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First local dogs receive ‘amazing’ stem-cell therapy

Posted: February 16, 2012 at 4:21 am

Just before 10 a.m. Tuesday, Jake — a hobbling, 12-year-old yellow Labrador retriever — went into surgery at the Stanley Veterinary Clinic in Overland Park with crippling arthritis, no longer able to run without pain or even walk down stairs.

He had already been on months of medications that seemed to turn the normally happy dog sad. And hip and joint replacements costing tens of thousands of dollars were not feasible, said owners Mike and Elizabeth LeBlanc of Leawood.Still, their 8-year-old daughter, Mia, had just one request at Christmas. “All I want is for Jake to feel better,” she wrote.So, on Tuesday morning, Jake became one of the first canines in the Kansas City area to undergo a somewhat new and controversial procedure in which stem cells were harvested from the fat of his own body and then injected into his joints. The expectation is that within a few weeks the cells will regenerate missing cartilage and turn his arthritic joints healthy again.“It’s amazing,” said veterinarian Les E. Pelfrey, who conducted the procedure. “A few weeks later, these guys are running up and down.”The stem-cell procedure, which has gained notice in recent years with anecdotal stories of success on YouTube and cable television, remains controversial not only for its quick adoption in veterinary clinics nationwide, but also because some researchers say it remains scientifically unproven and expensive, at $1,800 or more per treatment.“Let me tell you one thing,” said James L. Cook, a professor of orthopedics at the University of Missouri’s College of Veterinary Medicine. “I don’t want to write off stem cells. Stem cells may hold the key for truly restorative medicine.”In horses, stems cells have been shown to help rejuvenate damaged tendons and other problems. They are being tested for cardiac problems.“But in the joints for dogs with arthritis? No way,” Cook said. “I would never recommend anyone get this done.”Stem cells essentially are the equivalent of young and impressionable cells whose genetic gears have yet to determine their fate. Because they are so young, they theoretically can turn into any kind of cell, from cartilage to neurons. In humans, stem cells have long been held out as possible therapy for diseases such as Parkinson’s.The problem, Cook said, is that although a few studies have shown that the injection of stem cells into arthritic canine joints does reduce pain, compared with “control” dogs not injected with stems cells, no studies have convincingly shown that stems cells are any better at helping dogs than the current, and less expensive, standard of care. That typically involves a combination of weight loss, pain medications and, when necessary, injections of hyaluronic acid, a slippery substance that often goes missing in arthritis. Those injections, given a couple of times a year, cost less than $100 each.Moreover, even if the stem cells work, no one knows at this point how long the improvement will persist, although some vets have noted benefits lasting a year or more.“We know for sure that it (stem cell injections) does have some palliative effects. It can make symptoms better,” Cook said. “And we do know for sure that it does not regenerate cartilage in arthritic joints. The palliative effects are not as good, or no better, than hyaluronic acid injections.”That is far from the case being made by companies now promoting stem-cell therapy in dogs, or owners who believe in it.A number of stem-cell companies have emerged in recent years. Chief among them are Vet-Stem, based in Poway, Calif., and MediVet America, a division of MediVet, based in Sydney, Australia, which notes that it is currently conducting studies on canines, stem cells and cartilage regeneration.Both use largely similar technologies and methods. At the vet’s office, the dog undergoes a quick procedure in which a bolus of fat about the size of a golf ball is taken from above the shoulder.The fat is processed and treated with chemicals to extract millions of stem cells. Some of those cells are then injected into a dog’s damaged joints; the rest enter the body through an intravenous line into the bloodstream.One prime difference between the Vet-Stem and MediVet systems is that Vet-Stem costs about $3,000 or more.Vet-Stem requires the veterinarian to ship the fat sample to California, where it is processed and sent back for injection. Several dogs in the Kansas City area have been injected with stem cells from Vet-Stem.The MediVet system costs pet owners about $1,800. It provides veterinarians with a kit to process the stem cells in their own offices over about four hours. Dogs are injected with stems cells on the same day the fat is removed. The pet typically goes home the next day.In Topeka, the University Bird and Small Animal Clinic has used the MediVet kit and system with what it says are positive results on about 40 dogs since November 2010. A veterinarian there, Larry Snyder, helped train Pelfrey in Overland Park.Snyder came to the clinic two weeks ago to perform the procedure on another hobbled yellow Labrador retriever, Milo, owned by dentist Jon Finley and his wife, Sharon, in Leawood.“Dr. Pelfrey and Mrs. Finley didn’t tell me how much this procedure was going to cost,” Jon Finley said, “and I’d rather you not tell me. No matter what, he’s walking better, standing upright, feeling better. I can’t help but think he’s going to get better and better.”Jake’s owner said that, whatever the outcome, she knows that the procedure is not a cure.“I’m hoping this gives him a better quality of life,” Elizabeth LeBlanc said. “I got him when he was just 6 weeks old. He was such a blessing. It will be worth it, even if I can give him one more great summer.”

