Regenerating functional heart tissue for myocardial repair

Abstract

Heart disease is one of the leading causes of death worldwide and the number of patients with the disease is likely to grow with the continual decline in health for most of the developed world. Heart transplantation is one of the only treatment options for heart failure due to an acute myocardial infarction, but limited donor supply and organ rejection limit its widespread use. Cellular cardiomyoplasty, or cellular implantation, combined with various tissue-engineering methods aims to regenerate functional heart tissue. This review highlights the numerous cell sources that have been used to regenerate the heart as well as cover the wide range of tissue-engineering strategies that have been devised to optimize the delivery of these cells. It will probably be a long time before an effective regenerative therapy can make a serious impact at the bedside.

Hydrogels for cardiac tissue engineering

“…5 Therefore cardiac transplantation remains a viable option to treat end-stage heart failure patients. 2 However, due to the limited number of organ donors and potential rejection problems, innovative alternative approaches are needed.…”

“…6,7 Direct injection of cells into the cardiac muscle has been used as a method of delivering cells into the infarcted tissue. 4,5,8,9 In vivo, this approach has been shown to achieve some success in regaining muscle function after MI. 10,11 However, B90% of the injected cells die after implantation, demonstrating the importance of vasculature and appropriate tissue microarchitecture for cardiac tissue regeneration.…”

Potentiality of Very Small Embryonic-Like Stem Cells to Repair Myocardial Infarction

“…As a result, a significant proportion of survivors with ICM will still develop HF and have briefer life-span. Pathologically, HF and myocardial remodeling aggratate each other and a core pathogenic factor of ICM is loss of massive cardiomyocytes [1]. In fact, the myocardium itself posseses little capacity for self-regeneration.…”

New scaffolding materials for the regeneration of infarcted myocardium

“…Cell sheets can be obtained by employing temperature-responsive plates whose behaviour switches from hydrophobic to hydrophilic when the temperature is lowered below 37ºC [56]. The muscle mass loss following an infarction is significant, up to 50 g [5 8 F59], so the amount of cells needed to overcome this loss is obviously not covered with a single sheet of cells.…”

“…Many attempts have been done in this direction, like the incorporation of oxygen carriers to the culture medium to simulate the effect of the haemoglobin in the blood Synthetic materials include: polylactic acid and polyglycolic acid (PLA and PGA) [56] that are usually blended as poly(lactic-co-glycolic acid) (PLGA), or with other polyesters, to combine their properties as desired. PLGA has been employed as electrospun fibrous membranes [1 1 8 F119] or as porous beads [1 1 9 F120].…”