Editors' ChoiceTissue Engineering

Growing Blood Vessels in Cardiac Grafts

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Science Translational Medicine  03 Feb 2010:
Vol. 2, Issue 17, pp. 17ec19
DOI: 10.1126/scitranslmed.3000894

Heart disease is a leading cause of death in developed countries and is becoming more prevalent in the developing world. The most common type affects the coronary vessels, which supply the heart with blood, causing narrowing that restricts blood flow to the heart. This condition often leads to a myocardial infarction—a heart attack—in which the vessels become blocked, and the resulting loss of blood supply leads to death of cardiac tissue. Even with advanced medical treatments that can save a heart attack victim, the dead heart tissue remains: The injured heart cannot fully heal itself. This lingering damage increases the person’s chances of future complications, such as congestive heart failure, that have poor prognoses and come with a high chance of death. This situation has motivated tissue engineers to develop cardiac grafts for the repair of damaged heart muscle. Most of these are composed of only heart muscle cells (cardiomyocytes); vascularization, which is crucial to long-term integration and survival of the engineered tissue, is expected to occur in vivo after implantation. Now, Lesman et al. have created a tissue patch from human cardiomyocytes supplemented with cells that can form blood vessels (embryonic fibroblasts and endothelial cells). When these grafts were implanted into rats, this mixed-cell approach resulted in grafts with 10 times better vascularization than cardiomyocyte-only control grafts. The newly formed blood vessels were functional and connected to the rat’s vascular network, effectively perfusing blood into the tissue grafts. These findings present a new, multicellular paradigm for cardiac graft tissue engineering and highlight the potential for regenerative medicine as a treatment for heart disease.

A. Lesman et al., Transplantation of a tissue-engineered human vascularized cardiac muscle. Tissue Engineering 16, 115–125 (2010). [Abstract]

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