Page 9 - GTM-3-3

Global Translational Medicine

EDITORIAL
Cardiac regenerative therapy using induced

pluripotent stem cells

Tadahisa Sugiura *
†
Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center/Albert Einstein
College of Medicine, New York, United States of America
(This editorial belongs to the Special Issue: Exploring Cardiovascular Regenerative Therapy Using
Induced Pluripotent Stem Cells)

Heart failure following myocardial infarction is a major cause of death and disability
worldwide. This syndrome is a morbid and lethal syndrome for which existing therapies
are inadequate. Drugs that augment inotropy can ameliorate symptoms in the short term
but paradoxically increase mortality by exacerbating adverse myocardial remodeling,
cardiomyocyte apoptosis, and arrhythmias. Existing pharmacological therapies that
1
reduce mortality include β-blockers and inhibitors of the renin-angiotensin-aldosterone
axis;, yet, these drugs are insufficient to prevent the progression to end-stage heart
failure in a significant proportion of patients. Cardiac transplantation can be an effective
1
treatment but is limited by organ donor availability. Left ventricular assist devices can
be destination therapy or provide a bridge to transplantation, but their use is often
complicated by infection, stroke, or gastrointestinal bleeding. To fill this therapeutic
gap, cardiac regenerative therapies have been considered and implantation of various
cell types to the heart including cardiomyocytes and progenitors, skeletal myocytes and
myoblasts, and various stem cell populations has demonstrated safety and efficacy in
preclinical and clinical trials. 2
† The author is the guest editor for New strategies of cardiac regenerative therapy using induced pluripotent stem cells
this Special Issue (iPSC) have been explored. iPSCs are reprogrammed somatic cells with the capacity
*Corresponding author: to differentiate into cells of all three embryonic germ layers. The concept behind the
3
Tadahisa Sugiura development of iPSCs is that overexpression of the genes that maintain pluripotency is
(tsugiura@montefiore.org)
sufficient to reprogram a somatic cell to an embryonic stem cell-like state. These cells
4
Citation: Sugiura T. Cardiac can be differentiated into almost any cell of interest for use in regenerative therapies.
regenerative therapy using induced
pluripotent stem cells. Global Transl Advantages of the iPSC-based approach include an unlimited source of replacement
Med. 2024:3(3):3586. cells and avoidance of potential controversy concerning the use of fetal tissue. 5
doi: 10.36922/gtm.3586
iPSC-derived cardiomyocytes (iPSC-CMs) have drawn global attention as a potential
Received: May 6, 2024 therapy for treating different kinds of heart disease. However, cardiac regenerative
Published Online: June 11, 2024
therapy using iPSC-CMs in real clinical settings remains challenging. There are still some
Copyright: © 2024 Author(s). obstacles, such as immaturity of iPSC-CMs, ineffective delivery routes, poor engraftment
This is an Open-Access article
distributed under the terms of the of implanted cells, immunogenicity and immune rejection, arrhythmogenicity, and
Creative Commons Attribution possible tumorigenesis. Although clinical translation of iPSC-CM therapy is still fraught
License, permitting distribution, with these limitations, numerous investigations have been conducted to surmount these
and reproduction in any medium,
provided the original work is barriers. The transplantation of iPSC-CMs offers hope for cardiac regenerative therapy
properly cited. and could potentially provide a long-awaited answer for severely intractable heart failure
Publisher’s Note: AccScience by supplying freshly matured cardiomyocytes.
Publishing remains neutral with
regard to jurisdictional claims in Conflict of interest
published maps and institutional
affiliations. The author declares no conflicts of interest.

Volume 3 Issue 3 (2024) 1 doi: 10.36922/gtm.3586