To reach Eric Adler, call 816-234-4431 or send email to eadler@kcstar.com.

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First local dogs receive ‘amazing’ stem-cell therapy

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Stem cell study in mice offers hope for treating heart attack patients

Posted: February 16, 2012 at 4:21 am

ScienceDaily (Feb. 15, 2012) — A UCSF stem cell study conducted in mice suggests a novel strategy for treating damaged cardiac tissue in patients following a heart attack. The approach potentially could improve cardiac function, minimize scar size, lead to the development of new blood vessels -- and avoid the risk of tissue rejection.

In the investigation, reported online in the journal PLoS ONE, the researchers isolated and characterized a novel type of cardiac stem cell from the heart tissue of middle-aged mice following a heart attack.

Then, in one experiment, they placed the cells in the culture dish and showed they had the ability to differentiate into cardiomyocytes, or "beating heart cells," as well as endothelial cells and smooth muscle cells, all of which make up the heart.

In another, they made copies, or "clones," of the cells and engrafted them in the tissue of other mice of the same genetic background who also had experienced heart attacks. The cells induced angiogenesis, or blood vessel growth, or differentiated, or specialized, into endothelial and smooth muscle cells, improving cardiac function.

"These findings are very exciting," said first author Jianqin Ye, PhD, MD, senior scientist at UCSF's Translational Cardiac Stem Cell Program. First, "we showed that we can isolate these cells from the heart of middle-aged animals, even after a heart attack." Second, he said, "we determined that we can return these cells to the animals to induce repair."

Importantly, the stem cells were identified and isolated in all four chambers of the heart, potentially making it possible to isolate them from patients' hearts by doing right ventricular biopsies, said Ye. This procedure is "the safest way of obtaining cells from the heart of live patients, and is relatively easy to perform," he said.

"The finding extends the current knowledge in the field of native cardiac progenitor cell therapy," said senior author Yerem Yeghiazarians, MD, director of UCSF's Translational Cardiac Stem Cell Program and an associate professor at the UCSF Division of Cardiology. "Most of the previous research has focused on a different subset of cardiac progenitor cells. These novel cardiac precursor cells appear to have great therapeutic potential."

The hope, he said, is that patients who have severe heart failure after a heart attack or have cardiomyopathy would be able to be treated with their own cardiac stem cells to improve the overall health and function of the heart. Because the cells would have come from the patients, themselves, there would be no concern of cell rejection after therapy.

The cells, known as Sca-1+ stem enriched in Islet (Isl-1) expressing cardiac precursors, play a major role in cardiac development. Until now, most of the research has focused on a different subset of cardiac progenitor, or early stage, cells known as, c-kit cells.

The Sca-1+ cells, like the c-kit cells, are located within a larger clump of cells called cardiospheres.

The UCSF researchers used special culture techniques and isolated Sca-1+ cells enriched in the Isl-1expressing cells, which are believed to be instrumental in the heart's development. Since Isl-1 is expressed in the cell nucleus, it has been difficult to isolate them but the new technique enriches for this cell population.

The findings suggest a potential treatment strategy, said Yeghiazarians. "Heart disease, including heart attack and heart failure, is the number one killer in advanced countries. It would be a huge advance if we could decrease repeat hospitalizations, improve the quality of life and increase survival." More studies are being planned to address these issues in the future.

An estimated 785,000 Americans will have a new heart attack this year, and 470,000 who will have a recurrent attack. Heart disease remains the number one killer in the United States, accounting for one out of every three deaths, according to the American Heart Association.

Medical costs of cardiovascular disease are projected to triple from $272.5 billion to $818.1 billion between now and 2030, according to a report published in the journal Circulation.

First author Ye, Henry Shih, Richard E. Sievers, Yan Zhang, and Megha Prasad are with the UCSF Division of Cardiology; Yeghiazarians and Andrew Boyle are with the UCSF Division of Cardiology and the UCSF Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research; William Grossman is with the UCSF Division of Cardiology and the UCSF Cardiovascular Research Institute; Harold S. Bernstein is with the UCSF Cardiovascular Research Institute, the UCSF Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, and the UCSF Department of Pediatrics; Hua Su is with UCSF Department of Anesthesia and Perioperative Care; and Yan Zhou with the UCSF Department of Cell and Tissue Biology.

The study was supported by funds from the Wayne and Gladys Valley Foundation, the UCSF Cardiac Stem Cell Fund and the Harold Castle Foundation.

