Stem cell therapy offers potential new treatment option for people with chronic heart failure
Injecting patients with human bone marrow-derived stem cells significantly reduces their rate of heart attack or stroke according to the results from the largest cell therapy trial in patients with chronic heart failure.
The therapy also reduced the rate of heart attack or stroke in patients with high levels of a blood marker for inflammation by 75%.
Inflammation plays a pivotal role in the initiation and progression of heart failure and this is what the stem cell type, called mesenchymal precursor cells (MPCs), addresses.
“The cells appear to work by reducing inflammation, increasing microvascular flow, and strengthening heart muscle,” says lead author, Dr Emerson C. Perin, Medical Director at The Texas Heart Institute in the US.
“The results of DREAM-HF are an important step in understanding how cell therapy provides benefits in patients with chronic heart failure due to poor pump function.”
DREAM-HF stands for Double-Blind Randomized Assessment of Clinical Events With Allogeneic Mesenchymal Precursor Cells in Heart Failure.
The new study is in the Journal of the American College of Cardiology. The research was performed at 51 sites across North America in 565 patients (18-80 years of age) with chronic heart failure due to low “ejection fraction” – meaning the heart isn’t pumping enough blood.
Patients enrolled in the trial were already on full guideline-recommended drug therapy for heart failure, so the effect of the cell therapy was synergistic with, and additive, to the heart failure medication.
They were treated with MPCs by direct injections into the heart, while control patients underwent a mock procedure with no injections.
Within the first 12 months following injection, patients showed a significant strengthening of the left ventricular muscle, measured by an increase in the percentage of blood leaving the heart each time it squeezes. This improvement was even more pronounced in patients with higher inflammation levels.
MPCs are multipotent stem cells found in bone marrow. They can differentiate into a variety of cell types and have potent anti-inflammatory, pro-angiogenic (formation of new blood vessels), and pro-healing effects.
“Locally, in the heart, the MPCs can protect cardiac muscle cells from dying and can improve blood flow and energetics,” says Perin.
“In large blood vessels throughout the body, the reduced inflammation resulting from the activation of MPCs may decrease plaque instability, which is what leads to heart attacks and strokes.
“The cells seem to have a systemic immune-modulatory and anti-inflammatory effect.”
This trial sets the stage for eventually incorporating stem cell therapy into the toolbox for treating heart failure.
“The Texas Heart Institute has spent two decades pioneering the development of cellular therapies for the heart and continues to lead the world in this breakthrough work,” says advanced heart failure specialist Dr Joseph G. Rogers, CEO and President of The Texas Heart Institute.
“MPC therapy could change the future of cardiovascular care for patients with heart failure due to inflammation.”
Cosmos, 9 March 2023