“…Nevertheless, while amniotic fluid stem cells can easily adopt a smooth muscle and/or endothelial fate both in vitro and in vivo (Sartore et al, 2005 ; Iop et al, 2008 ; Bollini et al, 2011a ; Ghionzoli et al, 2013 ; Schiavo et al, 2015 ; Tancharoen et al, 2017 ), a general consensus on their cardiomyogenic potential has not been reached yet. AF-MSC and hAFSC have shown to acquire cardiomyocyte-like phenotype following specific in vitro treatment (i.e., via direct co-culture with rodent neonatal cardiomyocytes or chemical induction by 5-aza-2′-deoxycytidine, with or without the addition of transforming growth factor beta-1, or by a mixture of hyaluronic, butyric and retinoic acids, up to modulation of Wnt signaling by small molecules), with evidence including immature expression of sarcomeric proteins, like cardiac troponins, along with up-regulation of early cardiac transcription factors, such as Nkx-2.5, Islet-1 and Gata-4 (Chiavegato et al, 2007 ; Bollini et al, 2011a ; Guan et al, 2011 ; Maioli et al, 2013 ; Gao et al, 2014 ; Connell et al, 2015 ; Jiang and Zhang, 2017 ). However, in most cases, no organized sarcomeres were detected in the differentiated cells (Connell et al, 2015 ), with limited spontaneous contraction or functional maturation of their phenotype (Bollini et al, 2011a ).…”