Thursday, November 24, 2011


The word "stem cells" mean different things to different people. For some, it is a panacea of cures for all ailments, from spinal cord injury, to burn repairs, to joint cartilage repairs, to cardiac muscle repairs. It is sometimes very difficult to separate the facts from the myths. I also have that difficulty, as I hear many surgeons around me using stem cells for various kinds of surgery and the commercialisation of cord blood storage for stem cells. I have been searching for the clinical trial data? I must say that they are few to find.
Anyway, at the just concluded AHA annual Scientific meeting at Orlando, Florida, a few papers were presented on cardiac stem cell therapy. I was particularly impressed by the paper from the University of Louisville, Kentucky. Dr Robert Bolli and colleagues, studied 16 patients with placebo control. They harvested cardiac muscle tissue from their ischemic cardiomyopathy patients ( the non ischemic portions ), process the harvested cardiac muscles, culture it to derive their adult cardiac stem cells, and at an average of 16 weeks or jusy over 3 months, infuse 1 million of these process autologous cardiac stem cells into the targetted coronary artery. A follow up MRI LV function assessment showed that the LV function have improved from a mean of 30.2% to 38.5%, and the infarct size have decreased. This is indeed good news. This is a phase 1 trial, meaning that it was primarily to test safety of the trial. However, the improvement is staggering and wonderful. There is no mention of sudden cardiac death. This gives hope to many out there whose LV function is 30%, following a severe myocardial infarction.
At the same meeting, the investigators of REPAIR-AMI ( this study was written up earlier, years ago ), also reported their 5 year follow-up. The results continue to show sustained improvement. Just to recap that in this study, Dr David Leistner and colleagues were using intracoronary autologous bone marrow infusions.
There was a third study presented at the same meeting, the LATE-TIME study, on intracoronary autologous bone marrow infusion. This study was neutral, showing no benefit.
Looks like much work is being done in this area of cardiac stem cells for myocardial repair following myocardial damage, following an acute myocardial infarction. The embryonic work is minimal in USA, but the adult stem cells research in going on, with some optimism.
There is hope out there for patients with Ischemic Cardiomyopathy, where in many cases. cardiac transplantation remains the only viable alternative.

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