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dc.creatorLópez-Muneta, L. (Leyre)-
dc.creatorMiranda-Arrubla, J. (Josu)-
dc.creatorCarvajal-Vergara, X. (Xonia)-
dc.identifier.citationLópez-Muneta, L. (Leyre); Miranda-Arrubla, J. (Josu); Carvajal-Vergara, X. (Xonia). "The future of direct cardiac reprogramming: Any GMT cocktail variety?". International Journal of Molecular Sciences. 21 (21), 2020, 7950es_ES
dc.description.abstractDirect cardiac reprogramming has emerged as a novel therapeutic approach to treat and regenerate injured hearts through the direct conversion of fibroblasts into cardiac cells. Most studies have focused on the reprogramming of fibroblasts into induced cardiomyocytes (iCMs). The first study in which this technology was described, showed that at least a combination of three transcription factors, GATA4, MEF2C and TBX5 (GMT cocktail), was required for the reprogramming into iCMs in vitro using mouse cells. However, this was later demonstrated to be insufficient for the reprogramming of human cells and additional factors were required. Thereafter, most studies have focused on implementing reprogramming efficiency and obtaining fully reprogrammed and functional iCMs, by the incorporation of other transcription factors, microRNAs or small molecules to the original GMT cocktail. In this respect, great advances have been made in recent years. However, there is still no consensus on which of these GMT-based varieties is best, and robust and highly reproducible protocols are still urgently required, especially in the case of human cells. On the other hand, apart from CMs, other cells such as endothelial and smooth muscle cells to form new blood vessels will be fundamental for the correct reconstruction of damaged cardiac tissue. With this aim, several studies have centered on the direct reprogramming of fibroblasts into induced cardiac progenitor cells (iCPCs) able to give rise to all myocardial cell lineages. Especially interesting are reports in which multipotent and highly expandable mouse iCPCs have been obtained, suggesting that clinically relevant amounts of these cells could be created. However, as of yet, this has not been achieved with human iCPCs, and exactly what stage of maturity is appropriate for a cell therapy product remains an open question. Nonetheless, the major concern in regenerative medicine is the poor retention, survival, and engraftment of transplanted cells in the cardiac tissue. To circumvent this issue, several cell pre-conditioning approaches are currently being explored. As an alternative to cell injection, in vivo reprogramming may face fewer barriers for its translation to the clinic. This approach has achieved better results in terms of efficiency and iCMs maturity in mouse models, indicating that the heart environment can favor this process. In this context, in recent years some studies have focused on the development of safer delivery systems such as Sendai virus, Adenovirus, chemical cocktails or nanoparticles. This article provides an in-depth review of the in vitro and in vivo cardiac reprograming technology used in mouse and human cells to obtain iCMs and iCPCs, and discusses what challenges still lie ahead and what hurdles are to be overcome before results from this field can be transferred to the clinical settings.es_ES
dc.description.sponsorshipThis work was funded by PID2019-107150RB-I00/AEI/10.13039/501100011033.es_ES
dc.publisherMDPI AGes_ES
dc.relationinfo:eu-repo/grantAgreement/AEI/Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020/PID2019-107150RB-I00/ES/INCAPACITACION DE LAS CELULAS ENDOGENAS DEL TEJIDO CARDIACO DAÑADO PARA AUMENTAR EL INJERTO DE LOS PROGENITORES CARDIOVASCULARES TRASPLANTADOSes_ES
dc.subjectDirect reprogramminges_ES
dc.subjectiCMs (induced cardiomyocytes)es_ES
dc.subjectiCPCs (induced cardiac progenitor cells)es_ES
dc.subjectCardiovascular diseaseses_ES
dc.subjectCardiovascular repaires_ES
dc.subjectCardiovascular regenerationes_ES
dc.titleThe future of direct cardiac reprogramming: any GMT cocktail variety?es_ES
dc.description.noteThis article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (
dadun.citation.publicationNameInternational Journal of Molecular Scienceses_ES

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