Can the heart heal itself? New study says it can

Jonas Frisén, MD, PhD, and Olaf Bergmann, MD, PhD, of the Karolinska Institute in Stockholm, led teams in Sweden and Germany and used their own innovative method of carbon dating human heart tissue to track whether these samples contained newly generated cells.

The investigators found that patients with artificial hearts regenerated muscle cells at more than six times the rate of healthy hearts.

"This is the strongest evidence we have, so far, that human heart muscle cells can actually regenerate, which really is exciting, because it solidifies the notion that there is an intrinsic capacity of the human heart to regenerate," Sadek said. "It also strongly supports the hypothesis that the inability of the heart muscle to 'rest' is a major driver of the heart's lost ability to regenerate shortly after birth. It may be possible to target the molecular pathways involved in cell division to enhance the heart's ability to regenerate." A research team co-led by a physician-scientist at the University of Arizona College of Medicine -- Tucson's Sarver Heart Center found that a subset of artificial heart patients can regenerate heart muscle, which may open the door to new ways to treat and perhaps someday cure heart failure. The results were published in the journal Circulation.

According to the Centers for Disease Control and Prevention, heart failure affects nearly 7 million U.S. adults and is responsible for 14% of deaths per year. There is no cure for heart failure, though medications can slow its progression. The only treatment for advanced heart failure, other than a transplant, is pump replacement through an artificial heart, called a left ventricular assist device, which can help the heart pump blood.

"Skeletal muscle has a significant ability to regenerate after injury. If you're playing soccer and you tear a muscle, you need to rest it, and it heals," said Hesham Sadek, MD, PhD, director of the Sarver Heart Center and chief of the Division of Cardiology at the U of A College of Medicine -- Tucson's Department of Medicine. "When a heart muscle is injured, it doesn't grow back. We have nothing to reverse heart muscle loss."

Sadek led a collaboration between international experts to investigate whether heart muscles can regenerate. The study was funded through a grant awarded to Sadek by the Leducq Foundation Transatlantic Networks of Excellence Program, which brings together American and European investigators to tackle big problems.

The project began with tissue from artificial heart patients provided by colleagues at the University of Utah Health and School of Medicine led by Stavros Drakos, MD, PhD, a pioneer in left ventricular assist device-mediated recovery.

Finding better ways to treat heart failure is a top priority for Sadek and the Sarver Heart Center. This study builds on Sadek's prior research into rest and heart muscle regeneration.

In 2011, Sadek published a paper in Science showing that while heart muscle cells actively divide in utero, they stop dividing shortly after birth to devote their energy to pumping blood through the body nonstop, with no time for breaks.

In 2014, he published evidence of cell division in patients with artificial hearts, hinting that their heart muscle cells might have been regenerating.

These findings, combined with other research teams' observations that a minority of artificial heart patients could have their devices removed after experiencing a reversal of symptoms, led him to wonder if the artificial heart provides cardiac muscles the equivalent of bedrest in a person recovering from a soccer injury.

"The pump pushes blood into the aorta, bypassing the heart," he said. "The heart is essentially resting."

Sadek's previous studies indicated that this rest might be beneficial for the heart muscle cells, but he needed to design an experiment to determine whether patients with artificial hearts were actually regenerating muscles.

"Irrefutable evidence of heart muscle regeneration has never been shown before in humans," he said. "This study provided direct evidence."

Next, Sadek wants to figure out why only about 25% of patients are "responders" to artificial hearts, meaning that their cardiac muscle regenerates.

"It's not clear why some patients respond and some don't, but it's very clear that the ones who respond have the ability to regenerate heart muscle," he said. "The exciting part now is to determine how we can make everyone a responder, because if you can, you can essentially cure heart failure. The beauty of this is that a mechanical heart is not a therapy we hope to deliver to our patients in the future -- these devices are tried and true, and we've been using them for years."

Journal Reference:

1. Wouter Derks, Julian Rode, Sofia Collin, Fabian Rost, Paula Heinke, Anjana Hariharan, Lauren Pickel, Irina Simonova, Enikő Lázár, Evan Graham, Ramadan Jashari, Michaela Andrä, Anders Jeppsson, Mehran Salehpour, Kanar Alkass, Henrik Druid, Christos P. Kyriakopoulos, Iosif Taleb, Thirupura S. Shankar, Craig H. Selzman, Hesham Sadek, Stefan Jovinge, Lutz Brusch, Jonas Frisén, Stavros Drakos, Olaf Bergmann. A Latent Cardiomyocyte Regeneration Potential in Human Heart Disease. Circulation, 2024; DOI: 10.1161/CIRCULATIONAHA.123.067156

Courtesy:

University of Arizona Health Sciences. "Can the heart heal itself? New study says it can." ScienceDaily. ScienceDaily, 27 December 2024. <www.sciencedaily.com/releases/2024/12/241220191007.htm>.