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The above story is reprinted from materials provided by University of California, San Francisco (UCSF), via Newswise. The original article was written by Leland Kim.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal Reference:

Jianqin Ye, Andrew Boyle, Henry Shih, Richard E. Sievers, Yan Zhang, Megha Prasad, Hua Su, Yan Zhou, William Grossman, Harold S. Bernstein, Yerem Yeghiazarians. Sca-1 Cardiosphere-Derived Cells Are Enriched for Isl1-Expressing Cardiac Precursors and Improve Cardiac Function after Myocardial Injury. PLoS ONE, 2012; 7 (1): e30329 DOI: 10.1371/journal.pone.0030329

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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Stem cell study in mice offers hope for treating heart attack patients

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Stem Cell Stocks: Mending Scarred Hearts

Posted: February 16, 2012 at 4:21 am

A new study at Johns Hopkins University has shown that stem cells from patients' own cardiac tissue can be used to heal scarred tissue after a heart attack. This is certainly exciting news considering heart failure is still the No. 1 cause of death in men and women.

The study included 25 heart attack victims, 17 of whom got the stem cell treatment. Those patients saw a 50% reduction in cardiac scar tissue after one year, while the eight control patients saw no improvement.

The procedure involves removing a tiny portion of heart tissue through a needle, cultivating the stem cells from that tissue, and reinserting them in a second minimally invasive procedure, according to Bloomberg.

"If we can regenerate the whole heart, then the patient would be completely normal," said Eduardo Marban, director of Cedars-Sinai Heart Institute who was the study's lead author. "We haven't fulfilled that yet, but we've gotten rid of half of the injury, and that's a good start."

Business section: Investing ideas
Interested in investing in the promise that stem cell therapy holds? For a look at the investing landscape, we compiled a list of the 10 largest companies involved in stem cell therapy.

Do you think this industry will see growth from stem cell research? (Click here to access free, interactive tools to analyze these ideas.)

1. BioTime (NYSE: BTX  ) : Focuses on regenerative medicine and blood plasma volume expanders. Market cap at $291.95M. The company develops and markets research products in the field of stem cells and regenerative medicine. It develops therapeutic products derived from stem cells for the treatment of retinal and neural degenerative diseases; cardiovascular and blood diseases; therapeutic applications of stem cells to treat orthopedic diseases, injuries, and cancer; and retinal cell product for use in the treatment of age-related macular degeneration.

2. Cleveland BioLabs (Nasdaq: CBLI  ) : Market cap at $111.50M. Its products include Protectan CBLB502, a radioprotectant molecule with multiple medical and defense applications for reducing injury from acute stresses, such as radiation and chemotherapy by mobilizing various natural cell protecting mechanisms, including inhibition of apoptosis, reduction of oxidative damage, and induction of factors that induce protection and regeneration of stem cells in bone marrow and the intestines, and Protectan CBLB612, a modified lipopeptide mycoplasma that acts as a stimulator and mobilizer of hematopoietic stem cells to peripheral blood, providing hematopoietic recovery during chemotherapy and during donor preparation for bone marrow transplantation.

3. Gentium: Focuses on the development and manufacture of its primary product candidate, defibrotide, an investigational drug based on a mixture of single-stranded and double-stranded DNA extracted from pig intestines. Market cap at $128.29M. The company develops defibrotide for the treatment and prevention of hepatic veno-occlusive disease (VOD), a condition that occurs when veins in the liver are blocked as a result of cancer treatments, such as chemotherapy or radiation, that are administered prior to stem cell transplantation.

4. Geron (Nasdaq: GERN  ) : Develops biopharmaceuticals for the treatment of cancer and chronic degenerative diseases, including spinal cord injury, heart failure, and diabetes. Market cap at $265.57M. The company has licensing agreement with the University Campus Suffolk to develop human embryonic stem cell-derived chondrocytes for the treatment of cartilage damage and joint disease.

5. Harvard Bioscience: Develops, manufactures, and markets apparatus and scientific instruments used in life science research in pharmaceutical and biotechnology companies, universities, and government laboratories in the United States and internationally. Market cap at $118.28M. Develops devices used by clinicians and researchers in the field of regenerative medicine, including bioreactors for growing tissue and organs outside the body, and injectors for stem cell therapy.

6. Lydall (NYSE: LDL  ) : Designs and manufactures specialty engineered products for thermal/acoustical, filtration/separation, and bio/medical applications in the United States. Market cap at $163.44M. In addition, it offers Cell-Freeze, a medical device used for cryogenic storage of peripheral blood stem cells.

