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Regional Stem Cell Infusion trials show exciting promise for the future of cardiac medicine

On January 6th, 2010, Brenda Sigmund of Sebewaing, had a heart attack.

Brenda was first taken to the hospital in Sebewaing, and then transferred to St. Mary’s in Saginaw. “I had pain in the back of my upper arms, and then it felt like there was a cinder block on my chest,” Brenda said.

Women may experience fewer typical symptoms than men, most commonly shortness of breath, weakness, a feeling of indigestion, and fatigue. In some cases women experience flu-like symptoms, pain in the arms, shoulders, back, and jaw.

Once at St. Mary's, Brenda received a number of diagnostic tests, such as an electrocardiogram (ECG, EKG), a chest X-ray and blood tests to detect elevations in cardiac markers (blood tests to detect heart muscle damage). A heart attack is the interruption of blood supply to part of the heart, causing some heart cells to die. When these blood cells die, chemicals are released that are detectable by a simple blood test.

Ultimately, Brenda underwent a heart catheterization, and then four days later, became the second patient to receive the Prochymal® Stem Cell Infusion. The procedure is simple. The patient is given a dose of Benadryl to prevent an allergic reaction, and the stem cells are administered through an I.V.

Prochymal® is a formulation of adult stem cells taken from bone marrow that is currently under clinical investigation to determine its ability to reduce inflammation and promote regeneration of heart tissue. As a participant in the trial, Brenda doesn’t know whether she received the stem cells, or a placebo.

Mesenchymal stem cells are very abundant in the bone marrow, and able to multiply rapidly outside the body. Enough can be produced from just one donor to treat many people, and since everyone has the same stem cells, there’s no risk of rejection. Race and gender are not factors in producing the formulation.

“Stem cells represent a promising cardiac research avenue, given their potential to preserve heart function in at-risk patients,” said Safwan Kassas, MD, Director of Stem Cell and Regenerative Medicine Program at MCVI. Dr. Kassas is an interventional cardiologist with MCVI and conducting research at Covenant HealthCare.

The purpose of the trial is to show that stem cell treatment will improve the heart muscle. Only a select group of people will be chosen to participate in the blind test. The evaluation will span 1 to 2 years in order to determine if the heart muscle can recover.

"We're so happy to have someone like Brenda who is willing to participate in our program," said Kathleen Mostek, RN, CCRC, Clinical Director of Research and Regenerative Medicine, State of the Heart Research Program.

Perhaps the most important potential application of human stem cells is the generation of cells and tissues that could be used for cell-based therapies. Today, donated organs and tissues are often used to replace ailing or destroyed tissue, but the need for transplantable tissues and organs far outweighs the available supply. Stem cells offer the possibility of a renewable source of replacement cells and tissues to treat diseases including Alzheimer's diseases, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis, and rheumatoid arthritis.

For example, it may become possible to generate healthy heart muscle cells in the laboratory and then transplant those cells into patients with chronic heart disease.

Cardiovascular disease can deprive heart tissue of oxygen, thereby killing cardiac muscle cells (cardiomyocytes). This loss triggers a cascade of detrimental events, including formation of scar tissue, an overload of blood flow and pressure capacity, the overstretching of viable cardiac cells attempting to sustain cardiac output, leading to heart failure, and eventual death. Restoring damaged heart muscle tissue, through repair or regeneration, is therefore a potentially new strategy to treat heart failure.

It is entirely possible that within 5 years, stem cells could become a commonly used medical treatment.

 

 

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