Even after recovery, heart attacks can leave a lasting mark on your ticker—scar tissue weakens the muscle and prevents it from functioning as well as it did before seizing up. A pioneering stem-cell procedure, however, could cut the damage in half.

According to the results of a small safety trial by the Cedars-Sinai Heart Institute and published in the Lancet medical journal, introducing stem cells derived from the patient's own heart have shown an "unprecedented" ability to reduce scarring as well as regenerate healthy cardiac tissue.

During a heart attack, the organ is deprived of oxygen and its tissue begins to die off. As the heart heals from the attack, any damaged muscle is replaced by scar tissue, which prevents the heart from beating properly and pumping the requisite blood flow the body needs.

The CADUCEUS (CArdiosphere-Derived aUtologous stem CElls to Reverse ventricUlar dySfunction) study involved 25 patients—eight serving as the control group, the other 17 actually receiving the treatment. Researchers first performed extensive imaging scans to identify location and severity of scarring, then biopsied a half-raisin-sized piece the patient's heart tissue. Doctors then isolated and cultured stem cells from it and injected the lab-grown stem cells—roughly 12-25 million of them—back into the heart.

After a year, scarring in patients that received the treatment decreased by an astounding fifty percent while the control group showed no decrease in scarring. "These results signal an approaching paradigm shift in the care of heart attack patients," said Shlomo Melmed, dean of the Cedars-Sinai medical faculty. The scars were once believed to be permanent but this technique shows promise as a means to regenerate the damaged muscle. It should be noted however, that the heart's ability to pump did not increase as the scar tissue disappeared.

"While the primary goal of our study was to verify safety, we also looked for evidence that the treatment might dissolve scar and regrow lost heart muscle," Eduardo Marbán, director of the Cedars-Sinai Heart Institute, told PhysOrg. "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."

Researchers hope to soon begin an expanded clinical trial and, if the results are as promising as these, eventually use the procedure to assist the US's annual 770,000 coronary disease sufferers. [The Lancet via Physorg - BBC News]

Image: Shortkut / Shutterstock

Here is the original post:
Stem Cells Could Help Heal Broken Hearts [Medicine]

Home > News > health-news

Washington, Feb 14 : Researchers have shown for the first time that radiation treatment ?despite killing half of all tumour cells during every cycle - transforms other cancer cells into treatment-resistant breast cancer stem cells.

According to researchers with the UCLA Department of Radiation Oncology at UCLA's Jonsson Comprehensive Cancer Center, the generation of these breast cancer stem cells counteracts the otherwise highly efficient radiation treatment.

If scientists can uncover the mechanisms and prevent this transformation from occurring, radiation treatment for breast cancer could become even more effective, said study senior author Dr. Frank Pajonk, an associate professor of radiation oncology and Jonsson Cancer Center researcher.

"We found that these induced breast cancer stem cells (iBCSC) were generated by radiation-induced activation of the same cellular pathways used to reprogram normal cells into induced pluripotent stem cells (iPS) in regenerative medicine," said Pajonk, who also is a scientist with the Eli and Edythe Broad Center of Regenerative Medicine at UCLA.

"It was remarkable that these breast cancers used the same reprogramming pathways to fight back against the radiation treatment."

"Controlling the radiation resistance of breast cancer stem cells and the generation of new iBCSC during radiation treatment may ultimately improve curability and may allow for de-escalation of the total radiation doses currently given to breast cancer patients, thereby reducing acute and long-term adverse effects," the study stated.

There are very few breast cancer stem cells in a larger pool of breast cancer cells. In this study, Pajonk and his team eliminated the smaller pool of breast cancer stem cells and then irradiated the remaining breast cancer cells and placed them into mice.

Using a unique imaging system Pajonk and his team developed to visualize cancer stem cells, the researchers were able to observe their initial generation into iBCSC in response to the radiation treatment.

The newly generated iBCSC were remarkably similar to breast cancer stem cells found in tumors that had not been irradiated, Pajonk said.

The team also found that the iBCSC had a more than 30-fold increased ability to form tumors compared to the non-irradiated breast cancer cells from which they originated.

Pajonk said that the study unites the competing models of clonal evolution and the hierarchical organization of breast cancers, as it suggests that undisturbed, growing tumors maintain a small number of cancer stem cells.

