MedicalResearch.com Interview with:
Nenad Bursac PhD
Professor of Biomedical Engineering
Associate Professor of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Every year about 1 million new people in US suffers from heart attack, resulting in death of hundreds of millions of cardiac muscle cells. This massive cell loss leads to gradual deterioration of heart function, which for many patients results in the occurrence of heart failure that ultimately will require heart transplant. Heart transplantation is complicated and expensive procedure and donor hearts are in short supply, rendering this disease to be not only highly prevalent but ultimately lethal.
For almost 30 years, researchers have been exploring transplantation of stem cells into injured hearts as a means to replace dead cardiac muscle with new muscle cells that would yield improved heart function. However, injections of stem cells in the heart have so far met with limited clinical success and surgical implantation of pre-made heart muscle tissue in a form of a “cardiac patch” has been explored as an alternative strategy with a proven benefit of enhancing transplanted cell survival. Others and we have engineered cardiac tissue patches in a dish starting from human pluripotent stem cells, which have advantage of being able to become bona fide contracting cardiac muscle cells. So far, however, no one has been able to engineer a highly functional cardiac muscle patch of a size that is large enough to be used in human therapies for heart disease.
My lab has been developing cardiac tissue engineering technologies since the inception of the field. Last several years we have devoted to scaling up our human cardiac muscle patches to a clinically relevant size (an area of 4cm x 4cm), while ensuring that individual cells within the patch remain uniformly dense and well-connected as well as capable of strong contractions and fast spread of electrical activity, both of which are the hallmarks of normally functioning human heart.
In the just published study, we have demonstrated that this can be accomplished using a relatively simple technology that does not require complex stimuli and cell culture conditions, which makes it amenable to further development towards clinical use. We have also transplanted smaller versions of these patches onto rat hearts and have shown that after a month, transplanted patches survive robustly, connect to host vasculature, and do not cause abnormal electrical activity (arrhythmias).
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: The main message from our report is that now, for the first time, researchers can make a large-size, highly functional human heart muscle patch in a Petri dish in a relatively short time (5 weeks). This functional muscle patch is of sufficient size to cover the surface area of the human heart under which cardiac muscle cells have died from heart attack.
This is an important stepping stone for being able to eventually advance cardiac tissue engineering strategies into clinical practice.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: The two important remaining challenges in the field are how to make thicker human cardiac tissues and how to electrically connect them with the recipient hearts. Additionally, these large human cardiac tissue patches need to be thoroughly tested in a large animal (e.g. pig) model of heart attack that mimics human pathology.
We are currently working in all of these areas and hope to have promising results in the next couple of years.
MedicalResearch.com: Is there anything else you would like to add?
Response: I would like to acknowledge our support from National Institutes of Health without which this research would not be possible.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community
Ilya Y. Shadrin,Brian W. Allen,Ying Qian,Christopher P. Jackman, Aaron L. Carlson, Mark E. Juhas &Nenad Bursac
Nature Communications 8, Article number: 1825 (2017)
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