28 April 2008
ByAppeared in BioNews 455
Two men were the first subjects of a groundbreaking clinical research trial to establish the efficacy of treating patients with stem cells from their own bone marrow hours after a heart attack. The randomised controlled trial, the first to be supported by the UK Stem Cell Foundation, was designed by Dr Anthony Mathur, senior lecturer and consultant cardiologist, and Professor John Martin, British Heart Foundation chair in cardiovascular sciences; at Barts and the London NHS Trust and University College London respectively.
The men were treated at the London Chest Hospital (Barts and the London NHS Trust) and the Heart Hospital, (UCLH Trust), where they underwent angioplasty within five hours of having a heart attack. This technique opens the blocked coronary arteries that supply the heart muscle with blood using a tiny balloon inserted through a catheter in an artery in the groin. Professor Martin and Dr Mathur added to the treatment by injecting either bone marrow stem cells or a placebo into the heart via the angioplasty route.
'Taking heart attack patients to centres where their blocked coronary artery can be opened immediately has lead to significant increases in survival and decreases in the damage to heart muscle', said Professor Martin. 'Previous studies in the heart have shown that stem cell delivery to the heart is safe. We will show whether it works in acute heart attack. Our study combines the two new ways of treating heart attack victims for the first time', he continued.
Heart attacks damage the heart muscle, but research has shown that stem cells can promote the development of new muscle tissue. Previous studies using bone marrow stem cells following heart attacks were inconclusive, but in the new trial the treatment was given weeks to years after the damage had occurred, not hours.
Stem cells are undeveloped precursors that can form a wide range of tissues. Those present in adult bone marrow are mainly blood and blood-vessel precursors that may be 'harvested' using a needle. Other sources for stem cells are human embryos and umbilical cord blood. By using their patients' own stem cells the researchers ensured that there was no risk of immune rejection.
Mr Robin Marston, one of the two men to receive the treatment, said he was happy to participate in the trial because 'not only would I help myself but other people too'. He added, 'I feel practically 100 per cent now. I had a tiny bit of pain last night, but nothing since then and I'm feeling fine'.
Although it is too early to draw conclusions from the trial, in which patients may receive a placebo or stem cell injection, the results will indicate whether bone marrow stem cell autografts, as they are known, can aid recovery following a heart attack.