Rozprawy doktorskie na temat „Cardiomyogenesis”

The cellular microenvironment consists of soluble and insoluble factors that provide signals that dictate cell behavior and cell fate. Limited characterization has hindered our ability to mimic the physiological or pathophysiological environment. While stem cells have vast promise in the areas of regenerative medicine and disease therapy, harnessing this potential remains elusive due to our limited understanding of differentiation mechanisms. Similarly, many in vitro cardiac disease models lack the critical structure- function relationships of healthy and diseased cardiac tissue. The goal of this work is to induce cardiomyogenesis and pathogenesis in vitro by recapitulating features of the native microenvironment during development and disease.
Engineering and Applied Sciences

Ex vivo cardiomyocytes production from pluripotent stem cells is highly attractive as a future clinical therapy for cardiovascular diseases. Scaled-up 3-dimensional cell culture can be used to produce clinically relevant cell numbers but requires numerous bioprocess design considerations. In this thesis, we employed hydrogel encapsulation of mouse embryonic stem cells (mESCs) to study various novel design parameters that could be used for large-scale cardiomyocyte production. First, we demonstrated that our novel rotary, perfused bioreactor provided a dynamic and perfused environment that was superior to a commercial rotary wall bioreactor and conventional tissue culture vessels in terms of cell numbers and cardiac differentiation. With this novel bioreactor, we had also investigated the effects of pH on cardiomyogenesis. Cardiomyogenesis was found to be sensitive to different pH values, where slight fluctuations could cause significant changes to cell proliferation and cardiac differentiation. Last but not least, we utilised ultrasound as a novel mechanical stimulus for cardiac differentiation of mESCs and demonstrated its benefits in improving cardiomyocyte yield.

Cardiovascular diseases contribute a large amount of morbidity and mortality in developing and developed countries all around the world. In conditions such as the myocardial infarction, a significant amount of cardiomyocytes die leading to an impaired function of the heart. One promising method for replacing these cardiomyocytes would be with the use of cardiomyocytes derived from embryonic stem cells. However, a large number of cardiomyocytes and a highly efficient method for obtaining cardiomyocytes are needed. Using the principles of small molecule treatment to induce differentiation in a serum-free based differentiation protocol, I have demonstrated that the induction of canonical Wnt signalling via CHIR 99021, and subsequent addition of bone morphogenetic protein 4 was best able to induce cardiomyogenesis in mouse embryonic stem cells. While improvements in efficiency are still required, the manipulation of the Wnt and BMP4 signalling pathways hold great promise in improving cardiomyogenesis in mESCs.

Cardiovascular diseases are among the leading causes of death in North America. Currently, there are no effective treatment options for directly repairing the damaged myocardial tissue. Therefore, cell-based therapies utilizing cardiomyocytes generated from stem cells to replace necrotic tissue will be a promising approach. However, the molecular mechanisms regulating stem cell differentiation into cardiomyocytes are not fully understood. Since GATA-4 is one of the primary regulators of cradiomyogenesis, we investigated the molecular basis of GATA-4 expression during the early stages of stem cell differentiation. Using chromatin immunoprecipitation, we have observed the direct involvement of p300 in GATA-4 gene expression. We have also examined the importance ofhHistone acetylation and acetyltransferase activity on GATA-4 expression during the early stage of cardiomyogensis using the histone deactylase inhibitor Valproic Acid and the acetyltransferase inhibitor Curcumin respectively.

The application of cellular therapies for the treatment of myocardial infarction has provided encouraging evidence for the possibility of cellular therapies to restore normal heart function. However, questions still remain as to the optimal cell source, pre-conditioning methods and delivery techniques for such an application. Here I propose the use of a unique population of stem cells arising from the embryonic neural crest. These cells were shown to express neural crest markers as well as pluripotency-associated markers. Furthermore, the cells were shown to express proteins essential to the formation of gap junctions and to possess a cardiomyogenic differentiation potential by several means. Furthermore, I explore the use of mechanical strain as an inducer of cardiomyogenesis and possibly pre-conditioning stimulus for the better engraftment of the cells while in the heart. Mechanical strain was shown to elicit a cardiomyogenic response from the cells following just a couple of hours of stimulation. The mode in which mechanical strain elicited these responses was demonstrated to be via the mediation of the reactive oxygen species (ROS) pathways. Given the results presented here, the use of these periodontal ligament-derived stem cells (PDLSC) in combination with mechanical strain preconditioning of the cells prior to their delivery into the heart may pose a valuable alternative for the treatment of myocardial infarction and merits further exploration for its capacity to augment the already observed beneficial effects of cellular therapies.