8. Osiris Therapeutics (Nasdaq: OSIR  ) : Focuses on the development and marketing of therapeutic products to treat various medical conditions in the inflammatory, autoimmune, orthopedic, and cardiovascular areas. Market cap at $157.26M. A stem cell company, focuses on the development and marketing of therapeutic products to treat various medical conditions in the inflammatory, autoimmune, orthopedic, and cardiovascular areas.

7. Verastem: Market cap at $229.00M. Focuses on discovering and developing proprietary small molecule drugs targeting cancer stem cells (CSCs) in breast and other cancers.

Interactive Chart: Press Play to compare changes in analyst ratings over the last two years for the stocks mentioned above. Analyst ratings sourced from Zacks Investment Research.

Kapitall's Alexander Crawford does not own any of the shares mentioned above.

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Stem Cell Stocks: Mending Scarred Hearts

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Verastem to Present at Molecular Medicine Tri-Conference Symposium “Targeting Cancer Stem Cells in Oncology”

Posted: February 16, 2012 at 3:07 am

CAMBRIDGE, Mass.--(BUSINESS WIRE)--

Verastem, Inc., (NASDAQ: VSTM - News) a biopharmaceutical company focused on discovering and developing drugs to treat breast and other cancers by targeting cancer stem cells, announced that the company will present at the 2012 Molecular Medicine Tri-Conference Symposium “Targeting Cancer Stem Cells in Oncology.” The presentation is on February 19, 2012 at 2:00pm PT at the InterContinental San Francisco Hotel.

About Verastem, Inc.

Verastem, Inc. (NASDAQ: VSTM - News) is a biopharmaceutical company focused on discovering and developing drugs to treat breast and other cancers by targeting cancer stem cells. Cancer stem cells are an underlying cause of tumor recurrence and metastasis. Verastem is translating discoveries in cancer stem cell research into new medicines for the treatment of major cancers such as breast cancer.

Forward-looking statements:

Any statements in this press release about future expectations, plans and prospects for the Company constitute forward-looking statements within the meaning of The Private Securities Litigation Reform Act of 1995. Actual results may differ materially from those indicated by such forward-looking statements. The Company anticipates that subsequent events and developments will cause the Company’s views to change. However, while the Company may elect to update these forward-looking statements at some point in the future, the Company specifically disclaims any obligation to do so.

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First local dogs receive ‘amazing’ stem-cell therapy

Posted: February 15, 2012 at 1:05 pm

Just before 10 a.m. Tuesday, Jake — a hobbling, 12-year-old yellow Labrador retriever — went into surgery at the Stanley Veterinary Clinic in Overland Park with crippling arthritis, no longer able to run without pain or even walk down stairs.

