JoVE Logo
Faculty Resource Center

Sign In





Representative Results





Developmental Biology

Generation and Expansion of Human Cardiomyocytes from Patient Peripheral Blood Mononuclear Cells

Published: February 12th, 2021



1Center for Cardiovascular Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, 2The Heart Center, Nationwide Children’s Hospital, 3Department of Physiology and Cell Biology, The Ohio State University College of Medicine, 4Department of Anatomy, The Ohio State University College of Medicine, 5MCDB Graduate Program, The Ohio State University, 6Department of Pediatrics, The Ohio State University College of Medicine

Here, we present a protocol to robustly generate and expand human cardiomyocytes from patient peripheral blood mononuclear cells.

Generating patient-specific cardiomyocytes from a single blood draw has attracted tremendous interest in precision medicine on cardiovascular disease. Cardiac differentiation from human induced pluripotent stem cells (iPSCs) is modulated by defined signaling pathways that are essential for embryonic heart development. Numerous cardiac differentiation methods on 2-D and 3-D platforms have been developed with various efficiencies and cardiomyocyte yield. This has puzzled investigators outside the field as the variety of these methods can be difficult to follow. Here we present a comprehensive protocol that elaborates robust generation and expansion of patient-specific cardiomyocytes from peripheral blood mononuclear cells (PBMCs). We first describe a high-efficiency iPSC reprogramming protocol from a patient's blood sample using non-integration Sendai virus vectors. We then detail a small molecule-mediated monolayer differentiation method that can robustly produce beating cardiomyocytes from most human iPSC lines. In addition, a scalable cardiomyocyte expansion protocol is introduced using a small molecule (CHIR99021) that could rapidly expand patient-derived cardiomyocytes for industrial- and clinical-grade applications. At the end, detailed protocols for molecular identification and electrophysiological characterization of these iPSC-CMs are depicted. We expect this protocol to be pragmatic for beginners with limited knowledge on cardiovascular development and stem cell biology.

The discovery of human induced pluripotent stem cells has revolutionized modern cardiovascular medicine1,2. Human iPSCs are capable of self-renewing and generating all cell types in the heart, including cardiomyocytes, endothelial cells, smooth muscle cells and cardiac fibroblasts. Patient iPSC-derived cardiomyocytes (iPSC-CMs) can serve as indefinite resources for modeling genetically inheritable cardiovascular diseases (CVDs) and testing cardiac safety for new drugs3. In particular, patient iPSC-CMs are well poised to investigate genetic and molecular etiologies of CVDs that are deriv....

Log in or to access full content. Learn more about your institution’s access to JoVE content here

The experimental protocols and informed consent for human subjects were approved by the Institutional Review Board (IRB) at Nationwide Children's Hospital.

1. Preparation of cell culture media, solutions, and reagents

  1. Prepare PBMC media
    1. Mix 20 mL of basal PBMC culture media (1x) and 0.52 mL of supplement. Add 20 μL of SCF and FLT3 each (stock concentration: 100 μg/mL), 4 μL of IL3, IL6 and EPO each (stock concentration: 100 μg/mL) and 200 μL.......

Log in or to access full content. Learn more about your institution’s access to JoVE content here

Human iPSC reprogramming from PBMCs
After pre-culture with Complete Blood Media for 7 days, PBMCs become large with visible nuclei and cytoplasm (Figure 1B), indicating that they are ready for virus transfection. After transfection with the Sendai virus reprogramming factors, PBMCs will undergo an epigenetic reprogramming process for another week. Typically, we get 30-50 iPSC colonies from the transfection of 1 x 105 PBMCs an.......

Log in or to access full content. Learn more about your institution’s access to JoVE content here

During iPSC reprogramming, it is critical to culture PBMCs for 1 week until they are enlarged with clear nuclei and cytoplasm. Because PBMCs do not proliferate, an appropriate cell number for viral transduction is important for successful iPSC reprogramming. Cell number of PBMCs, multiplicity of infection (MOI) and titer of virus should be considered and adjusted to reach the optimal transduction outcomes. For cardiac differentiation, initial seeding density is critical for iPSCs to reach over 90% confluent on the day wh.......

Log in or to access full content. Learn more about your institution’s access to JoVE content here

This study was supported by the American Heart Association (AHA) Career Development Award 18CDA34110293 (M-T.Z.), Additional Ventures AVIF and SVRF awards (M-T.Z.), National Institutes of Health (NIH/NHLBI) grants 1R01HL124245, 1R01HL132520 and R01HL096962 (I.D.). Dr. Ming-Tao Zhao was also supported by startup funds from the Abigail Wexner Research Institute at Nationwide Children's Hospital.


