First successful human stem cell treatment for heart disease uses adult stem cells
The first reports of successful treatment for heart disease using the patient’s own adult muscle stem cells after heart attack are encouraging news. French physicians implanted skeletal muscle stem cells back into the patient; the encouraging result after eight months’ follow-up underlines the potential of this new approach. Further clinical trials are now underway in Europe and the U.S. for other patients with heart disease. No human trials using embryonic stem cells have ever been reported.
A review of potential heart treatments notes that cell transplantation is a potential therapeutic approach for patients with chronic heart failure. Experimental transplantation of muscle cells showed that the grafted cells can functionally integrate with and augment the function of the recipient heart. The scientists note that skeletal muscle stem cells are abundant and can be grafted successfully into the animal’s own heart even after genetic manipulation in vitro.1, Arch Mal Coeur Vaiss 94(3), 180-182, March 2001; “Doctor Puts Arm Muscle Cells Into Patient’s Heart, Associated Press, May 30, 2001; “First Percutaneous Endovascular Case of Heart Muscle Regeneration Completed with Bioheart’s MyoCell(TM) Product, PRNewswire, May 30, 2001; R.M. El Oakley et al., “Myocyte transplantation for cardiac repair: A few good cells can mend a broken heart, Annals of Thoracic Surgery 71, 1724 –1733, 2001.]
Adult stem cells from bone marrow form heart muscle, blood vessels
Researchers at Baylor College of Medicine have shown that adult bone marrow stem cells can form functional heart muscle and blood vessels in mice with heart damage. They note that their results demonstrate the potential of adult bone marrow stem cells for heart repair, and suggest a therapeutic strategy that eventually could benefit patients with heart attacks. Their results also suggest that circulating stem cells may naturally contribute to repair of tissues in adult humans.
In another study, NIH researchers injected adult bone marrow stem cells into an area of the heart where damage had been induced in mice. Newly formed heart tissue occupied 68% of the damaged portion of the ventricle nine days after transplanting the bone marrow cells. The studies indicate that locally delivered bone marrow cells can generate new heart tissue, decreasing the damage of coronary artery disease.
Columbia University scientists have implanted human bone-marrow-derived stem cells into rats with cardiac damage. The cells participated in formation of new cardiac blood vessels and stimulated existing vessels. The authors note that the use of human bone marrow from patients themselves to repair damage from heart attack has the potential to significantly reduce disease and death associated with heart disease.
Researchers in Canada have shown that adult bone marrow stem cells (“stromal” cells) can incorporate into heart muscle tissue in rats, using the rats’ own cells. The scientists said: “Because marrow stromal cells can be obtained repeatedly by bone marrow aspiration and expanded vastly in vitro before being implanted or used as autologous [same patient] implants, and because their use does not call for immunosuppression, the clinical use of marrow stromal cells for cellular cardiomyoplasty [heart tissue regeneration] appears to be most advantageous.”
In another animal study, when compared to fetal heart cells, the adult stem cells were equally good at repairing heart damage. The authors point out that they also have the advantage of being obtainable from the patients themselves, preventing transplant rejection complications.2
Adult stem cells from liver form heart tissue
Scientists at Duke University Medical Center have shown that adult stem cells from liver can transform into heart tissue when injected into mice. They say that “Recent evidence suggests that adult-derived stem cells, like their embryonic counterparts, are pluripotent”, and that “These results demonstrate that adult liver-derived stem cells respond to the tissue microenvironment of the adult heart in vivo and differentiate into mature cardiac myocytes.”3
Heart tissue may be regenerated from a heart stem cell
Researchers at New York Medical College, Valhalla, NY, report results that show regeneration of heart muscle is possible after heart attack. The research indicates that the heart may contain its own adult stem cell, which could possibly be stimulated to grow and repair damage after a heart attack.4
- P. Menasché et al., “Myoblast transplantation for heart failure, Lancet 357, 279-280, January 27, 2001; P. Menasché et al., [“Autologous skeletal myoblast transplantation for cardiac insufficiency. First clinical case (article in French) ↩
- K.A. Jackson et al., “Regeneration of ischemic cardiac muscle and vascular endothelium by adult stem cells, Journal of Clinical Investigation 107, 1395-1402, June 2001; N.N. Malouf et al., “Adult-derived stem cells from the liver become myocytes in the heart in vivo,” American Journal of Pathology 158, 1929-1935, June 2001; D. Orlic et al., “Bone marrow cells regenerate infarcted myocardium,” Nature 410, 701-705, April 5, 2001; A.A. Kocher et al., “Neovascularization of ischemic myocardium by human bone-marrow-derived angioblasts prevents cardiomyocyte apoptosis, reduces remodeling and improves cardiac function,” Nature Medicine 7, 430-436, April 2001; J.S. Wang, et al., “Marrow stromal cells for cellular cardiomyoplasty: feasibility and potential clinical advantages, The Journal of Thoracic and Cardiovascular Surgery 120, 999-1006, November 2000; M. Scorsin, et al., “Comparison of the effects of fetal cardiomyocyte and skeletal myoblast transplantation on postinfarction left ventricular function, The Journal of Thoracic and Cardiovascular Surgery 119, 1169-1175, June 2000. ↩
- N.N. Malouf et al., “Adult-derived stem cells from the liver become myocytes in the heart in vivo, American Journal of Pathology 158, 1929-1935, June 2001. ↩
- A.P. Beltrami et al., “Evidence That Human Cardiac Myocytes Divide after Myocardial Infarction, New England Journal of Medicine 344, 1750-1757, June 7, 2001. ↩