However, if challenged by various stressors that threaten their numbers, including ionizing radiation, the breast cancer cells generate iBCSC that may, together with the surviving cancer stem cells, repopulate the tumour.

"What is really exciting about this study is that it gives us a much more complex understanding of the interaction of radiation with cancer cells that goes far beyond DNA damage and cell killing," Pajonk said.

"The study may carry enormous potential to make radiation even better."

Pajonk stressed that breast cancer patients should not be alarmed by the study findings and should continue to undergo radiation if recommended by their oncologists.

"Radiation is an extremely powerful tool in the fight against breast cancer," he said.

"If we can uncover the mechanism driving this transformation, we may be able to stop it and make the therapy even more powerful," Pajonk added.

The study has been published in the online edition of peer-reviewed journal Stem Cells. (ANI)

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See the original post:
Radiation therapy transforms breast cancer cells into cancer stem cells

The damage caused by a heart attack was healed by using stem cells gathered from the patient’s own heart in a small trial written up in The Lancet journal, according to the BBC.

The preliminary study was carried out at the Cedars-Sinai Heart Institute in Los Angeles and Johns Hopkins University in Baltimore, and involved 25 patients who had suffered heart attacks recently, reported The Los Angeles Times.

Seventeen of the subjects in the study were given infusions of stem cells “cultured from a raisin-sized chunk of their own heart tissue,” while the other eight were given standard care, reported The LA Times.

The size of the scars on heart tissue damaged by a heart attack decreased in size from 24 percent of the heart to 12 percent of the heart, said Dr. Eduardo Márban, the lead researcher in the study. He wrote to The LA Times in an email that the most surprising aspect of the findings was the fact that the heart could regrow healthy tissue.

More on GlobalPost: Global malaria deaths twice as high as estimated, Lancet study says

The study used a procedure invented by Márban to isolate heart stem cells from healthy tissue from each patient’s heart, and then grow millions of new cells in a petri dish, according to CNN. The patients who received the stem cell treatment either had 12 million or 25 million such cells injected back into their hearts.

Deepak Shrivastava, the director of the Gladstone Institute of Cariovascular Disease based in San Francisco, told Bloomberg, “There’s a dire need for new therapies for people with heart failure, it’s still the No. 1 cause of death in men and women.”

Márban told CNN, “If we can regenerate the whole heart, then the patient would be completely normal. We haven’t fulfilled that yet, but we’ve gotten rid of half the injury, and that’s a good start."

More on GlobalPost: Study links high calorie intake with memory loss

http://www.globalpost.com/dispatch/news/health/120213/stem-cells-used-heal-heart-attack-damage

