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Can Stem Cells Mend A Broken Heart?
September 2019

The British Heart Foundation announced earlier this summer that heart failure could be treated with stem cells, and Celixir is wholeheartedly behind this research as we too look to research stem cell based therapy to treat heart failure. 

Cambridge-based researchers found that by transplanting heart muscle stem cells alongside other supportive cells from the outer wall of the heart, into the area of damaged heart tissue, the stem cells could potentially help the heart to recover after becoming damaged following a heart attack. 

Cardiovascular disease is the number one cause of death around the world, taking over 17 millions lives annually. Heart failure affects over 25 million people worldwide, and in the UK alone, there are approximately 7.4 million people who live with heart disease, and just under 1 million living with heart failure. 

What is heart failure

Heart failure is a syndrome of the heart being impaired. Heart failure is not caused by one specific condition, nor are the signs and symptoms of heart failure alike for each individual person. 

Common signs and symptoms of heart failure:

  • Shortness of breath
  • Tiredness
  • Swelling in the lower legs
  • Irregular heartbeat
  • Sudden shortness of breath
  • Coughing pink, foamy mucus
  • Chest pain caused by heart attack

Heart failure doesn’t tend to happen out of the blue, it is usually a result of other conditions and issues that have weakened the heart, damaging it and preventing it from working efficiently. Heart failure is not always a result of a weakened heart, however, it can also occur following the heart becoming stiff (caused by high blood pressure). 

Other common causes of heart failure:

  • Coronary artery disease – this is one of the most common forms of heart disease that causes heart failure due to a buildup of fatty deposits in the arteries, reducing blood flow, leading to a heart attack.
  • High blood pressure – hypertension causes the heart to work harder than usual to pump blood around the body, which over time can result in overworking the heart muscle, making it stiff and ineffective at pumping blood. 
  • Damaged heart valve – heart valves prevent blood from flowing the wrong way through the heart, but when a valve becomes damaged, through coronary heart disease for example, the heart has to work harder to keep blood flowing the right way. Resulting in a weakened heart. 
  • Myocarditis – inflammation of the heart tissues, most commonly caused by a virus, result in the failure of the left side of the heart to work. 
  • Congenital heart defects – if the heart has never worked properly, over time it has to work harder to get the blood pumped around the body, leading to heart failure. 

In any case, heart failure is the result of the heart’s inability to keep up with the regular demands the body places on it, rendering it unable to pump blood all around the body. 

Heart failure typically begins on the left side of the heart, more specifically, it occurs in the left ventricle – the heart’s main chamber for pumping blood and spreads from there. 

And the heart is not able to regenerate, like the liver. So once damaged, the healthy tissue becomes scar tissue, leaving patients with reduced cardiac function and can lead to heart failure. 

What is the current treatment for heart failure

Heart failure is not something that typically can be treated overnight, heart failure is a chronic disease that currently requires lifelong management, to ensure the symptoms don’t worsen. 

There are of course exceptions to this – for example, in the case of faulty heart valves, if replaced, the heart can return to normal function. 

But for the vast majority of people living with heart failure, it needs to be treated with a combination of medications such as Beta blockers or ACE (angiotensin-converting enzyme) inhibitors, and in some cases the use of devices and/or surgery. 

Surgical treatments can include: 

  • Coronary artery bypass – where the blocked artery in the heart is bypassed using other blood vessels.
  • Valve repair – where the faulty valve is repaired to prevent blood flowing the wrong way, or an artificial valve replaces the damaged valve. 
  • Pacemaker – a small electrical device that is inserted into the chest or abdomen in order to control the heart’s beating rhythms. 

But despite these treatments managing heart failure, none of them are able to slow the progression of heart failure, nor can they prolong life, and nor do they address the issue of the root problem, the actual cause of the heart failure – the loss of functioning heart muscle cells. Because once heart muscle cells are lost, they cannot be replaced by the body.

How stem cells could help treat heart failure

Stem cells are being researched to help treat heart failure in two ways. Firstly, the heart muscle derived stem cells can be used to research and test potential new drugs, and secondly, as a way to replace the damaged heart tissue. 

Which is where the recent BHF research fits in – by introducing new, functioning heart tissue stem cells into the damaged tissue, they might be able to help the heart to recover following significant damage caused by, for example, a heart attack. 

The problem of this approach up until recently has been that the transplanted stem cells have not survived beyond a few days following transplantation. And the Cambridge scientists have been looking into how to extend the life of the transplanted cells, recently finding epicardial cells to be supportive in helping the heart muscle stem cells to survive, to grow and to restore the damaged heart tissue.

Celixir itself received clinical trial application approval in January 2018 to initiate a Phase IIb human clinical trial using its Heartcel medicine, to help treat moderate to severe heart failure in adults. 

Heartcel is Celixir’s investigational cardiac regenerative medicine made up of off the shelf iMP cells. Adult heart failure trials are due to be completed in 2020, and will be conducted at Imperial College London’s Royal Brompton, UK. 

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