According to a study on how to repair the effects of cardiac failure, stem cells taken from a patient’s own body could help restore the health of a malfunctioning heart.

To replace damaged heart tissue, scientists have shown that it is possible to grow cardiac stem cells in the laboratory prior to transplanting them back into a patient.

Offering an alternative treatment to a complete heart-transplant operation, the findings demonstrate the prospect of rebuilding cardiac muscle that had been destroyed during a heart attack.

Since a pig’s heart is so similar to the human heart, the experiment was conducted on pigs. But the researchers involved said that clinical trials on people could begin in 12 months’ time.

The technique involves taking a small biopsy – a sample of living heart muscle – that is no bigger than a grain of rice said Professor Eduardo, head of cardiology at the Johns Hopkins University School of Medicine in Baltimore, Maryland.

Using a standard method of accessing the organ through a catheter inserted into an artery in the leg, an infusion of stem cells was put into the animal’s heart. The stem cells were derived from a biopsy and then grown in the laboratory prior to infusion.

“This is a relatively simple method of stem cell extraction that can be used in any community-based clinic, and if further studies show the same kind of organ repair that we see in pigs, it could be performed on an outpatient basis,” Professor Eduardo said.

“Starting with just a small amount of tissue, we demonstrated that it was possible, very soon after a heart attack, to use the healthy parts of the heart to regenerate some of the damaged parts,” he said.

The stem cells in the experiment were labeled with a colored dye so that the scientists could see where they became integrated into the structure of the heart. The cells were cultured for up to a month in the laboratory.

About 10 million cells were injected back into the heart after growing them in the laboratory. The preliminary biopsy extracted about a million stem cells initially. After infusion, the stem cells were still embedded in functioning tissue two months later.

Professor Eduardo said that rather than measuring the physical benefits, the purpose of the experiment was to see whether or not the integration occurred. An examination of the therapeutic qualities of the infusion will form the next stage of the experiment.

“But we have proof of principle, and we are planning to use larger numbers of cells implanted in different sites of the heart to test whether we can restore function as well,” Professor Eduardo said.

“If the answer is yes, we could see the first phase of studies in people in later 2007,” he said.

As the undifferentiated cells of the body, stem cells are capable of forming specialized tissues, such as cardiac muscle.

Taking adult stem cells from a patient’s own heart could provide an alternative to using stem cells taken from a cloned human embryo.

Among other advantages, the transplanted tissue will not be rejected by the body’s immune system since the patient will be using his or her own cells. This will eliminate the need for potentially damaging drugs.

“The goal is to repair heart muscle weakened not only by heart attack but by heart failure, perhaps averting the need for heart transplants,” said Peter of the Hopkins’ Heart Institute.

“By using a patient’s own adult stem cell rather than a donor’s, there would be not risk of triggering an immune response that could cause rejection,” he said.

The results of the study were released yesterday at the American Heart Association’s annual meeting in Chicago.

Routine stem cell therapies for certain types of heart disease will become a reality in 3-5 years according to Dr. Amit of the University of Pittsburgh Medical Center. All he has to do is succeed in his ongoing clinical trials using cell therapy in congestive heart failure.

The U.S. Food and Drug Administration (FDA) has made Amit the only individual in the entire nation to gain its endorsement to undertake clinical trials for treating heart patients by directly injecting adult stem cells into the heart. Bone marrow is the source of stem cells for the experiment.

The clinical trial for ‘Autologous Bone Marrow Progenitor Cell Treatment for Heart Failure,’ at the University of Pittsburgh Medical Center is lead by Dr. Amit. He is the director of the Center for Cardiac Cell Therapy at the university.

Amit has taken 5 volunteers who would eventually undergo heart transplantation after a few months and injected adult stem cells into the patients’ hearts. As routine as it is to harvest hearts from animals that are under trial, the same is close to reality for humans as well. Removing and studying the hearts that have been injected with adult stem cells a few months prior to transplantation is a possibility.

“This will give an opportunity to evaluate the mechanism of the cells delivered into the human heart,” he noted. “This is the primary endpoint of the study.”

In an earlier study he had shown that “Autologous stem cell transplantation led to significant improvement in cardiac function in patients undergoing off-pump coronary artery bypass grafting for ischemic cardiomyopathy.”

Hearts that were removed 3-6 months after the stem cells were injected showed, “significant angiogenesis,” said Dr. Amit. Four hearts have been removed and examined since the trial started. “We are seeing growth of new blood vessels — angiogenesis,” he said.

