Cellular regeneration as a potential strategy to treat cardiac conduction disorders
Satadru K. Lahiri, … , Mohit M. Hulsurkar, Xander H.T. Wehrens
Satadru K. Lahiri, … , Mohit M. Hulsurkar, Xander H.T. Wehrens
Published October 1, 2021
Citation Information: J Clin Invest. 2021;131(19):e152185. https://doi.org/10.1172/JCI152185.
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Commentary

Cellular regeneration as a potential strategy to treat cardiac conduction disorders

Abstract

Loss of atrioventricular conduction system (AVCS) cells due to either inherited or acquired deficits leads to conduction diseases, which can deteriorate into fatal cardiac arrhythmias and sudden death. In this issue of the JCI, Wang et al. constructed a mouse model of atrioventricular block (AVB) by inducing AVCS cell–specific injury using the Cx30.2 enhancer to drive expression of diphtheria toxin fragment A. AVCS cell ablation in adult mice led to irreversible AVB. jkjkIn contrast, AVCS cell injury in neonatal mice was followed by spontaneous recovery in a subset of mice, revealing a limited postnatal time window during which the regeneration of AVCS cells can occur as a result of cellular plasticity. This exciting study paves the way for future research into biological or cellular treatment approaches for cardiac conduction diseases by exploiting the regenerative potential of AVCS cells.

Authors

Satadru K. Lahiri, Mohit M. Hulsurkar, Xander H.T. Wehrens

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Figure 1

Schematic of cardiac conduction disease and therapeutic options.

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Schematic of cardiac conduction disease and therapeutic options. Schemat...
Schematic of the CCS showing AVCS cells (inset) during normal sinus rhythm or third-degree AVB, which is caused by injury or dysfunction. The current therapy for cardiac conduction disorders often involves cardiac pacing using an electronic pacemaker, but the AVCS cells remain dysfunctional (left). On the other hand, cardiac regeneration and plasticity focus on the restoration of the AVCS cells that are damaged due to injury (right).