胚胎干细胞向心肌诱导分化及其在心脏组织工程中的应用

Embryonic stem cell differentiation towards cardiomyocytes and its application in cardiac tissue engineering

胚胎干细胞在建立心脏药理学模型、形成三维的心肌组织、构建生物起搏器等方面有着广泛的应用前景。胚胎干细胞生成心肌细胞的过程其实是在体外模拟心脏生长发育的过程,国内外已有将胚胎干细胞成功移植到动物模型中的案例,并证实可以改善心功能;带有血管系统的组织工程心肌片的研发为临床心肌修补带来了可能;相关研究诱导出的起搏样细胞则可以诱发静止的心室肌产生节律收缩活动;潜在的免疫排斥反应是其临床受限的主要因素。胚胎干细胞虽拥有强大的分化能力,但由于其向心肌细胞分化过程的不确定性,胚胎干细胞的诱导策略及信号调控途径,诱导后的心肌细胞是否能够替代体内的心肌细胞等问题仍值得深入探讨。

Embryonic stem cells （ESCs） show potential prospect of wide application in establishing cardiac pharmacological model system, forming three-dimensional cardiac tissues and constructing biological pacemaker. The process of ESCs differentiating into cardiomyocytes is to simulate heart growth and development in vitro. The cases of transplanting ESCs into animal models confirm that the cardiac function is improved. Moreover, the research and exploitation of tissue engineered cardiac muscle tissue with vessel system brings hope for clinical cardiac muscle restoration. ESC-derived pacemaker can functionally integrate with quiescent ventricular muscle cells to induce rhythmic electrical and contractile activities in vitro. However, the immunological rejection limits its clinical application. Although ESCs have strong differentiation potential, the problems such as the differentiation process towards cardiomyocytes, ESC induction and signal regulatory pathway, and whether induced cardiomyocytes can substitute in vivo cardiomyocytes still need exploration.