So far all FDA approval has been for using adult stem cells for treating heart patients due to the ethical dilemmas surrounding embryonic stem cell research.

Millions of individuals exercise to get rid of unwanted body fat every single day. But that same fat that so many try to burn off, may one day save their lives.

The very fat that many try to rid themselves of contains baby fat cells. Those stem cells can be isolated form the tissue, cultivated in a laboratory dish and molded into the type of cells you want to grow. Singapore doctors are planning on doing just that. Clinical trials will soon be in progress to develop techniques that will take a patient’s fat tissue and create new cartilage, bone, and fat stem cells.

Promising results from animal experimentation has pushed ahead human clinical trials which should begin in 18 months.

The research team knows that the potential for new treatments is limitless, despite the dream still being quite young. The fat stem cells could help diabetics produce their own insulin, or help in breast reconstruction for cancer patients.

Renowned surgeon Dr. Susan is closely involved with this particular project, and for the past three years has been deeply involved with stem cell research at the National University of Singapore.

In 1990, the first successful liver transplant in South-East Asia was performed by Dr. Susan, and she says that stem cell research could revolutionize even that particular field in the future.

Whole organs like the pancreas or the liver were initially used during a transplant procedure. But as Dr. Susan explained, new procedures were put in place to split an organ and share it around instead due to short supply.

Islet cells to treat diabetes and liver cells to address liver failure will be the ultimate solution.

Cell rejection was once a possibly hurdle, but a person’s own stem cells can be used to treat him with adult stem cell research she said.

“This does not even pose any ethical questions, unlike the use of stem cells from embryos,” said Dr. Susan. “It is a very exciting and promising field.”

Multiple varieties of cells can be formed from stem cells. And since fat is something that most would be glad to part with, there is good reason for Dr. Susan to target fat tissue in her research.

“If someone says that he needs to take your liver cells for example, most patients will be hesitant,” she said. “So you must look for something that the patient is ready to part with. And everyone’s ready to part with fat.”

Dr. Susan’s team just has to build on the recipe for fat, cartilage, and bone cells, since there has already been a great deal of global research on how stem cells can be cultivated.

“The aim is to produce lots and lots of these particular cell types to treat the specific disease and in the end to transplant these cells back to the person,” said Susan.

She says that the current cost of whole organ transplantation is more than what the stem cell procedures will cost.

Even more ambitious plans that exceed breast reconstruction for cancer patients are being tested for future application. Stem cells could be used by diabetic patients to generate islets so they can produce their own insulin. Generating heart muscle cells are also on tap for the future.

“We are greatly inspired to continue this work as there are many patients to-date with spinal cord injuries and other degenerative nerve injuries who desperately need new treatment options,” she said.

All that is needed is for individuals to be willing to part with those parts of the body that may be a little to curvaceous for their own taste.

When Florida doctors could do no more to improve his failing heart, Jack flew to Thailand for help.

In an experimental procedure to improve the heart’s ability to pump blood, stem cells from his blood were multiplied by the millions and put into his heart.

Improvement wasn’t certain, and at the Bangkok Heart Hospital the treatment cost him between $30,000 and $35,000.

The Lakeland man wasn’t willing to risk not receiving the operation. Without the procedure, Jack would have been giving in to his steadily worsening congestive heart failure.

“My thoughts were `I don’t have much time left and I’m going to do what I have to do,’ ” said Jack, who is 76.

When he left for Thailand, the percentage of blood pumped from the heart each beat – his ejection fraction – was 20 percent or less, Jack said. Anything below 35 is low; normal pumping ability is 50 to 75 percent.

Jack is happy he got the procedure because his pumping percentage began to increase only four months later to 23 percent. Jack is optimistic that it will continue to go up instead of down.

“I can tell I’m much stronger on the inside than I was,” he said. “If I can make the same progress in the next three months . . . I’ll be in good shape.”

Don Ho, a world famous singer who is well known for “Tiny Bubbles” and “The Hawaiian Wedding Song” had the same procedure done late last year. Jack decided to get the treatment after seeing the improved condition of Ho.

The treatment isn’t mumbo jumbo, although it is still considered experimental.

A growing number of researchers in the United States and abroad are studying whether cellular treatment, using a patient’s own stem cells, can present enhanced health for many patients.