Continued here:
Stem cells used to heal heart attack damage

Related To Story

iStock/pashalgnatov

By the CNN Wire Staff

POSTED: 6:59 pm MST February 13, 2012

UPDATED: 8:11 pm MST February 13, 2012

(CNN) -- A patient's own heart cells can be used to regrow new heart tissue and help undo damage caused by a heart attack, according to early research published on Monday.Scientists at Cedars-Sinai Medical Center in Los Angeles and Johns Hopkins University in Baltimore were able to treat 17 heart attack patients with cells grown from their own heart tissue and not only show the procedure was safe, but also that the cells can help reduce scarring and even cause new heart muscle to grow.When a person suffers a heart attack, he or she is often left with huge areas of scarring in the heart. Scarred heart muscle doesn't pump blood as well as it used to, putting stress on other parts of the heart to make up for the deficit. The damaged area also doesn't conduct electric current as well, leading to an abnormal heart rhythm, which can cause more problems. Heart attack patients often go on to develop heart failure. "This is the first instance of therapeutic regeneration," says Dr. Eduardo Marbán, director of the Cedars-Sinai Heart Institute. He says while nature abounds with examples of spontaneous regeneration of limbs or tissues - like a salamander's new tail or a human liver regrowing to full size if partially damaged - doctors have not been able to help patients regrow heart tissue. This could change in the future if larger clinical trials and longer patient outcomes confirm the results of this early research published Monday in the journal The Lancet. Marbán and his colleagues first presented this research at an American Heart Association conference in November.To qualify for this clinical trial, patients had to have suffered a recent heart attack and "had to have a significant amount of damage to begin with and weren't squeezing [blood into the body] as well as they should have," says Dr. Peter Johnston, one of the study authors who injected the new heart cells into patients treated at Johns Hopkins Hospital.A total of 25 patients participated in the clinical trial, which was designed to determine if it was safe to have cells grown from one's own heart tissue injected back into the heart. Seventeen patients received the stem cell transplants, while the other eight patients were given conventional post-heart attack therapy.In an outpatient procedure under local anesthesia, doctors funneled a catheter into the patient's heart and removed peppercorn-sized bits of tissue from the part of the patient's heart that was unaffected by the heart attack. Using a procedure invented by Marbán, heart stem cells were isolated from the tissue and then millions of new cells were grown in a petri dish. About four to six weeks after having suffered the heart attack, the patients had either 12 million or 25 million heart-derived cells injected back into the their hearts.Marbán says when the first patient data came in, he and his colleagues were relieved to see the procedure was safe. After 12 months, researchers report only one patient appeared to have a serious side effect that may have been connected to the experimental cells.Six months after the first patient was injected with his cells grown from his own heart tissue, Marbán says there was dramatic shrinking of scar tissue and new tissue had grown. "That was unprecedented" he says. "No one had demonstrated that before."All patients were followed for six months and researchers have 12-month data for 21 patients. In patients who received the cell transplant, Marbán says about half of their scar tissue dissolved and the reduction in scar size appears to get bigger after the first six months. He says that why this is happening is still unclear.Marbán says the amount of new heart tissue that grew was not subtle. [On average] "22 grams (about .78 ounces) of new heart tissue grew," which he says is quite remarkable considering this had never been done before and the average weight of the part of the heart that is responsible for pumping the blood through the body is about 150 grams (about 5.3 ounces).Patients in the control group, those who didn't get a cell transplant, did not regenerate any tissue and the amount of scar tissue they had remained the same.Sonia Skarlatos, Ph.D and deputy director of the Division of Cardiovascular Sciences at the NIH's National Heart, Lung, and Blood Institute says this early research is very exciting and a move in the right direction. She cautions that this procedure has to be tested on many more patients and they have to be observed for longer periods than in the current study, but she says these results are all very positive. She is hopeful further studies will confirm these early results. "By preventing the consequences of a heart attack you may be able to prevent further down the heart failure that happens in [many of these] patients." Skarlatos says. She was not involved in the research but the National Heart, Lung, and Blood Institute did help fund the it.Skarlatos also says it's still not clear exactly what is making the heart regenerate and scar tissue disappear. Is it the cells themselves or proteins and other factors produced by these newly introduced cells that help fix the heart? Further research will hopefully also help answer those questions, she says. The study authors say based on these results, further research is warranted.Marbán, who began his research at Johns Hopkins, says "we did see a glimmer [of regeneration] in animal testing," but the results in humans were much better. "That doesn't usually happen this way in research."

Copyright CNN 2012

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Read the original post:
Research: Patient's Stem Cells Help Heal Heart

They also help to reduce scar size

Infusion of cardiac stem cells into persons who suffered heart attack recently can help to regenerate their heart muscles, says a study published on February 14, in The Lancet.

Phase I of the study was conducted on 17 patients, who received stems cells, and eight, who received standard care (control group), at the Cedars-Sinai Heart Institute in Los Angeles and Johns Hopkins Hospital, Baltimore. All of them had had heart attacks about a month before the study began in May 2009. The stem cells were created from the patients' heart tissues.

Visible improvements were seen in those who received infusion of stem cells, compared with the control group at the end of six months and a year. While no change in the scar size was seen in the control group, there was more than 12 per cent reduction in the size at the end of six months in the treatment group.

As scar size is directly related to scar mass, a reduction of 8.4 gram (28 per cent) and almost 13 gram (42 per cent) in scar mass was seen in the treatment group at the end of six months and 12 months.

Surprisingly, scar mass reduction was accompanied by an increase in viable myocardial mass. In fact, on an average, the increase in viable myocardial mass was “about 60 per cent more than scar reduction.” This is significant as it had led to a “partial restoration of lost left ventricular mass in patients with CDCs [cardiosphere-derived cells],” the authors of the study noted.

The study thus “challenges the conventional wisdom that once established, cardiac scarring is permanent, and that, once lost, healthy heart muscle cannot be restored.”