He had already been on months of medications that seemed to turn the normally happy dog sad. And hip and joint replacements costing tens of thousands of dollars were not feasible, said owners Mike and Elizabeth LeBlanc of Leawood.Still, their 8-year-old daughter, Mia, had just one request at Christmas. “All I want is for Jake to feel better,” she wrote.So, on Tuesday morning, Jake became one of the first canines in the Kansas City area to undergo a somewhat new and controversial procedure in which stem cells were harvested from the fat of his own body and then injected into his joints. The expectation is that within a few weeks the cells will regenerate missing cartilage and turn his arthritic joints healthy again.“It’s amazing,” said veterinarian Les E. Pelfrey, who conducted the procedure. “A few weeks later, these guys are running up and down.”The stem-cell procedure, which has gained notice in recent years with anecdotal stories of success on YouTube and cable television, remains controversial not only for its quick adoption in veterinary clinics nationwide, but also because some researchers say it remains scientifically unproven and expensive, at $1,800 or more per treatment.“Let me tell you one thing,” said James L. Cook, a professor of orthopedics at the University of Missouri’s College of Veterinary Medicine. “I don’t want to write off stem cells. Stem cells may hold the key for truly restorative medicine.”In horses, stems cells have been shown to help rejuvenate damaged tendons and other problems. They are being tested for cardiac problems.“But in the joints for dogs with arthritis? No way,” Cook said. “I would never recommend anyone get this done.”Stem cells essentially are the equivalent of young and impressionable cells whose genetic gears have yet to determine their fate. Because they are so young, they theoretically can turn into any kind of cell, from cartilage to neurons. In humans, stem cells have long been held out as possible therapy for diseases such as Parkinson’s.The problem, Cook said, is that although a few studies have shown that the injection of stem cells into arthritic canine joints does reduce pain, compared with “control” dogs not injected with stems cells, no studies have convincingly shown that stems cells are any better at helping dogs than the current, and less expensive, standard of care. That typically involves a combination of weight loss, pain medications and, when necessary, injections of hyaluronic acid, a slippery substance that often goes missing in arthritis. Those injections, given a couple of times a year, cost less than $100 each.Moreover, even if the stem cells work, no one knows at this point how long the improvement will persist, although some vets have noted benefits lasting a year or more.“We know for sure that it (stem cell injections) does have some palliative effects. It can make symptoms better,” Cook said. “And we do know for sure that it does not regenerate cartilage in arthritic joints. The palliative effects are not as good, or no better, than hyaluronic acid injections.”That is far from the case being made by companies now promoting stem-cell therapy in dogs, or owners who believe in it.A number of stem-cell companies have emerged in recent years. Chief among them are Vet-Stem, based in Poway, Calif., and MediVet America, a division of MediVet, based in Sydney, Australia, which notes that it is currently conducting studies on canines, stem cells and cartilage regeneration.Both use largely similar technologies and methods. At the vet’s office, the dog undergoes a quick procedure in which a bolus of fat about the size of a golf ball is taken from above the shoulder.The fat is processed and treated with chemicals to extract millions of stem cells. Some of those cells are then injected into a dog’s damaged joints; the rest enter the body through an intravenous line into the bloodstream.One prime difference between the Vet-Stem and MediVet systems is that Vet-Stem costs about $3,000 or more.Vet-Stem requires the veterinarian to ship the fat sample to California, where it is processed and sent back for injection. Several dogs in the Kansas City area have been injected with stem cells from Vet-Stem.The MediVet system costs pet owners about $1,800. It provides veterinarians with a kit to process the stem cells in their own offices over about four hours. Dogs are injected with stems cells on the same day the fat is removed. The pet typically goes home the next day.In Topeka, the University Bird and Small Animal Clinic has used the MediVet kit and system with what it says are positive results on about 40 dogs since November 2010. A veterinarian there, Larry Snyder, helped train Pelfrey in Overland Park.Snyder came to the clinic two weeks ago to perform the procedure on another hobbled yellow Labrador retriever, Milo, owned by dentist Jon Finley and his wife, Sharon, in Leawood.“Dr. Pelfrey and Mrs. Finley didn’t tell me how much this procedure was going to cost,” Jon Finley said, “and I’d rather you not tell me. No matter what, he’s walking better, standing upright, feeling better. I can’t help but think he’s going to get better and better.”Jake’s owner said that, whatever the outcome, she knows that the procedure is not a cure.“I’m hoping this gives him a better quality of life,” Elizabeth LeBlanc said. “I got him when he was just 6 weeks old. He was such a blessing. It will be worth it, even if I can give him one more great summer.”

To reach Eric Adler, call 816-234-4431 or send email to eadler@kcstar.com.

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Bone gives 'some' heart healing

Posted: February 15, 2012 at 1:04 pm

14 February 2012 Last updated at 19:10 ET By James Gallagher Health and science reporter, BBC News

Bone marrow stem cell therapy offers "moderate improvement" to heart attack patients, according to a large UK review of clinical trials.

The analysis by the Cochrane Collaboration looked at 33 trials involving more than 1,700 patients.

It said longer-term studies were needed to see if the experimental therapy affected life expectancy.

The review comes a day after doctors reported the first case of using heart cells to heal heart attack damage.

If a patient survives a heart attack, dead heart muscle is replaced with scar tissue - leaving the patient weaker and possibly on a lifetime of medicine.

Researchers are beginning to show that taking cells from a heart, growing millions of new heart cells in the laboratory and pumping those back into the heart may reduce scar tissue and lead to new heart muscle.

Continue reading the main story “Start Quote

Stem cell therapy may also reduce the number of patients who later die or suffer from heart failure, but currently there is a lack of statistically significant evidence based on the small number of patients treated so far”

End Quote Dr Enca Martin-Rendon Lead researcher

However, the trials are at a very early stage and in only a handful of patients. Using a similar technique with cells taken from the bone marrow, which is a prime source of stem cells, has a much longer pedigree.

The report by Cochrane pooled the data from all 33 bone marrow trials which had taken place up to 2011.

It concluded that bone marrow therapy "may lead to a moderate long-term improvement" in heart function which "might be clinically very important".

Longer life uncertain

It said there was still no evidence of "any significant effect on mortality" in comparison with standard treatment. However, this may be due to the size of the studies and that patients were followed for a short period of time.

Lead author Dr Enca Martin-Rendon, from NHS Blood and Transplant at the John Radcliffe Hospital in Oxford, said: "This new treatment may lead to moderate improvement in heart function over standard treatments.

"Stem cell therapy may also reduce the number of patients who later die or suffer from heart failure, but currently there is a lack of statistically significant evidence based on the small number of patients treated so far."

