Abstract
An inability to recover lost cardiac muscle following acute ischemic injury remains the biggest shortcoming of current therapies to prevent heart failure. As compared to standard medical and surgical treatments, tissue engineering strategies offer the promise of improved heart function by inducing regeneration of functional heart muscle. Tissue engineering approaches that use stem cells and genetic manipulation have shown promise in preclinical studies but have also been challenged by numerous critical barriers preventing effective clinical translational. We believe that surgical intervention using acellular bioactive ECM scaffolds may yield similar therapeutic benefits with minimal translational hurdles. In this review, we outline the limitations of cellular-based tissue engineering strategies and the advantages of using acellular biomaterials with bioinductive properties. We highlight key anatomic targets enriched with cellular niches that can be uniquely activated using bioactive scaffold therapy. Finally, we review the evolving cardiovascular tissue engineering landscape and provide critical insights into the potential therapeutic benefits of acellular scaffold therapy.
Highlights
Heart failure is a growing epidemic that is predicted to disable 1 in 5 Americans in their life time [1]
We focus on the translational limitations of contemporary cardiac regenerative approaches and describe how acellular bioactive extracellular matrix (ECM) scaffolds may provide an effective solution
The use of acellular bioactive scaffolds for cardiac repair and regeneration is rationalized by two key points
Summary
Heart failure is a growing epidemic that is predicted to disable 1 in 5 Americans in their life time [1]. Despite the prevalence of heart failure, effective treatment options remain limited. Organ transplantation remains the only curative option but a disparity between donor heart supply and patient demand coupled with the need for immunosuppressive therapy makes this an ineffective solution to address the growing needs of the heart failure population [3]. Durable mechanical support therapies continue to evolve and improve but complications for destination therapy patients are a concern. As our understanding of the factors and mechanisms that regulate heart structure and function have improved, the concept of engineering cardiovascular tissues to restore heart function has rapidly advanced [4, 5]. Tissue engineering approaches using stem cell and gene therapy have shown promise, but remain fraught with translational hurdles. There has been an increasing shift in focus towards utilizing tissue engineering strategies that can stimulate repair by modulating the host-substrate microenvironment and enhancing endogenous tissue repair processes [6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
