Stem cells

Stem cell heart repairs: 21st century medicine in action

 

Special to The Miami Herald

Gerard Cuomo loves to dance.

Until recently, however, the 70-year-old couldn’t even do a two-step.

After having three heart attacks in the early 1990s, Cuomo’s heart was severely damaged. The scar tissue that had formed around his heart left him easily fatigued.

“I felt like an old man,” said Cuomo of Aventura. “I could barely climb the stairs. I could walk for about a quarter of a mile. Shopping at the mall — I wish I did not have to sit down all the time.”

In May 2010, he participated in a University of Miami Miller School of Medicine’s clinical trial in which doctors injected stem cells directly into his heart muscle. The stem cells, because they are not fully formed, have the potential to grow into different kinds of cells, internalizing information from their environment to determine their future growth.

The study found that the injections built up the healthy heart tissue and reduced scar tissue by 33 percent — a “dramatic improvement,’’ said Dr. Joshua Hare, director of UM’s Interdisciplinary Stem Cell Institute, which conducted the study with Johns Hopkins University. The new tissue remodeled the heart to look more like a healthy, football-shaped heart.

“This is a real example of 21st century medicine,” said Hare, the Louis Lemberg Professor of Medicine in the Cardiovascular Division. “Without doing any specific manipulation, we didn’t coax them, they knew where to go. They work in ways that make a lot of sense.”

The results of the study, funded by the National Institutes of Health, were published in November by the Journal of the American Medical Association. Half of the 30 men enrolled in the study received injections of their own stem cells, while the other half got stem cells from a third-party donor.

“Using a donor is a huge convenience factor,” Hare said. “We can store large quantities of the stem cells in a cell bank and use them whenever the need arises.”

Cuomo’s stem cells were extracted from his bone marrow. He had to wait about six weeks after extraction to have them re-injected into his heart. During that time, doctors cultivated and tested the cells.

Now, UM doctors are working to take their research a step further — combining bone marrow stem cells with stem cells taken directly from the heart. Preliminary results of heart/stem cell studies at the University of Louisville have been encouraging.

“The bottom line is, can we do something to further help patients?” Hare asked.

The research into stem cells dates back to late last century. Previously, once an organ was damaged from a heart attack, the scarring was permanent unless the patient underwent a heart transplant — a relatively rare procedure.

Doctors have studied embryonic stem cells as well as adult stem cells stored in the bone marrow, umbilical cord blood and body fat.

The Food and Drug Administration has not approved these stem cell treatments. Rather, researchers are trying to determine if this is a valid protocol for treating a damaged heart.

Cuomo said he would rather be enrolled in a clinical trial of a non-FDA-approved treatment than live the limited life he was living.

“I’d rather take the shot and have a better quality of life,” he said.

Today, he enjoys daily long walks with his dog, Muffy, and has been on several cruises with his family.

“We didn’t travel before I had the treatment,” he said. “You are reluctant to travel when you feel gingerly about your condition.”

Hare said it would take about five years to receive FDA approval if stem cells are cleared as a drug, perhaps less time if stem cells are approved as a non-drug.

“We are envisioning a time when this could become an established treatment,” he said. “The point is that the results are very exciting and very promising.”

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