Injections To Replace Heart Surgery?

chareverie writes "Researchers at Harvard University have been working towards a goal of replacing some types of heart surgery with injections of cells that would grow into blood vessels for damaged hearts. The cells that would be used are progenitor cells obtained from the blood or bone marrow, as opposed to stem cells that are obtained from human embryos. The research team was successful with their tests on growing heart blood vessels in mice. Joyce Bishoff, an associate professor of medicine at Harvard and senior author of the report, says, 'Our next goal down the line is to use them in humans.' She also notes that more studies need to be done on animals to see how these cells would react and behave with other types of tissues. A similar human experiment was done two years ago in Germany, during which a few people from a group of 75 heart attack victims were given injections of progenitor cells from their own bone marrow or blood. The report concluded that there were improved heart functions." Reader w1z4rd points out related coverage with some more information at BBC News.

What if you're afraid of shots?

Couldn't we *please get this in a pill already?

Re:What if you're afraid of shots?

I am afraid not, the cells will just be digested in Your GI tract. When You are in position that You are in need of this kind of therapy, the injection will be the least of Your worries.

Re:

It's called needlephobia and there are solutions [bioject.com] to it

Re:

Ehm, yeah, cause that kind of system will certainly fix the part of extracting cells from the blood or bone marrow. The injection of the purified cells is the least painful step of this procedure.

Re:

Well it seems [utahmed.com] you can extract blood without a needle as well. I'm not sure about needleless bone marrow cell extraction though ;-).

Re:

That's a syringe to draw blood from an existing vascular access line, which would have to be put in place using a needle.

Re:

Does it involve a shot of a sedative? How deliciously ironic.

Re:

Where do you see that?

Re:What if you're afraid of shots?

I don't, but I wasn't going to let that stand in the way of the irony.

Re:

If you're so afraid of shots that you would rather have heart surgery than a shot, then more power to you.

Re:

Indeed. As someone who has had open heart surgery in his late twenties (twice), I can tell you that you're going to get a hell of a lot of needles going the old-fashioned way, too.

Re:

But what if the only pill form that works is a jagged little pill? I'll take the needle thanks.

Re:

If it's really a problem they could probably just knock you out with some of the old-school ether. But as someone mentioned, the fear of the shot would be a small price to pay.

Re:

Seriously, the best way to overcome that fear is to look at them while they are giving you the shot. It takes all the surprise out and you can prepare mentally for it...... this is of course assuming you don't have a rational medical fear of shots(you are allergic to some of the stuff they put in most shots etc.)

Re:

What if you're afraid of pills? [grin]

Looks neat. It'll work on humans eventually

Looks like they're using human cells in mice. And they're not using stem cells. Of course, the other way in humans to do this is to do aerobic excercises. A wife of one of my bosses apparently had complete blockage of her main coronary arteries. She's around 50ish and had basically been walking around like that for many years before any symptoms arrived. Hooray for collateral blood vessels!

Re:

Of course, the other way in humans to do this is to do aerobic excercises.

Not really. The guy who discovered or first promoted aerobic exorcise was good for the heart ended up dying of a heart attack while jogging.\

This wasn't because he was wrong, but because it doesn't address every aspect of heart disease. The type of repair they are talking of here is where tissue is basically dead or isolated to a point they aren't functioning competently enough. This isn't about reversing plaque damage or increasin

What surgery this might replace

Bypass surgery is significant portion of all heart operations. This is typically done when atherosclerosis (fatty calcific deposits) block the vessels, reduce the blood supply to the hearts muscle, and people wind up with chest pain, and sometimes a heart attack.

Hearts are operated on for many other reasons as well, which are not just for needing new vessels. Hearts get leaky valves, become too thick, transplants etc.

Stem cells have been used before for heart surgery

The cells that would be used are progenitor cells obtained from the blood or bone marrow,...

The word you're looking for to describe those cells is stem cells. But it wasn't the poster's fault. The poorly written article makes the same mistake.

Don Ho [wikipedia.org] had this surgery done where his own stem cells, extracted from his blood, were injected into his heart. He died soon after but his surgeon claims that the surgery was so successful that Don didn't recover fully before resuming touring and put too much strain on his heart and died.

Re:Stem cells have been used before for heart surg

The cells that would be used are progenitor cells obtained from the blood or bone marrow,...

The word you're looking for to describe those cells is stem cells. But it wasn't the poster's fault. The poorly written article makes the same mistake.

