DNAplays a part in immune system reaction to Heart Failure
DNA from a person’s own heart can play a significant part in heart failure by wrongly activating the immune response. A study co-funded by the British Heart Foundation and carried out by researchers in the UK and Japan found that in some people with this DNA the immune response is triggered during heart failure. This causes inflammation which makes the heart muscles less effective and reduces the ability to pump blood around the body.
The study, published by the journal Nature, found that the immune system is triggered by the release of DNA from the energy-generating structures in heart cells called mitochondria. Mitochondria evolved billions of years from bacteria and now share a similar DNA footprint, often causing a mistaken response from the immune system which recognises it as bacteria. “This intriguing discovery is an important breakthrough in our understanding of why, during heart failure, the immune system becomes activated without the presence of any obvious external threat,” Dr Shannon Amoils, research advisor at the BHF said.
Stem cells taken from a patient’s own heart have, for the first time, been used to repair damaged heart tissue, researchers claim. The study, published in the Lancet, was designed to test the procedure’s safety, but also reported improvements in the heart’s ability to pump blood.
The authors said the findings were “very encouraging”
Other experts said techniques with bone marrow stem cells were more advanced and that bigger trials were needed. The scientists say this is the first reported case of cardiac stem cells being used as a treatment in people after earlier studies had shown benefits in animals.
The preliminary trial was on patients with heart failure who were having heart bypass surgery. During the operation, a piece of heart tissue, from the right atrial appendage, was taken. While the patient was being sown up, researchers isolated cardiac stem cells from the sample and cultured them until they had about two million stem cells for each patient. The cells were injected about 100 days later. Doctors measured how efficiently the heart was pumping using the left ventricle ejection fraction – what percentage of blood was leaving one of the heart’s main chamber with every beat. Dr Roberto Bolli University of Louisville said “We believe these finding are very significant”
In the 14 patients given the treatment, the percentage increased from 30.3% at the beginning of the trial, to 38.5% after four months.
There was no change in the ejection fraction in the seven patients who were not injected with stem cells.
“Our results indicate that cardiac stem cells can markedly improve the contractile function of the heart.”
However the heart is not the only source of potentially useful stem cells. Trials have already taken place using stems cells from bone marrow.
Prof Anthony Mathur, from Barts and the London School of Medicine and Dentistry, and Prof John Martin, from University College London, are already conducting large randomised clinical trials. Prof Peter Weissberg British Heart Foundation “This is positive, but the crucial next steps are to see whether this improvement is confirmed in the final completed trial”
Prof Mathur said of the cardiac stem cell study: “Caveats very much apply. It’s a phase one trial so while the early results are great and promising, they need to design a big study to see if the results translate.”
He also cautioned that improvements in ejection fraction were not the same as increasing survival or quality of life.
Prof Martin said he was “concerned” that the seven patients in the control group showed no improvement in ejection fraction, which would normally be expected, and that they were not given a sham treatment to account for the placebo effect.
He said that was acceptable when just testing a procedure’s safety, but not when looking at effectiveness, which relies on the difference between the treated and control groups. Prof Peter Weissberg, medical director at the British Heart Foundation, argued that the improvement in heart function was similar to those in other studies.
“This is positive, but the crucial next steps are to see whether this improvement is confirmed in the final completed trial, and to understand whether the cells are actually replacing damaged heart cells or are secreting molecules that are helping to heal the heart,” he added.
Dr Bolli argues that stem cells from the heart might be more useful as “their natural function is to replace the cells that continuously die in the heart due to wear and tear”. He hopes to start the next phase of clinical trials in 2012
The official launch of the “Heart of Blackburn” appeal happened 0n 19th May 2011 at the cardiology department of the Royal Blackburn Hospital. The appeal needs to raise £128,000 to purchase this new machine.
So why does East Lancashire need this machine?
