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Chimerism and microchimerism of the human heart: evidence for cardiac regeneration

Nature Clinical Practice Cardiovascular Medicine volume 4, pages S40–S45 (2007)Cite this article

Abstract

For decades, it has been widely accepted that the heart is a terminally differentiated organ that is unable to regenerate. Studies of recipients of hearts donated by other humans have shed light on the regenerative potential of the human heart. Investigators have been able to trace the Y chromosome by fluorescence in situ hybridization or polymerase chain reaction, or both, in sex-mismatched heart recipients. Cardiac chimerism has been reported, with concentrations of chimeric cells ranging from 0.04% to 10.0%. Cardiac chimerism after bone marrow or progenitor cell transplantation has also been reported to a low extent (∼0.20%), suggesting that a fraction of the extracardiac cells that colonize the myocardium are of bone marrow origin. Cardiac chimerism after pregnancy with male offspring (fetal cell microchimerism) has also been demonstrated. Cells of fetal origin have been shown to be capable of differentiating into myocardial cells. Collectively, we show that chimerism studies provide a proof of concept of a process that it is likely to be part of normal cardiac homeostasis in humans but apparently insufficient for cardiac repair in diseased hearts.

Key Points

  • Cardiac chimerism occurs after heart transplantation to a small extent, but this effect is unable to meet long-term demand for organ repair

  • A percentage of chimeric cells that home to the myocardium are of bone marrow origin

  • Cardiac chimerism after pregnancy with a male offspring (fetal cell microchimerism) has also been demonstrated

  • Future studies must address unresolved issues, such as the mechanisms responsible for myocardial differentiation of primitive cells

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Figure 1: Cardiac chimerism after heart transplantation
Figure 2: Cardiac chimerism after bone marrow or progenitor cell transplantation
Figure 3: Fetal cell cardiac microchimerism after pregnancy

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Acknowledgements

We appreciate the valuable help of Jose Montiel and Prous Science with the artwork. Grant support was provided by the Spanish Ministry of Science and Education (SAF 2004-08044-C03-01), Novartis, BMS, and Fundación Bravo Andreu.

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Authors and Affiliations

  1. A Bayes-Genis is a cardiologist and translational researcher, S Roura is a postdoctoral fellow in biochemistry, C Prat-Vidal and C Soler-Botija are postdoctoral fellows in biological sciences, J Farré is studying for a PhD in biotechnology, A Bayes de Luna is a cardiologist and clinical researcher, and J Cinca is a cardiologist and translational researcher in the Cardiology Service at the Hospital de la Santa Creu i Sant Pau, Institut Català de Ciencies Cardiovasculars, Barcelona, Spain.,

    Antoni Bayes-Genis, Santiago Roura, Cristina Prat-Vidal, Jordi Farré, Carolina Soler-Botija, Antoni Bayes de Luna & Juan Cinca

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  1. Antoni Bayes-Genis
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Correspondence to Antoni Bayes-Genis.

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Bayes-Genis, A., Roura, S., Prat-Vidal, C. et al. Chimerism and microchimerism of the human heart: evidence for cardiac regeneration. Nat Rev Cardiol 4 (Suppl 1), S40–S45 (2007). https://doi.org/10.1038/ncpcardio0748

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