Well, actually, they were progenitor cells, or at least that's what the investigators called them. http://americanheart.mediaroom.com/index.php?s=43&item=471 [mediaroom.com]

Stem cells are able to differentiate along different pathways, to become the cells that form tissues, such as the lining and structural tissues used to form blood vessels. But progenitor cells also differentiate along different pathways to become cells that form tissues. If cell A is on the pathway to cell B, then A is a progenitor of B. Cell A might or might not be a stem cell. Some researchers do refer to the cells that lead to specific tissues, like heart muscle, as stem cells. But people also refer to them as progenitor cells. The source of funding might have something to do with the choice of language.

Actually, I think it was a pretty well-written article. (Disclosure: I know Ed Edelson.)

But I don't think Edelson would mind the criticism. Good science teachers always want students to show off how smart they are and try to prove them wrong. Better to be cocky than stupid.

Don Ho [wikipedia.org] had this surgery done where his own stem cells, extracted from his blood, were injected into his heart. He died soon after but his surgeon claims that the surgery was so successful that Don didn't recover fully before resuming touring and put too much strain on his heart and died.

Actually, there were several studies that infused heart muscle stem cells into damaged hearts, over the last few years. Some German researchers are widely regarded as the most aggressive, or the most irresponsible, depending on who you talk to. The problem is that their patients also died. As I recall, the treatment didn't do any harm, but it didn't do any good. (That was dumb luck; patients can die in these studies.) There was a good review article in Science magazine that I'm too lazy to look up. A lot of people thought that human trials were premature, and they should go back to the mice and get it working first.

The problem with mice is that they don't pay doctors' bills. The advantage of mice is that, if the mouse dies, you can always get another mouse.

The Harvard researchers went back to the mice, which is what they should be doing. The interesting thing they did was mix the endothelial progenitor cells with the mesenchymal progenitor cells (or stem cells, if you prefer). And they got it working in real, living mice. The vessels lined up just right, and joined each other just the way real blood vessels are supposed to. I'd like to read the Circulation article and see what growth factors they used (probably VEGF and some other stuff).

To put this in context, it's important to realize that circulatory heart disease damages blood vessels, which then damages heart muscle. These Harvard guys are repairing blood vessels. Other people are working on heart muscle.

Here's the Bishchoff lab http://chbresearch.org/bischoff/research/index.htm [chbresearch.org]

Review

The NIH has written an excellent review of stem cell therapy for myocardial infarction [nih.gov] for those interested. It hasn't been updated in several years, but it should provide a lot of the biological context and rationale for these types of experiments.

Previous Study had like a 3% improvement

Coincidintally, I was watching this [google.com] on google video yesterday. It's a presentation by a researcher in the field talking about stem cells (for the record, she used stem cells and "progenator" cells seemingly-interchangably) and she mentioned that particular study. It's about 60% of the way through the video if I remember right. Anyway, while there was an improvement when placing stem cells into the heart along with the surgury, the improvement was in the area of 5.5% improvement, with 3.5% using a saline placebo. So yes, technically, the poster was right with the improvements, we're still quite a ways away from having developed any sort of new human treatments.

Adult Stem Cells

Wowâ¦got to love it. Instead of saying "adult stem cells", they say "progenitor cells". Amazing. Despite not one real solution from embryonic stem cell research around the world and a continuous train or real solutions from adult stem cells, so many people want to keep pushing for embryonic research.

Why not pull for the winning team.

Needed this a few years ago

Now they can do this with a shot. Damn! Two years ago I had quintuple (5) bypsss surgery. The surgery went fine, it was the series of post-op infections that nearly done me in.

And BTW, my total cholesterol was under 160 and my triglycerides were at 150, high normal, at the time of the surgery. My cardiac ejection fraction was @ 60% and I had no symptoms of any sort until a bit of arrhythmia showed up during a routine exam when I had been at 60bps for years. Genetics - the boomerang that catches you from behind.

Re:Progenitor?

The hierarchy of blood is a bit complicated. Everything starts with hematopoietic ("blood making") stem cells. Stem cells can divide to make more stem cells, or they can mature and become blood progenitors. Blood progenitors can't go backwards and form stem cells. However, progenitors can divide to form multiple blood lineages such as platelets and white blood cells depending on the biological signals they receive. Most articles talk about hematopoietic progenitors rather than stem cells to be technically precise. Stem cells are incredibly elusive; as far as I know, it is currently technically impossible get a completely pure population of them. You can, however, purify populations of bone marrow that contains nearly all the stem cells but also have a bunch of progenitors as well. These populations, confusingly, are often called progenitors themselves, even though they actually contain stem cells.