RhoA is a small GTPase that acts as a molecular switch to control a variety of signal transduction pathways in eukaryotes. From an initial established role in the regulation of the actin cytoskeleton, RhoA has now been implicated in a range of functions that include gene transcription and regulation of cell morphology. In earlier studies from this laboratory that employed differential display and in situ hybridisation, RhoA was indicated as being up-regulated during the stages of early heart development in the developing chick embryo. Given the important effects of RhoA on both gene expression and morphology in other systems, it was hypothesised that RhoA plays a central role in the molecular mechanisms controlling cardiogenesis. This thesis describes investigations undertaken to elucidate the role of RhoA in these processes. As an initial approach to corroborate the earlier gene expression findings and provide further evidence for a role in tissue developmental mechanisms, RhoA proteins levels in the developing chick embryo were analysed using immunocytochemistry. These experiments demonstrated that RhoA is most abundant in heart-forming regions, findings compatible with the earlier gene expression studies and the proposed role of this protein in early heart development. Preliminary studies from this laboratory had also suggested that chick RhoA is expressed as different length mRNA transcripts that vary only in the 3' untranslated region (UTR). This thesis presents additional evidence for the existence of these different RhoA transcripts from experiments using Northern hybridisation and RT-PCR analyses. These analyses also serve to demonstrate that the second shortest RhoA transcript (designated RhoA2) is the most abundant transcript in developing heart tissue, in contrast to the situation in other embryonic tissues, findings that could be taken to suggest a possible role for this 3'UTR in developmental mechanisms that is yet to be elucidated. One potentially informative approach for testing the function of a protein in a biological system is to inhibit its expression and/or activity and observe the changes induced. The effects of inhibiting RhoA in early heart development and early organogenesis in the chick embryo model were investigated using small interfering RNAs (siRNA). Reduction in RhoA expression by siRNA treatment, as confirmed by real-time PCR, resulted in loss of heart tube fusion and abnormal head development, the former result providing further direct evidence of a role for RhoA in heart developmental processes. In order to investigate the function of RhoA specifically during the process of cardiomyocyte differentiation, an inducible model of cardiomyogenesis, P19CL6 cells, was used in combination with over-expression of different forms of mouse RhoA. The striking result from these investigations was that over-expression of the dominant negative mutant of mouse RhoA (mRhoAN19) prevented the differentiation of induced P19CL6 cells to the cardiomyocyte phenotype, results consistent with an essential role for RhoA in this cellular transition. The mechanism by which RhoA mediates its different cellular functions is unclear, however some studies have implicated RhoA in the regulation of transcription factors. To investigate such a mechanism as a possible explanation for the requirement of RhoA in cardiomyocyte differentiation, the P19CL6 inducible cell system over-expressing different forms of RhoA was analysed through real-time PCR to quantify the levels of transcription of genes known to play an important role in early heart development. These investigations indicated that RhoA inhibition causes an accumulation of the cardiac transcription factors SRF and GATA4 and the early cardiac marker cardiac-cx-actin. The expression of a protein is controlled by, among other factors, regulatory proteins that control transcription. To investigate factors in heart that potentially regulate RhoA expression at the molecular level, the chick RhoA gene organisation was analysed. The gene was shown to contain three introns that interrupt the protein coding sequence and at least one intron in the 5'UTR. Comparative RhoA gene studies indicated both an almost identical organisation and coding sequence of the chick, mouse and human RhoA genes, indicative of strict conservation of this gene during evolution. The putative promoter region of RhoA was predicted by computer analyses and tested for promoter activity using luciferase reporter analyses in non-differentiated and differentiated cardiomyocytes, using the inducible P19CL6 cell system. These investigations served to define a putative core promoter region that exhibited significantly higher promoter activity in differentiated cardiomyocytes than in non-differentiated cells, and other elements upstream of this core region that appear to be required for transcriptional regulation of RhoA. The majority of the consensus transcription factor sites identified in this putative promoter have been previously implicated in either heart development and/or organogenesis. These results therefore provide further, although indirect, evidence for an important role for RhoA in the molecular mechanisms controlling both cardiogenesis and embryogenesis in general. In summary, this thesis provides novel information on the role of RhoA in the processes of cardiogenesis and provides a firm foundation for continuing investigations aimed at elucidating the molecular basis of this contribution.