Prof Anthony Mathur, from Barts and the London School of Medicine and Dentistry, is leading the largest ever trial of stem cells in heart attack patients.

It starts this year, however, he told the BBC that the results could come quite quickly. Three thousand patients across Europe will take part. They will be injected with stem cells five days after a heart attack and then followed for two years to see if the therapy affects life expectancy.

Prof Peter Weissberg, medical director at the British Heart Foundation, said: "This review reflects the consensus of opinion about these trials - cell therapy has a modestly beneficial effect.

"Despite that, no-one knows why, or even if, cell therapies will translate into better survival or sustained improvement in damaged hearts. It's much too early to judge the likely long-term benefits."

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Heart's stem cells used to mend attack damage

Posted: February 15, 2012 at 11:36 am

SAN FRANCISCO -- Stem cells grown from patients' own cardiac tissue can heal damage once thought to be permanent after a heart attack, according to a study that suggests the experimental approach may one day help stave off heart failure.

In a trial of 25 heart-attack patients, 17 who got the stem cell treatment showed a 50 percent reduction in cardiac scar tissue compared with no improvement for the eight who received standard care. The results were published Tuesday in the medical journal Lancet.

The study, by researchers from Cedars-Sinai Heart Institute in Los Angeles and Johns Hopkins University in Baltimore, tested the approach in patients who recently suffered a heart attack, with the goal that repairing the damage might help stave off failure. While patients getting the stem cells showed no more improvement in heart function than those who didn't get the experimental therapy, the theory is that new tissue regenerated by the stem cells can strengthen the heart, said Eduardo Marban, the study's lead author and director of Cedars-Sinai Heart Institute.

The stem cells were implanted within five weeks after patients suffering heart attacks. Doctors removed heart tissue, about the size of half a raisin, using a minimally invasive procedure that involved a thin needle threaded through the veins. After cultivating the stem cells from the tissue, doctors reinserted 12.5 million to 25 million cells using a second minimally invasive procedure.

A year after the procedure, six patients in the stem cell group had serious side effects.

While the main goal of the trial was to examine safety, the decrease in scar tissue in those treated merits a larger study that focuses on broader clinical outcomes, researchers said.

"If we can regenerate the whole heart, then the patient would be completely normal," Dr. Marban said. "We haven't fulfilled that yet, but we've gotten rid of half of the injury, and that's a good start."

First published on February 15, 2012 at 12:00 am

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Stem Cells Regrow Healthy Heart Muscle In Heart Attack Patients

Posted: February 15, 2012 at 11:36 am

Stem cells are proving themselves beneficial once again after scientists used the controversial building blocks to resurrect dead, scarred heart muscle damaged by recent heart attack.

Results from a Cedars-Sinai Heart Institute clinical trial show that treating heart attack patients with an infusion of their own heart-derived cells helps damaged hearts re-grow healthy heart muscle.

Reporting in The Lancet medical journal, the researchers said this is the clearest evidence yet that broken hearts can heal. All that is needed is a little help from one’s own heart stem cells.

“We have been trying as doctors for centuries to find a treatment that actually reverses heart injury,” Eduardo Marban, MD, PhD, and lead author of the study, told WebMD. “That is what we seem to have been able to achieve in this small number of patients. If so, this could change the nature of medicine. We could go to the root of disease and cure it instead of just work around it.”

Marban invented the “cardiosphere” culture technique used to create the stem cells and founded the company developing the treatment.

“These findings suggest that this therapeutic approach is feasible and has the potential to provide a treatment strategy for cardiac regeneration after [heart attack],” wrote University of Hong Kong researchers Chung-Wah Siu and Hung-Fat Tse in an accompanying editorial of Marban’s paper.

The British Heart Foundation told James Gallagher of BBC News that this could “be great news for heart attack patients” in the future.

A heart attack occurs when the heart is starved of oxygen, such as when a clot is blocking the blood flow to the organ. As the heart heals, the dead muscle is replaced by scar tissue, which does not beat like heart muscle. This in turn reduces the hearts ability to pump blood around the body.

Doctors have long been searching for ways to regenerate damaged heart muscle, and now, it seems heart stem cells are the answer. And the Cedars-Sinai trial was designed to test the safety of using stem cells taken from a heart attack patient’s own heart.

The researchers found that one year after receiving the treatment, scar size was reduced from 24 percent to 12 percent of the heart in patients treated with heart stem cells. Patients in the control group, who did not receive stem cells, did not experience a reduction in their heart attack scar tissues.