However, a change in scar size was accompanied by only 2 per cent increase in ejection factor (the amount of blood pumped by the heart), which is not considered significant.

While “the reasons for the discrepancy are unclear,” the study noted that “ejection factor at baseline was only moderately impaired, leaving little room for improvement.”

Of the six patients in the treatment group who had serious adverse events, only one was found to be related to the study.

The rest is here:
Cardiac stem cells can restore heart muscles, says study

February 13, 2012, 9:47 PM EST

By Ryan Flinn

Feb. 14 (Bloomberg) -- 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, from the first of three sets of clinical trials generally needed for regulatory approval, were published today in the medical journal Lancet.

“The findings in this paper are encouraging,” Deepak Srivastava, director of the San Francisco-based Gladstone Institute of Cardiovascular Disease, said in an interview. “There’s a dire need for new therapies for people with heart failure, it’s still the No. 1 cause of death in men and women.”

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.

“What our trial was designed to do is to reverse the injury once it’s happened,” said Marban, director of Cedars- Sinai Heart Institute. “The quantitative outcome that we had in this paper is to shift patients from a high-risk group to a low- risk group.”

Minimally Invasive

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 them using a second minimally invasive procedure. Patients got 12.5 million cells to 25 million cells.

A year after the procedure, six patients in the stem cell group had serious side effects, including a heart attack, chest pain, a coronary bypass, implantation of a defibrillator, and two other events unrelated to the heart. One of patient’s side effects were possibly linked to the treatment, the study found.

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

Heart Regeneration

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

While the study resulted in patients having an increase in muscle mass and a shrinkage of scar size, the amount of blood flowing out of the heart, or the ejection fraction, wasn’t different between the control group and stem-cell therapy group. The measurement is important because poor blood flow deprives the body of oxygen and nutrients it needs to function properly, Srivastava said.

“The patients don’t have a functional benefit in this study,” said Srivastava, who wasn’t not involved in the trial.

The technology is being developed by closely held Capricor Inc., which will further test it in 200 patients for the second of three trials typically required for regulatory approval. Marban is a founder of the Los Angeles-based company and chairman of its scientific advisory board. His wife, Lisa Marban, is also a founder and chief executive officer.

--Editors: Angela Zimm, Andrew Pollack

-0- Feb/13/2012 22:32 GMT

To contact the reporter on this story: Ryan Flinn in San Francisco at rflinn@bloomberg.net

To contact the editor responsible for this story: Reg Gale at rgale5@bloomberg.net

Read more:
Scarred Hearts Can Be Mended With Stem Cell Therapy, Study Shows

By Jenny Hope

Last updated at 12:01 AM on 14th February 2012

Breakthrough: The heart's own stem cells can be used to heal it, according to a new study

The heart’s own stem cells can be used to repair damage caused to it, scientists say.

They help the organ re-grow healthy muscle after a heart attack, a clinical trial shows.

The procedure was found to halve the size of scar left on a patient’s heart muscle and led to a ‘sizeable increase’ in healthy muscle.

Scientists said this discovery challenges a belief that scarring is permanent and that, once lost, healthy heart muscle cannot be restored.

One year after receiving the experimental treatment, scar size was reduced on average from 24 per cent to 12 per cent of the heart.

Patients who did not receive the heart stem cells had no reduction.

Results from the U.S. study, published online in The Lancet medical journal, offer hope for patients with heart failure, where the pumping action is diminished.

Researcher Eduardo Marb?n, director of the Cedars-Sinai Heart Institute, said: ‘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.

‘The effects are substantial, and surprisingly larger in humans than they were in animal tests.’

Shlomo Melmed, dean of the Cedars-Sinai medical faculty, said the treatment could mark a new era in heart medicine. ‘This study shows there is a regenerative therapy that may actually reverse the damage caused by a heart attack,’ he said.

As an initial part of the trial in 2009, Mr Marb?n and his team completed the world’s first procedure in which a patient’s own heart tissue was used to grow specialised heart stem cells.

Hope: Researchers from Cedars-Sinai in Los Angeles, pictured, described the effects of the stem cells as 'substantial'

These cells were then injected back into their hearts. All the patients monitored – with an average age of 53 – had survived heart attacks.

Eight served as controls, receiving conventional care including prescription medicine, exercise recommendations and dietary advice.

