: 35202604 DOI: 10.1016/j.ab.2022.114608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The goal of regenerative medicine is to replace or restore missing, dysfunctional, or damaged cells, tissues and organs of a person to reproduce their normal function. The main approaches are cell therapy, tissue engineering, and gene therapy. Postnatal neural crest-derived multipotent stem cells (NC-MSC) are a promising cell type for use in regenerative medicine. This is due to the specific features of their embryonic origin and the role of the neural crest in phylogeny and ontogeny of vertebrates. METHODS The study used research in vitro culture (monolayer cell culture, 3D culture based on hydrogels, organotypic culture of hippocampal slices, spherogenesis, directed differentiation); flow cytometry; cytochemical, immune-cytochemical and histomorphometric analysis; molecular genetic (RNA (ribonucleic acid) isolation, PCR (polymerase chain reaction) with reverse transcription, real-time PCR, nucleic acid electrophoresis); microscopy (transmitted light, phase contrast, fluorescent, confocal laser scanning); microsurgical; statistical analysis. RESULTS In this systematic review, the results showed that recently the neural crest-derived cells have been isolated from a wide range of tissues and organs of mammals at the postnatal stage of development. These cells, at least in vitro, demonstrate the ability to self-repair and multilinear differentiation into neurons, Schwann cells, melanocytes, adipocytes, osteoblasts, chondrocytes, and other types of cells, that is, according to their functional characteristics, they are multipotent stem cells. CONCLUSION According to the obtained results, tissue sources of postnatal neural crest-derived multipotent stem cells differ considerably in the degree of invasiveness of biopsy sampling, as well as the possibility of obtaining a homogeneous population of NC-MSCs, which is important for further clinical use.
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Affiliation(s)
- Suriya Ye Yessentayeva
- Department of Oncology and Mammalogy, Kazakh-Russian Medical University, Almaty, Kazakhstan.
| | - Lyazat Zh Orakbay
- Department of Public Health, Kazakh-Russian Medical University, Almaty, Kazakhstan
| | - Azhar Adilhanova
- Department of Public Health, Kazakh-Russian Medical University, Almaty, Kazakhstan
| | - Nabi Yessimov
- Male Clinical Department, Republican Scientific and Practical Center of Mental Health, Almaty, Kazakhstan
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Kim Y, Zharkinbekov Z, Sarsenova M, Yeltay G, Saparov A. Recent Advances in Gene Therapy for Cardiac Tissue Regeneration. Int J Mol Sci 2021; 22:9206. [PMID: 34502115 PMCID: PMC8431496 DOI: 10.3390/ijms22179206] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/16/2021] [Accepted: 08/16/2021] [Indexed: 12/12/2022] Open
Abstract
Cardiovascular diseases (CVDs) are responsible for enormous socio-economic impact and the highest mortality globally. The standard of care for CVDs, which includes medications and surgical interventions, in most cases, can delay but not prevent the progression of disease. Gene therapy has been considered as a potential therapy to improve the outcomes of CVDs as it targets the molecular mechanisms implicated in heart failure. Cardiac reprogramming, therapeutic angiogenesis using growth factors, antioxidant, and anti-apoptotic therapies are the modalities of cardiac gene therapy that have led to promising results in preclinical studies. Despite the benefits observed in animal studies, the attempts to translate them to humans have been inconsistent so far. Low concentration of the gene product at the target site, incomplete understanding of the molecular pathways of the disease, selected gene delivery method, difference between animal models and humans among others are probable causes of the inconsistent results in clinics. In this review, we discuss the most recent applications of the aforementioned gene therapy strategies to improve cardiac tissue regeneration in preclinical and clinical studies as well as the challenges associated with them. In addition, we consider ongoing gene therapy clinical trials focused on cardiac regeneration in CVDs.
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Affiliation(s)
| | | | | | | | - Arman Saparov
- Department of Medicine, School of Medicine, Nazarbayev University, Nur-Sultan 010000, Kazakhstan; (Y.K.); (Z.Z.); (M.S.); (G.Y.)
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