Scientists
have found cells that have the ability to grow into fresh arteries and
restore blood supply to the organ that could eventually lead to natural
bypass therapies that coax heart cells into forming new arteries capable
of re-routing blood around diseased and blocked blood vessels. (A) This
treatment can be performed after one has had a heart attack or if he or
she is at risk. Giving these individuals extra arteries that would be
ready to take over should their own become clogged.Coronary heart
disease affects the arteries that supply the heart with oxygen rich
blood. These arteries become narrowed by the build up of fatty tissues.
The narrowing forces blood into a smaller network of neighboring vessels
that re-route blood around the diseased artery. However, these
collateral blood vessels are not large enough to supply the heart with
all the blood it needs. (A)
Stanford
team describe how they were able to track down these very same cells
that form arterial muscle in adult mice. The first step was to add a
flourescent tag to a single cell in the epicardium (i.e. the tissue
layer that covers the heart). Now able to trace epicardial cell through
the tag as well as every generation of the cell it gave rise to become
divided. What they soon noticed was that some of the cells became
arterial muscle cells called pericytes.(A)
The
reason as to why bypass therapy has taken so long for scientists to
accomplish is because of the lack of understanding or knowledge of how
coronary arteries form. It was ambiguous to which heart cells formed
smooth muscle sheathes needed to form new arteries and if they even
existed in adults. (A) With time and many tests later, they were able to
find the molecular signals that tell the pericytes to grow into
arterial muscle cells. This conclusion was key in making a drug that
could mimic these very same signals where the heart cells could be
persuaded to form fresh arteries on the hearts surface (where blood can
flow). There is now hope in the future of growing new arteries in mice
within the next 5 years. (A)
Only
124,000 individuals within the UK suffer heart attacks each year.
Databases show that one in three die before ever reaching the hospital.
Angioplasty is the only available treatment with patients who have
obstructed arteries. This treatment removes the material causing the
blockage. However, many times the blockage returns. With Bypass surgery,
regenerating arteries may work better since this process uses blood
vessels used in the bridge of the blocked region. Regenerative medical
research will drive major advances in treating heart disease as well as
heart attacks. (A)
Recent
research by the Royal Brompton and Harefeild NHS foundation published
their work in the Journal of Cardiovascular Translational Research.
Their research included a study where 40 patients a month were assessed
for an inherited heart condition. Genetic testing for these inherited
heart conditions are vital in saving lives in the near future. As of
now, there are no symptoms or ways in which physicians can prove
children do not have the condition or that they will develop it later
on. However, through genetic testing it is much easier to diagnose
whether one is at risk. (B)The test looks at a smaller number of genes
and only identify specific conditions. Other experts can also develop
upon this new test. As other genes are identified as being linked to
IHCs, they too can be incorporated into the test. IHCs affect the heart
and circulatory system, are passed down through families and can affect
people of any age.(B)
If
effective,A single test may be able to identify the causative gene
mutation in someone with an inherited heart condition thereby allowing
their relatives to be easily tested for the same gene. genetic testing
on family members can identify those who carry the faulty gene and steps
can be taken to reduce the risk of sudden death, such as surgery,
medication – for example beta blockers – or lifestyle changes. Prof
Peter Weissberg, medical director at the BHF, said: “In this rapidly
evolving field of research the aim is to achieve ever greater diagnostic
accuracy at ever-reducing cost.(B)
Heart muscle cells regrown in medical research breakthrough: Weizmann Institute of Science in Israel as well as Victor Chang Institute in Sydney have uncovered a way to stimulate heart muscles to grow. Humans are unable to regenerate heart cells thus making it difficult to recover from the permanent damage caused by heart attacks. While human blood, hair and skin cells renew themselves throughout
life, cell division in the heart comes to almost a standstill shortly
after birth, an author of the research. One of the many theories as to why the human heart can not regenerate
vessels is because of our sophisticated immune system and because human
cardiomyoctes are in deeper state of quiescence making it very difficult
to stimulate them to divide. Because of this, there has always been much interest in the mechanism of fish such as salamaders which are capable of heart regeneration. They send their cardiomyoctes (muscle cells) into a dormant state, then enter a proliferative state (where they start dividing rapidly and replacing lost cardiomyocytes. (C)
Through the many studies conducted with mice, scientists were able to uncover a way to overcome that regenerative barrier. By stimulating a signalling system in the heart by the hormone 'neuregulin' heart muscle cells divide in both adolescent and adult mice. In humans 'neuregulin' is blunted a week after birth but at 20 weeks after birth in mice. The key is to trigger the neuregulin pathway after a heart attack in mice lead to replacement of lost muscle, therefore repairing the lost muscle and restoring the heart to its original healthy condition before the heart attack. Within five years, scientists will know whether it will be possible to replicate the results in humans. Heart attacks occur when one of the vessels that feed blood to the
heart muscle becomes blocked, causing billions of cardiomyocytes to die.
Many people who survive a heart attack have a diminished quality of
life because of this. (C)
Links:
(A)http://www.theguardian.com/society/2015/oct/19/artery-cell-discovery-paves-way-for-new-heart-disease-treatment
(B) http://www.theguardian.com/society/2016/feb/19/new-test-detects-genes-for-every-known-inherited-heart-condition
(C)https://www.theguardian.com/science/2015/apr/07/heart-muscle-cells-regrown-in-medical-research-breakthrough
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