First new treatment for asthma attacks in 50 years

An injection given during some asthma and COPD attacks is more effective than the current treatment of steroid tablets, reducing the need for further treatment by 30%.

The findings, published today in The Lancet Respiratory Medicine, could be "game-changing" for millions of people with asthma and COPD around the world, scientists say.

Asthma attacks and COPD flare-ups (also called exacerbations) can be deadly. Every day in the UK four people with asthma and 85 people with COPD will tragically die. Both conditions are also very common, in the UK someone has an asthma attack every 10 seconds. Asthma and COPD costs the NHS £5.9B a year.

The type of symptom flare-up the injection treats are called 'eosinophilic exacerbations' and involve symptoms such as wheezing, coughing and chest tightness due to inflammation resulting from high amounts of eosinophils (a type of white blood cell). Eosinophilic exacerbations make up to 30% of COPD flare-ups and almost 50% of asthma attacks. They can become more frequent as the disease progresses, leading to irreversible lung damage in some cases.

Treatment at the point of an exacerbation for this type of asthma has barely changed for over fifty years, with steroid drugs being the mainstay of medication. Steroids such as prednisolone can reduce inflammation in the lungs but have severe side-effects such as diabetes and osteoporosis. Furthermore, many patients 'fail' treatment and need repeated courses of steroids, re-hospitalisation or die within 90 days.

Results from the phase two clinical trial ABRA study, led by scientists from King's College London and sponsored by the University of Oxford, show a drug already available can be re-purposed in emergency settings to reduce the need for further treatment and hospitalisations. The multi-centre trial was conducted at Oxford University Hospitals NHS Foundation Trust and Guy's and St Thomas' NHS Foundation Trust.

Benralizamab is a monoclonal antibody which targets specific white blood cells, called eosinophils, to reduce lung inflammation. It is currently used for the treatment of severe asthma. The ABRA trial has found a single dose can be more effective when injected at the point of exacerbation compared to steroid tablets.

The study investigators randomised people at high risk of an asthma or COPD attack into three groups, one receiving benralizumab injection and dummy tablets, one receiving standard of care (prednisolone 30mg daily for five days) and dummy injection and the third group receiving both benralizumab injection and standard of care. As a double-blind, double-dummy, active-comparator placebo-controlled trial, neither the people in the study, or the study investigators knew which study arm or treatment they were given.

After 28 days, respiratory symptoms of cough, wheeze, breathlessness and sputum were found to be better with benralizumab. After ninety days, there were four times fewer people in the benralizumab group that failed treatment compared to standard of care with prednisolone.

Treatment with the benralizumab injection took longer to fail, meaning fewer episodes to see a doctor or go to hospital. There was also an improvement in the quality of life for people with asthma and COPD.

Lead investigator of the trial Professor Mona Bafadhel from King's College London said: "This could be a game-changer for people with asthma and COPD. Treatment for asthma and COPD exacerbations have not changed in fifty years despite causing 3.8 million deaths worldwide a year combined.

"Benralizumab is a safe and effective drug already used to manage severe asthma. We've used the drug in a different way -- at the point of an exacerbation -- to show that it's more effective than steroid tablets which is the only treatment currently available. The big advance in the ABRA study is the finding that targeted therapy works in asthma and COPD attacks. Instead of giving everyone the same treatment, we found targeting the highest risk patients with very targeted treatment, with the right level of inflammation was much better than guessing what treatment they needed."

The benralizumab injection was administered by healthcare professionals in the study but can be potentially administered safely at home, in the GP practice, or in the Emergency Department. Benralizumab was safe in the study and similar in safety to many past studies.

Professor Mona Bafadhel said, "We hope these pivotal studies will change how asthma and COPD exacerbations are treated for the future, ultimately improving the health for over a billion people living with asthma and COPD across the world."

Dr Sanjay Ramakrishnan, Clinical Senior Lecturer at the University of Western Australia, who is the first author of the ABRA trial and started the work while at the University of Oxford, said: "Our study shows massive promise for asthma and COPD treatment. COPD is the third leading cause of death worldwide but treatment for the condition is stuck in the 20th century. We need to provide these patients with life-saving options before their time runs out.

"The ABRA trial was only possible with collaboration between the NHS and universities and shows how this close relationship can innovate healthcare and improve people's lives."

