Abstract

Great number of patients with a failing heart have only poor prognosis without a heart transplantation all over theworld. Therefore, an innovation of cardiac regeneration therapy is quite necessary for them. ES cells and inducible pluripotent stem (iPS) cells, which have multipotency to postnatal organs, can easily differentiate into beating cardiomyocyte in vitro. However, in vivo situation, they have not yet provided a clinical privilege to cardiovascular patients because of uncontrollable teratoma formation and primitive cardiomyocytes in host myocardium post transplantation. To overcome the future of iPS/ES cells without a milestone that ameliorates a failing heart, iPS and ES cells are quite needed a splendid harmony between differentiated-cardiomyocyte and host myocardium. Furthermore, human iPS cells derived from various somatic cells still have not enough quality to cardiac regeneration accompanied with poorly reprogramming. Cardiac stem/progenitor cells existing in cardiac niche can be good candidates for “predetermined elite” cells, predisposed to reprogramming. iPS cells derived from failing heart, e.g. ischemic and non-ischemic cardiomyopathy, will be a powerful tool of disease researching and drug screening. Through a genetic or epigenetic modification of iPS and ES cells, we will be able to discover a reliable route to clinical privilege against a failing heart.

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