Promising results from two of the first patients to get the treatment suggest that the muscle ‘patches’ survive well and improve the heart’s function.
“This exciting study is an outstanding example of how years of dedicated research is helping to mend broken hearts,” said Professor James Leiper, director of research at the British Heart Foundation. “These early results are promising.”
Heart disease is one of the leading causes of death. While there are some effective treatments, many people who have heart attacks eventually experience the organ becoming weaker over the years, in a condition called heart failure.
The answer, some scientists have said, lies in stem cells, an unusual kind of cell with regenerative potential. The idea is to use them to rebuild cardiac muscle damaged by heart attacks, potentially reversing heart failure or even stop it from developing.
Stem cells, in contrast, are unspecialised, like the immature cells of early embryos. They can be turned into different tissues in the lab by manipulating them with biochemicals. The hope is that we could use stem cells to regrow damaged parts of the body – like heart muscle.
Bone marrow stem cells have been turned into treatments for a few other conditions, such as leukaemia. Unfortunately, they don’t work for heart disease. Some of the papers describing the heart treatment experiments were found to contain faked data, in investigations by bodies including Harvard Medical School.
Embryo-like cells turned into heart muscle
But the new approach is different. Unlike in past work, the scientists have taken cells from an adult and “reprogrammed” them into an immature embryo-like state, before coaxing them to become heart muscle cells.
“We now have, for the first time, a laboratory grown biological transplant available which has the potential to stabilise and strengthen the heart muscle,” said Professor Wolfram-Hubertus Zimmermann, a heart surgeon at the University Medical Center Göttingen in Germany, who helped to develop the patches.
Although the full results from the trial have not yet been released, the doctors announced in March that the first patient to get 10 patches, a 66-year-old called Frank Teege, had better heart function two years after the operation.
He has continued to improve since then, Professor Zimmermann told The i Paper. “Our hypothesis is that the muscle contributes to the contractile performance of the heart,” he said.
Several patches are stitched together before being sewn on to the patient’s heart (Photo: University Hospital Schleswig-Holstein)In 2021, she was put on a waiting list for a heart transplant as she was considered terminally ill. While on the list, she received the heart patch treatment, but after three months a suitable donated heart became available and she accepted.
But the transplant did mean the scientists could examine her original heart, to see how the patches had fared. They were found to be functioning well and blood vessels had grown into them. “This is one case report where we really could see that the patches survived, and we saw vital [heart muscle cells], and this was quite promising,” said Dr Ingo Kutschka, also at University Medical Center Göttingen.
Heart stem cells the ‘Wild West’ of research
The results from the team’s experiments on monkeys, which had been done before the human trial could begin, have also now been made available – but these are more equivocal.
This means it is unclear how well the treatment works, said Professor Charles Murry, a stem cell researcher at the University of Southern California, who was not involved in the trial. “It is mysterious to me why some of the animals don’t respond,” he said. “We would like them all to respond.”
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Read More“Further clinical trials in larger numbers of patients are needed to determine the effectiveness of the heart patch,” said Professor Leiper. “If these are positive, it could help to usher in a new era of heart failure treatment.”
“This has been the Wild West of a field. People went to the clinic way too soon with crazy things like bone marrow cells that had no chance,” he added
“I get that people are frustrated, and they are like, ‘Haven’t we tried this already?’ And the answer is, ‘No, not for real. This field is just coming online.”
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