Abstract

Drug-induced cardiotoxicity reduces the success rates of drug development. Thus, the limitations of current evaluation methods must be addressed. Human cardiac organoids (hCOs) derived from induced pluripotent stem cells (hiPSCs) are useful as an advanced drug-testing model; they demonstrate similar electrophysiological functionality and drug reactivity as the heart. How-ever, similar to other organoid models, they have immature characteristics compared to adult hearts, and exhibit batch-to-batch variation. As the cell cycle is important for the mesodermal differentiation of stem cells, we examined the effect of ZM447439, an aurora kinase inhibitor that regulates the cell cycle, on cardiogenic differentiation. We determined the optimal concentration and timing of ZM447439 for the differentiation of hCOs from hiPSCs and developed a novel protocol for efficiently and reproducibly generating beating hCOs with improved electrophysiological functionality, contractility, and yield. We validated their maturity through electro-physiological- and image-based functional assays and gene profiling with next-generation sequencing, and then applied these cells to multi-electrode array platforms to monitor the cardio-toxicity of drugs related to cardiac arrhythmia; the results confirmed the drug reactivity of hCOs. These findings may enable determination of the regulatory mechanism of cell cycles underlying the generation of iPSC-derived hCOs, providing a valuable drug testing platform.

Highlights

  • Published: 20 December 2021Fifty-four percent of all drugs developed between 1998 and 2008 were eliminated at the clinical stage of development and thereby not approved [1,2]

  • We aimed to determine whether the production efficiency of iPSC-Human cardiac organoids (hCOs) can be increased using cell cycle-regulating drugs and explore whether iPSC-hCOs can be used as a drug-testing model in non-clinical studies

  • Previous studies showed that the fibroblast marker CD13 is downregulated in human-induced pluripotent stem cells (hiPSCs), whereas the pluripotency markers stage-specific embryonic antigen 4 (SSEA-4) and TRA1–60 are upregulated [27]

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Summary

Introduction

Published: 20 December 2021Fifty-four percent of all drugs developed between 1998 and 2008 were eliminated at the clinical stage of development and thereby not approved [1,2]. Candidate drugs are generally eliminated at this stage because of their low efficacy or safety issues, including cardiac toxicity [3]. Existing experimental methods used for cardiac toxicity and efficacy evaluations at nonclinical stages include two-dimensional culture cell models and in vivo animal models; the former exhibit advantages of having a large volume of available research data and are easier to use in experiments compared to in vivo models [5]. Because in vivo environments cannot be simulated in cell models, it is difficult to predict clinical-stage results using these data [6]. Drug reactivity can vary between humans and animal models [8]. It tends to be reduced in animal studies due to ethical problems [9,10].

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