© 2004 by European Society of Cardiology
Copyright © 2004, European Society of Cardiology
Genes, stem cells and biological pacemakers
aCenter for Molecular Therapeutics, Deparment of Pharmacology, Columbia University, New York, NY, USA
bDepartment of Pediatrics, Columbia University, New York, NY, USA
cDepartments of Physiology and Biophysics, Institute of Molecular Cardiology, SUNY Stony Brook, Stony Brook, NY, USA
* Corresponding author. Center for Molecular Therapeutics, Deparment of Pharmacology, Columbia University, 630 West 168 Street, PH 7 West-321, New York, NY 10032, USA. Tel.: +1-212-305-8754; fax: +1-212-305-8351. E-mail address: mrr1{at}columbia.edu (M.R. Rosen).
The advent of gene therapy and cell therapy has led to reconsideration of standard therapies for cardiac disease. One such area of reconsideration is that of the cardiac pacemaker, which has been the mainstay of treatment for high-degree heart block and sinoatrial node dysfunction. Over the past five years, gene therapy has been used to explore the overexpression of β2-adrenergic receptors, the down-regulation of inward rectifier current, and the overexpression of pacemaker current as potential sources of biological pacemakers. Cell therapy approaches have explored the "forcing" of embryonic stem cells to evolve along cardiac (and specifically pacemaker) cell lines and the use of adult mesenchymal stem cells as platforms for delivery of specific gene therapies. This review considers the strengths and weaknesses of each of the approaches used to date and attempts to look to the future of biological alternatives to electronic pacemakers.
KEYWORDS Arrhythmia therapy; Ion channels; Gene therapy; ECG; Gap junctions
Time for primary review 17 days
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