Revista nº 809

· 39 · REVISIÓN Actualidad Médica A C T U A L I D A D M É D I C A www.actualidadmedica.es ©2020.Actual.Med.Todoslosderechosreservados Advances in tissue engineering of the cardiac muscle for myocardial regeneration Abstract Tissue engineering is currently at the avant-garden of research and aims to build regenerative alternatives in vitro by means of combining a scaffold material, adequate cells and bioactive molecules. It has been 20 years since the initial description of a tissue engineering construct, but in relation to the management of heart disease, these new technologies are not yet fully established, due to the challenges presented by their transfer to the clinic. However, advancements are being made into these therapies, and therefore it necessary, for example, support to academic laboratories, adequate funding, cooperation between di- fferent laboratories by coordinating comparable approaches and evidence-based information. Generally, scaffold materials such as gelatin, collagen alginate or synthetic polymers and cardiac cells are used to reconstitute native tissue-like constructs in vitro. They should have propensity to intgrate and remain contractile in vivo . This review aim is to present cardiac tissue engineering strategies for the functional recovery of altered cardiac tissue with a focus on different methods of application, neovascularization, advances in 3D bioprinting and future perspectives. Resumen La ingeniería de tejidos está actualmente en la vanguardia de la investigación y tiene como objetivo construir alternativas regenerativas in vitro mediante la combinación de un material de andamiaje, células adecuadas y moléculas bioactivas. Han pasado 20 años desde la primera descripción de una construcción de ingeniería tisular, pero en relación con el manejo de las enfermedades cardiacas, estas nuevas tecnologías aún no están completamente establecidas, por los desafíos que presenta su traslación a la clínica. No obstante, se está progresando con estas terapias y por ello se necesita, por ejemplo, apoyo a los laboratorios académicos, financiación adecuada, cooperación entre los distintos laboratorios mediante la coordinación de enfoques comparados e información basada en evidencia. Generalmente, se utilizan materiales de andamiaje como gelatina, colágeno, alginato o polímeros sintéticos y células cardíacas para reconstuir in vitro constructos similares a los tejidos nativos. Estos deben ser propensos a integrarse y permanecer contráctiles in vivo. El objetivo de esta revisión es presentar las principales estrategias de ingeniería tisular para la recuperación funcional del tejido cardiaco alterado con un enfoque en los distintos métodos, la neovascularización, los avances en la bioimpresión 3D y las perspectivas futuras. Ruiz-de-Almirón-de-Andrés, B. Estudiante de la Facultad de Medicina. Universidad de Granada Blanca Ruiz de Almirón de Andrés Facultad de Medicina Avenida de la investigación, 11 · 18016 Granada E-mail: blancaruizdealmiron@correo.ugr.es Palabras clave: Insuficiencia cardiaca; Ingeniería tisular; Biomateriales; Regeneración; Células madre; Cardiomiocitos. Keywords: Heart failure; Tissue engineering; Biomaterials; Regeneration; Stem cells; Cardiomyocytes. Avances en la ingeniería tisular del músculo cardíaco para la regeneración miocárdica Enviado: 04-02-2020 Revisado: 06-02-2020 Aceptado: 19-04-2020 DOI: 10.15568/am.2020.809. re01 Actual. Med. 2020; 105: (809): 39-47 INTRODUCTION Myocardial infarction (MI) is the outcome of many cardio- vascular diseases and heart transplant is actually the only so- lution for these patients. Althought, stem cell-based therapy has emerged as a promising approach for prompting cardiac rejuvenation, it still has its limitations in terms of the degree of regeneration of the infarcted tissue and the improvement of cardiac function (1). A major problem for cell therapy is the low level of retention of infused or injected cell products. Most studies concur that only few of the transplanted cells survive in the hostile environment of the host tissue, and even fewer integrate and are retained in the host myocardium scar (2). However, transplantation also has its limitations in relation to the lower number of donors or the risk of inmune rejection of the graft. Faced with the need to overcome the- se obstacles, strategies have emerged over the years focused on restoring complete cardiac function by reconstructing the affected tissue by incorporating within scaffolds cells, wich provide optimal structural, mechanical and physiological pro- perties (3). This field of work is called Tissue Engineering (TE), wich is a multidisciplinary field that combines the principles of