http://www.vancouversun.com/health/Stem+cells+help+heart+regeneration+after+surgery+Study/2902504/story.html

A revolutionary treatment whereby stems cells are injected into the heart during surgery could have enormous benefits for Canadians suffering from chronic heart disease, according to researchers.

In a study unique to North America, researchers in Montreal are using stem cells removed from a patient's bone marrow as a way to treat ischemic heart disease, which is characterized by a decrease in bloody supply to the heart and heart failure.

The study is a collaboration by researchers at the Research Centre of the University of Montreal Hospital Centre and the Maisonneuve-Rosemont Hospital.

The procedure was performed on the first patient only a few weeks ago, said cardiac surgeon and the lead investigator for the study, Dr. Nicolas Noiseux, but the patient's heart is already pumping blood better than it was before the surgery.

"We are facing heart disease on a daily basis as clinicians and often we are limited for the available treatments for our patients," said Noiseux. "We tried to find other treatments that we can add to what we're already doing." The single injection is a simple procedure, he said, and only adds a few additional minutes to coronary artery bypass surgery. The injection won't replace surgery, he said, but it could help regenerate the heart muscle and heal it faster.

Adult stem cells are harvested from the patient's bone marrow in the hip bone and transferred to a cell therapy lab where the most immature stem cells are isolated.

Processing the cells takes anywhere from six to eight hours, Noiseux said, and the immature cells are used because they have been shown to help regenerate the heart.

"Stems have been shown over the last decade to help to regenerate and help to repair the heart," he said. "These specific cells have never been used in (North) America in the context of coronary artery bypass."

Although it is clear the stem cells help repair and regenerate the heart, it's not clear yet how they do it, Noiseux said, although there are several possibilities.

The cells could transform into heart muscle or vessels, he said.

Another possibility is that the cells join with the damaged cells and helps them survive. The stem cells could also secrete agents that help the repair of the cells that are already there.

It could be many years before the procedure becomes mainstream, as researchers need to expand their work to include more clinical trials and more patients, and ensure the procedure is safe and effective.

As well, removing and processing the stem cells is a long, intensive same-day process, said Dr. Denis-Claude Roy, a hematologist from Maisonneuve-Rosemont Hospital and an researcher for the study.

"If we were to do that on a large scale, it would be right now difficult," Roy said. "We have to improve on strategies to make this more efficient. However, before you go there you want to be really sure your process is working."

The team now intends to recruit 20 patients from Quebec to undergo the procedure. Researchers at the General Hospital of the University of Toronto will also take part in the trial.

Apr. 13, 2010 (Vancouver Sun)