The Hedgehog (Hh) signalling pathway is one of the key signalling pathways orchestrating intricate organogenesis, including the development of neural tube, heart and skeletal muscle. Yet, insufficient mechanistic understanding of its diverse roles is available. Here, we show the molecular mechanisms regulating the neurogenic, cardiogenic and myogenic properties of Hh signalling, via effector protein Gli2, in embryonic and adult stem cells. In Chapter 2, we show that Gli2 induces neurogenesis, whereas a dominant-negative form of Gli2 delays neurogenesis in P19 embryonal carcinoma (EC) cells, a mouse embryonic stem (ES) cell model. Furthermore, we demonstrate that Gli2 associates with Ascl1/Mash1 gene elements in differentiating P19 cells and activates the Ascl1/Mash1 promoter in vitro. Thus, Gli2 mediates neurogenesis in P19 cells at least in part by directly regulating Ascl1/Mash1 expression. In Chapter 3, we demonstrate that Gli2 and MEF2C bind each other’s regulatory elements and regulate each other’s expression while enhancing cardiomyogenesis in P19 cells. Furthermore, dominant-negative Gli2 and MEF2C proteins downregulate each other’s expression while imparing cardiomyogenesis. Lastly, we show that Gli2 and MEF2C form a protein complex, which synergistically activates cardiac muscle related promoters. In Chapter 4, we illustrate that Gli2 associates with MyoD gene elements while enhancing skeletal myogenesis in P19 cells and activates the MyoD promoter in vitro. Furthermore, inhibition of Hh signalling in muscle satellite cells and in proliferating myoblasts leads to reduction in MyoD and MEF2C expression. Finally, we demonstrate that endogenous Hh signalling is important for MyoD transcriptional activity and that Gli2, MEF2C and MyoD form a protein complex capable of inducing skeletal muscle-specific gene expression. Thus, Gli2, MEF2C and MyoD participate in a regulatory loop and form a protein complex capable of inducing skeletal muscle-specific gene expression. Our results provide a link between the regulation of tissue-restricted factors like Mash1, MEF2C and MyoD, and a general signal-regulated Gli2 transcription factor. We therefore provide novel mechanistic insights into the neurogenic, cardiogenic and myogenic properties of Gli2 in vitro, and offer novel plausible explanations for its in vivo functions. These results may also be important for the development of stem cell therapy strategies.

The Hedgehog (HH) signalling pathway and its primary transducer, GLI2, regulate cardiomyogenesis in vivo and in differentiating P19 embryonal carcinoma (EC) cells. To further assess the role of HH signalling during mouse embryonic stem (mES) cell differentiation, we studied the effects of GLI2 overexpression during mES cell differentiation. GLI2 overexpression resulted in temporal enhancement of cardiac progenitor genes, Mef2c and Nkx2-5, along with enhancement of Tbx5, Myhc6, and Myhc7 in day 6 differentiating mES cells. Mass spectrometric analysis of proteins that immunoprecipitate with GLI2 determined that GLI2 forms a complex with BRG1 during mES cell differentiation. Furthermore, modulation of HH signalling during P19 EC cell differentiation followed by chromatin immunoprecipitation with an anti-BRG1 antibody determined that HH signalling regulates BRG1 enrichment on Mef2c. Therefore, HH signalling accelerates cardiac progenitor gene expression during mES cell differentiation potentially by recruiting a chromatin remodelling factor to at least one cardiac progenitor gene.

