A 46 -year -old woman with a serious heart failure received an experimental treatment to the desperate in the summer of 2021: literally a whip in her party, a patch made in the laboratory with 800 million cells derived from the umbilical cord of a donor. Three months later, the patient underwent a heart transplant and scientists were able to directly examine their patching organ and already discarded. The results of the analysis, demonstrate for the first time that it is possible to regenerate the human heart.
The research leader, the German doctor, underlines the magnitude of the advance. Heart failure – the inability of the heart to pump blood efficiently – threatens the life of in the world. “99% of patients with advanced heart failure, about six million in the world, will never receive a heart transplant. Our goal is to deal with that 99%, ”proclaims Zimmermann, from the University of Medicine of Gontinga. The situation of these people is distressing, because donated organs are scarce. The International Heart and Lung Transplant Society estimates that cardiac substitution are barely made every year worldwide, some in Spain.
A fortnight of people have already received one of these patches since March 2021. One of them, Frank Teege, last year. “I was weakening me more and more and I couldn’t walk 50 meters without being breathless. In fact, I had a cardiac output [el volumen de sangre bombeado por el corazón] Of just 10%, ”said Teege, a 66 -year -old man from the German city of Lubec. “After the operation with the patch, my cardiac output has improved significantly. Now it reaches 35%, ”he explained. The identity of the 46 -year -old woman whose heart and extracted heart has confirmed the effectiveness of the strategy is unknown.
The biologist, born in Madrid 34 years ago, participated in the investigation during his doctorate at the German Primates Center, in Gontintga, where he helped to improve the experiments in Macacos. The technique is based on the revolutionaries discoveries of the Japanese doctor, winner of the Nobel Prize in Medicine in 2012 for demonstrating that an adult cell – of the skin, for example – can be reprogrammed thanks to a cocktail of four molecules and return to an embryonic state, capable If any other type of cell becomes, such as a brain neuron or a cardiomyocyte of the heart muscle. Rodríguez Polo and his colleagues generated the heart cells from the skin of the monkeys. In the 46 -year -old woman, the cell source is a donated umbilical cord.
Rodríguez Polo is very optimistic about these cell therapies. “In the future it will be one more tool against different degenerative diseases. There are also advances in the regeneration of the black substance, which is one of the most affected brain parts in the Parkinson, or in front of the macular degeneration of the eye. With the amount of clinical trials with promising data that is now, I sincerely believe that it will occur in the short or medium term. It is increasingly tangible, ”says Rodríguez Polo, now a researcher, in London.
The data presented this Wednesday are the culmination of a work of more than 30 years. Other groups have made similar attempts. The Chinese surgeon, from the University of Nanjing, announced that in May 2019 he injected cardiomyocytes generated in the laboratory in the hearts of, but never published his scientific results. As of January 2020, the Japanese surgeon of the University of Osaka, implanted sheets of these cells in with the weakened heart muscle.
“Our study is the first that demonstrates the remuscularization of the heart,” says Zimmermann. The German doctor explains that people with these patches of foreign cells need to receive a life treatment that reduces their defenses and avoid rejection. “It is a manageable challenge. Remember that these patients with terminal diseases have a mortality of 50% each year. The side effects of immune suppression must be taken into account, but they are manageable, ”he says. Its results, published on Wednesday, show that neither in women nor in the 20 operated monkeys have been detected arrhythmias nor tumors, two of the most feared side effects.
The National Cardiovascular Research Center, in Madrid, has a group dedicated to regenerative heart therapies. In front is the German doctor. “How do I know, these data show for the first time that cardiomiocytes derived from induced pluripotent stem cells [las células reprogramadas] They can graft into a human heart. It is not a surprise, and the amount of grafted myocardium is relatively small, but it is a great step towards the clinical application, ”he celebrates.
Weinberger, however, maintains a certain skepticism. “I think there is a fundamental question without answering: the mechanism of action. Although the authors clearly affirm their objective of remuscularizing, that is, adding new contractile tissue to the damaged heart, the histological analysis suggests that the newly formed myocardium is separated from the myocardium from the host by scar tissue, ”he warns. “The authors propose that the new cells can adopt contractility thanks to mechanical coupling with the host heart, that is, grafted cells will follow the rhythm of the heart without being electrically coupled, but the tests that support this hypothesis are limited. We will need more studies to support this statement, ”adds Weinberger. “In general, I stay optimistic, although somewhat more critical than the authors,” Zanja.
