ANALYSIS:THE POTENTIAL impact of the latest research into stem cell therapy is immense. Heart failure is one of the leading causes of chronic illness and disability in Ireland and other developed countries; if the significant improvements shown in the Scipio (Stem Cell Infusion in Patients with Ischemic cardiOmyopathy) trial can be reproduced in larger studies then we truly have a game-changing treatment on our hands.
Until now, experiments using stem cells from bone marrow have produced limited results in people with cardiac disease. And existing treatments for heart failure do not address the fundamental problem of dead cardiac muscle tissue.
At present, a person diagnosed with heart failure will likely be treated with a diuretic – to remove some of the pooled fluid from the legs, lungs and other parts of the body where it lodges because the heart can no longer pump blood. They may also be prescribed drugs called ACE inhibitors and other agents designed to increase the contractility of the surviving heart muscle.
However, these treatments aim to correct the effects of heart failure rather than address its most common root cause: damaged heart muscle following a heart attack. Adult hearts contain stem cells that are self-renewing and they have the ability to turn into heart muscle or heart vessel cells. Prof Roberto Bolli and his colleagues infused the stem cells into the hearts of some 16 patients using a tube inserted into the groin and threaded up into the coronary arteries. Not alone did the treatment increase the pumping action of the heart but the researchers also showed a reduction in the amount of previously dead heart muscle tissue. And although the numbers reported from this ongoing trial are small, patients reported a reduction in heart failure symptoms.
The main reasons for optimism from this research are its rigorous quality standards and the unexpected magnitude of its reported benefits. Once its results are reproduced in greater numbers and over a longer time period many people with severe heart failure can look forward to benefiting from a new treatment paradigm.