The other 17 allocated to receive the stem cells had a minimally invasive biopsy, under local anaesthesia.

Previous trials have shown remarkable results from using stem cells, but they have been taken from different areas of a patient’s body.

Stem cells can become almost any type of cell, but are in short supply in adult organs.

Several thousand patients worldwide have received them from  bone marrow, but this trial seems to confirm cardiac stem cells may be the most effective for heart damage.

Professor Jeremy Pearson, of the British Heart Foundation charity, said the results were encouraging.

Here is the original post:
How a heart's own stem cells could be used to heal it following a heart attack

Newswise — Breast cancer stem cells are thought to be the sole source of tumor recurrence and are known to be resistant to radiation therapy and don’t respond well to chemotherapy.

Now, researchers with the UCLA Department of Radiation Oncology at UCLA’s Jonsson Comprehensive Cancer Center report for the first time that radiation treatment –despite killing half of all tumor cells during every treatment - transforms other cancer cells into treatment-resistant breast cancer stem cells.

The generation of these breast cancer stem cells counteracts the otherwise highly efficient radiation treatment. If scientists can uncover the mechanisms and prevent this transformation from occurring, radiation treatment for breast cancer could become even more effective, said study senior author Dr. Frank Pajonk, an associate professor of radiation oncology and Jonsson Cancer Center researcher.

“We found that these induced breast cancer stem cells (iBCSC) were generated by radiation-induced activation of the same cellular pathways used to reprogram normal cells into induced pluripotent stem cells (iPS) in regenerative medicine,” said Pajonk, who also is a scientist with the Eli and Edythe Broad Center of Regenerative Medicine at UCLA. “It was remarkable that these breast cancers used the same reprogramming pathways to fight back against the radiation treatment.”

The study appears DATE in the early online edition of the peer-reviewed journal Stem Cells.

“Controlling the radiation resistance of breast cancer stem cells and the generation of new iBCSC during radiation treatment may ultimately improve curability and may allow for de-escalation of the total radiation doses currently given to breast cancer patients, thereby reducing acute and long-term adverse effects,” the study states.

There are very few breast cancer stem cells in a larger pool of breast cancer cells. In this study, Pajonk and his team eliminated the smaller pool of breast cancer stem cells and then irradiated the remaining breast cancer cells and placed them into mice.

Using a unique imaging system Pajonk and his team developed to visualize cancer stem cells, the researchers were able to observe their initial generation into iBCSC in response to the radiation treatment. The newly generated iBCSC were remarkably similar to breast cancer stem cells found in tumors that had not been irradiated, Pajonk said.

The team also found that the iBCSC had a more than 30-fold increased ability to form tumors compared to the non-irradiated breast cancer cells from which they originated.

Pajonk said that the study unites the competing models of clonal evolution and the hierarchical organization of breast cancers, as it suggests that undisturbed, growing tumors maintain a small number of cancer stem cells. However, if challenged by various stressors that threaten their numbers, including ionizing radiation, the breast cancer cells generate iBCSC that may, together with the surviving cancer stem cells, repopulate the tumor.

“What is really exciting about this study is that it gives us a much more complex understanding of the interaction of radiation with cancer cells that goes far beyond DNA damage and cell killing,” Pajonk said. “The study may carry enormous potential to make radiation even better.”

Pajonk stressed that breast cancer patients should not be alarmed by the study findings and should continue to undergo radiation if recommended by their oncologists.

“Radiation is an extremely powerful tool in the fight against breast cancer,” he said. “If we can uncover the mechanism driving this transformation, we may be able to stop it and make the therapy even more powerful.”

This study was funded by the National Cancer Institute, the California Breast Cancer Research Program and the Department of Defense.

UCLA's Jonsson Comprehensive Cancer Center has more than 240 researchers and clinicians engaged in disease research, prevention, detection, control, treatment and education. One of the nation's largest comprehensive cancer centers, the Jonsson center is dedicated to promoting research and translating basic science into leading-edge clinical studies. In July 2011, the Jonsson Cancer Center was named among the top 10 cancer centers nationwide by U.S. News & World Report, a ranking it has held for 11 of the last 12 years. For more information on the Jonsson Cancer Center, visit our website at http://www.cancer.ucla.edu.

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See the rest here:
Radiation Treatment Generates Cancer Stem Cells from Less Aggressive Breast Cancer Cells