Heart failure: enabling the heart to regenerate itself

Heart failure occurs when the heart is unable to supply the blood in a quantity appropriate to the actual demand of the body. In Switzerland, more than 150,000 people suffer from this condition, and research is increasingly focusing on how to replace damaged tissue in order to maintain cardiac function for as long as possible.

Leonard Y. Lee, President of the Department of Surgery at Robert Wood Johnson Medical School at Rutgers University in New Jersey, and his team of researchers recently published their study on the creation of heart muscle cells from stem cells to help damaged hearts heal themselves.

The research began with the collection of connective tissue cells from a human heart (fibroblasts) that were reverse-engineered, i.e. converted into stem cells, and then “transformed” back into heart muscle cells (re-engineered).

These new cardiac muscle cells grouped into a single unit, the beat of which was visible under the microscope. Normally, the cells thus created do not come together. The revolutionary and innovative aspect of this study lies in fact in the discovery of the ability of a protein – CREG – to group the created cardiac muscle cells into a single unit.

The over-expression of the CREG protein has made this process possible. Gene expression means the process by which the information contained in a gene (consisting of DNA) is converted into a functional macromolecule (typically a protein). The CREG protein, when over-expressed, i.e. expressed in increased amounts, induces the differentiation of stem cells into specific cells – in this case, cardiac muscle cells.

«Heart failure has reached epidemic proportions. Right now, the only option to treat it is surgery, transplant or connecting the patient with a blood-pumping machine» says Lee, «But transplantable hearts are in short supply and mechanical devices limit the patient’s quality of life, so we are working for ways to help hearts heal themselves».

The ultimate goal of this research is therefore to be able to remove small amounts of heart tissue from a patient, convert it into stem cells, use the CREG protein to transform them into heart muscle cells, and re-insert these cells into the patient’s heart so that it can self-regenerate. Moreover, because the new cells are created from those of the patient’s own organ, they would be easily accessible and there would be no fear of rejection.