Myocardial Infarction (MI) is one of the most prevalent and deadliest diseases in the United States. Since the host myocardium becomes irreversibly damaged following MI, current research is focused on identification of novel, less invasive, and more effective treatment options for patients. Cellular cardiomyopathy, in which viable cells are transplanted into the necrotic tissue, has the potential to regenerate and integrate with the host myocardium. Stem cells, specifically pluripotent stem cells such as embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSC), are ideal candidates for this procedure because they are pluripotent; however, ESCs must be predifferentiated to avoid teratoma formation in vivo. In this dissertation, our goal was improve upon current protocols to direct differentiation of ESCs into cardiomyocytes using an embryoid body (EB) model. We immobilized pro-cardiomyogenic proteins, specifically Sonic Hedgehog (SHH) and Bone Morphogenetic Protein 4 (BMP4) to paramagnetic beads and delivered them in the interior of the EB. While lineage commitment was indiscriminate, the presence of the beads alone appeared to guide differentiation into cardiomyocytes: there were significantly more contracting areas in EBs containing beads than in the presence of SHH or BMP4. To take advantage of this result, we immobilized Arginine-Glycine-Aspartic Acid (RGD) peptides to the beads and magnetized them following incorporation into the EB. Magnetically mediated strain increased the expression of mechanochemical markers, and in combination with BMP4 increased the percentage of cardiomyocytes. Finally, PEGylated fibrin gels were used to investigate the effect of seeding method and fibrinogen concentration on cardiomyocyte behavior and maturation. Cells seeded on top of compliant hydrogels had the most contracting regions compared to stiffer PEGylated fibrin gels, whereas cardiomyocytes seeded within the hydrogels could not remodel the matrix or maintain contractility. As an alternative to 3D culture, we seeded cardiomyocytes within gel layers, which maintained viability as well as contractile activity. We observed that PEGylated fibrin gels can maintain ESC-derived cardiomyocytes; however, the ratio of cardiomyocytes and non-cardiomyocytes should be optimized to maintain contractile phenotypes. Therefore, this dissertation presents novel methods to differentiate ESCs into cardiomyocytes, and subsequently promote their maturation in vitro, for the treatment of MI.
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碩士
國立陽明大學
生物醫學工程學系
103
Mechanical properties is known to have impact on cell proliferation and differentiation, and silk fibroin (SF) (S) crystallinity (C) is the key factor that influence Young’s modulus of SF. Whether effects of silk fibroin crystallinity on the proliferation and cardiomyogenesis of human bone marrow-derived mesenchymal stem cell (hBMSC) has not been reported. To investigate, poly (ε-caprolactone) (PCL) P, PSC20%, PSC30%, PSC37%, PSC44% cardiac patches, fabricated by a photochemical technique, were applied to culture hBMSC on the patches for in-vitro proliferation and cardiomyogenesis of the cells after they were induced by 5-aza for ten days. The crystallinity of SF was determined by FTIR-ATR, analyzed by Fourier-deconvolution method. AFM and SEM images were used for comparing the surface morphology of different cardiac patches. And Young’s modulus of these patches were determined by universal material machine. Results showed that the higher the crystallinity, the stronger Young’s modulus will be. Proliferations and cardiomyogenesis of hBMSC were determined by MTS assay, and immunofluorescence stains of cytoskeletal-actin, focal adhesion protein-paxillin and cardiac proteins including connexin 43 (CX43), α-actin and troponin T (cTNT), respectively. After 12 hours cultivation, spheroid formations of hBMC on both PSC20%, PSC30% patches were observed, while there were only monolayer cells on PSC37% and PSC44% patches. Besides immunofluorescence stains for cytoskeletal and focal adhesion protein showed that monolayer cells had higher expressions of actin and paxillin, indicating better adhesion of hBMSC. But for those cardiac proteins, spheroids on PSC20%, PSC30% showed significant higher expressions or better cardiomyogenesis. Adjusting SF mechanical properties by altering the crystallinity, we can guide hBMSC morphology from monolayer to spheroids. Moreover, PSC20% and PSC30% patches can induce spheroids formation and further promote better in-vitro cardiomyogenesis of the cells.

