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Stem cells as biological heart pacemakers.

机译:干细胞可作为生物心脏起搏器。

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Abnormalities in the pacemaker function of the heart or in cardiac impulse conduction may result in the appearance of a slow heart rate, traditionally requiring the implantation of a permanent electronic pacemaker. In recent years, a number of experimental approaches have been developed in an attempt to generate biological alternatives to implantable electronic devices. These strategies include, initially, a number of gene therapy approaches (aiming to manipulate the expression of ionic currents or their modulators and thereby convert quiescent cardiomyocytes into pacemaking cells) and, more recently, the use of cell therapy and tissue engineering. The latter approach explored the possibility of grafting pacemaking cells, either derived directly during the differentiation of human embryonic stem cells or engineered from mesenchymal stem cells, into the myocardium. This review will describe each of these approaches, focusing mainly on the stem cell strategies, their possible advantages and shortcomings, as well as the avenues required to make biological pacemaking a clinical reality.
机译:心脏起搏器功能异常或心脏冲动传导异常可能导致出现心律缓慢,传统上需要植入永久性电子起搏器。近年来,已经开发了许多实验方法,以尝试产生可植入电子设备的生物替代物。这些策略最初包括许多基因治疗方法(旨在操纵离子电流或其调节剂的表达,从而将静止的心肌细胞转化为起搏细胞),以及最近使用的细胞治疗和组织工程学。后一种方法探讨了将起搏细胞移植到心肌中的可能性,该起搏细胞可以是在人类胚胎干细胞分化过程中直接衍生的,也可以是由间充质干细胞改造而成的。这篇综述将描述每种方法,主要集中在干细胞策略,其可能的优点和缺点以及使生物学起搏成为临床现实所需的途径。

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