A recent study, published in Circulation Research, has shown how umbilical cord mesenchymal stem cells may help patients who suffer from heart failure. The researchers observed patients with heart failure that was chronic and stable and that presented with reduced ejection fraction. Ejection fraction refers to the percentage of blood that leaves the heart each time the heart contracts and is normally 55% or higher. A reduced ejection fraction can indicate weakness, damage, or other problems.
In their investigation, the scientists aimed to evaluate whether infusing umbilical cord mesenchymal stem cells in this group of heart failure patients is safe – and whether the cells could improve any of the clinical features of heart failure in these patients. To do this, they infused 15 patients with umbilical cord mesenchymal stem cells and used a placebo in 15 other patients. They then tested patients for adverse side effects on the day they underwent infusions, as well as 15 and 90 days after the procedure.
None of the patients who underwent mesenchymal stem cell infusions exhibited adverse side effects over the period of time in which they were observed. Additionally, none of the patients tested positive for antibodies against the stem cells, meaning that the patients’ immune systems were not negatively reacting to the infusions. Based on these results, the researchers concluded that the mesenchymal stem cell transplants were safe for this group of heart failure patients.
The researchers also tested the patients’ cardiac function and quality of life 3, 6, and 12 months after the mesenchymal stem cell infusions. To do so, the scientists used imaging to look at the heart, employed ejection fraction level tests, and implemented what are known as the New York Heart Association functional class and Minnesota Living with Heart Failure Questionnaire.
The scientists’ tests showed that ejection fraction increased in the patients who had undergone mesenchymal stem cell infusions, with the most significant increase apparent at 6-month post-infusion. The patients who had received the placebo treatment, on the other hand, did not show any change in ejection fraction. Functional status and quality of life were also better because of mesenchymal stem cell infusion than placebo. Future studies will help us better understand how we can use these cells to help those with heart failure.
Learn about the regenerative potential of Mesenchymal stem cells here.
Heart failure is currently treated using pharmacologic interventions that help to control the symptoms of heart failure and slow the process of deterioration. However, these drugs do not stop problematic processes occurring at the cellular level, and so patients using these drugs continue to decline toward end-stage heart failure. Because the progression of heart failure involves things like cardiac remodeling and fibrosis at the cellular level, researchers have reasoned that cell-based therapies may be a promising way to treat heart failure patients. A recent review published in Stem Cells International outlines the rationale for using mesenchymal stem cells to treat heart failure and presents data from relevant clinical trials.
Mesenchymal stem cells are an attractive type of stem cell for both research clinical applications because of their ease of accessibility. These cells can be retrieved from a number of tissues, including fat tissue, heart tissue, umbilical cord tissue, and bone marrow tissue. A number of properties of mesenchymal stem cells also make them a promising therapeutic option for heart failure and other diseases. For instance, they have been shown to reduce inflammation and the initiation of inflammation and to promote the growth of blood vessels. Indeed, it has been suggested that the central process of heart failure is inflammation.
In cardiology, many of the clinical trials that have been performed with mesenchymal stem cells have focused on ischemic heart failure, though there are data demonstrating the promise of these stem cells in both ischemic and non-ischemic heart failure. While there are not as many data on the impact of mesenchymal stem cells on non-ischemic heart failure patients, the authors of the review argue that these cells could be even more advantageous in this group of patients (versus those with ischemic heart failure) because the damaged part of the heart still has adequate blood supply in the case of non-ischemic heart failure.
Overall, studies have tended to show that mesenchymal stem cells are a safe option, with little risk for significant adverse side effects. Clinical trials have helped to elucidate the specific ways that mesenchymal stem cells can be used to help with heart failure. Cellular scaffolds, for example, can be used to ensure that the stem cells are able to reach the target area of the heart in enough abundance to have an impact. Future studies will help to clarify the contexts in which these cells can be useful – and how their use can be optimized to help patients.