What You Need To Know About The New Implants To Patch Up Failing Hearts Is It Really A 'Breakthrough'?

(MENAFN- The Conversation) There are many difficulties in converting any biological research into a medicine that will treat patients. Because of the complexity involved, these difficulties apply especially to translating cell research in the laboratory to a successful treatment for heart failure, where the heart is unable to pump blood around the body properly.

The definitive treatment for heart failure is a heart transplant – a difficult and costly procedure. Pills are prescribed for the condition, but they only delay death and are not effective in changing the cause of the disease.

Fifteen to 20 years ago, scientists started enthusiastically exploring the use of heart muscle precursor cells grown in the laboratory to transplant to the failing heart in the hope that they might make new heart muscle. Although results in animal tests were positive, they all failed in humans. Included in the failures was the one that my colleagues and I conducted .

We'd had success with animal studies and even some positive results in small groups of patients. Buoyed by these results, we organised a randomised controlled trial – the gold standard for medical studies in humans.

Our study was funded by the European Commission and entailed a massive effort by a large group of researchers across Europe. The result was that the therapy, which entailed injecting bone marrow cells into the heart muscle of patients who had had a heart attack, did not work.

I was therefore surprised to read recently that an article in Nature on this subject had an enthusiastic reception in the press. It was variously described as “groundbreaking” , “remarkable” and a “major breakthrough” .

The authors of the article report growing patches of heart muscle in the lab from precursor cells and then applying those patches to the hearts of monkeys that had had an induced heart attack, producing heart failure.

A woman who'd had a heart attack in 2016 also had the procedure. Three months later, she had a heart transplant, allowing the researchers to analyse her heart.

As this was the only case of a human receiving this treatment, and the procedure had failed, as the heart was removed from the patient, the title of the Nature article is perhaps too wide in its scope: Engineering heart muscle allografts for heart repair in primates and humans.

It is noted that a senior author of the article declares that he has shares in the company that will commercialise any success. This conflict may have been declared, but it is still a potential conflict.

Pills for heart failure only delay death. They don't reverse the cause. studiomode/Alamy Stock Photo Heart arrhythmia

The article does not discuss previous attempts to use heart muscle precursor cells for treating heart failure in humans. In particular, the pioneering work in Paris of the surgeon Philippe Menasché who in 2003 reported in the Lancet that he had injected heart muscle precursor cells into the myocardium (heart muscle) of a patient with apparent success.

He then published the results of a study where he repeated the same procedure in a larger group. The study was not successful. Menasché noted that some of the patients suffered from cardiac rhythm abnormalities following the procedure.

There was much discussion in the field that the junctions between the transplanted cells and the patient's own heart muscle cells might give rise to abnormal electrical activity that would unpredictably produce potentially fatal heart rhythm change.

Because of the history of failure of cell therapy in human trials after positive tests in lab animals, the objective reader should regard results from animal experiments with scepticism.

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