Reversible reprogramming of cardiomyocytes to a fetal state drives heart regeneration in mice

Cardiomyocyte (CM) replacement is very slow in adultmammalian hearts, preventing regeneration of damaged myocardium. By contrast, fetal hearts display considerable regenerative potential owing to the presence of less mature CMs that still have the ability to proliferate. In this study, we demonstrate that heart-specific expression of Oct4, Sox2, Klf4, and c-Myc (OSKM) induces adult CMs to dedifferentiate, conferring regenerative capacity to adult hearts. Transient, CM-specific expression of OSKM extends the regenerative window for postnatal mouse hearts and induces a gene expression program in adult CMs that resembles that of fetal CMs. Extended expression of OSKM in CMs leads to cellular reprogramming and heart tumor formation. Short-term OSKM expression before and during myocardial infarction ameliorates myocardial damage and improves cardiac function, demonstrating that temporally controlled dedifferentiation and reprogramming enable cell cycle reentry of mammalian CMs and facilitate heart regeneration.

Automated summary

Research shows that expression of OSKM genes in adult cardiomyocytes can induce these cells to dedifferentiate, conferring regenerative capacity to the heart. This short-term dedifferentiation and reprogramming can ameliorate myocardial damage and facilitate heart regeneration.