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An innovative solution for a major problem
Heart failure, which often results from a myocardial infarction, high blood pressure, or coronary artery disease, affects the heart's ability to pump blood effectively. In its most severe forms, options are limited to ventricular assist devices or heart transplantation, which are heavy and have limited availability.
It is in this context that researchers at the University Medical Center of Göttingen, Germany, have developed a biological heart patch. Applied directly to the heart muscle, it is designed to restore part of the heart's contractile function by gradually integrating with the native tissue.
A design derived from stem cells
The scientists used human blood cells, reprogrammed into pluripotent stem cells capable of differentiating into heart cells. This process allowed them to recreate muscle tissue similar to that of an eight-year-old child's heart, capable of contracting and supporting cardiac activity.
The patch, embedded in a collagen gel, is implanted through minimally invasive surgery. It targets patients with end-stage heart failure, whose one-year mortality rate is around 50%.
Encouraging initial results
Clinical trials have already shown promising results. A 46-year-old patient treated with this patch saw her heart exhibit significantly improved vascularization. Additionally, tests conducted on rhesus macaques with heart failure revealed a significant increase in left ventricular ejection fraction, a key indicator of heart function.
The implantation did not cause arrhythmia or tumor growth, confirming its safety. Vascularization of the patch and cell retention were observed over a period of six months, suggesting a lasting beneficial effect.
Towards broader clinical application?
Within five years, this type of cell graft could be available for patients with advanced heart failure. According to Professor Wolfram-Hubertus Zimmermann, the study's lead, the main challenge is to produce and implant a sufficient number of heart muscle cells while avoiding complications.
Beyond cardiology, this approach could also open the way to applications in other medical fields, such as the repair of nerve or muscle tissues.
While additional studies are needed to assess the maturity of the implanted cells and the durability of the effects, this biological patch already represents a significant advance in the treatment of heart failure.
To go further: How are stem cells reprogrammed to create a heart patch?
Researchers use adult blood cells that they reprogram into pluripotent stem cells using specific transcription factors. These cells thus regain an embryonic state, allowing them to differentiate into functional heart cells capable of contracting and integrating with the patient's heart tissue.
Once reprogrammed, these cells are cultured in a controlled environment that mimics the conditions of heart development. This promotes their maturation and organization into viable muscle tissue, endowed with contractile capabilities comparable to those of a growing heart.
The goal is to obtain tissue that is sufficiently stable and functional to adapt to the constraints of the human heart. Thanks to their flexibility, these reprogrammed stem cells open up prospects for regenerative medicine, beyond cardiology, with potential applications for other damaged organs.