Presentation 1
心臓の再生医療に関する記述。
Restoring Cardiac Electromechanical Functions With Cell Therapy And Tissue Engineering.
Lior Gepstein MD,PhD
The Sohnis Family Research Laboratory For Cardiac Electrophysiology and Regenerative Medicine, the Bruce Rappaport Faculty of Medicine Technion-Israel Institute of Technology
*****************
Cardiovascular diseases remain the leading cause of morbidity and mortality in the western world. Adult cardiomyocytes have limited regenerative capacity and therefore any significant cell loss, such as occurs during myocardial infarction is mostly irreversible and may result in the development of progressive heart failure. Similar processes may also lead to the development of abnormalities in the electrical function of the heart (collectively called arrhythmias).These rhythm disorders may result in abnormally low heart rate (bradyarrhthmias) requiring the implantation of an electronic pacemaker or abnormally high and uncoordinated rate (tachyarrhthmias).
The recent advancements in stem cell biology, molecular biology, and tissue engineering have paved the way to the development of a new discipline in biomedicine, regenerative medicine. This may replace or modify the function of diseased tissues. Here we describe our efforts in this exciting field in restoring the electromechanical function of the heart. Specifically, three areas of research will be discussed.
(1)Regenerating functional heart issue to improve the mechanical function of the heart using human embryonic stem cells (hESC).These unique cells, established from early-stage blastocysts, can be continuously grown in culture and coaxed to differentiate into every cell type in the body. Recently, we were able to establish a reproducible differentiation system from these unique cells in which human heart cells with typical molecular, structural and functional properties can be generated. More recently, we have shown that this differentiating system can result in generation of cardiac tissue with spontaneous pacemaker activity and electrical propagation and that this tissue can integrate structurally and functionally with host cardiac tissue, restoring the electromechanical function of the heart.
(2)Regenerating the cardiac conduction system by established a biological pacemaker or specialized conduction tissue for the treatment of slow heart rate.
(3) To test the hypothesis that genetically engineered cell grafts can be used to modulate the myocardial tissue electrophysiological substrate supress abnormally fast electrical activity for the treatment of tachyarrythmias.
