Proliferation and Maturation: Janus and the Art of Cardiac Tissue Engineering

In this work, our emerging understanding of proliferation and maturation of cardiomyocytes is described with an emphasis on the fact that both processes are necessary but do not seem to be able to function simultaneously.  Hence the reference to the Roman god of doorways, Janus, depicted with two faces - one looking forward, the other backward – represented transition across a metaphorical threshold dividing two incompatible ways of being.  Proliferation is always associated with an immature state, or with de-differentiation, while maturation invariably precludes proliferation.  Understanding this dichotomy and its mechanistic underpinnings allows us to better understand the challenges facing cardiac tissue engineering, and also opens up opportunities based on managing or directing the transition across the threshold that divides proliferation and maturation.  This review co-authored by 5 SCI faculty members described key findings that demonstrate the proliferation/maturation dichotomy (PMD) and suggeseted engineering approaches that might take advantage of it.  Read the published paper.