With the potential to develop into many types of cells, the range of stem cells cannot be questioned.

The use of adult stem cells avoids many of the ethical and moral disagreements inherent in embryonic stem cell use, which has dominated public discussion of stem-cell treatment thus far.

Doctors want additional treatments to offer their patients, especially with an aging population and the increasing number of heart-attack survivors with damaged hearts.

“I’m very excited about it,” said Dr. Kevin, a Lakeland cardiologist and director of Watson Clinic Center for Research.

“The future of this whole area may revolutionize our care of people with weak hearts. . . . That’s one of the most cutting edge approaches that’s happening, but it’s a little ways off.”

Before accepting him as a patient, Jack said his cardiologist, Dr. Luis, was very cooperative in providing the doctors in Thailand with information. Dr. Luis could not be reached for comment.

Jack said concern arose amongst the heart doctors in Thailand as to whether his heart would be able to accept stem cells.

However, it was determined that more than 50 percent of his heart was in good shape when Dr. Luis tested him.

“Though that operation is not legal in this country, supplying the supporting information is not illegal, so Clark & Daughtrey (Medical Group) gave them records back to 1999,” he said.

In 1977, Jack had a heart attack. A double bypass, valve repair and surgery to peel away scar tissue were performed in 1999. The procedure didn’t end his weakness in his heart’s pumping mechanism, but it did by him some time.

“Congestive heart failure is a breakdown in the heart’s ability to squeeze out liquid,” he said.

There was a lot of information to assess prior to being accepted as a patient for stem cell treatment.

Jack had extreme weakness and suffered from hallucinations last fall when he was admitted to LRMC. It was with the understanding that he would get hospice care when he finally went home, said Jack.

His mind and heart weren’t prepared for dying.

“You join a hospice to have a comfortable death,” he said. “That’s why I joined, but I fooled them.”

While researching Jack’s condition online, his daughter Susan found information about the procedure.

Dr. Luis continues to monitor Jack’s heart. His experience is different form that of another Florida man whose doctor actually dropped him as a patient after he received stem-cell therapy.

Jack agreed earlier this month to talk about his experience and the stem-cell treatment at a Lakeland South Rotary Club meeting, and he is eager to make others aware of the procedure.

Jack and his wife, Norma, spent three weeks in Thailand.

Tests occupied one week. Another was spent sending the blood to a lab in Israel, where the stem cells were multiplied, said Jack.

Receiving the cells involved two incisions, a small one on his right side and another, about six inches long, on the left side.

“The most difficult part of the whole thing was the trip back,” he said. “A 24-hour day became a 36-hour day.”

Powerless to catch his breath, Shelton initially became aware of the fact that his heart was straining while square-dancing one evening.

“He started getting worse and worse,” Shelton said, and he was finally diagnosed with congestive heart failure at Cape Canaveral Hospital in Cocoa Beach.

“I overheard one of my doctors talking to another doctor who said I was on a slippery slope,” and that is when the 74-year-old Merrit Island resident realized the critical nature of his heart condition. Congestive heart failure afflicts about 5 million other Americans.

His relatives felt a hospice was the best choice, a non-curative care center for those individuals whose life expectancy is not anticipated to surpass six months.

While under hospice care, Strickland read about how doctors use adult stem cells taken from the patients own blood, and through an experimental procedure treat and strengthen an individuals deteriorating heart.

Referring to the $34,500 price tag he said, “it is expensive.” The price includes treatment and accommodations for 14 days in Bangkok and is not covered by insurance. “But my kids told me: ‘Go for it.’”

He did; and in late April, accompanied by his wife, Carolyn, he left the country for the adult stem cell operation.

This is a final option that less than a projected 200 patients worldwide have searched out. This adult stem cell procedure involves injecting millions of these early-developmental cells directly into his heart. It has the potential to construct new blood vessels and heart muscle by contributing to new blood vessel development and helping to generate new tissue in the heart.

The clinic states that, “overall, our success rate is 70 to 80 percent, as measured by how the patients themselves feel” after treatment. “At least half feel markedly better; another 25 percent feel somewhat better or no worse; and 25 percent have little benefit.”

Securing a second opinion from a heart doctor in Brevard County and talking with six other heart patients in the United States who had undergone the same procedure helped him make up his mind. The doctor told him, “If it was worth anything, we would be doing it here,” Shelton recalled.

