A new study based on the practical application of stem cell research offers hope for the treatment of heart disease. In addition, if the initial results of this study are confirmed, its findings can be applied for the treatment of several other serious diseases. In the study, heart failure patients who were given adult stem cells taken from their own bodies showed dramatic and lasting improvement of their condition.
Embryonic stem cells are cells that have the ability to divide for indefinite periods in culture, and to give rise to specialized cells (such as heart muscle cells, blood cells or nerve cells) under certain physiologic or experimental conditions. Adult stem cells, also called somatic stem cells, can be found in many organs and tissues in the body.
The study involved 16 patients, and used adult cardiac stem cells which had been collected from the patients’ hearts during coronary bypass surgery. The cells thus obtained were purified and prepared for infusing them back into the damaged tissue.
Although bone marrow stem cells --which are much easier to extract and prepare-- had been used in other studies to reverse the damage caused by heart attacks, they were not as effective as cardiac stem cells.
Fourteen patients in the study who showed a good response to the treatment had an increase in their heart blood-pumping capacity from 30.3 percent before the treatment to 38.5 percent afterward the treatment. Seven patients out of those 14 underwent also magnetic resonance imaging (MRI) which showed that there was less dead heart muscle tissue one year after the treatment than before.
Dr. Roberto Bolli, director of cardiology at University of Louisville and lead author of the study published in The Lancet, considers this one of the biggest advances in cardiology in his lifetime. What is particularly important in this study is that the positive results are caused by the fact that it addressed the fundamental problem, replacing dead tissue with new cardiac muscle, according to Bolli. Seven control patients in the study who didn’t receive the stem cell treatment showed no improvement in their condition.
Dr. Bolli also indicated that this procedure may also benefit patients whose heart damage was up to three and a half years old. Another advantage of this procedure is that the quantity of cells need for the procedure - estimated in between one to two million - can be prepared from a heart biopsy, eliminating the need for surgery.
The cells obtained from biopsy can then be re-infused back into the heart through a catheter while the patient is awake. Another advantage of the use of adult stem cells is that they are less likely to be rejected by the immune system of the patient. This is a considerable benefit since immune rejection needs to be circumvented by immunosuppressive drugs which may cause serious side effects on the patients.
Mike Jones, who suffered a massive heart attack in 2004, and who was the first patient to receive this treatment in July 2009, stated that the procedure not only gave him more years to live but also a better quality of life.
Although there was considerable optimism with these results some experts expressed caution. One of them, Dr. Peter Weissberg, medical director of the British Heart Foundation, told the BBC that although these results were encouraging they still need to be confirmed in the final completed trial, and that it was still necessary to understand the mechanism that is producing the effect.
Cardiovascular disease (CVD), which includes hypertension, coronary heart disease, stroke and congestive heart failure, has ranked as the number one cause of death since the early 1900s. It is estimated that approximately 2,600 Americans die of CVD each day. Given the aging of the population and the dramatic increases in other diseases such as obesity and type 2 diabetes, CVD will increasingly become a serious health concern. In this context, the benefits of this new procedure should not be underestimated.
Cesar Chelala, MD, PhD, carried out research in molecular genetics at The Public Health Research Institute of the City of New York.