Steering signal transduction pathway towards cardiac lineage from human pluripotent stem cells: A review

In humans injured myocardium cannot avert the onset and progression of ventricular dysfunction because of limited regenerative ability of myocytes. Although limited renaissance of cardiomyocytes has been reported in human infarcted hearts, it is generally accredited that non-functional fibrous tissue replaces the dead myocardium. High cardiovascular morbidity and dearth of donor hearts warrant a constant hunt for radically different approach to treat heart failure. Pluripotent stem (PS) cells possess the ability to produce functional cardiomyocytes for clinical applications and drug development, which may provide the answer to this problem. Although progress has been made in differentiating human PS cells into cardiomyocytes, however, the in vitro differentiation of pluripotent cells into cardiomyocytes involves a poorly defined, inefficient and relatively non-selective process. A thorough understanding of signaling pathways would tender a roadmap for the streamlined development of in vitro cardiac differentiation strategies. The ability to obtain unlimited numbers of human cardiomyocytes would improve development of cell-based therapies for cardiovascular diseases, facilitate the study of cardiovascular biology and improve the early stages of drug discovery. Here in this review, we highlight the interacting endogenous cellular signals and their modulators involved in directing the human PSCs towards cardiac differentiation.

► Injured myocardium can't avert the onset and progression of ventricular dysfunction.
► PS cells can differentiate into cardiomyocytes for clinical application.
► In vitro cardiac differentiation involves a poorly defined and inefficient process.
► In vitro cardiomyogenesis recapitulate the in vivo developmental stages.
► Wnt signaling regulates imperative aspects of cardiac differentiation.