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Medicines (Basel). 2018 Jun 4;5(2). pii: E48. doi: 10.3390/medicines5020048.

Direct Reprograming to Regenerate Myocardium and Repair Its Pacemaker and Conduction System.

Author information

1
Department of Medical Biology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
2
Department of Cardiology, Isala Klinieken, 8025 AB Zwolle, The Netherlands.
3
Department of Medical Biology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands. g.j.boink@amc.uva.nl.
4
Department of Cardiology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands. g.j.boink@amc.uva.nl.

Abstract

The regenerative medicine field has been revolutionized by the direct conversion of one cell type to another by ectopic expression of lineage-specific transcription factors. The direct reprogramming of fibroblasts to induced cardiac myocytes (iCMs) by core cardiac transcription factors (Gata4, Mef2c, Tbx5) both in vitro and in vivo has paved the way in cardiac regeneration and repair. Several independent research groups have successfully reported the direct reprogramming of fibroblasts in injured myocardium to cardiac myocytes employing a variety of approaches that rely on transcription factors, small molecules, and micro RNAs (miRNAs). Recently, this technology has been considered for local repair of the pacemaker and the cardiac conduction system. To address this, we will first discuss the direct reprograming advancements in the setting of working myocardium regeneration, and then elaborate on how this technology can be applied to repair the cardiac pacemaker and the conduction system.

KEYWORDS:

biological pacemaker; cardiac conduction system; direct reprogramming

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