Clinical trials in-a-dish for cardiovascular medicine

IF 37.6 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

European Heart Journal Pub Date : 2024-09-14 DOI:10.1093/eurheartj/ehae519

Xuekun Wu, Kyle Swanson, Zehra Yildirim, Wenqiang Liu, Ronglih Liao, Joseph C Wu

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Abstract

Cardiovascular diseases persist as a global health challenge that requires methodological innovation for effective drug development. Conventional pipelines relying on animal models suffer from high failure rates due to significant interspecies variation between humans and animal models. In response, the recently enacted Food and Drug Administration Modernization Act 2.0 encourages alternative approaches including induced pluripotent stem cells (iPSCs). Human iPSCs provide a patient-specific, precise, and screenable platform for drug testing, paving the way for cardiovascular precision medicine. This review discusses milestones in iPSC differentiation and their applications from disease modelling to drug discovery in cardiovascular medicine. It then explores challenges and emerging opportunities for the implementation of ‘clinical trials in-a-dish’. Concluding, this review proposes a framework for future clinical trial design with strategic incorporations of iPSC technology, microphysiological systems, clinical pan-omics, and artificial intelligence to improve success rates and advance cardiovascular healthcare.

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心血管内科的 "菜中菜 "式临床试验

心血管疾病一直是全球性的健康挑战，需要创新方法才能有效开发药物。由于人类与动物模型之间存在显著的种间差异，依赖动物模型的传统方法失败率很高。为此，最近颁布的《食品与药物管理局现代化法案 2.0》鼓励采用包括诱导多能干细胞（iPSCs）在内的替代方法。人类 iPSC 为药物测试提供了一个病人特异、精确和可筛选的平台，为心血管精准医疗铺平了道路。本综述讨论了 iPSC 分化的里程碑及其在心血管医学中从疾病建模到药物发现的应用。然后探讨了实施 "盘中临床试验 "所面临的挑战和新出现的机遇。最后，本综述提出了未来临床试验设计的框架，其中战略性地纳入了 iPSC 技术、微生理系统、临床泛组学和人工智能，以提高成功率并推动心血管医疗保健的发展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Heart Journal 医学-心血管系统

CiteScore

39.30

自引率

6.90%

发文量

3942

审稿时长

1 months

期刊介绍： The European Heart Journal is a renowned international journal that focuses on cardiovascular medicine. It is published weekly and is the official journal of the European Society of Cardiology. This peer-reviewed journal is committed to publishing high-quality clinical and scientific material pertaining to all aspects of cardiovascular medicine. It covers a diverse range of topics including research findings, technical evaluations, and reviews. Moreover, the journal serves as a platform for the exchange of information and discussions on various aspects of cardiovascular medicine, including educational matters. In addition to original papers on cardiovascular medicine and surgery, the European Heart Journal also presents reviews, clinical perspectives, ESC Guidelines, and editorial articles that highlight recent advancements in cardiology. Additionally, the journal actively encourages readers to share their thoughts and opinions through correspondence.