Cardiac regeneration: the gene therapy approach

Background: Ischemic heart disease often results in myocardial infarction, after which surviving tissue undergoes remodeling. Unfortunately, the regenerative capacity of adult cardiomyocytes is poor. Repopulating myocardium with contractile cells is an objective of regenerative medicine. The most investigated strategy is implantation of stem cells. An alternative approach is stimulating cardiomyocytes to re-enter the cell cycle and progress to mitosis and cytokinesis through gene-mediated interventions targeting cell cycle regulators, or by injecting genes coding for mitotic cytokines. Objective/methods: To summarize work done and examine postnatal growth of the heart in small rodents and large mammals to emphasize the need for caution when extrapolating results from mice and rats to humans. Results/conclusions: Today we have evidence that under certain circumstances adult cardiomyocytes re-enter the cell cycle and advances to mitosis, The problem is that our current knowledge of the triggering phenomena and the cascade of events leading to cardiomyocyte mitosis is poor.