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Heart On chip based on induced pluripotent Stem cell Technology for personalized Medicine

Periodic Reporting for period 2 - CISTEM (Heart On chip based on induced pluripotent Stem cell Technology for personalized Medicine)

Reporting period: 2020-01-01 to 2023-06-30

Duchenne muscular dystrophy (DMD) is a serious genetic disorder, occurring in 1/3 500- 5000 children and develops due to mutation in dystrophin gene. Cardiomyopathy in DMD develops in the second decade of life in the significant proportion of patients (more than 60% at age of more than 18 years) together with the respiratory failure and both ultimately lead to death in second or third decade of life. Understanding the mechanisms of cardiomyopathy can provide better chance for patients, improving their conditions of life and prolonging its extent. However, the available animal models only partially reflect the severity of human diseases. In parallel, due to the variability in disease mechanisms, medications and dosages may vary among patients, making it difficult the provision of universally efficacious treatment, creating a tremendous burden on the healthcare system. Microfluidic technology-based “Organs-on-a-chip” like “Heart-on-a-chip” that mimic tailored micro-environment architecture inspired by organ-level functions in vivo represents a powerful tool for investigating DMD disease mechanisms and testing new drug and treatment. Its conjunction with hiPSCs (Human-induced pluripotent stem cells) might offer an excellent opportunity to engineer heart-on-a-chip in a patient-matched manner and overcome the variability in DMD disease mechanisms that can occur from one patient to another. CISTEM project aims to merge recent progress in stem cell biology and advanced microfluidic and MEMS technologies in order to develop a novel “heart-on-chips” platform based on iPSCs-derived cardiomyocytes and to propose a new model of DMD-cardiomyopathy. To achieve this objective, CISTEM has defined two main steps:

• Engineering Heart–on-a-Chip from Cardiomyocytes-derived hiPSCs using microfluidic and microsystem technologies
• Use of the developed platform to model and investigate the cardiomyopathy coming from the Duchenne muscular dystrophy.

In addition, CISTEM project aims also to implement a high quality staff exchange programme in order to :

• Connect high-quality research infrastructures using them as training facilities for developing and completing the skills of the CISTEM’participants
• Contribute to bridging the gap between industry and high education institutions by implementing a structured secondment-based exchange programme
CISTEM has established a novel and strong multidisciplinary and intersectoral network of European and non-European researchers benefitting considerably from the exchange of expertise and resources. During the second periodic period, scientific exchange has allowed the achievement of significant progress towards the scientific objectives and the network has produced a large number of results in the area of heart-on-chip which have been published in peer-reviewed international journal. The main scientific results achieved are:
• The establishment of a protocol for 3D surface functionalization

• Optimisation of the co-culture conditions with fibroblasts and endothelial cells inside a microfluidic device.
• Differentiation of hiPSCs into cardiomyocytes
• Development of a perfusion station for investigating the shear stress effect on the maturation of cardiomyocytes
• Establishment of protocol for the formation of cardiac 3D structures from patients derived hiPSC-Cardiomyocytes.
• The establishment of Organ-On-Chip microfluidic set-up
• Two Organs-On-a-Chip platforms have been developed to measure trans-endo(epi)thelial electrical resistance: One approach is based on microfluidic technologies and the second approach consists in the integration of the TEER sensor in a 24 multi well plate.

The scientific results have been generated through the secondments/return phases of CISTEM secondees. The secondees have participated in many training activities for acquiring knowledge related to the project research activities such as cell culture protocols and procedures, surface functionalisation, cell culture characterization, microfluidic and microfabrication.
Career development of secondees is also an important objective of CISTEM which has been achieved through training, transfer of knowledge and know-how, both inter-sectoral and international, mainly by means of secondment visits, lectures, and seminars that have been organized in the frame of the project. CISTEM has offered a good opportunity for the seconded researchers to reinforce their respective CV, consolidate their laboratory and general skills.
Genetic Rare Disorders such as Cardiomyopathy coming from Duchenne muscular dystrophy still represent an unmet medical need. Developing a heart model in a patient-match manner might contribute to a better understanding of mechanisms of cardiomyopathy that can provide better chance for patients, improving their conditions of life and prolonging its extent.
CISTEM became a sustainable international network of academics and SMEs who collectively worked in the development of Heart-on-chip for personalised medicine. As mentioned before the network has already provided clear results towards this objective: In the first period of the project, the CISTEM work has been focused on the optimisation of the culture condition of cardiomyocytes derived from iPSCs inside a microfluidic device. Different approaches have been evaluated and combined to improve cardiomyocyte viability and to reproduce the in-vivo environment inside the microfluidic device. Firstly, a robust protocol has been designed for 3D Surface functionalization of the device to reinforce the hydrogel attachment to the device and maintain the hydrogel architecture for a week. In addition, hiPSC-CM co-culture with human endothelial cells and fibroblasts was optimized to provide the CM-iPSc a more realistic cell culture environment which has shown to improve CM-iPSCs viability. Furthermore, to reproduce the dynamic condition of the in-vivo environment, a microfluidic set-up has been developed to generate controllable shear stress through the microfluidic device. Preliminary investigation has shown that the shear stress conditioning results in a change in cell morphology and an increase in vinculin production (protein needed for proper electrochemical signal transduction through cell-cell adhesion). In the second period, the consortium worked on the development and optimization of Heart-On-Chip platform using equipment and microfluidic devices provided by the industrial partners. Innovative approaches have been established to perform TEER measurement in microfluidic devices and multi-well disposables. Furthermore, the effective differentiation of DMD-derived hiPSC-cardiomyocytes, hiPSC-derived cardiac fibroblasts (hiPSC-CF) and hiPSC-derived endothelial cells (hiPSC-EC) has been achieved along with the formation of complex three-dimensional cardiac microtissues.
Apart from the research activities, CISTEM has already promoted joint research initiatives and new collaborative projects have been generated from the network. In addition, the researchers involved in the project have gathered additional skills, knowledge and know-how that will significantly contribute to advance their careers by opening new professional opportunities.
TEER sensor in the Be-Gradient microfluidic chip
Viability staining of iPSC-CM inside the microfluidic chip B-Gradient
Cardiac microtissues generated from hiPSC-CM by Jagiellonian University
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