Geoffrey Pointing, 77 from Banbury, who took part in the study, said: "Honestly, when you're having a flare up, it's very difficult to tell anybody how you feel -- you can hardly breathe. Anything that takes that away and gives you back a normal life is what you want. But on the injections, it's fantastic. I didn't get any side effects like I used to with the steroid tablets. I used to never sleep well the first night of taking steroids, but the first day on the study, I could sleep that first night, and I was able to carry on with my life without problems. I want to add that I'm just grateful I took part and that the everyone involved in the ABRA study are trying to give me a better life."

Dr Samantha Walker, Director of Research and Innovation, at Asthma + Lung UK, said: "It's great news for people with lung conditions that a potential alternative to giving steroid tablets has been found to treat asthma attacks and chronic obstructive pulmonary disease (COPD) exacerbations. But it's appalling that this is the first new treatment for those suffering from asthma and COPD attacks in 50 years, indicating how desperately underfunded lung health research is.

"Every four minutes in the UK, someone dies from a lung condition. Thousands more live with the terror of struggling to breathe every day. With your help, we're fighting for more life-changing, life-saving research to transform the future for everyone living with breathing problems. Together, we'll make sure that families everywhere never face a lung condition without the best treatment and care.

"Our vision is a world where everyone has healthy lungs. We can only get there with your help."

This research was conducted with support from AstraZeneca UK Limited.

Journal Reference:

1. Sanjay Ramakrishnan, Richard E K Russell, Hafiz R Mahmood, Karolina Krassowska, James Melhorn, Christine Mwasuku, Ian D Pavord, Laura Bermejo-Sanchez, Imran Howell, Mahdi Mahdi, Stefan Peterson, Thomas Bengtsson, Mona Bafadhel. Treating eosinophilic exacerbations of asthma and COPD with benralizumab (ABRA): a double-blind, double-dummy, active placebo-controlled randomised trial. The Lancet Respiratory Medicine, 2024; DOI: 10.1016/S2213-2600(24)00299-6 

Courtesy:

King's College London. "First new treatment for asthma attacks in 50 years." ScienceDaily. ScienceDaily, 27 November 2024. <www.sciencedaily.com/releases/2024/11/241127191934.htm>.

 

Faculty Positions at KAHE Coimbatore

 

 

 

More Info: https://kahedu.edu.in/current-vacancies/

Faculty Position at SIRMVIT Bengaluru

 

Scientist at CSIR- CENTRAL LEATHER RESEARCH INSTITUTE. Chennai

 

CSIR- CENTRAL LEATHER RESEARCH INSTITUTE

Adyar, 

Chennai-600 020 Tamil Nadu

Recruitment of Scientists

Last date for submission of ONLINE applications 19.01.2025 (23:30 hrs. IST)

2. Scientist S2402 01 Post SC 

Microbiology 

Theme: Quality Assurance 

37 Years 

Ph. D thesis submitted in Microbiology / Life sciences in the area of basic and applied microbiology from a recognized University. 

Ph. D research in the area of Microbial Taxonomy / Molecular Biology / Identification and microbial testing, method and Tool development / Modern Techniques for Microbial Preservation and Conservation, Leather microbiome. Post-doctoral research experience in the above mentioned area. Research publications in high impact factor journals. 

Experience in product Development / Technology Innovation / Applied Technology in relevant area. Capability to carry out independent research. To carry out Research and Development of microbes, microbial methods, animal skin and leather microbiome research and applied microbial research. Preparation, extraction and characterization of various enzymes for leather manufacturing, and tannery wastewater and solid waste treatment. To carry out independent/team research with the potential of securing and sustaining independent extramural funding to fulfil the mandate of institute. To lead the research / testing environment in the area. Any other responsibilities assigned by the competent authority

11. Scientist S2411 01 Post UR 

Disease Biology 

32 years 

Ph.D. submitted in Life Sciences / Biochemistry / Biotechnology / Molecular Biology Research experience in Protein Chemistry/Molecular genetics/biological processes at cellular and organism level /immunomodulatory functions in disease biology demonstrated by their research publications in SCI Journals and / or Patent in the area. 

Experience in Product Development / Technology innovation / Applied Technology 

Research in the area of immunological and physiological basis of diseases in different in-vitro and in-vivo models for detailed understanding of diseases to design and develop therapeutics.

15. Scientist S2415 01 Post EWS 

Bio Materials 

32 Years 

Ph.D. submitted in Life Sciences Research experience in Biomaterials for implant/graft design and development as demonstrated by their research publications in SCI Journals and / or Patent in the area. 

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Research, development and validation of graft materials through pre-clinical and clinical trials 

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