Heart Organ Performance Dramatically Improves with Adult Stem Cells
By Abigail Leonard, ABC News, March 26, 2007
Some of the first evidence that stem cells could be used to treat patients for heart failure has now come to fruition. The much-hyped theory now seems more like reality with the investigations resulting in significant clinical benefits.
To treat patients, instead of using more controversial embryonic stem cells, scientists used adult stem cells. The two studies showed marked improvement in the patients’ health and were reported at the American College of Cardiology conference. In order to confirm the results, experts note that the early studies need to be replicated in larger groups, but the outlook is promising.
The seventy-four year old Joseph had to have a pacemaker implanted 9 years ago following a bleak prognosis post heart attack. His cardiologists told him there was nothing more that they could do since 75% of his heart muscle had died. For Joseph, the findings are welcome news.
He eventually sought out and enrolled in a stem cells study at the University of California San Diego after feeling short of breath and frequent fatigue for many years. Stem cells were injected into his heart at the university after begin taken from his leg and cultivated in a lab.
He swims and even walks on a treadmill now two years after treatment. Today, he no longer has problems maintaining energy.
"My ejection fraction went up. My heart reduced a little in size," he said, "but I don't need any numbers or proof that I am doing great. I have my body to tell me. I feel excellent, and I can do whatever I want to do.”
He insists the procedure added years to his life. "My first cardiologist said he couldn't do anything for me and I would only live for five years, and now it is nine years later."
One of the most notable aspects of the treatment is how minimally invasive it is said Nabil Dib. He is the study leader and director of clinical cardiovascular therapy at the University of California San Diego. Dib adds that patients don’t even require anesthesia.
"We can do it with a catheter so they are awake during the procedure and can go home within 24 hours," he said.
For high-risk patients that may be excluded from general surgery, this kind of targeted therapy is particularly valuable. Such was the case for Joseph.
23 patients who had heart failure or poor heart function like Joseph participated in the study. Dib and his team extracted stem cells from the thigh muscles of all of the patients. The cells were delivered directly to the patients’ hearts via catheter after being grown in the lab.
Patients who had standard medical therapies worsened but those receiving the stem cells reported an improvement in quality of life and health during a follow-up six months post treatment.
In a second study conducted at 10 medical institutions, stem cells were infused intravenously into cardiac patients within 10 days of a heart attack. In this case, researchers took muscle stem cells not from the patients themselves, but from donors.
The stem cell patients showed improved lung and heart function six months later. And they all had fewer side effects than those who had not received stem cells.
"There was a lot of concern in the medical community about whether taking cells from an unrelated donor would cause a rejection reaction or cause tumors," said Joshua M. Hare, chief of cardiology and director of the Stem Cell Institute at the University of Miami School of Medicine.
Hare led the study. "We felt we had a solid footing, and to our great surprise the stem cells are more than safe. We got significant evidence that the cells were helping the patients on a number of measures."
The cells could potentially be made in large quantities and administered like an off-the-shelf- drug since they came from donors and not the patients.
Dib says that stem cell therapy could possibly run as low as $8,000, but the expectation is more in the $20,000 to $25,000 dollar range. Despite the cost, it is nothing compared to standard therapy where a heart transplant can cost upward of $200,000 over three years.
The treatment requires a specialized method of coaxing stem cells into heart tissue and thus, very few doctors are capable of performing the treatment at this time.
It remains to be seen how well the therapies will work in a larger population, and experts are keeping the excitement to a low hum since the trials are still in the early stages.
"Obviously, in 23 patients you can't say anything definitive, but it at least it gives you the green light now to do many more patients and do some definitive trials," said William O'Neill, executive dean for clinical affairs at the Miller School of Medicine at the University of Miami.
Dib is hopeful that the wait won't be long before it is standard treatment. "This procedure will be available in five years worldwide. I think it will be part of the standard of care."
Hare sees an even larger goal: ending cardiovascular disease, as we know it. With the advent of these treatments, he said he envisioned heart disease -- now the No. 1 killer of Americans -- becoming more like infectious disease, which has been more easily treatable and much less fatal since antibiotics were introduced.