Infarction therapy: Scarred tissue renewed

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Researchers were able to convert scarred tissue into heart cells for the first time

Can scarred heart muscle tissue be healed in the future after a heart attack? A team of researchers from Duke University Medical in the United States was able to successfully convert scar tissue into cardiac muscle cells with the help of an injection of stem cells. The research results could be the first breakthrough in otherwise unsuccessful stem cell research for 15 years.

The regeneration of the heart with new, functional heart cells remains an enormous challenge for cardiac medicine. A therapeutic approach could be the direct conversion of injured heart regions into functional tissue. Apparently a team of researchers has now succeeded.

Scarred tissue converted into cardiac muscle cells
After a heart attack, scarred tissue remains in the heart of many affected people. As a result, diseases such as heart failure and sometimes dangerous cardiac arrhythmias develop. US researchers were able to convert defective scar tissue directly into cardiac muscle cells during an animal experiment with laboratory mice. This was done without detour by injecting stem cells directly into the affected tissue. The scientists believe that after a trial and probation period, a new type of therapy can be developed that could also be used in heart attack patients.

Without using stem cells
In the laboratory test, the scientists converted scarred heart tissue into functional heart muscle cells without the use of stem cells. In principle, the process shows “a new way to replace diseased or destroyed tissue in humans,” as the researchers led by study leader Tilanthi Jayawardena from the Duke University Medical Center (Durham / North Carolina) write in their results report. They use so-called “microRNAs” to convert the scar tissue. These consist of microscopic molecules that are responsible for the regulation of numerous genes. To achieve an effect, the microRNAs were inserted into the fibroblasts. Fibroblasts are cells that form in the surrounding regions of the heart muscle after a myocardial infarction. Due to the formation of the cells, the pumping and beating power of the heart is limited depending on the strength of the heart attack. Patients suffer from impaired cardiac performance, which is why heart failure (heart failure) often develops afterwards. Physical exertion such as gardening or climbing stairs is becoming increasingly difficult for those affected. They suffer from shortness of breath, weak pulse, water in the legs and lungs.

Detour to bypass ethical and technical reservations
In the first round of research, the researchers checked the functionality of the microRNAs in several cell examinations. The question was whether the molecules can actually reanimate damaged tissue. Cells with a similar structure to conventional heart muscle cells actually formed in the laboratory. Afterwards, mice were treated with the molecules in animal experiments. The desired cell conversion was also achieved in the second round. The therapy option "avoids ethical and technical reservations that arise when using embryonic stem cells", as the research team wrote in the journal "Circulation Research".

Various treatment options for injured tissue
The result opens up “diverse therapeutic treatment options”, as co-author Victor Dzau writes in a communication distributed by Duke University. "If the therapy is successful in the heart, it can also be used in the brain, kidneys and other tissues." The researchers assume that they have explored a whole new way to regenerate tissue. “The results showed that microRNAs have the ability to convert fibroblasts directly to a cardiac muscle cell-like phenotype,” the researchers said in the abstract of the study.

Stem cell research has been controversial since the beginning. Previously, research institutions involved had been focused on processing stem cells. Embryonic stem cells must be obtained from embryos that are killed for this. The cells can be converted into any cell type in the laboratory in order to replace damaged organ tissue. However, the processes involve numerous technical problems, and there is also a controversial discussion about whether embryos can be killed to obtain stem cells. The criticized procedures are therefore prohibited in many countries around the world.

Instead of embryonic cells induced pluripotent stem cells
The US researchers now see a way out in the so-called induced pluripotent stem cells. Instead of embryonic stem cells, body cells in the laboratory are methodically restored to a state similar to that of embryonic cells. These can then practically transform into a new type of cell. The method published by the US scientists could be an alternative variant without treating the described detours and without foreign cells to treat sick tissue. In the next step, the researchers want to apply their discovery to larger live animals.

The stem cell researcher Oliver Brüstle from Bonn also attests that the novel method of converting cells into the subject's body may be successful in the future. In another study, researchers had already succeeded in producing cells that produce insulin from progenitor cells in the pancreas directly in the tissue. "This brings us to completely new paradigms in regeneration - no longer introducing cells, but simply converting resident cells into the desired cell type," said the expert. However, it will take several years before therapies are developed for humans. (sb)

Also read:
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Researchers grow cartilage from stem cells
Stem cells for the treatment of eye diseases?

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Video: Scar Tissue Massage


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