Log in or to access full content. Learn more about your institution’s access to JoVE content here

Name Company Catalog Number Comments
ABI 7300 Fast Real-Time PCR System Thermo Fisher Scientific
Axon Axopatch 200B Microelectrode Amplifier Molecular Devices Microelectrode Amplifier
B27 supplement Thermo Fisher Scientific 17504044
B27 supplement minus insulin Thermo Fisher Scientific A1895601
BD Cytofix/Cytoperm Fixation/Permeabilization Kit BD Biosciences 554714 Fixation/Permeabilization solution, Perm/Wash buffer
BD Vacutainer CPT tube BD Biosciences 362753 Blood cell separation tube
CHIR99021 Selleck Chemicals S2924
CytoTune-iPS 2.0 Sendai Reprogramming Kit Thermo Fisher Scientific A16517 Sendai virus reprogramming kit
Digidata 1200B Axon Instruments Acquisition board
Direct-zol RNA Miniprep kit Zymo Research R2050 RNA extraction kit
DMEM/F12 Thermo Fisher Scientific 11330057
Essential 8 medium Thermo Fisher Scientific A1517001 E8 media for iPSC culture
GlutaMAX supplement Thermo Fisher Scientific 35050061 L-glutamine alternative
Growth factor reduced Matrigel Corning 356231 Basement membrane matrix
iScript cDNA Snythesis Kit Bio-Rad 1708891 cDNA synthesis
IWR-1-endo Selleck Chemicals S7086
KnockOut Serum Replacement (KSR) Thermo Fisher Scientific 10828028
pCLAMP 7.0 Molecular Devices Electrophysiology data acquisition & analysis software
Recombinant human EPO Thermo Fisher Scientific PHC9631
Recombinant human FLT3 Thermo Fisher Scientific PHC9414
Recombinant human IL3 Peprotech 200-03
Recombinant human IL6 Thermo Fisher Scientific PHC0065
Recombinant human SCF Peprotech 300-07
RPMI 1640 medium Thermo Fisher Scientific 11875093
RPMI 1640 medium, no glucose Thermo Fisher Scientific 11879020
SlowFade Gold Antifade Mountant Thermo Fisher Scientific S36936 Mounting media
StemPro-34 SFM Thermo Fisher Scientific 10639011 PBMC culture media
TaqMan Fast Advanced Master Mix Thermo Fisher Scientific 4444964 qPCR master mix
TrypLE Select Enzyme 10x, no phenol red Thermo Fisher Scientific A1217703 CM dissociation solution
UltraPure 0.5 M EDTA Thermo Fisher Scientific 15575020 iPSC dissociation solution
Y-27632 2HCl Selleck Chemicals S1049

