Advertisement Then she tried something unusual. She signed up for a study in which stem cells are infused into the arm to potentially do what the body can’t do on its own: grow new heart muscle.
It’s one of seven studies for cardiovascular disease at UW Hospital involving regenerative medicine: the use of stem cells, gene therapy or growth factors to repair damaged tissue.
“If it might help my heart heal better or quicker, it was worth a try,” said Treichel, a retired nurse practitioner from Oregon who also is exercising more and eating better since her heart attack.
UW Hospital didn’t offer any such studies until Dr. Amish Raval arrived five years ago. Raval, a cardiologist who heads up six of the seven studies, said regenerative medicine gives hope to the thousands of heart disease patients each year who aren’t helped much by angioplasty, surgery or drugs.
He said many of the patients eventually die from heart failure, which about 5 million Americans have, according to the American Heart Association.
“They are labeled as having no options,” Raval said. “Now there are options.”
The stem cell studies use adult stem cells from donors or the patients. They don’t involve embryonic stem cells, discovered in 1998 by UW-Madison scientist James Thomson.
Raval said he hopes that within a decade, embryonic stem cells — or the induced pluripotent stem cells Thomson helped discover three years ago — will be used in similar studies.
For now, the research involving adult stem cells, gene therapy or growth factors is testing a relatively new concept in heart disease: that injury to the heart from a heart attack or other problem can be partly reversed.
“We’re trying to regenerate heart function, rather than just stop ongoing damage,” Raval said.
Anti-inflammatory cells
Treichel felt sluggish after Thanksgiving, lacking her normal enthusiasm for decorating the Christmas tree. On Dec. 11, she woke up in the middle of the night with what felt like heartburn.
The feeling persisted in the morning. She called her doctor, who told her to go the emergency room, where tests found she had a heart attack.
A week later, she received the infusion. She doesn’t know if she got real stem cells or the fake treatment given to some study participants to test if the real treatment works.
The study involves mesenchymal stem cells, one of two kinds of adult stem cells found in bone marrow. The cells are thought to reduce the inflammation after a heart attack that further damages heart muscle. The cells also may encourage the heart’s own stem cells to grow new muscle, Raval said.
Collected from donors and delivered in the arm, the cells travel to the heart by homing in on proteins released by injured heart tissue, he said.
The cells appear not to trigger rejection when transplanted into other people, so recipients don’t have to take drugs to suppress their immune systems.
Treichel is the first patient at UW Hospital in the national study, by Osiris Therapeutics, a biotech company in Columbus, Md. Osiris, which processes the cells and ships them frozen in bags, plans to enroll 220 patients, including at least 10 at UW Hospital, Raval said.
Since her heart attack, Treichel has been riding an exercise bike, walking around West Towne Mall, avoiding red meat and cooking low-fat, low-salt meals.
“I’m feeling better than I was before the heart attack,” possibly because of the infusion, she said.
Relief temporary
Steve Myrah also felt better three years ago after receiving an injection in one of the other studies at UW Hospital, for chest pain. But the relief didn’t last, he said.
For years, the 71-year-old from Middleton with severe coronary artery disease could barely walk without sharp chest pain. He wore nitroglycerin patches on his chest and took nitroglyercin pills under his tongue to try to ease the pain, which continued despite bypass surgery and several angioplasties.
In the study, doctors first gave Myrah a drug that releases stem cells from the bone marrow into the bloodstream. They collected his blood, separating out the stem cells.
Then they used a special catheter to inject a solution into Myrah’s heart muscle. He also doesn’t know if he received his stem cells or a fake treatment.
But soon afterward, he could walk longer without pain and reduce the nitroglycerin.
“I felt wonderful for about four months,” he said. “Then it slowly started creeping back. Now I’m right back where I was. I might be a little worse.”
Most of the studies are primarily looking at whether the therapies are safe, Raval said. Later studies, which likely will include several doses of cells or more specialized cells, will look more at how much benefit the treatments provide, he said.
MENDING A BROKEN HEART
Three of seven studies for cardiovascular disease at UW Hospital in regenerative medicine - the use of stem cells, gene therapy or growth factors to repair tissue - are enrolling patients. Another is expected to resume enrollment soon. The other three are full.
A brief look at the studies:
For more information about the studies, call 608-262-2290, e-mail Cathlyn Leitzke at cjl@medicine.wisc.edu or visit www.uwhealth.org and search for "options clinic."
