Recent research conducted at Stanford University shows the possibility of reversing cellular damage caused by heart attacks. Their solution is a ‘protein patch’ that instigates the regeneration of cells.
During a heart attack or myocardial infarction, heart muscle cells die due to lack of oxygen from reduced blood flow. Adult mammals are unable to fully regenerate the damaged and dead cardiomyocytes after a heart attack, leading the heart muscle to form scar tissue in an attempt to heal.
The zebrafish, a tropical freshwater minnow, has heart cells capable of complete regeneration. Past research shows that the epicardium–the inner layer of the pericardium that lines the wall of heart muscles–is the key to the regeneration process.
Inspired by the sea creature’s independent damage reversal, scientists wondered if the principles of the phenomenon would translate to a potential solution for human heart cell regeneration.
“We wanted to know what in the epicardium stimulates the myocardium, the muscle of the heart, to regenerate,” says Professor Pilar Ruiz-Luzano, of Stanford University, in a quote reported by Medical News Today.
The team analyzed the epicardial cells of healthy mammalian hearts and found that these cells triggered replication of cardiomyocytes. Using mass spectrometry, they analyzed over 300 different proteins produced by epicardial cells, attempting to identify a single compound that may be responsible for cardiomyocyte regeneration.
The researchers succeeded in identifying a natural protein called Follistatin-like 1 (FSTL1) responsible for stimulating cell replication. This protein, however, diminishes after a heart attack.
The innovative therapeutic strategy, inspired by the zebrafish, is a patch made of acellular collagen that simulates fetal epicardial tissue and is embedded with FSTL1. These two substances are slowly absorbed by tissue when applied to a damaged heart.
In the laboratory, the researchers tested the patch on the hearts of pigs and mice that had been damaged by myocardial infarction. Regeneration of existing heart muscle cells and growth of new blood vessels began within two to four weeks. Overall heart function improved, even when the patch was applied a week after the heart attack.
“Many [of the animals] were so sick prior to getting the patch that they would have been candidates for heart transplantation,” says Ruiz-Lozano.
He believes the findings of this study are the beginnings of a “completely revolutionary” treatment for heart attack patients. The team hopes the patch will enter human clinical trials within the next two years.
The study is published in the journal Nature.