People who suffer from heart failure could someday be able to use their own skin stem cells to regenerate their damaged heart tissue, according to a new Israeli study.
Researchers took stem cells from the skin of two patients with heart failure and genetically programmed them to become new heart muscle cells. They then transplanted the new cells into healthy rats and found that the cells integrated with cardiac tissue that already existed.
The study, published in European Heart Journal, marks the first time ever that scientists could use skin cells from people with heart failure and transform damaged heart tissue this way.
The newly generated cells turned out to be similar to embryonic stem cells, which can potentially be programmed to grow into any type of cell.
"What is new and exciting about our research is that we have shown that it's possible to take skin cells from an elderly patient with advanced heart failure and end up with his own beating cells in a laboratory dish that are healthy and young – the equivalent to the stage of his heart cells when he was just born," Dr. Lior Gepstein, lead researcher and a senior clinical electrophysiologist at Rambam Medical Center in Haifa, Israel, said in a news release.
The findings open up the possibility, the authors wrote, that people can use their own skin cells to repair their damaged hearts, which could prevent the problems associated with using embryonic stem cells.
"This approach has a number of attractive features," said Dr. Tom Povsic, an interventional cardiologist at Duke University Medical Center. "We can get the cells that you start with from the patient himself or herself. It avoids the ethical dilemma associated with embryonic stem cells and it removes the possibility of rejection of foreign stem cells by the immune system." Povsic was not involved with the Israeli study.
Another advantage of using skin cells is that other types of cells taken from patients themselves, such as bone marrow cells, could potentially lead to the development of unhealthy tissue.
"If a patient is already sick with heart disease, one of the reasons it may develop is that stem cells weren't able to repair the heart the way they should," Povsic added. Skin cells, he explained, are generally healthy.
Promising, but Still Very Early
"It is very exciting and very interesting, but we are far away from taking this to patients," said Dr. Marrick Kukin, director of the Heart Failure Program at St. Luke's-Roosevelt Hospital who was also not involved in the Israeli study.
Kukin explained that the study only involved two patients, and the cells were transplanted into healthy rat hearts that showed no signs of heart failure.
"Will it work in heart muscle that's dead? Also, how many cells are needed to get an effect in the human heart, and how will they grow the cells to get the critical mass needed," he asked.
There are still a number of major experimental steps that need to take place before trying out this type of therapy in humans, Kukin added.
"These results need to be replicated, and animal studies on mammals need to be done," he said. There should also be studies done on animals whose hearts have been damaged.
Research into cardiac regeneration is ongoing using skin and other types of cells, the experts say, and it could offer hope to people living with damaged hearts.
"With heart attacks, there is no clinically meaningful regeneration. The damage is done, and most medical therapy is aimed at preventing further damage or cope with existing damage," said Povsic. "If we can generate stem cells in a sufficient quantity and manner, we can potentially regenerate organs that have limited native regenerative capacity. We're excited by these steps forward."