Umbilical cord stem cells show promise in Tx of heart failure

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A small study suggests that stem cells derived from umbilical cord show promise in treating heart failure – it says the umbilical cord-derived stem cells might help in improving the functions of the heart muscle and thereby increases the quality of life.

Globally, nearly 37m people are affected with heart failure that is marked by the inability of the heart muscle to pump blood efficiently.

According to Dr Jorge Bartolucci, the lead author and a cardiologist from Cells for Cells and professor at the Universidad de los Andes, in controlling heart failure, regular drug treatments could be sub-optimal and in most cases, the patients might have to undergo more invasive therapies like heart transplantation or mechanical ventricular assist devices.

THE findings of the current study are encouraging as they might lead to the development of a new promising non-invasive therapy for those who faces grim odds.

The study involved 30 patients at the age of 18-75 who had stable heart failure and were receiving optimal drug therapy. All the participants were provided with intravenous infusions either with umbilical cord-derived stem cells or placebo.

The umbilical cord was gained through caesarean sections from full-term human placentas of healthy donors after informed consent.

In the year following the treatment, the stem cell therapy displayed a constant and noteworthy improvement in the ability of the hearts to pump blood when compared with the placebo treatment. Also, the stem cell therapy indicated improvements on measures of life quality and daily functional status.

The findings indicated that the treatment via umbilical cord-derived stem cells were safer than the placebo treatment with no other adverse side effects or development of allo-antibodies, a complication with the immune system that is common among patients receiving blood transfusions or organ transplants.

The capability of bone marrow-derived stem cells to be used as treatment was previously studied; however, umbilical cord-derived stem cells are found more appealing as they possess many advantages like, wide availability, ease of accessibility, absence of immune complications and ethical concerns that surround embryonic stem cells.

Abstract
Rationale: Umbilical cord-derived mesenchymal stem cells (UC-MSC) are easily accessible and expanded in vitro, possess distinct properties, and improve myocardial remodeling and function in experimental models of cardiovascular disease. While bone marrow-derived mesenchymal stem cells (BM-MSCs) have been previously assessed for their therapeutic potential in individuals with heart failure and reduced ejection fraction (HFrEF), no clinical trial has evaluated UC-MSCs in these patients.
Objective: Evaluate the safety and efficacy of the infusion of UC-MSC in patients with chronic stable HFrEF.
Methods and Results: HFrEF patients under optimal medical treatment were randomized to intravenous infusion of allogenic UC-MSCs (Cellistem, Cells for Cells S.A., Santiago, Chile) (1×106 cells/Kg) or placebo (n=15 per group). UC-MSCs in vitro, compared to BM-MSCs, displayed a 55-fold increase in the expression of Hepatocyte Growth Factor (HGF), known to be involved in myogenesis, cell migration and immunoregulation. UC-MSC treated patients presented no adverse events related to the cell infusion and none of the patients tested at 0, 15 and 90 days presented alloantibodies to the UC-MSCs (n=7). Only the UC-MSC treated group exhibited significant improvements in left ventricular ejection fraction at 3, 6 and 12 months of follow-up assessed both through transthoracic echocardiography (p=0.0167 versus baseline) and cardiac magnetic resonance imaging (p=0.025 versus baseline). Echocardiographic LVEF change from baseline to month 12 differed significantly between groups (+7.07±6.22% vs +1.85±5.60, p=0.028). In addition, at all follow-up time points, UC-MSCs treated patients displayed improvements of NYHA functional class (p=0.0167 versus baseline) and MLHFQ (p<0.05 versus baseline). At study completion, groups did not differ in mortality, heart failure admissions, arrhythmias or incident malignancy.
Conclusions: Intravenous infusion of UC-MSC was safe in this group of patients with stable HFrEF under optimal medical treatment. Improvements in left ventricular function, functional status and quality of life were observed in patients treated with UC-MSCs.

Authors
Jorge G Bartolucci, Fernando J Verdugo, Paz L González, Ricardo E Larrea, Ema Abarzua, Carlos Goset, Pamela G Rojo, Ivan Palma, Ruben Lamich, Pablo A Pedreros, Gloria Valdivia, Valentina M Lopez, Carolina Nazzal, Francisca Alcayaga, Jimena Cuenca, Matthew J Brobeck, Amit N Patel, Fernando E Figueroa, Maroun Khoury

American Heart Association material
Clinical Research abstract


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