In a unique feat, Israeli scientists reprogrammed skin cells from heart failure patients to grow into healthy, new heart muscle cells capable of integrating with existing heart tissue. The research opens up the prospect of treating heart failure patients with their own, human-induced pluripotent stem cells (hiPSCs) to repair their damaged hearts. As the reprogrammed cells would be derived from the patients themselves, this could avoid the problem of the patients’ immune systems rejecting the cells as “foreign,” the European Heart Journal reported.
However, the researchers warn that there are a number of obstacles to overcome before it would be possible to use hiPSCs in humans in this way and it could take at least five to 10 years before clinical trials could start. Recent studies have shown that it is possible to derive hiPSCs from young and healthy people and that these are capable of transforming into heart cells. However, until now, it has not been shown that hiPSCs could be obtained from elderly and diseased patients.
Lior Gepstein, professor of medicine (cardiology) and physiology at the Rambam Medical Center in Haifa, Israel, who led the research, said: “What is new and exciting . . . is that we have shown that it’s possible to take skin cells from an elderly patient with advanced heart failure and end up with his own beating cells in a laboratory dish that are healthy and young — the equivalent to the stage of his heart cells when he was just born.”
Limor Zwi-Dantsis, doctoral student in the Sohnis Research lab, Gepstein and colleagues took skin cells from male heart failure patients (above 50 years) and reprogrammed them by delivering three genes or “transcription factors,” followed by a small molecule called valproic acid, to the cell nucleus, according to a university statement. ”One of the obstacles to using hiPSCs clinically in humans is the potential for the cells to develop out of control and become tumours,” explained Gepstein.
The researchers also used an alternative strategy that involved a virus that delivered reprogramming information to the cell nucleus but which was capable of being removed afterwards so as to avoid becoming cancerous. The resulting hiPSCs were able to differentiate to become heart muscle cells(cardiomyocytes) just as effectively as hiPSCs that had been developed from healthy, young volunteers who acted as controls for this study.