But he was undeterred, and with fluid backing up and accumulating in his lungs and other tissues of the body, Shelton had nothing to lose.

After a sequence of tests to check kidney function and his heart status, blood was drawn from his arm and the stem cell expansion process began. (An average of 20,000 stem cells are extracted during the process and then expanded up to 20 million) A week later the cells were injected directly into his heart.

“They cut a 1.5-inch incision between the ribs, and collapsed my lung, separating it from the heart,” he said. “Then they injected the stem cells into 30 different locations — into the heart muscle, the veins and the arteries.”

After a four day hospital stay following the surgery, Strickland was discharged to his hotel where he relaxed for the next few weeks.

Through surgical operation the cells are directly implanted into heart muscle or akin to an angioplasty, the reinfusion is directed through a catheter.

“Generally, those with severe coronary artery blockage get stem cells through a catheter,” doctors said, “while those in heart failure, like Mr. Strickland, get a direct injection into the heart.”

Now, approximately three months following his operation, his heart is pumping far more efficiently than it did — a doubling in his ejection fraction from less than 10 percent to between 20 percent and 25 percent — he already has been hospitalized once since his return, because of fluid accumulation around his heart again.

When asked about his progress so far he stated that, “I can change the oil in my car and put up storm shutters, but that’s about it.”

But he has been told it will be “a while” — at least a year — before the stem cells begin to fix his heart tissue, he said. And he is no longer in hospice care or on daily oxygen.

Now he follows the advice of his heart doctor in Cocoa Beach and sends back his test results to his doctors overseas every three months.

“He said: ‘Just stay active and do what you feel you can do,'” Shelton said. “There is no other option.”

Richard has congestive heart failure. This disease affects his heart’s ability to pump sufficient blood to suit the body’s daily needs. Ultimately, the disease will progress to the point where the heart becomes weaker and weaker to a point of failure. That is why on August 16th, Richard a Braselton resident, and his wife Terre will fly to Thailand to receive stem cell therapy in Bangkok.

“I’m just weak, tired, and short of breath all the time,” Richard said. “I constantly have to monitor my blood pressure and my heart rate. All the medications, there’s no end to it.”

Outside of prescribing blood pressure medications, Richard’s doctors told him that there was nothing they could do when he was diagnosed in January. Angered by the lack of options they were presented with, Richard and Terre began to explore alternative treatment options. Their search finally concluded in Thailand, where a Bangkok-based biotechnology company will provide treatment for Richard using a relatively new medical procedure, utilizing adult stem cell therapy.

Richard’s own stem cells will be multiplied after doctors extract cells form a half pint of Richard’s blood. Later, doctors will take the newly multiplied stem cells and re-inject them into Richard’s ailing heart. He should experience less chest pain and greater strength in his daily living once the cells start to take effect, about a month or two following the procedure.

After performing the procedure on over 120 patients over a period of two years, the company claims a success rate of 80 percent. 11Alive, Paul Harvey, and the 700-Club have all joined in support of the treatment, touting “miracle” recoveries on their respective programs. The company’s website has these video news segments available for individuals to watch online as well as news of patients testifying before the congress about the benefits of adult stem cell therapy.

All this and there is still a poor understanding about the technicalities behind stem-cell led repair. Researchers see a result but question the process after stem cell are injected into an injured area of the body.

Adult stem cells hold the most potential at the present time. The course that future research will take has much to do with the ethical clash that is occurring over the use of embryos. The issue has now left the floor of the congress and has entered the lives of average people.

For Richard and Terre, the very fact that stem cells work trumped the need to know what manner the cells actually work in.

The advice that Richard should focus primarily on keeping his blood pressure down did not make neither him nor his wife very happy.

“We just didn’t expect that answer, that there’s nothing we can do,” Terre said. “This is just not an option for us.”

Terre began looking into the program in Bangkok after a family member heard of the treatment and told her. She spoke with several patients of the company along with a few company representatives after looking over the website. Later she learned that one of her co-workers knew someone who had successfully received treatment as well.

Three months ago, Richard was accepted into the program. Once they reach Bangkok, they will stay there for 20 days to tour the area before and after the procedure. The couple will pay $32,500 in cash for the “medical tourism” trip; this will cover the expenses completely minus the price of airfare.

They feel comfortable that they know enough about the non-US based company and stem cell therapy stated Terre.