  1. Takahashi, K., et al. Induction of pluripotent stem cells from adult human fibroblasts by defined factors. Cell. 131 (5), 861-872 (2007).
  2. Yu, J., et al. Induced pluripotent stem cell lines derived from human somatic cells. Science. 318 (5858), 1917-1920 (2007).
  3. Sayed, N., Liu, C., Wu, J. C. Translation of Human-Induced Pluripotent Stem Cells: From Clinical Trial in a Dish to Precision Medicine. Journal of American College of Cardiology. 67 (18), 2161-2176 (2016).
  4. Itzhaki, I., et al. Modelling the long QT syndrome with induced pluripotent stem cells. Nature. 471 (7337), 225-229 (2011).
  5. Hinson, J. T., et al. Titin mutations in iPS cells define sarcomere insufficiency as a cause of dilated cardiomyopathy. Science. 349 (6251), 982-986 (2015).
  6. Deacon, D. C., et al. Combinatorial interactions of genetic variants in human cardiomyopathy. Nature Biomedical Engineering. 3 (2), 147-157 (2019).
  7. Gifford, C. A., et al. Oligogenic inheritance of a human heart disease involving a genetic modifier. Science. 364 (6443), 865-870 (2019).
  8. Lo Sardo, V., et al. Unveiling the role of the most impactful cardiovascular risk locus through haplotype editing. Cell. 175 (7), 1796-1810 (2018).
  9. Liu, Y. W., et al. Human embryonic stem cell-derived cardiomyocytes restore function in infarcted hearts of non-human primates. Nature Biotechnology. 36 (7), 597-605 (2018).
  10. Zhao, M. T., Shao, N. Y., Garg, V. Subtype-specific cardiomyocytes for precision medicine: where are we now. Stem Cells. 38, 822-833 (2020).
  11. Burridge, P. W., Keller, G., Gold, J. D., Wu, J. C. Production of de novo cardiomyocytes: human pluripotent stem cell differentiation and direct reprogramming. Cell Stem Cell. 10 (1), 16-28 (2012).
  12. Protze, S. I., Lee, J. H., Keller, G. M. Human pluripotent stem cell-derived cardiovascular cells: from developmental biology to therapeutic applications. Cell Stem Cell. 25 (3), 311-327 (2019).
  13. Lian, X., et al. Robust cardiomyocyte differentiation from human pluripotent stem cells via temporal modulation of canonical Wnt signaling. Proceedings of the National Academy of Sciences of the United States of America. 109 (27), 1848-1857 (2012).
  14. Zhao, M. T., et al. Molecular and functional resemblance of differentiated cells derived from isogenic human iPSCs and SCNT-derived ESCs. Proceedings of the National Academy of Sciences of the United States of America. 114 (52), 11111-11120 (2017).
  15. Burridge, P. W., et al. Chemically defined generation of human cardiomyocytes. Nature Methods. 11 (8), 855-860 (2014).
  16. Lian, X., et al. Chemically defined, albumin-free human cardiomyocyte generation. Nature Methods. 12 (7), 595-596 (2015).
  17. Buikema, J. W., et al. Wnt activation and reduced cell-cell contact synergistically induce massive expansion of functional human ipsc-derived cardiomyocytes. Cell Stem Cell. 27 (1), 50-63 (2020).
  18. Lee, J. H., Protze, S. I., Laksman, Z., Backx, P. H., Keller, G. M. Human pluripotent stem cell-derived atrial and ventricular cardiomyocytes develop from distinct mesoderm populations. Cell Stem Cell. 21 (2), 179-194 (2017).
  19. Liang, W., et al. Canonical Wnt signaling promotes pacemaker cell specification of cardiac mesodermal cells derived from mouse and human embryonic stem cells. Stem Cells. 38 (3), 352-368 (2020).
  20. Protze, S. I., et al. Sinoatrial node cardiomyocytes derived from human pluripotent cells function as a biological pacemaker. Nature Biotechnology. 35 (1), 56-68 (2017).
  21. Ren, J., et al. Canonical Wnt5b signaling directs outlying Nkx2.5+ mesoderm into pacemaker cardiomyocytes. Developmental Cell. 50 (6), 729-743 (2019).
  22. Zhang, Q., et al. Direct differentiation of atrial and ventricular myocytes from human embryonic stem cells by alternating retinoid signals. Cell Research. 21 (4), 579-587 (2011).
  23. Fusaki, N., Ban, H., Nishiyama, A., Saeki, K., Hasegawa, M. Efficient induction of transgene-free human pluripotent stem cells using a vector based on Sendai virus, an RNA virus that does not integrate into the host genome. Proceedings of the Japan Academy, Seriers B, Physical and Biological Sciences. 85 (8), 348-362 (2009).
  24. Stacey, G. N., Crook, J. M., Hei, D., Ludwig, T. Banking human induced pluripotent stem cells: lessons learned from embryonic stem cells. Cell Stem Cell. 13 (4), 385-388 (2013).
  25. Karbassi, E., et al. Cardiomyocyte maturation: advances in knowledge and implications for regenerative medicine. Nature Reviews Cardiology. 17 (6), 341-359 (2020).
  26. Zhao, L., Ben-Yair, R., Burns, C. E., Burns, C. G. Endocardial notch signaling promotes cardiomyocyte proliferation in the regenerating zebrafish heart through Wnt pathway antagonism. Cell Reports. 26 (3), 546-554 (2019).
  27. Heallen, T. R., Kadow, Z. A., Wang, J., Martin, J. F. Determinants of cardiac growth and size. Cold Spring Harbor Perspectives in Biology. 12 (3), 037150 (2020).
  28. Campa, V. M., et al. Notch activates cell cycle reentry and progression in quiescent cardiomyocytes. Journal of Cell Biology. 183 (1), 129-141 (2008).
  29. Collesi, C., Zentilin, L., Sinagra, G., Giacca, M. Notch1 signaling stimulates proliferation of immature cardiomyocytes. Journal of Cell Biology. 183 (1), 117-128 (2008).
  30. Heallen, T., et al. Hippo pathway inhibits Wnt signaling to restrain cardiomyocyte proliferation and heart size. Science. 332 (6028), 458-461 (2011).

This article has been published

Video Coming Soon

JoVE Logo


Terms of Use





Copyright © 2024 MyJoVE Corporation. All rights reserved