26-6-2023 (SINGAPORE) Researchers at Duke-NUS Medical School in Singapore have made significant progress in developing a new stem cell therapy that could revolutionize heart failure treatment. The therapy utilizes immature stem cells to address a persistent challenge faced by previous methods: the synchronization of implanted cells with the patient’s heartbeat.
In a study published in the journal npj Regenerative Medicine, the team cultivated immature stem cells in the laboratory to produce heart muscle precursor cells. These precursor cells have the potential to develop into various types of heart cells. By injecting these cells into the damaged area of the heart, which occurs during a heart attack, the team observed successful regeneration of heart tissue and an improvement in heart function. The study’s positive outcomes were demonstrated in pre-clinical trials involving pigs.
Dr Lynn Yap, who led the research while serving as an assistant professor at Duke-NUS Medical School, explained the significance of the new approach. “This gives us an edge over beating heart cells. These less mature cells possess higher potency, and we also observed a reduction in arrhythmia,” she said. Arrhythmia refers to abnormal heart rhythms that can impede blood flow.
Previous attempts using transplanted beating heart cells often resulted in adverse effects such as ventricular arrhythmia, a condition where irregular electrical signals disrupt the lower chambers of the heart’s rhythm. The clash between the transplanted cells’ rhythm and the existing heartbeat created a conflict that proved fatal in many pre-clinical studies.
The foundation of the immature stem cell project lies in three decades of research on laminin, a group of human proteins, by Professor Karl Tryggvason from Sweden’s Karolinska Institutet and Duke-NUS Medical School. “Our approach represents an emerging method of treating diseases. The therapy involves stem cell-derived cells that can replace degenerated tissue or cells, ultimately repairing the affected organ or tissue by creating new healthy tissues,” explained Prof Tryggvason.
The team transplanted immature stem cells into ten pigs during the study, with five of them developing ventricular tachycardia (V-tach), a heart rhythm disorder caused by irregular electrical signals in the heart’s lower chambers. However, the V-tach observed in these cases was temporary and non-lethal, lasting for 30 days. Dr. Yap foresees that approximately half of the patients receiving the transplant may experience this condition, but she emphasized that they would be closely monitored and receive necessary interventions to ensure their safety.
The next phase of this treatment involves addressing arrhythmia control. “In this current study, we did not use any drug treatment to intervene, so there is room for improvement. Moving forward, I plan to develop a second-generation cell therapy that is even safer. We will collaborate with clinicians to incorporate arrhythmia-controlling drugs and reduce the incidence of such events. Once we achieve success, we will be one step closer to initiating phase 1 clinical trials,” stated Dr. Yap.
Phase 1 clinical trials typically involve testing a new drug, treatment, or medical device on human participants for the first time.
According to the Singapore Myocardial Infarction Registry Report 2020, there was a significant increase in heart attack cases, with nearly 11,631 reported in that year alone, compared to 7,344 cases in 2010. The report also highlighted that over 9% of cases resulted in death within 30 days. The development of this stem cell therapy offers hope for improving the treatment outcomes and prognosis of heart failure patients, potentially reducing the mortality rate associated with heart attacks.
