Heart failure is a serious yet relatively common condition that limits the ability of the human heart to properly supply the body with blood. The odds of heart failure increase as we age, so finding treatment options is becoming increasingly important as the population ages, particularly given the high cost of current heart failure treatment. However, ongoing research using stem cells seems to be opening doors for new treatment options.
Dr. Bernhard Kuhn, Associate in cardiology at Boston Children’s Hospital and Assistant Professor of paediatrics at Harvard Medical School, has been looking into the damage done during heart failure, and how naturally-occurring heart regeneration, which isn’t typically significant enough to reverse the damage, can be stimulated in order to encourage new heart cell development. What prompted Dr. Kuhn‘s research was the long-standing observation that some heart cells will re-enter the cell development cycle after a myocardial infarction (heart attack).
“Over the past 100 years, researchers have repeatedly found that some cardiomyocytes—heart muscle cells—in the border zone of the infarct re-enter the cell cycle,” Dr. Kuhn said during a February 8 presentation at the Ottawa Hospital Research Institute. “This was found repeatedly, and our work is based in part on that notion that there is some renewal and attempt to regenerate after myocardial infarction in an adult mammalian heart. It is not sufficient to induce clinically significant cardiac regeneration, but it suggests that some cardiomyocytes can be induced to re-enter the cell cycle. We are investigating this systematically with the goal of enhancing this process for therapeutic applications.”
Dr. Kuhn’s experiments began using neuregulin and periostin peptide, both extracellular proteins, to encourage cell development in rats which have suffered an infarction. What he found was that the injection of neuregulin did increase the number of heart cells. Subsequent tests confirmed that the heart became denser, rather than larger; that the new cells were fully differentiated and functional heart cells; and that the regeneration was sustained even after treatment, leading Dr. Kuhn to conclude that “neuregulin induces permanent, functional improvements.”
In moving forward in this pre-clinical research, Dr. Kuhn is looking to test his findings using larger animals, and different methods of treatment. Eventually, he hopes to determine how it might be used in human clinical trials in order to stem the progressive deterioration of the heart after heart failure.
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