Graphical Abstract Highlights d Positive force frequency and post-rest potentiation are achieved in human tissues d Engineered atrial and ventricular tissues have distinct electrophysiology and drug responses d Atrio-ventricular tissues show spatially confined drug responses d Long-term electrical conditioning enables polygenic cardiac disease modeling SUMMARYTissue engineering using cardiomyocytes derived from human pluripotent stem cells holds a promise to revolutionize drug discovery, but only if limitations related to cardiac chamber specification and platform versatility can be overcome. We describe here a scalable tissue-cultivation platform that is cell source agnostic and enables drug testing under electrical pacing. The plastic platform enabled on-line noninvasive recording of passive tension, active force, contractile dynamics, and Ca 2+ transients, as well as endpoint assessments of action potentials and conduction velocity. By combining directed cell differentiation with electrical field conditioning, we engineered electrophysiologically distinct atrial and ventricular tissues with chamber-specific drug responses and gene expression. We report, for the first time, engineering of heteropolar cardiac tissues containing distinct atrial and ventricular ends, and we demonstrate their spatially confined responses to serotonin and ranolazine. Uniquely, electrical conditioning for up to 8 months enabled modeling of polygenic left ventricular hypertrophy starting from patient cells.

The developmental programs that generate a broad repertoire of regulatory T cells (T reg cells) able to respond to both self antigens and non–self antigens remain unclear. Here we found that mature T reg cells were generated through two distinct developmental programs involving CD25 + T reg cell progenitors (CD25 + T reg P) and Foxp3 lo T reg cell progenitors (Foxp3 lo T reg P). The CD25 + T reg P had higher rates of apoptosis and interacted with thymic self-antigens with higher affinity than Foxp3 lo T reg P, and had a T cell antigen receptor (TCR) repertoire and transcriptome distinct from that of Foxp3 lo T reg P. The development of CD25 + T reg P and Foxp3 lo T reg P was controlled by distinct signaling pathways and enhancers. Transcriptomic and histocytometric data suggested that CD25 + T reg P and Foxp3 lo T reg P arose by coopting negative and positive selection programs, respectively. T reg cells derived from CD25 + T reg P, but not Foxp3 lo T reg P, prevented experimental autoimmune encephalitis. Our findings indicate that T reg cells arise through two distinct developmental programs that are both required for a comprehensive T reg cell repertoire capable of establishing immune tolerance.

Pharmacogenetic (PGx) testing is increasingly available from clinical laboratories. However, only a limited number of quality control and other reference materials (RMs) are currently available to support clinical testing. To address this need, the Centers for Disease Control and Prevention (CDC) based Genetic Testing Reference Material Coordination Program (GeT-RM), in collaboration with members of the pharmacogenetic testing community and the Coriell Cell Repositories, has characterized 137 genomic DNA samples for 28 genes commonly genotyped by PGx testing assays (CYP1A1, CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP2E1, CYP3A4, CYP3A5, CYP4F2, DPYD, GSTM1, GSTP1, GSTT1, NAT1, NAT2, SLC15A2, SLC22A2, SLCO1B1, SLCO2B1, TPMT, UGT1A1, UGT2B7, UGT2B15, UGT2B17, VKORC1). 137 Coriell cell lines were selected based on ethnic diversity and partial genotype characterization from previous testing. DNA samples were coded and distributed to volunteer testing laboratories for targeted genotyping using a number of commercially available and laboratory developed tests. Through consensus verification, we confirmed the presence of at least 108 variant PGx alleles. These samples are also being characterized by other PGx assays, including next-generation sequencing, which will be reported separately. Genotyping results were consistent among laboratories, with the majority of differences in allele assignments attributed to assay design and variability in reported allele nomenclature, particularly for CYP2D6, UGT1A1, and VKORC1. These publicly available samples will help assure the accuracy of pharmacogenetic testing.

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