EchoCardiographs are a specialised test which look at the strucutre of the patient‘s heart. A probe is placed on the chest and a pulse of high frequency sound is passed through the skin. The echoes reflected by the pulse show as a picture on the screen. The images provide extremley accurate and detailed information about the structure, valves and pumping action of the heart, helping Doctors make more informed and speedier diagnoses. Dr Emily Ho says “The new machine will enable patients to be seen more quickly, to expedite their treatment and this ultimatley saves lives.
Images of our latest Charity fundraising event on European Heart Failure Awareness Day for Heart Failure Patients in conjunction with the BHF and NHS East Lancahsire. We raised £500 on the day.
Optimistic – We are!
The Sunday Times has reported the following information reference fixing damaged hearts. It goes to show that research and more interestingly practical steps are being made on stem cell development for injured hearts.
American researchers believe that artificial hearts developed in laboratories could start beating within weeks. The experiment is a major step towards the first ‘grow-your-own’ heart. The organs were created by removing muscle cells from donor organs to leave behind tough hearts of connective tissue. Researchers then injected stem cells which multiplied and grew around the structure, eventually turning into healthy heart cells. Dr Doris Taylor, an expert in regenerative medicine at the University of Minnesota in Minneapolis, said: ‘The hearts are growing, and we hope they will show signs of beating within the next few weeks.” ‘There are many hurdles to overcome to generate a fully functioning heart, but my prediction is that it may one day be possible to grow entire organs for transplant.’
Patients given normal heart transplants must take drugs to suppress their immune systems for the rest of their lives.
This can increase the risk of high blood pressure, kidney failure and diabetes.
If new hearts could be made using a patient’s own stem cells, it is less likely they would be rejected.
So how are they doing it…
The lab-grown organs have been created using these types of cells – the body’s immature ‘master cells’ which have the ability to turn into different types of tissue. The experiment follows a string of successes for researchers trying to create spare body parts for transplants.
In 2007, British doctors grew a human heart valve using stem cells taken from a patient’s bone marrow
Grow your own heart
- The donor heart is removed from the body; pig hearts may also be suitable as they are very similair to humans.
- Detergents are then used to strip the cells from the heart leaving behind the protein skeleton or ‘ghost heart’.
- Stem cells grown from cells taken from a patient are then added to the ghost heart.
- The stem cells then multiply and generate new heart cells. now all that is left is the hope that these will start beating.
A year later, scientists grew a beating animal heart for the first time.
Dr Taylor’s team have already created beating rat and pig hearts. Although they were too weak to be used in animals, the work was an important step towards tailor-made organs. In their latest study, reported at the American College of Cardiology’s annual conference in New Orleans, researchers created new organs using human hearts taken from dead bodies. The scientists stripped the cells from the dead hearts with a powerful detergent, leaving ‘ghost heart’ scaffolds made from the protein collagen.
The ghost hearts were then injected with millions of stem cells, which had been extracted from patients and supplied with nutrients. The stem cells ‘recognised’ the collagen heart structure and began to turn into heart muscle cells. The hearts have yet to start beating – but if they do, they could be strong enough to pump blood.
However, the race to create a working heart faces many obstacles. One of the biggest is getting enough oxygen to the organ through a complex network of blood vessels. Scientists also need to ensure the heart cells beat in time. Dr Taylor indicated that: ‘We are a long way off creating a heart for transplant, but we think we’ve opened a door to building any organ for human transplant.’
We are of course will be following the developments carefully especially with the British Heart Foundations “Mending Broken Hearts Campaign” in aid of raising £50 million for research into mending broken hearts.
New 3D Echo Appeal for the Royal Blackburn Cardiology Department
The BHF are supporting and fund raising for a new 3D Echo Cardiogram machine that will enable cardiac consultants to further help heart failure patients in the East Lancs area via the Royal Blackburn Hospital. Pumping Marvellous will be adding that local touch to the campaign and assisting the BHF with it’s target. When we have further details we will do a more concise piece on it but here are some of the photos taken that will be used in the media campaign to build awareness of the cause.
That clever little fish!
If you are interested this is the science behind our new friend the Zebra Fish