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Drug discovery and disease modeling in the field of cardiovascular research face several challenges due to a lack of clinically relevant samples and inadequate translational tools1. Highly complex pre-clinical models or oversimplified in vitro single-cell models do not exhibit pathophysiological conditions in a reproducible manner. Therefore, several miniaturized tissue-engineered platforms have evolved to help bridge the gap, with the goal of achieving a balance between ease of application in a high-throughput manner and faithful recapitulation of tissue function2,3. With the advent of induced pluripotent stem cell (iPSC) technology, tissue engineering tools can be applied to patient-specific cells with or without underlying cardiovascular disease state to answer research questions4,5,6. Such tissue engineered models with cellular composition similar to the heart tissue could be utilized in drug development efforts to test for cardiotoxicity and dysfunction induced by pathological changes in behavior of one or multiple cell types.
Self-assembled microtissues or organoids derived from human iPSCs are three-dimensional (3D) structures that are miniature tissue-like assemblies exhibiting functional similarities to their in vivo counterparts. There are several different approaches that allow formation of organoids in situ via directed differentiation of iPSCs or through the formation of embryoid bodies4. The resulting organoids are an indispensable tool to study morphogenetic processes that drive organogenesis. However, the presence of a variety of cell populations and differences in self-organization can lead to variability in outcomes between different organoids5. Alternatively, pre-differentiated cells that are self-assembled into microtissues with tissue-specific cell types to study local cell-cell interactions are excellent models, where it is feasible to isolate the self-assembled components. Particularly in human cardiac research, development of 3D cardiac microtissues with multicellular components has proven to be challenging when cells are derived from different patient lines or commercial sources.
To improve our mechanistic understanding of cell behaviors in a physiologically relevant, personalized, in vitro model, ideally all component cell types should be derived from the same patient line. In the context of a human heart, a truly representative cardiac in vitro model would capture the crosstalk among predominant cell types, namely, cardiomyocytes (CMs), endothelial cells (ECs), and cardiac fibroblasts (CFs)6,7. The faithful recapitulation of a myocardium not only requires biophysical stretch and electrophysiological stimulation, but also cell-cell signaling that arise from supporting cell types such as ECs and CFs8. CFs are involved in the synthesis of extracellular matrix and maintaining tissue structure; and in a pathological state, CFs can induce fibrosis and alter electrical conduction in the CMs9. Similarly, ECs can regulate contractile properties of CMs through paracrine signaling and supplying vital metabolic demands10. Hence, there is a need for human cardiac microtissues composed of all three major cell types to allow physiologically relevant high-throughput experiments to be conducted.
Here, we describe a bottom-up approach in fabrication of cardiac microtissues by derivation of human iPSC-derived cardiomyocytes (iPSC-CMs), iPSC-derived endothelial cells (iPSC-ECs), and iPSC-derived cardiac fibroblasts (iPSC-CFs) and their 3D culture in uniform cardiac microtissue arrays. This facile method of generating spontaneously beating cardiac microtissues can be utilized for disease modeling and rapid testing of drugs for functional and mechanistic understanding of heart physiology. Furthermore, such multicellular cardiac microtissue platforms could be exploited with genome editing techniques to emulate cardiac disease progression over time under chronic or acute culture conditions.