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Garbern JC, Lee RT. Mitochondria and metabolic transitions in cardiomyocytes: lessons from development for stem cell-derived cardiomyocytes. Stem Cell Res Ther 2021; 12:177. [PMID: 33712058 PMCID: PMC7953594 DOI: 10.1186/s13287-021-02252-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 02/28/2021] [Indexed: 12/13/2022] Open
Abstract
Current methods to differentiate cardiomyocytes from human pluripotent stem cells (PSCs) inadequately recapitulate complete development and result in PSC-derived cardiomyocytes (PSC-CMs) with an immature or fetal-like phenotype. Embryonic and fetal development are highly dynamic periods during which the developing embryo or fetus is exposed to changing nutrient, oxygen, and hormone levels until birth. It is becoming increasingly apparent that these metabolic changes initiate developmental processes to mature cardiomyocytes. Mitochondria are central to these changes, responding to these metabolic changes and transitioning from small, fragmented mitochondria to large organelles capable of producing enough ATP to support the contractile function of the heart. These changes in mitochondria may not simply be a response to cardiomyocyte maturation; the metabolic signals that occur throughout development may actually be central to the maturation process in cardiomyocytes. Here, we review methods to enhance maturation of PSC-CMs and highlight evidence from development indicating the key roles that mitochondria play during cardiomyocyte maturation. We evaluate metabolic transitions that occur during development and how these affect molecular nutrient sensors, discuss how regulation of nutrient sensing pathways affect mitochondrial dynamics and function, and explore how changes in mitochondrial function can affect metabolite production, the cell cycle, and epigenetics to influence maturation of cardiomyocytes.
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Affiliation(s)
- Jessica C Garbern
- Department of Stem Cell and Regenerative Biology and the Harvard Stem Cell Institute, Harvard University, 7 Divinity Ave, Cambridge, MA, 02138, USA
- Department of Cardiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Richard T Lee
- Department of Stem Cell and Regenerative Biology and the Harvard Stem Cell Institute, Harvard University, 7 Divinity Ave, Cambridge, MA, 02138, USA.
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
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Slaats RH, Schwach V, Passier R. Metabolic environment in vivo as a blueprint for differentiation and maturation of human stem cell-derived cardiomyocytes. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165881. [PMID: 32562698 DOI: 10.1016/j.bbadis.2020.165881] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/10/2020] [Accepted: 06/14/2020] [Indexed: 12/26/2022]
Abstract
Patient-derived human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs) are increasingly being used for disease modeling, drug screening and regenerative medicine. However, to date, an immature, fetal-like, phenotype of hPSC-CMs restrains their full potential. Increasing evidence suggests that the metabolic state, particularly important for provision of sufficient energy in highly active contractile CMs and anabolic and regulatory processes, plays an important role in CM maturation, which affects crucial functional aspects of CMs, such as contractility and electrophysiology. During embryonic development the heart is subjected to metabolite concentrations that differ substantially from that of hPSC-derived cardiac cell cultures. A deeper understanding of the environmental and metabolic cues during embryonic heart development and how these change postnatally, will provide a framework for optimizing cell culture conditions and maturation of hPSC-CMs. Maturation of hPSC-CMs will improve the predictability of disease modeling, drug screening and drug safety assessment and broadens their applicability for personalized and regenerative medicine.
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Affiliation(s)
- Rolf H Slaats
- Department of Applied Stem Cell Technologies, TechMed Centre, University of Twente, Drienerlolaan 5, 7500AE Enschede, the Netherlands
| | - Verena Schwach
- Department of Applied Stem Cell Technologies, TechMed Centre, University of Twente, Drienerlolaan 5, 7500AE Enschede, the Netherlands
| | - Robert Passier
- Department of Applied Stem Cell Technologies, TechMed Centre, University of Twente, Drienerlolaan 5, 7500AE Enschede, the Netherlands; Department of Anatomy and Embryology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, the Netherlands.
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Bellotti M, Pennati G, De Gasperi C, Battaglia FC, Ferrazzi E. Role of ductus venosus in distribution of umbilical blood flow in human fetuses during second half of pregnancy. Am J Physiol Heart Circ Physiol 2000; 279:H1256-63. [PMID: 10993792 DOI: 10.1152/ajpheart.2000.279.3.h1256] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Color Doppler sonography was used to study umbilical and ductus venosus (DV) flow in 137 normal fetuses between 20 and 38 wk of gestation. Hepatic flows were also evaluated. In all parts of the venous circulation examined, blood flow increased significantly with advancing gestational age. The weight-specific amniotic umbilical flow did not change significantly during gestation (120 +/- 44 ml. min(-1). kg(-1)), whereas DV flow decreased significantly (from 60 to 17 ml. min(-1). kg(-1)). The percentage of umbilical blood flow shunted through the DV decreased significantly (from 40% to 15%); consequently, the percentage of flow to the liver increased. The right lobe flow changed from 20 to 45%, whereas the left lobe flow was approximately constant (40%). These changes are related to different patterns of growth of the umbilical veins and DV diameters. The present data support the hypothesis that the DV plays a less important role in shunting well-oxygenated blood to the brain and myocardium in late normal pregnancy than in early gestation, which leads to increased fetal liver perfusion.
