Cardiac Tissue Engineering

• Published in: Tissue engineering. Part A 2009-03, Vol.15 (3), p.678-678
• Main Authors: Tiburcy, M, Christalla, P, Didie, M, Doker, S, Eschenhagen, T, Zimmermann, W-H
• Format: Article
• Language: English
• ISSN: 1937-3341; 1937-335X

Endogenous repair mechanisms do not suffice to reconstitute relevant heart muscle after a cardiac insult. We have, consequently, developed a novel technology to generate Engineered Heart Tissue (EHT) with structural and functional properties of native myocardium to be used as surrogate heart tissue. Subsequent in vivo studies in a rat model of myocardial infarction did indeed confirm that EHTs may indeed be utilized to at least partially repair in-farcted hearts. Yet, numerous hurdles remain to be overcome to advance our experimental technology into a clinically applicable treatment modality. One main issue will be to identify a suitable cell source for human cardiac tissue engineering. Primary cardio-myocytes are naturally post-mitotic and are therefore not suitable for clinically relevant heart muscle repair. This is why cardiogenic stem cells have attracted significant attention. We have recently been able to apply murine and human embryonic stem cells to generate EHT with functional and structural properties of native myocardium. Implantation studies demonstrated survival and vascularization of human EHT grafts in immune suppressed rats. To address immunological concerns potentially autologous cardiomyocyte sources are presently tested in myocardial tissue engineering. They include therapeutic cloning derived stem cells, reprogrammed somatic cells, parthenogenetic stem cells, or germ line stem cells. Despite the prospect of having the right and ideally autologous human cell in hand, we are still facing compelling caveats, including the risk of tumor formation, imperfect cell integration into recipient myocardium, arrhythmia induction, and reaching a clinically relevant scale.