A new study shows that cell therapy containing adult stem cells from bone marrow reduces the risk of heart attack and stroke in patients with severe heart failure.
A single injection of adult stem cells directly into the inflamed heart through a catheter may reduce the long-term risk of heart attack and stroke by 58% in heart failure patients with reduced ejection fraction. , suggests a study published Monday in the Journal of the American College of Cardiology.
The study is called the largest clinical trial of cell therapy to date in patients with heart failure, a serious condition that occurs when the heart cannot pump enough blood to meet the body’s needs.
“We’ve followed these patients for several years, three years, and we’ve found that their hearts have become stronger. We’ve seen very significant reductions in heart attacks and strokes. When we measured the blood in the heart, there was more inflammation going on,” said Emerson Perrin, M.D., a cardiologist and medical director at the Texas Heart Institute in Houston, the study’s lead author. .
“The effect was there for everyone, but it was even more significant for the inflamed patients.”
This therapy involves injecting mesenchymal progenitor cells into the heart. These particular stem cells have anti-inflammatory properties and may improve outcomes in heart failure patients, as increased inflammation is a hallmark of chronic heart failure.
More than 6 million adults in the United States have chronic heart failure, most of which are treated with medications to treat symptoms. The patients included in the new study were all taking medications for heart failure, and the new study suggests that cell therapy may be beneficial when used in combination with heart failure medications.
“As you can imagine, we’re on this drug to keep everyone well, and now we have a cure that actually addresses the cause and calms it all down. So “There’s a really great future for this line of research, and I can see it. With confirmatory trials, we can make this kind of treatment mainstream,” said Perin. .
“We can treat heart failure differently,” he said. “We have a new weapon against heart failure. This research really opens the door and is leading the way for us to get there.”
“We have taken a big step”
The new study, sponsored by Australian biotechnology company Mesoblast, included 565 heart failure patients with weakened heart muscles between the ages of 18 and 80. Patients were screened between 2014 and 2019 and randomly assigned to receive cell therapy or placebo treatment. at 51 laboratories in North America.
Patients who received cell therapy had about 150 million stem cells delivered to their hearts through catheters. Cells were obtained from the bone marrow of 3 healthy young adult donors.
Researchers at the Texas Heart Institute and various other institutions in the United States, Canada and Australia monitored each patient for heart-related events and life-threatening arrhythmias.
Compared with patients who underwent sham surgery, those who received stem cell therapy showed a small but statistically significant strengthening of the heart’s left pump chamber muscle within one year.
Researchers also found that cell therapy reduced the risk of heart attacks and strokes by 58% overall.
“This is a long-term effect, lasting an average of 30 months, so we are very excited,” said Perin.
Researchers found that patients with high levels of inflammation in their bodies had an even greater reduction in combined heart attack and stroke risk of 75%.
“These cells directly deal with inflammation,” Perin said.
“There are very few receptors for these inflammatory substances, some called interleukins, others,” he said. “When you put them in an inflamed heart, the cells are activated and the cells have to respond, ‘Wow, this house is on fire. We need to put the fire out.’ secretes inflammatory agents. “
The researchers wrote in their study that their findings should be considered “hypothesis-generating” in that they show that this cell therapy concept might work, but these Clinical trials are needed to specifically confirm the effects of stem cells on heart attack, stroke, and other heart disease events. It is not yet known how long the effects of stem cell therapy will last beyond 30 months and whether patients will need more stem cell injections in the future.
Overall, there were no significant differences in adverse events reported between patients receiving cell therapy and those in the control group, and researchers reported no major safety concerns.
“We have taken a huge step forward in harnessing the true power of adult stem cells for heart therapy.”This trial truly signals a new era.
Benefits patients with inflammation
For more than a decade, scientists have been studying potential stem cell therapies for heart failure patients to determine whether this therapeutic approach can reduce the amount of hospitalizations, emergency care events, or complications in heart failure patients. requires further research.
Cardiologist Nieka Goldberg, M.D., medical director of Atria, New York City and associate professor of clinical medicine at New York University’s Grossman School of Medicine, who was not involved in the new study, said the new study didn’t find it. rice field.
A new study reveals that “there may be a population of people who may benefit from stem cell therapy, especially those with inflammation.”
“It’s actually an interesting treatment and it’s an interesting thing to look at. Once again the studies are demonstrating its benefits. In heart failure, there’s more than one thing going on, especially with the inflammatory component, which is interesting. “It could be therapeutic,” she said. “It may have a role in heart failure patients with inflammation.”
The effect of the treatment on heart attack and stroke risk was “positive,” said Dr. Brett Victor, a cardiologist at Philadelphia cardiologist, in an email. He was not involved in the study.
“Specifically, patients who received stem cell therapy were less likely to have a heart attack or stroke over the next 2.5 years, especially in those whose laboratory tests revealed a high degree of systemic inflammation.” Victor said in an email, adding that this shows how heart failure has a significant inflammatory component.
These “positive signals” are likely to be evaluated further in subsequent studies, Victor said.
“Current treatments for heart failure, including lifestyle changes, a growing list of good medicines, and device therapy, will remain the standard of care in the short term.” “I think this trial will continue to advance this field in heart cell therapy research, not only as we continue to look for ways to actually find a cure.”
