by Amy Martinez
Updated 5 months ago
About 6 million people in the U.S. suffer from heart failure, a condition in which the heart no longer pumps blood like it should. Most have had a heart attack that left them with a weakened heart muscle. Treatment options are limited, and more than half of those with heart failure die within five years of being diagnosed.
For nearly two decades, researchers have been studying whether stem cells can be used to repair the damage from a heart attack. Of particular interest is therapy using mesenchymal stem cells (MSCs) — unspecialized cells that come from bone marrow and can transform into another cell type, including heart cells.
MSC therapy for heart failure involves collecting stem cells from the body, growing the cells in a lab and then injecting them into a patient’s heart to regenerate muscle.
Although clinical trials have shown that the process is safe, it’s questionable whether it actually does much good for patients. Last year, experts at Harvard Medical School declared MSC-based therapy “not ready for prime time,” pointing to a lack of “clear, consistent evidence” that it works on heart failure. So far, none of the trials has resulted in an FDA-approved treatment.
A Scripps Florida scientist now aims to make the experimental therapy more effective. In August, biologist Donald Phinney won a $2.9-million, four-year grant from the National Heart, Lung and Blood Institute to develop a method for assessing the viability of manufactured stem cells in different patients.
“There have been lots of clinical trials, and the results are all over the place,” he says. “Sometimes it works; sometimes it doesn’t. Why?” Phinney, who has studied MSCs since the early 2000s, believes the answer, to a large extent, lies in the cell manufacturing process.
“There is no standard process,” he says. “People do it all different kinds of ways, and that affects how the cells come out.”
He notes that because patients require large doses of the cells, providers often choose manufactured cells that multiply most rapidly. He has found, however, that fast-growing cells may not have enough of the regenerative or anti-inflammatory qualities that a patient needs. “How you culture them matters,” he says. “It’s not as simple as taking bone marrow out of you, magically making MSCs and then putting them in you.”
Phinney and his team at the Scripps Research Institute in Jupiter have begun developing metrics to help the industry tailor-make stem cells for particular diseases, including heart failure. He says the grant will allow them to retroactively use their metrics to assess MSCs injected into patients from various clinical trials and determine if they were the “best possible cells.”
“We’re trying to improve the manufacturing process to help get the right cells for the right disease,” he says. “Our ultimate goal is to tailor MSCs to specific diseases so that they’re more potent.”
Read more in our January 2019 issue.
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