“While the primary goal of our study was to verify safety, we also looked for evidence that the treatment might dissolve scar and re-grow lost heart muscle,” Marban said in a statement. “This has never been accomplished before, despite a decade of cell therapy trials for patients with heart attacks. Now we have done it. The effects are substantial, and surprisingly larger in humans than they were in animal tests.”

“These results signal an approaching paradigm shift in the care of heart attack patients,” said Shlomo Melmed, MD, dean of the Cedars-Sinai medical faculty and the Helene A. and Philip E. Hixon Chair in Investigative Medicine. “In the past, all we could do was to try to minimize heart damage by promptly opening up an occluded artery. Now, this study shows there is a regenerative therapy that may actually reverse the damage caused by a heart attack.”

Marban cautioned that stem cells do not do what people generally think they do. The general idea has been that stem cells multiply over and over again, and, in time, they turn themselves and their daughter cells into new, working heart muscle.

But Marban said the stem cells are actually doing something more amazing.

“For reasons we didn’t initially know, they stimulate the heart to fix itself,” he told Daniel J. DeNoon of WebMD. “The repair is from the heart itself and not from the cells we give them.”

Exactly how the stem cells invigorate the heart to do this was a matter of “feverish research” in the lab.

The CArdiosphere-Derived aUtologous stem CElls to reverse ventricUlar dySfunction (CADUCEUS) clinical trial was part of a Phase I study approved by the US Food and Drug Administration (FDA) and supported by the National Heart, Lung, and Blood Institute.

Marban used 25 volunteer patients who were of an average age of 53 and had recently suffered a heart attack that left them with damaged heart muscle. Each patient underwent extensive imaging scans so doctors could pinpoint the exact location and severity of the scars. Patients were treated at Cedars-Sinai in LA and at Johns Hopkins Hospital in Baltimore.

Eight of the 25 patients served as a control group, receiving conventional medical treatment. The other 17 patients who were randomized to receive the stem cell treatments underwent a minimally invasive biopsy, under local anesthesia. Using a catheter inserted through a vein in the neck, doctors removed a small sample of heart tissue, about half the size of a raisin. The heart tissue was then taken to the lab at Cedars-Sinai and cultured and multiplied the cells using specially developed tools.

The doctors then took the multiplied heart-derived cells — roughly 12 million to 25 million of them per patient — and reintroduced them into the patient’s coronary arteries during another minimally invasive catheter procedure.

The process used in the trial was developed earlier by Marban when he was on the faculty at Johns Hopkins. Johns Hopkins has filed for a patent on the intellectual property and has licensed it to a company in which Marban has a financial interest. However, no funds from that company were used to support the clinical study. All funding was derived from the National Institutes of Health and Cedars-Sinai Medical Center.

This study followed another in which doctors reported using cells taken from the heart to heal the heart. That trial reported in November 2011 that cells could be used to heal the hearts of heart failure patients who were having heart bypass surgery.

And another trial is about to get underway in Europe, which will be the largest ever for stem cell therapy in heart attack patients.

The BAMI trial will inject 3,000 heart attack patients with stem cells taken from their bone marrow within five days of the heart attack.

Marban said despite the heart’s ability to re-grow heart muscle with the help of heart stem cells, they found no increase in a significant measure of the heart’s ability to pump — the left ventricle ejection fraction: the percentage of blood pumped out of the left ventricle.

Professor Anthony Mathur, a coordinating researcher for the upcoming BAMI trial, said that even if the Marban trial found an increase in ejection fraction then it would be the source of much debate. As it was a proof-of-concept study, with a small group of patients, “proving it is safe and feasible is all you can ask.”

“The findings would be very interesting, but obviously they need further clarification and evidence,” he told BBC News.

“It’s the first time these scientists’ potentially exciting work has been carried out in humans, and the results are very encouraging,” Professor Jeremy Pearson, associate medical director at the British Heart Foundation, told BBC News.

“These cells have been proven to form heart muscle in a petri dish but now they seem to be doing the same thing when injected back into the heart as part of an apparently safe procedure,” he added. “It’s early days, and this research will certainly need following up, but it could be great news for heart attack patients who face the debilitating symptoms of heart failure.”

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Stem Cells Regrow Healthy Heart Muscle In Heart Attack Patients

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Stem cells a fix for 'broken hearts'?

Posted: February 15, 2012 at 11:36 am

When a piece of muscle in a person’s heart dies from lack of blood flow, it scars over and is lost.  But a team of researchers from the Cedars-Sinai Heart Institute in Los Angeles has proven that those muscles may not necessarily be gone forever.

In a ground-breaking study that may change how heart attacks are treated, Dr. Eduardo Marban and his team used stem cells to re-grow damaged heart muscle.  In the 17 patients who received the therapy, Marban measured an average 50 percent reduction in the size of the scar tissue

“One of the holy grails in medicine has been the use of medicine to achieve regeneration,” Marban said.  “Patients that were treated not only experienced shrinkage of their scars, but also new growth of their heart muscle, which is very exciting.”

