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      A multi-cellular 3D bioprinting approach for vascularized heart tissue engineering based on HUVECs and iPSC-derived cardiomyocytes

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          Abstract

          The myocardium behaves like a sophisticated orchestra that expresses its true potential only if each member performs the correct task harmonically. Recapitulating its complexity within engineered 3D functional constructs with tailored biological and mechanical properties, is one of the current scientific priorities in the field of regenerative medicine and tissue engineering. In this study, driven by the necessity of fabricating advanced model of cardiac tissue, we present an innovative approach consisting of heterogeneous, multi-cellular constructs composed of Human Umbilical Vein Endothelial Cells (HUVECs) and induced pluripotent cell-derived cardiomyocytes (iPSC-CMs). Cells were encapsulated within hydrogel strands containing alginate and PEG-Fibrinogen (PF) and extruded through a custom microfluidic printing head (MPH) that allows to precisely tailor their 3D spatial deposition, guaranteeing a high printing fidelity and resolution. We obtained a 3D cardiac tissue compose of iPSC-derived CMs with a high orientation index imposed by the different defined geometries and blood vessel-like shapes generated by HUVECs which, as demonstrated by in vivo grafting, better support the integration of the engineered cardiac tissue with host’s vasculature.

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          Epidemiology and risk profile of heart failure.

          Heart failure (HF) is a major public health issue, with a prevalence of over 5.8 million in the USA, and over 23 million worldwide, and rising. The lifetime risk of developing HF is one in five. Although promising evidence shows that the age-adjusted incidence of HF may have plateaued, HF still carries substantial morbidity and mortality, with 5-year mortality that rival those of many cancers. HF represents a considerable burden to the health-care system, responsible for costs of more than $39 billion annually in the USA alone, and high rates of hospitalizations, readmissions, and outpatient visits. HF is not a single entity, but a clinical syndrome that may have different characteristics depending on age, sex, race or ethnicity, left ventricular ejection fraction (LVEF) status, and HF etiology. Furthermore, pathophysiological differences are observed among patients diagnosed with HF and reduced LVEF compared with HF and preserved LVEF, which are beginning to be better appreciated in epidemiological studies. A number of risk factors, such as ischemic heart disease, hypertension, smoking, obesity, and diabetes, among others, have been identified that both predict the incidence of HF as well as its severity. In this Review, we discuss key features of the epidemiology and risk profile of HF.
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            Heart failure.

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              Cardiac progenitor cells from adult myocardium: homing, differentiation, and fusion after infarction.

              Potential repair by cell grafting or mobilizing endogenous cells holds particular attraction in heart disease, where the meager capacity for cardiomyocyte proliferation likely contributes to the irreversibility of heart failure. Whether cardiac progenitors exist in adult myocardium itself is unanswered, as is the question whether undifferentiated cardiac precursor cells merely fuse with preexisting myocytes. Here we report the existence of adult heart-derived cardiac progenitor cells expressing stem cell antigen-1. Initially, the cells express neither cardiac structural genes nor Nkx2.5 but differentiate in vitro in response to 5'-azacytidine, in part depending on Bmpr1a, a receptor for bone morphogenetic proteins. Given intravenously after ischemia/reperfusion, cardiac stem cell antigen 1 cells home to injured myocardium. By using a Cre/Lox donor/recipient pair (alphaMHC-Cre/R26R), differentiation was shown to occur roughly equally, with and without fusion to host cells.
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                Author and article information

                Contributors
                claudia.bearzi@cnr.it
                roberto.rizzi@cnr.it
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                10 September 2018
                10 September 2018
                2018
                : 8
                : 13532
                Affiliations
                [1 ]Operational Research Unit, Fondazione di Ricerca e Cura Giovanni Paolo II, Largo Gemelli, Campobasso, 86100 Italy
                [2 ]Institute of Cell Biology and Neurobiology (IBCN), National Research Council of Italy (CNR), Monterotondo Scalo, Rome, 00015 Italy
                [3 ]ISNI 0000 0001 1958 0162, GRID grid.413454.3, Institute of Physical Chemistry, , Polish Academy of Sciences, ; Warsaw, 01224 Poland
                [4 ]ISNI 0000 0004 1757 5329, GRID grid.9657.d, Tissue Engineering Lab, , Università Campus Bio-Medico di Roma, ; Rome, 00128 Italy
                [5 ]IRCCS MultiMedica, Scientific and Technology Pole, Milan, 20100 Italy
                [6 ]ISNI 0000000103426662, GRID grid.10251.37, Department of Cytology and Histology, Faculty of Veterinary Medicine, , Mansoura University, ; Mansoura, 35116 Egypt
                [7 ]ISNI 0000000121102151, GRID grid.6451.6, Department of Biomedical Engineering, , Technion Institute, ; Haifa, 32000 Israel
                [8 ]ISNI 0000 0001 2300 0941, GRID grid.6530.0, Department of Biology, , Tor Vergata Rome University, ; Rome, 00133 Italy
                Author information
                http://orcid.org/0000-0003-2756-5872
                Article
                31848
                10.1038/s41598-018-31848-x
                6131510
                30201959
                75be3987-65c9-4e14-9614-f57f4700ac87
                © The Author(s) 2018

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 23 May 2018
                : 24 August 2018
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