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Exploring Human Potential

Can A Damaged Heart Heal Itself? With a Little Help, Maybe.

Posted on | January 13, 2016 | 2 Comments

F1.mediumSource: AHA Journals

Mike Magee

At last night’s State of the Union address, President Obama placed Vice President Joe Biden in the command seat as director of the scientific assault on cancer. The destination – a cure for the dreaded and stubbornly complex myriad of disorders that have created so much suffering and loss of life. Near equal as a plague has been cardiovascular disease, and especially heart attacks and strokes. In this arena, we may be getting closer to the promised land.

We’re all familiar with the idea of a “heart attack”. Most know the cause is obstructed blood flow through the coronary arteries to the heart muscle. Most also can tell you that heart muscle dies, turns to scar, and as a result the “heart pump” doesn’t work as well, often leading to disability and early death.  But what actually happens on a cellular level, at the time of the heart attack, and in the recovery period?

An article in the New England Journal of Medicine this week addresses these questions. Here are a few of the insights:

1. Cardiomyocytes, contracting heart muscle cells, are the cells we lose with a heart attack.

2. The interruption of blood flow not only damages these cells, but is also responsible for a measurable decrease in a natural chemical called follistatin-like1 (FSTL 1) produced in the outer layer of the heart or the epicardium.

3. Heart muscle cells aren’t known for their rapid cell division. In fact only 1% undergo cell division each year. They speed up a bit when there is a heart attack, but not enough  to allow repair.

4. In the past decade, researchers have tried to infuse adult stem cells into ischemic cardiac scarred areas, in the hopes of increasing the number of healthy cardiomyoctes in the damaged area. These attempts have largely failed to get the cells to stick to the injured areas where they are needed, and when they have stuck, the stem cells have often refused to differentiate or transform into cardiomyocytes.

5. It turns out that the heart does possess in its outer layer a group of endocrine like protein chemical stimulators that possess the ability to naturally enhance cardiomyocyte survival if blood flow is restricted, and also stimulate small vessel growth to help deliver additional oxygen to the ischemic areas. These are called “cardiokines”, and FSTL1 is one of them.

6. Surgical suturing of an FSTL1 infused patch onto an ischemic cardiac scar in mice has successfully induced reparative growth of cardiomyocytes in the damaged area.

7. How FSTL1 actually works, the intermediaries and number of steps, remains to be fully elucidated. The mice researchers are also looking at amphibians which have the ability to regenerate their own hearts for clues. But clearly, for the many individuals who have suffered major heart attacks and survived, only to face eventual failure of their heart pumps, with heart transplant then the only option, there is hope.

Comments

2 Responses to “Can A Damaged Heart Heal Itself? With a Little Help, Maybe.”

  1. Shilpi
    January 14th, 2016 @ 4:11 pm

    Interesting piece of content and informative.

  2. Katherine
    June 1st, 2017 @ 9:37 am

    I think there has been capital raised for this kind of work.

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