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MESH Headings
- Blood Flow Velocity/physiology
- Female
- Fetal Weight
- Fetus/blood supply
- Gestational Age
- Humans
- Liver/blood supply
- Liver/diagnostic imaging
- Liver/embryology
- Liver Circulation/physiology
- Placental Circulation/physiology
- Pregnancy
- Pregnancy Trimester, Second/physiology
- Pregnancy Trimester, Third/physiology
- Reference Values
- Regression Analysis
- Ultrasonography, Doppler, Color
- Ultrasonography, Doppler, Pulsed
- Ultrasonography, Prenatal
- Umbilical Veins/diagnostic imaging
- Umbilical Veins/embryology
- Umbilical Veins/physiology
- Vena Cava, Inferior/diagnostic imaging
- Vena Cava, Inferior/embryology
- Vena Cava, Inferior/physiology
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Affiliation(s)
- M Bellotti
- Department of Obstetrics and Gynecology, University of Milan, 20142 Milan, Italy.
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Battaglia FC, Marconi AM. The new obstetrics: its integration into neonatal clinical practise, teaching and research. J Perinat Med 1998; 25:399-405. [PMID: 9438944 DOI: 10.1515/jpme.1997.25.5.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Most neonatologists have not yet incorporated into their teaching, clinical service and research the advances in high risk obstetrics particularly as it relates to fetal surveillance. This brief review emphasizes some of the "new obstetrics" from the viewpoint of perinatal medicine, particularly in terms of neonatal teaching and the design of future neonatal research. The information that can be obtained about an infant prenatally by the use of ultrasound. power doppler, computerized fetal heart rate monitoring, cordocentesis, etc is extensive and yet, has rarely been utilized in the design of neonatal research protocols. It is becoming imperative that the "new obstetrics" be recognized and utilized in modern neonatal thinking if a truly "perinatal medicine" is to be practised.
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Affiliation(s)
- F C Battaglia
- Department of Pediatrics and Obstetrics-Gynecology, University of Colorado School of Medicine, Denver, USA
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Battaglia C, Artini PG, D'Ambrogio G, Galli PA, Segre A, Genazzani AR. Maternal hyperoxygenation in the treatment of intrauterine growth retardation. Am J Obstet Gynecol 1992; 167:430-5. [PMID: 1497047 DOI: 10.1016/s0002-9378(11)91424-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE In the current study the efficacy of maternal hyperoxygenation on growth-retarded fetuses was evaluated. STUDY DESIGN Thirty-six pregnant women with intrauterine growth retardation were studied. The patients were divided in oxygen-treated (n = 17) and untreated (n = 19) groups. Doppler analysis of the fetal circulation was performed on the arrival to the hospital, after 12 hours, and thereafter on alternate days until delivery. Fetal blood was sampled by cordocentesis for immediate blood gas analysis at entrance to the study and the day of delivery. RESULTS Significant improvement in Doppler flow patterns in treated patients were found when compared with untreated women. The Doppler variations were associated with complementary modifications in fetal blood gas. These differences resulted in a significant modification in perinatal mortality with an incidence of 29% and 68% (p less than 0.01) in treated and untreated groups, respectively. CONCLUSION Our data suggest a benefit of maternal hyperoxygenation in the treatment of fetal growth retardation.
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Affiliation(s)
- C Battaglia
- Department of Obstetrics and Gynecology, University of Modena, Italy
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Abstract
This review covers the transplacental transport of amino acids to the fetus and the role of placental metabolism and fetal metabolism in the utilization of amino acids. Particular attention is paid to the non-essential amino acids and to their rates of production within the fetus or placenta. The supply of amino acids is compared with their requirements for accretion in protein and for their use as metabolic fuels. Recent studies of protein synthesis in relation to gestational age are also reviewed.
