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Current Cardiology Reports

, 19:78 | Cite as

Myocardial Tissue Engineering for Regenerative Applications

  • Buntaro Fujita
  • Wolfram-Hubertus ZimmermannEmail author
Regenerative Medicine (SM Wu, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Regenerative Medicine

Abstract

Purpose of Review

This review provides an overview of the current state of tissue-engineered heart repair with a special focus on the anticipated modes of action of tissue-engineered therapy candidates and particular implications as to transplant immunology.

Recent Findings

Myocardial tissue engineering technologies have made tremendous advances in recent years. Numerous different strategies are under investigation and have reached different stages on their way to clinical translation. Studies in animal models demonstrated that heart repair requires either remuscularization by delivery of bona fide cardiomyocytes or paracrine support for the activation of endogenous repair mechanisms. Tissue engineering approaches result in enhanced cardiomyocyte retention and sustained remuscularization, but may also be explored for targeted paracrine or mechanical support. Some of the more advanced tissue engineering approaches are already tested clinically; others are at late stages of pre-clinical development. Process optimization towards cGMP compatibility and clinical scalability of contractile engineered human myocardium is an essential step towards clinical translation. Long-term allograft retention can be achieved under immune suppression. HLA matching may be an option to enhance graft retention and reduce the need for comprehensive immune suppression.

Summary

Tissue-engineered heart repair is entering the clinical stage of the translational pipeline. Like in any effective therapy, side effects must be anticipated and carefully controlled. Allograft implantation under immune suppression is the most likely clinical scenario. Strategies to overcome transplant rejection are evolving and may further boost the clinical acceptance of tissue-engineered heart repair.

Keywords

Tissue engineering Engineered heart muscle Pluripotent stem cells Regeneration Remuscularization Heart failure Transplant immunology 

Notes

Compliance with Ethical Standards

Funding

Buntaro Fujita is supported by an Adumed research stipend. Wolfram-Hubertus Zimmermann is supported by the DZHK (German Center for Cardiovascular Research), the German Federal Ministry for Science and Education (BMBF FKZ 13GW0007A [CIRM-ET3]), the German Research Foundation (DFG ZI 708/10-1; SFB 937 TP18, SFB 1002 TPs C04, S1; IRTG 1618 RP12), the European Union FP7 CARE-MI, the Foundation Leducq, and the NIH (U01HL099997).

Conflict of Interest

The Universities of Hamburg and Göttingen have field several patent applications based on the original work by the Zimmermann lab. Patents have been acquired or licensed by Tissue Systems Holding GmbH (TSH), myriamed GmbH (myr), and Repairon GmbH (Rep). Patents issued with licenses are WO2008058917 and WO2015025030; patents pending with licenses are WO2015/040142 and EP 13182437 A 20130830. Wolfram-Hubertus Zimmermann is a co-founder and an uncompensated scientific advisor of TSH, myr, and Rep. Buntaro Fujita declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This review article does not contain any original data obtained from human or animal subjects.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Buntaro Fujita
    • 1
    • 2
    • 3
  • Wolfram-Hubertus Zimmermann
    • 1
    • 2
    Email author
  1. 1.Institute of Pharmacology and ToxicologyUniversity Medical Center GöttingenGöttingenGermany
  2. 2.DZHK (German Center for Cardiovascular Research), partner site GöttingenGöttingenGermany
  3. 3.Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRWRuhr-University BochumBad OeynhausenGermany

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