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(Circulation Research. 2006;98:1002.)
© 2006 American Heart Association, Inc.

Reviews

Stem Cells as a Source of Regenerative Cardiomyocytes

Keiichi Fukuda, Shinsuke Yuasa

From the Department of Regenerative Medicine and Advanced Cardiac Therapeutics, Keio University School of Medicine, Tokyo, Japan.

Correspondence to Keiichi Fukuda, MD, PhD, FACC, Professor and Chair, Department of Regenerative Medicine and Advanced Cardiac Therapeutics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan. E-mail kfukuda{at}sc.itc.keio.ac.jp

This Review is part of a thematic series on Cardiovascular Tissue Engineering, which includes the following articles:

Custom Design of the Cardiac Microenvironment With Biomaterials

Heart Valve Tissue Engineering

Engineering Myocardial Tissue

Small-Diameter Artificial Arteries Engineered In Vitro

Stem Cells as a Source of Regenerative Cardiomyocytes
Richard T. Lee Guest Editor

The realization of regenerative cardiac medicine depends on the availability of cardiomyocytes in sufficient numbers for transplantation of cardiac tissue and the accompanying blood vessels. Embryonic stem (ES) cells, bone marrow (BM) stem cells, and tissue-derived stem cells are all potential cell sources. Although ES cells are highly proliferative and suitable for mass production, an efficient protocol is yet to be established to ensure selective cardiomyocyte induction using these cells. Recent advances in developmental biology have clarified the involvement of critical factors in cardiomyocyte differentiation, including bone morphogenic protein and Wnt signaling proteins, and such factors have the potential to improve the efficiency of stem cell induction. Initial studies of the intracoronary administration of BM mononuclear cells after myocardial infarction has yielded promising results; however, intensive investigation of the underlying molecular mechanisms at play as well as double-blinded clinical trials will be necessary to establish the extent of both migration of the BM stem cells into the damaged cardiac tissue and their differentiation into cardiomyocytes. Several types of cardiac tissue stem cells have also been reported, but an accurate and extensive comparison of these cells with regard to their characteristics and multipotency remains to be done. An integrative study involving developmental biology, stem cell biology, and tissue engineering is required to achieve the full potential of cardiac regeneration.

Key Words: cardiomyocyte • stem cell • differentiation • tissue engineering • cell transplantation

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