Traditionnellement associée à la reproduction féminine, l'ocytocine (OT), une hormone peptidique synthétisée par les noyaux paraventriculaire et supraoptique de l'hypothalamus et sécrétée par l'hypophyse postérieure (neurohypophyse), a été récemment revue et a été démontrée avoir plusieurs nouveaux rôles dans le système cardio-vasculaire. En effet, notre laboratoire a montré que l’OT peut induire la différenciation des cellules souches embryonnaires (CSE) en cardiomyocytes (CM) fonctionnels. À l’aide du modèle cellulaire embryonnaire carcinomateux de souris P19, il a été démontré que ce processus survenait suite à la libération de la guanosine monophosphate cyclique (GMPc) dépendante du monoxyde d’azote. De même, il est connu que le peptide natriurétique auriculaire (ANP), un peptide produit, stocké et sécrété par les myocytes cardiaques, peut aussi induire la production du GMPc. De nombreuses études ont démontré que le cœur ayant subi un infarctus pouvait être régénéré à partir d’une population isolée de cellules souches et progénitrices transplantées. Une de ces populations de cellules, fréquemment isolées à partir d'organes provenant d'animaux aux stades de développement embryonnaire et adulte, appelée « Side Population » (SP), sont identifiées par cytométrie en flux (FACS) comme une population de cellules non marquées par le colorant fluorescent Hoechst 33342 (Ho). Les cellules SP expriment des protéines de transport spécifiques, de la famille ATP-binding cassette, qui ont pour rôle de transporter activement le colorant fluorescent Ho de leur cytoplasme. La sous-population de cellules SP isolée du cœur affiche un potentiel de différenciation cardiaque amélioré en réponse à un traitement avec l’OT. Récemment, l'hétérogénéité phénotypique et fonctionnelle des CSE a été mise en évidence, et cela a été corrélé avec la présence de sous-populations cellulaires ressemblant beaucoup aux cellules SP issues du cœur. Puisque l’ANP peut induire la production du GMPc et qu’il a été démontré que la différenciation cardiaque était médiée par la production du GMPc, alors nous émettons l'hypothèse selon laquelle l’ANP pourrait induire la différenciation cardiaque. Étant donné que les CSE sont composés d’un mélange de différents types cellulaires alors nous émettons aussi l’hypothèse selon laquelle l’utilisation d’une sous-population de CSE plus homogène renforcerait le potentiel de différenciation de l'ANP. Méthodes : Les SP ont été isolées des cellules P19 par FACS en utilisant la méthode d’exclusion du colorant fluorescent Ho. Puis, leur phénotype a été caractérisé par immunofluorescence (IF) pour les marqueurs de l’état indifférencié, d’auto-renouvellement et de pluripotence octamer-binding transcription factor 4 (OCT4) et stage-specific embryonic antigen-1 (SSEA1). Ensuite, la dose pharmacologique optimale d’ANP a été déterminée via des tests de cytotoxicité sur des cellules P19 (MTT assay). Pour induire la différenciation en cardiomyocytes, des cellules à l’état de sphéroïdes ont été formées à l’aide de la technique du « Hanging-Drop » sous la stimulation de l’ANP pendant 5 jours. Puis, des cryosections ont été faites dans les sphéroïdes afin de mettre en évidence la présence de marqueurs de cellules cardiaques progénitrices tels que GATA4, Nkx2.5 et un marqueur mitochondrial spécifique Tom22. Ensuite, les cellules SP P19 ont été stimulées dans les sphéroïdes cellulaires par le traitement avec de l'ANP (10-7 M) ou de l’OT (10-7 M), de l’antagoniste spécifique du guanylate cyclase particulé (GCp) A71915 (10-6 M), ainsi que la combinaison des inducteurs OT+ANP, OT+A71915, ANP+A71915. Après la mise en culture, la différenciation en cardiomyocytes a été identifié par l’apparition de colonies de cellules battantes caractéristiques des cellules cardiaques, par la détermination du phénotype cellulaire par IF, et enfin par l’extraction d'ARN et de protéines qui ont été utilisés pour le dosage du GMPc par RIA, l’expression des ARNm par RT-PCR et l’expression des protéines par immunobuvardage de type western. Résultats : Les sphéroïdes obtenus à l’aide de la technique du « Hanging-Drop » ont montré une hausse modeste de l’expression des ARNm suivants : OTR, ANP et GATA4 comparativement aux cellules cultivées en monocouches. Les sphéroïdes induits par l’ANP ont présenté une augmentation significative des facteurs de transcription cardiaque GATA4 et Nkx2.5 ainsi qu’un plus grand nombre de mitochondries caractérisé par une plus grande présence de Tom22. De plus, L’ANP a induit l’apparition de colonies de cellules battantes du jour 7 (stade précoce) au jour 14 (stade