 |
 |
| |||||||
|
|
 |
|
|
|
|
| ||
|
 |
| |||||||
|
 |
 |
 |
|
 | ||||
 |
Stem cells are cells that are capable of developing into other specialized cells required for organ or tissue functioning. Although adult stem cells lack the enormous versatility of embryonic stem cells, they may be easier to use clinically since they are already partially differentiated in the body. In addition, the use of adult stem cells does not confront the many ethical and legal questions associated with embryonic stem cell research. The therapeutic potential of adult stem cells is currently being put to test at NewYork-Presbyterian Hospital/Columbia University Medical Center. Silviu Itescu, MD, Director of Transplantation Immunology for the Departments of Surgery and Medicine at NewYork-Presbyterian Hospital/Columbia University Medical Center has shown that if adult blood vessel stem cells, known as angioblasts, are injected into animals with damaged hearts, these cells find their way to the heart and create new blood vessels in the muscle wall to help repair itself. More recently, Dr. Itescu has also investigated whether a different type of adult stem cell, called a mesenchymal precursor, can regenerate cardiac muscles and arteries in animals. Thanks to funding awarded by the NIH (National Institutes of Health), Dr. Itescu is initiating two clinical trials at Columbia to test both types of adult stem cells in human patients with heart disease. The initial trial–the first of its kind to receive FDA approval in the United States–evaluates the use of angioblasts in patients with ongoing symptoms of chest pain. The second trial will focus on patients with end-stage heart failure who have a left ventricular assist device (LVAD) implanted and will be performed in collaboration with Eric A. Rose, MD, Chairman, Columbia University Department of Surgery and Surgeon-in-Chief, NewYork-Presbyterian Hospital/Columbia University Medical Center. In this trial, angioblasts and mesenchymal precursors will be evaluated for their ability to help repair or regenerate the native hearts of these patients, so that ultimately, the LVAD might be removed. Dr. Itescu anticipates that cell therapy will also be used in patients with acute myocardial infarction (heart attack). "In an acute heart attack, the blood supply to an area of the heart is blocked. Without blood, the tissue in that area dies and forms scars, preventing the heart from functioning as well as it did previously and causing future problems for the patient," explains Dr. Itescu. "Stem cell therapy should be complementary to angioplasty by helping to create new blood vessels that should enable heart muscle cells to stay alive and maintain muscle function after the heart attack." The left hand panel demonstrates a representative rat heart that has undergone an experimental heart attack. The red depicts viable heart tissue and the blue represents dead heart tissue that has been replaced by scar. In contrast, in the panel on the right the animal has received stem cells resulting in far less dead heart tissue and translating into an improved heart function and prognosis for long term survival. The initial angioblast clinical trial is currently open and will run for the next two years. The second trial for LVAD patients is anticipated to commence in 2005. Eligibility criteria for the current trial include:
"Ultimately, I hope that these clinical trials will enable conclusions to be made about the optimal type of adult stem cell for treating acute and chronic coronary artery disease and for repairing the damaged heart," says Dr. Itescu. For more information about the stem cell clinical trials (IRB# 14577), please contact Dr. Itescu at 212.305.4354. |
|
|
|
|
|
|
|
| ©1999-2007. Columbia University Medical Center, Department of Surgery, New York, NY. |
 |