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Stem Cells International
Volume 2018, Article ID 1435746, 10 pages
https://doi.org/10.1155/2018/1435746
Review Article

Direct Cardiac Reprogramming: Progress and Promise

1Molecular, Cellular and Integrative Physiology Graduate Program, University of California, Los Angeles, CA 90095, USA
2Division of Cardiology, Department of Internal Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
3Eli and Edythe Broad Stem Cell Research Center, University of California, Los Angeles, CA 90095, USA

Correspondence should be addressed to Reza Ardehali; ude.alcu.tendem@ilahedrAR

Received 1 September 2017; Revised 15 December 2017; Accepted 9 January 2018; Published 13 March 2018

Academic Editor: Fatemeh Sharifpanah

Copyright © 2018 James L. Engel and Reza Ardehali. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The human adult heart lacks a robust endogenous repair mechanism to fully restore cardiac function after insult; thus, the ability to regenerate and repair the injured myocardium remains a top priority in treating heart failure. The ability to efficiently generate a large number of functioning cardiomyocytes capable of functional integration within the injured heart has been difficult. However, the ability to directly convert fibroblasts into cardiomyocyte-like cells both in vitro and in vivo offers great promise in overcoming this problem. In this review, we describe the insights and progress that have been gained from the investigation of direct cardiac reprogramming. We focus on the use of key transcription factors and cardiogenic genes as well as on the use of other biological molecules such as small molecules, cytokines, noncoding RNAs, and epigenetic modifiers to improve the efficiency of cardiac reprogramming. Finally, we discuss the development of safer reprogramming approaches for future clinical application.