mature) de façon presque similaire à l’OT. Cependant, la combinaison de l’ANP avec l’OT n’a pas induit de colonies de cellules battantes suggérant un effet opposé à celui de l’OT. Par IF, nous avons quantifié (nombre de cellules positives) et caractérisé, du jour 6 au jour 14 de différenciation, le phénotype cardiaque de nos cellules en utilisant les marqueurs suivants : Troponine T Cardiaque, ANP, Connexines 40 et 43, l’isoforme ventriculaire de la chaîne légère de myosine (MLC-2v), OTR. Les SP différenciées sous la stimulation de l’ANP ont montré une augmentation significative du GMPc intracellulaire comparé aux cellules non différenciées. À notre grande surprise, l’antagoniste A71915 a induit une plus grande apparition de colonies de cellules battantes comparativement à l’OT et l’ANP à un jour précoce de différenciation cardiaque et l’ajout de l’OT ou de l’ANP a potentialisé ses effets, augmentant encore plus la proportion de colonies de cellules battantes. De plus, la taille des colonies de cellules battantes était encore plus importante que sous la simple stimulation de l’OT ou de l’ANP. Les analyses radioimmunologiques dans les cellules SP P19 stimulés avec l’ANP, A71915 et la combinaison des deux pendant 15min, 30min et 60min a montré que l’ANP stimule significativement la production du GMPc, cependant A71915 n’abolit pas les effets de l’ANP et celui-ci au contraire stimule la production du GMPc via des effets agonistes partiels. Conclusion : Nos résultats démontrent d’une part que l’ANP induit la différenciation des cellules SP P19 en CM fonctionnels. D’autre part, il semblerait que la voie de signalisation NPRA-B/GCp/GMPc soit impliquée dans le mécanisme de différenciation cardiaque puisque l’abolition du GMPc médiée par le GCp potentialise la différenciation cardiaque et il semblerait que cette voie de signalisation soit additive de la voie de signalisation induite par l’OT, NO/GCs/GMPc, puisque l’ajout de l’OT à l’antagoniste A71915 stimule plus fortement la différenciation cardiaque que l’OT ou l’A71915 seuls. Cela suggère que l’effet thérapeutique des peptides natriurétiques observé dans la défaillance cardiaque ainsi que les propriétés vasodilatatrices de certains antagonistes des récepteurs peptidiques natriurétiques inclus la stimulation de la différenciation des cellules souches en cardiomyocytes. Cela laisse donc à penser que les peptides natriurétiques ou les antagonistes des récepteurs peptidiques natriurétiques pourraient être une alternative très intéressante dans la thérapie cellulaire visant à induire la régénération cardiovasculaire.
Traditionally associated with female reproduction, oxytocin (OT), a peptidic hormone synthesized in the paraventricular and supraoptic nuclei of the hypothalamus and secreted by the posterior pituitary (neurohypophysis), was revisited recently and was revealed to have several new roles in the cardiovascular system. Indeed, our laboratory has shown that OT can induce the differentiation of embryonic stem cells (ESC) into functional cardiomyocytes (CM). On the model of embryonal carcinoma cell line P19, it has been shown that this process occurs following the release of cyclic guanosine monophosphate (cGMP)-dependent nitric oxide. Similarly, it is known that atrial natriuretic peptide (ANP), a peptide produced, stored and secreted by cardiac myocytes, can also induce the release of cGMP. However, the cellular mechanisms involved in cardiac differentiation are still poorly understood. Numerous studies have shown that the injured heart can be regenerated from an isolated population of transplanted stem and progenitor cells. One of these cell populations, frequently isolated from embryonic and adult animal organs, called "Side Population" (SP), is characterized by active efflux of the fluorescent dye Hoechst 33342 (Ho). SP cells express specific ATP-binding cassette transporter proteins which actively transport Ho out of their cytoplasm. The SP cell subpopulation isolated from the heart display enhanced differentiation potential into cardiac phenotype in response to OT treatment. Recently, the phenotypic and functional heterogeneity of embryonic stem cells has been demonstrated, and this was correlated with the presence of cell subpopulations much like the SP cells from the heart and these cells can be identified by flow cytometry (FACS) as a population of unmarked cells by the Ho and which exhibit sensitivity to the inhibitor of the family of ATP-binding cassette ABC, verapamil. Thus, the SP from ESC could be a good candidate to induce cell differentiation more effectively to the cardiac