مفاجأة : Fetal stem-cell injections associated with functional gains in eight HF pati

الكاتب : مروان الغفوري   المشاهدات : 453   الردود : 1    ‏2005-06-15
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  1. مروان الغفوري

    مروان الغفوري شاعر وكاتب

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    Fetal stem-cell injections associated with functional gains in eight HF patients

    Jun 10, 2005 Steve Stiles

    New York, NY - Direct intramyocardial injections of fetal-derived stem cells in eight patients with NYHA class 3 or 4 heart failure (HF) were followed by pronounced improvements in LVEF, functional class, and exercise tolerance over three months, reported investigators here last week at the International Society for Minimally Invasive Cardiothoracic Surgery (ISMICS) 8th annual scientific meeting. Although fetal stem cells have been used to treat immune deficiencies, spinal-cord injuries, stroke damage, and other conditions, last week's report is the first of their use in HF patients, investigators say.

    One advantage fetal stem cells may have over other progenitor cells that have been explored for myocardial regeneration, predominantly myoblasts and marrow-derived stem cells, is a faster therapeutic effect. "The difference we observed initially is that fetal stem cells [appear] more powerful," Dr Frederico Benetti (Benetti Foundation, Rosario, Argentina) told heartwire. "Ejection fractions in patients improved within seven days initially. That didn't happen with our stem cells from bone marrow." Symptoms and other clinical features also improved more rapidly than they did in HF patients he had previously treated with marrow-derived stem cells, which have less potential for differentiation, according to Benetti, one of the surgeons who did the procedures at Luis Vernaza Hospital in Guayaquil, Ecuador.



    Ejection fractions in patients improved within seven days initially. That didn't happen with our stem cells from bone marrow.




    Initially, 10 patients with nonischemic cardiomyopathy and an LVEF <35% who were in NYHA class 3 or 4 despite optimal medications were injected with a total of 60 million to 80 million fetal-derived stem cells. Access to the heart was achieved by midline sternotomy in seven cases and by minithoracotomy in one. No patients died during the follow-up, but one patient who suffered an ischemic stroke three days after surgery and another who developed "clinically insignificant" pericardial effusion were excluded from further analysis.

    The remaining eight patients showed a mean relative LVEF increase of 41% within the first 30 days, an effect sustained at 90 days, reported lead investigator Dr Valavanur A Subramanian (Lenox Hill Hospital, New York, NY) at the ISMICS meeting. Both six-minute-walk distance and exercise tolerance had more than doubled by the 90-day evaluation.

    Intramyocardial fetal stem-cell injection in 8 patients with nonischemic HF: 90-day outcomes


    Parameter
    Baseline
    30 days
    90 days

    6-minute-walk-test distance (m)
    275.0
    474.3
    553.8

    Exercise-tolerance test (METs)
    2.5
    -
    5.6

    LVEF (%)
    26.6
    37.5
    37.5

    NYHA class
    3.5
    2.4
    2.0




    To download table as a slide, click on slide logo below

    In the patient who received the injections through a minithoracotomy, a technique Benetti says will probably be the standard if this form of cell therapy pans out in larger studies, LVEF improved from 22% to 35% at 90 days; the patient also showed gains in the other functional parameters.


    The stem cells and grant support for the investigation were provided by the Institute for Regenerative Medicine (St John, Barbados). Benetti reports having served as a consultant for the institute.










    Related links


    Clinicians and researchers clash over stem-cell trials, according to New York Times
    [HeartWire > MediaPulse; Mar 14, 2005]

    Progenitor cells discovered in the postnatal heart
    [HeartWire > News; Feb 16, 2005]

    Benefit of adult stem cells given via minimally invasive procedure
    [HeartWire > News; Jan 26, 2005]

    Bone-marrow stem cells show limited potential for cardiac repair
    [HeartWire > News; Dec 8, 2004]

    Bone-marrow cellular treatment showing promise
    [HeartWire > News; Nov 11, 2004]

    BOOST study published: An "important first" for stem-cell research and the heart
    [HeartWire > News; Jul 8, 2004]




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  2.   مشاركة رقم : 2    ‏2005-06-28
  3. little wing

    little wing عضو

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    nice article
    thankyou
     

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