Inducible Pluripotent Stem Cells For Cardiac Regeneration

The adult human heart has limited intrinsic regenerative capacity, and so the myocardium lost after a myocardial infarction is typically replaced by noncontractile scar tissue, often initiating congestive heart failure. Current treatment options are limited in preventing ventricular remodeling because of their inability to repair or replace damaged myocardium. Novel therapeutic modalities for improving cardiac function, such as cell therapy, are imperative. With the first derivation of human embryonic stem cells from preimplantation embryos more than a decade ago it seemed that a new potential source of cells for the treatment of many degenerative diseases had emerged, including cardiomyocytes for cardiac repair. Recently, another breakthrough took place. By the overexpression of four retrovirally transduced transcription factors in mouse dermal fibroblasts, grown in conditions favoring embryonic stem cells expansion, inducible pluripotent stem (iPS) cell could be generated. The promise of applying this technology to human cells was rapidly realized with the successful generation of human iPS cells from human fibroblasts. These cells have the potential to regenerate functional myocardium. In addition, they may be a useful model for studying genetic diseases. The development and potential of these cells for treating and studying cardiac diseases is reviewed in this chapter.