phenotype. Since ANP can induce the release of cGMP and it has been shown that cardiac differentiation was mediated by the release of cGMP through the nitric oxide (NO), then we therefore formulate the hypothesis that ANP could also induce cardiac differentiation. Since ESC are composed of a mixture of different cell types so as we emit the hypothesis that the use of a subpopulation of more homogeneous ESC strengthen the differentiation potential of ANP. Methods: SP were isolated from P19 cells by FACS using the method of exclusion of fluorescent dye Hoechst and their phenotype was characterized by immunofluorescence (IF) for markers of the undifferentiated state, self-renewal and pluripotency OCT4 and SSEA1. Then, the optimal pharmacological dose of ANP was determined via cytotoxicity tests in P19 cells (MTT assay). For cardiac differentiation, cells in the form of spheroids were formed using the technique of "Hanging Drop" under the stimulation of ANP for 5 days. Then cuts were made in the spheroids via cryosection to highlight the presence of cardiac progenitor cell markers such as GATA4, Nkx2.5 and a specific mitochondrial marker Tom22. Next, the P19-SP cells were stimulated in cell spheroids by the treatment with ANP (10-7 M) or OT (10-7 M), the specific antagonist of particulate guanylate cyclase A71915 (10-6 M), and the combination of the inducers OT + ANP, OT + A71915, A71915 + ANP. After cell plating, the differentiation into cardiomyocytes has been identified by the appearance of beating cell colonies characteristics of contractile cardiac cells, by determining the cellular phenotype by IF, and finally by the extraction of RNA and proteins that were used for the determination of cGMP by RIA, the mRNA expression by RT-PCR and protein expression by western blotting. Results: The spheroids induced by ANP showed a significant increase in the presence of cardiac transcription factors GATA4 and Nkx2.5 as well as a greater number of mitochondria characterized by a greater presence of Tom22 compared with no induced cells suggesting a cardiomyogenic effect of ANP. In addition, ANP induced the appearance of beating cell colonies from day 7 (early stage) to day 14 (mature stage) similarly to OT. However, the combination of ANP with OT did not induce beating cell colonies suggesting a negative additive effect on cardiomyogenesis. The spheroids, obtained using the technique of "Hanging Drop", have shown a modest increase in mRNA expression as follows: OTR, ANP and GATA4 compared to cells grown in monolayers. By IF, we quantified (number of positive cells) and characterized, from day 6 to day 14 of differentiation, the cardiac phenotype of our cells using the following markers: Cardiac Troponin T, ANP, Connexines 40 and 43, Myosin Light Chain-2V, OTR. The SP differentiated under the stimulation of ANP showed a significant increase in intracellular cGMP compared with undifferentiated cells. Surprisingly, the antagonist A71915 induced a greater appearance of beating cell colonies compared to OT and ANP in early day of cardiac differentiation and the addition of OT or ANP potentiated its effects, further increasing the proportion of beating cells colonies. In addition, the size of beating cell colonies was even greater than under the simple stimulation of OT or ANP. Radioimmunoassay analysis in SP P19 cells stimulated with ANP, A71915 and the combination of both during 15min, 30min and 60min showed that ANP significantly stimulates the release of cGMP, however, A71915 does not abolish the effects of ANP and it rather stimulates the release of cGMP through partial agonist effects. Conclusion: Our results demonstrate firstly that ANP induces the differentiation of P19-SP cells into functional CM. Moreover, it appears that the signaling pathway NPRA-B/pGC/cGMP seems to be involved in the mechanism of cardiac differentiation since the abolition of cGMP mediated by the pGC potentiates cardiac differentiation and it appears that this signaling pathway is additive to the signaling pathway induced by OT, NO/sGC/cGMP, since the addition of OT to the antagonist A71915 stimulates cardiac differentiation more strongly than OT or A71915 alone. This suggests that the therapeutic effect of natriuretic peptides observed in heart failure and vasodilatory properties of certain natriuretic peptide receptor antagonists included the stimulation of stem cell differentiation into cardiomyocytes. This would therefore suggest that the natriuretic peptides or natriuretic peptide receptor antagonists could be an attractive alternative to cell therapy to induce heart regeneration.