Stem Cell-Based Cardiac Tissue Engineering

Abstract

Cardiovascular diseases are the leading cause of death worldwide, and cell-based therapies represent a potential cure for patients with cardiac diseases such as myocardial infarction, heart failure, and congenital heart diseases. Towards this goal, cardiac tissue engineering is now being investigated as an approach to support cell-based therapies and enhance their efficacy. This review focuses on the latest research in cardiac tissue engineering based on the use of embryonic, induced pluripotent, or adult stem cells. We describe different strategies such as direct injection of cells and/or biomaterials as well as direct replacement therapies with tissue mimics. In this regard, the latest research has shown promising results demonstrating the improvement of cardiac function with different strategies. It is clear from recent studies that the most important consideration to be addressed by new therapeutic strategies is long-term functional improvement. For this goal to be realized, novel and efficient methods of cell delivery are required that enable high cell retention, followed by electrical integration and mechanical coupling of the injected cells or the engineered tissue to the host myocardium.

Epicardial application of cardiac progenitor cells in a 3D-printed gelatin/hyaluronic acid patch preserves cardiac function after myocardial infarction

“…For those that are retained, the new environmental surroundings are often detrimental to their viability and may not be inductive for the most optimal therapeutic cellular response. In this respect, tissue engineering has proven to be an effective method to improve the delivery, engraftment, and differentiation of stem cells in the injured heart [23]. For such applications, biomaterials have to be carefully selected and constructed to provide proper support and guidance to stem cells upon transplantation [24,25].…”

The Role of Tissue Engineering and Biomaterials in Cardiac Regenerative Medicine

“…External biophysical stimulation can be used to enhance the maturation levels of hESC-CMs or hiPSC-CMs that are generally considered immature compared to the terminally-differentiated adult human CMs (88, 89). Long-term (up to 6 months) monolayer culture has been demonstrated to push hESC-CMs and hiPSC-CMs toward higher maturation levels as assessed by morphology and subcellular organization, including myofibril density, alignment and Z-disk registration (90).…”

Nanotechnology meets regenerative medicine: a new frontier?

“…Currently, iPS cells have been shown to be promising for use in cardiac tissue-engineering strategies, as they can give rise to functional cardiomyocytes [127] . The use of iPS cells would not only overcome the ethical concerns related to the use of hESCs, but it might also allow for the generation of an unlimited supply of functional, proliferative, and possibly autologous human cardiomyocytes and vascular cells, thus, overcoming any immunogenic concerns as well [128] .…”