The stem cells were not derived from embryos, but instead were developed from the patients’ own hearts.  Marban’s team inserted a catheter into the diseased hearts and took a small biopsy of muscle.  In the laboratory, the tissue was manipulated into producing stem cells.  After a few weeks of marinating in culture, researchers had enough stem cells to re-inject them into the patients’ hearts.  Over the course of a year, the stem cells took root in cardiac tissue, encouraging the heart to create new muscle and blood vessels.  In other words, the heart actually began to mend itself.

Click here to see an animation of how the process works.

“We’ve achieved what we have achieved using adult stem cells – in this case – actually specifically from a patient’s own heart back into the same patient.   There’s no ethical issues with that – there’s no destruction of embryos.  There’s no reason to worry about immune rejection."

While similar research has been done using stem cells from bone marrow, this is the first time that stem cells derived from a patient’s own cardiac tissue have been used.

Marban believes this therapy could be broadly used in many of the 5 to 7 million Americans who suffer from heart disease every year.  And he said the applications could go well beyond diseased hearts.

“If we can do that in the heart, I don’t see any reason, conceptually, why we couldn’t do it in kidneys for example, or pancreas or other organs that have very limited regenerative capacity,” Marban said.

While the procedure may be a revolutionary medical technique, there are still a few more puzzling questions about the research that Marban would like to investigate further.  For example, while the patients grew new heart muscle and saw a dramatic reduction in scar tissue, the actual function of their hearts did not show a significant improvement.  And it appeared the stem cells themselves may not have turned into cardiac muscle, but rather they stimulated the heart to produce new muscle cells.

Because this was a “Phase 1” study, it was really meant to measure whether the procedure was safe.  Of the 17 patients who were given the stem cell injections, six experienced “serious adverse events,” but only one was regarded to be possibly related to the treatment.  

The potential success of this research could hold a lot of promise for the millions of Americans who suffer from heart disease each and every year, which is the leading cause of death in the United States.  If his future experiments yield the same results as this initial study, Marban believes he could be offering this therapy to patients within four years – and that could go a long way in mending all of America’s broken hearts.

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Stem cells a fix for 'broken hearts'?

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Stem cells could fix broken hearts

Posted: February 15, 2012 at 11:36 am

WHEN a piece of muscle in a person's heart dies from lack of blood flow, it scars over and is lost.

But a team of researchers from the Cedars Sinai Heart Institute in Los Angeles has proven that those muscles may not necessarily be gone forever.

In a study that may change how heart attacks are treated, Eduardo Marban and his team used stem cells to re-grow damaged heart muscle. In the 17 patients who received the therapy, Mr Marban measured an average 50 per cent reduction in the size of the scar tissue.

"One of the holy grails in medicine has been the use of medicine to achieve regeneration," he said. "Patients that were treated not only experienced shrinkage of their scars, but also new growth of their heart muscle, which is very exciting."

The stem cells were not derived from embryos, but instead were developed from the patients' own hearts. Mr Marban's team inserted a catheter into the diseased hearts and took a small biopsy of muscle. In the laboratory, the tissue was manipulated into producing stem cells to re-inject into the patients' hearts.

Over the course of a year, the cells took root in cardiac tissue, encouraging the heart to create new muscle and blood vessels. In other words, the heart actually began to mend itself.

While similar research has been done using stem cells from bone marrow, this is the first time that stem cells derived from a patient's own cardiac tissue have been used.

Mr Marban believes this therapy could be broadly used in many of the five to seven million Americans who suffer from heart disease every year. And he said the applications could go well beyond diseased hearts.

"If we can do that in the heart, I don't see any reason, conceptually, why we couldn't do it in kidneys for example, or pancreas or other organs that have very limited regenerative capacity," he said.

While the procedure may be a revolutionary medical technique, there are still a few more puzzling questions about the research that Mr Marban would like to investigate further.

For example, while the patients grew new heart muscle and saw a dramatic reduction in scar tissue, the actual function of their hearts did not show a significant improvement. And it appeared the stem cells themselves may not have turned into cardiac muscle, but rather they stimulated the heart to produce new muscle cells.

Nonetheless, the potential success of this research could hold a lot of promise for the millions of Americans who suffer from heart disease each and every year, which is the leading cause of death in the United States.

If his future experiments yield the same results as this initial study, Mr Marban said he could be offering this therapy to patients within four years - and that could go a long way in mending all of America's broken hearts.

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Stem cells could fix broken hearts

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