“9.61x6.69” b2815 Tissue Engineering and Nanotheranostics
Directed Differentiation of Human Pluripotent Stem Cells 91
in early stages of differentiation prevented the formation of cardio-
myocytes while late stage inhibition did not prevent cardiomyocyte
formation, illustrating a biphasic influence and the critical role of
Wnt/β-catenin signaling for mesoderm induction.^57 Willems et al.
tested the efficacy of several small molecule inhibitors of the Wnt/β-
catenin pathway to promote cardiomyocyte differentiation post meso-
derm induction.^58 Using Activin A, BMP4, and bFGF to promote
mesoderm specification, they performed extensive small molecule
screening and identified several small molecules (IWR-1, 53AH,
IWP-3, and XAV939) whose addition was sufficient to generate
cardiomyocytes from hESC derived mesodermal cells.^58
In 2012, Lian et al. developed a fully defined protocol for highly
efficient differentiation of cardiomyocytes using chemical manipula-
tion of the Wnt/β-catenin pathway (Fig. 2).59,60 This protocol used
dense monolayer culture with mesodermal induction by activation of
the Wnt/β-catenin pathway via small molecule Gsk3 inhibitor,
CHIR99021.59,60 Inhibition of the Wnt/β-catenin pathway was
accomplished by addition of a small molecule porcupine inhibitor:
IWP-2, IWP-4 or C59.59,60 This differentiation strategy yielded 98%
cardiac troponin T positive cells, illustrating high efficiency without
an extra purification step, and its efficacy was demonstrated with both
hESCs and iPSCs.^60 This protocol provided a defined and simple
strategy to generate cardiomyocytes; however scale-up challenges and
further delineation of the molecular underpinnings of this process
would benefit future applications of this technology.
Fig. 2. Schematic of the chemically defined directed differentiation protocol devel-
oped by Lian et al. using chemical modulators of Wnt/β-catenin pathway
activity.59,60