“There’s no downside to this,” Terre said. “We don’t have any questions, we don’t have any concerns. We realize there are risks, but with an 80-percent rate of success, it’s a risk worth taking” (20-percent of those receiving the therapy experience no change — positive or negative — in their condition).

“I’ve got nothing to lose,” Richard says. “Rather than live a bad life like I’m living and doing nothing, I’d rather take chance and get something done.”

“It’s not a lot of money,” Terre says, noting that the price is “a really minimal cost when you’re talking about saving a life.” “A lot of people who are sick and trying to exercise other options are going to be able to find that money.”

“It’s costly, but it’s worth your life, I guess,” Richard said.

Impressed by the new technology, particularly the advancement in adult stem cell treatment, Richard and Terre are optimistic about the future of adult stem cell therapy.

“It’s going to be the coming way of medicine,” said Richard. “It’s gotta be, because it’s pretty strong.”

“This could eradicate cancer,” Terre said. “It is my personal opinion; the future of medicine is going to be stem cells. There’s no doubt in my mind.”

The company performing the procedure on Richard claims that once the stem cells are placed in the area of the heart that they, “have the potential to build new blood vessels and heart muscle.”

The theory is that the stem cells improve blood flow to the heart by regenerating or “revascularizing” functional blood vessels. The cells may also act as “scaffolds” which offer mechanical strength to the heart at a occasion when it is weak, or even promote the heart to release chemicals for repairing itself.

The jury is till out on how the stem cells help, but only vast potential seems to exist says Dr. Samuel, a cardiologist with Emory University. A major advantage of the therapy is that the patient receives his own cells, thus negating any type of immune response that could neutralize the therapeutic benefits of treatment making it less effective. Future research will lead to the transfer of adult stem cells from one body to another. This would allow for immediate injection at hospitals that would keep stem cells ready.

Presently in the United States, only clinical trials are permitted, but in five years the treatments “could definitely be translated into a pure clinical product,” states Samuel.

The couple commented on their opinions about embryoinc versus adult stem cells. With no ethical dilemma, adult stem cells hold great potential alone and thus they both choose to promote adult stem cell therapy as opposed to embryonic.

“My opinion is the American public is not educated,” Terre said. “These are your own stem cells; this is your own blood.”

“If we could just get over the hump of educating all Americans. It could be their son or daughter’s lives that we could save.”

Researchers effectively used robotic surgery to deliver stem cell treatment to damaged heart tissue in pigs at the University of Minnesota.

The robotic surgery apparatus was minimally invasive throughout the injection procedure. The researchers took an extra step and “marked” the transplanted cells with iron particles in an effort to see if they engrafted in the pig hearts.

In six of seven cases, the transplant process was successful. The cells took hold and enhanced functioning of the heart as following MRI studies showed.

The cells that give rise to muscle, also know as myoblasts, in combination with bone-marrow derived cells were used in the experiment. Improving the development of new blood vessels as well as the performance of injured heart muscles were key characteristics confirmed by the implantation of both cell types. Both are in human clinical trials as well.

The research is available in the current issue of the Journal of Thoracic and Cardiovascular Surgery.

The method could be applied in human clinical trials once additional animal studies are completed.

“In people with heart failure, open surgery can be risky; finding a minimally invasive technique to deliver cell therapy to the damaged cardiac tissue would reduce the risk to patients,” said Doris, Ph.D., professor of Physiology, holder of the Medtronic Bakken Chair in Cardiovascular Repair, and co-leader of the study.

The minimally invasive approach would present several benefits for people with heart failure, Doris said. It offers surgeons the capability to target the cell infusion more precisely by utilizing a magnified view of the heart. It requires less time under anesthesia and can be performed while the heart is still beating. It is less dangerous to the patient.

Harald, M.D., co-leader of this study, now a surgery resident at Massachusetts General Hospital in Boston, pointed out, “Currently these types of cell therapies, in which stem cells are injected into damaged hearts, are only available to people who are enrolled in clinical research trials.”

Skeletal and bone marrow cells that are injected into damaged heart tissue have been shown to improve function in the left ventricle, the chamber of the heart that pumps blood into the aorta, the main artery through which oxygen-rich blood flows from the heart to the body.

Doris said more research needs to be done to establish if the minimally invasive technique can promise comparable results to open surgery, as well as which types of cells are most beneficial to infuse into damaged hearts. “But that is what keeps us busy,” she added,” finding the best treatment for patients with heart disease.”