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Affiliation(s)
- F C Battaglia
- University of Colorado School of Medicine, Denver 80262
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Affiliation(s)
- A M Marconi
- Department of Obstetrics and Gynecology, San Paolo Institute of Biomedical Sciences, University of Milano School of Medicine, Italy
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Daniel SS, James LS, MacCarter G, Morishima HO, Stark RI. Long-term acid-base measurements in the fetal and maternal baboon. Am J Obstet Gynecol 1992; 166:707-12. [PMID: 1536256 DOI: 10.1016/0002-9378(92)91701-b] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The purpose of the study was to examine the relationship between maternal and fetal acid-base indexes in the baboon. STUDY DESIGN Eight animals maintained in a tether system were studied during the third trimester. Results were analyzed using analysis of variance. RESULTS After recovery from surgery, pH in carotid artery blood of the fetus was 7.40 +/- 0.027 (mean +/- SD), PO2, 27.5 +/- 3.45 mm Hg; PCO2, 34.0 +/- 2.37 mm Hg; base deficit, 3.0 +/- 2.15 mEq/L; Hot, 33.4% +/- 2.69% and HbO2, 61.3% +/- 8.65%. The corresponding values in the mother were 7.48 +/- 0.035, 100.7 +/- 9.44 mm Hg, 26.4 +/- 2.95 mm Hg, 3.6 +/- 1.71 mEq/L, 32.6% +/- 4.0% and 97.9% +/- 1.28%, respectively. All indexes remained essentially the same until the onset of active labor, at which time the fetus became slightly acidotic and hypoxemic (pH less than 7.35, HbO2 less than 50%). CONCLUSION The baboon fetus has slightly higher pH2 and lower PaCO2 than the human fetus and PaO2, base deficit, and maternal-fetal gradients across the placenta in these two primate species are comparable.
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Affiliation(s)
- S S Daniel
- Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, NY 10032
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Ferrazzi E, Pardi G, Bauscaglia M, Marconi AM, Gementi B, Bellotti M, Makowski EL, Battaglia FC. Reply. Am J Obstet Gynecol 1990. [DOI: 10.1016/0002-9378(90)90069-j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Nicolaides KH, Economides DL, Soothill PW. Blood gases, pH, and lactate in appropriate- and small-for-gestational-age fetuses. Am J Obstet Gynecol 1989; 161:996-1001. [PMID: 2801852 DOI: 10.1016/0002-9378(89)90770-9] [Citation(s) in RCA: 307] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The pH, PO2, PCO2, and lactate concentration were measured in umbilical blood samples obtained by cordocentesis from 208 appropriate-for-gestational-age and 196 small-for-gestational-age fetuses at 18 to 38 weeks' gestation. In the appropriate-to-gestational-age fetuses umbilical venous (n = 173) and arterial (n = 35) PO2 and pH decreased, and umbilical venous and arterial PCO2 increased with advancing gestation. Blood lactate concentration did not change. Compared with the appropriate-for-gestational-age fetuses, the small-for-gestational-age fetuses were hypoxemic, hypercapnic, hyperlacticemic, and acidotic. There was mixed respiratory and metabolic acidosis, and the decrease in pH was significantly correlated with both hypercapnia and hyperlacticemia. In the umbilical artery (n = 53) there was a significant linear correlation between the degree of hypoxemia and the degrees of hypercapnia or acidosis. In the umbilical vein (n = 143), the correlations between the degree of hypoxemia and the degrees of hypercapnia, hyperlacticemia, or acidosis were exponential.
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Affiliation(s)
- K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, England
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Ferrazzi E, Pardi G, Bauscaglia M, Marconi AM, Gementi B, Bellotti M, Makowski EL, Battaglia FC. The correlation of biochemical monitoring versus umbilical flow velocity measurements of the human fetus. Am J Obstet Gynecol 1988; 159:1081-7. [PMID: 3189440 DOI: 10.1016/0002-9378(88)90418-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The pulsatility index of the fetal umbilical arteries was evaluated in 14 high-risk pregnant patients delivered by cesarean section between 30 and 35 weeks of gestation. Transabdominal cord sampling by ultrasonic guidance was performed on 10 of these patients. Umbilical arterial and venous blood was obtained in all patients from the doubly clamped cord at the time of cesarean section. The blood samples were analyzed for respiratory gases, acid-base balance, and lactate concentrations. A significant relationship was found between the pulsatility index and pH, PCO2, and lactate concentrations measured on umbilical venous blood sampled in utero. The pulsatility index also correlated with the same variables measured on venous and arterial blood sampled at cesarean section. Umbilical venous blood obtained transabdominally had a significantly higher oxygen content than blood obtained at cesarean section. No significant correlation was found between umbilical venous oxygen content obtained at transabdominal cord sampling and the pulsatility index. At a pulsatility index greater than 1.5, lactate concentrations in umbilical venous blood increased sharply. There would appear to be a curvilinear relationship between umbilical blood flow and these indices of fetal oxygenation, such that moderate increases in pulsatility index were not associated with a significant increase in fetal lactate concentrations.
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Affiliation(s)
- E Ferrazzi
- Department of Obstetrics-Gynecology, Ospedale Mangiagalli, University of Milano, Italy
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