Cord Blood May Help Repair Children’s Heart Defects

From Medical News Today:

Stem cells from umbilical cord blood may provide the raw material to repair the hearts of thousands of babies born each year with defective heart valves, according to data presented at the recent American Heart Association annual meeting.

Cardiologists from the University Hospital of Munich report they are about five years away from transplanting new heart valves into children with heart defects, made from the children’s own cord blood.(1)

Congenital heart defects – or problems with the heart’s structure that are present at birth – are the most common type of major birth defect.(2) In children with heart valve abnormalities, the valves do not fully open or close and impede the flow of blood.(3) While surgeons can transplant new valves from donors or from artificial material, these valves won’t grow as the children do, meaning these individuals will require repeated operations to provide them with new, larger valves, said Dr. Ralf Sodian, the cardiac surgeon who led the research.(1)

Replacement heart valves made from the child’s own cord blood stem cells would theoretically grow with the child and change shape as needed, significantly reducing the number of surgeries necessary for these patients.

In this study, the cord blood stem cells were seeded onto biodegradable heart valve scaffolds and grown in the laboratory. The cells formed a tissue layer around the scaffolding and further tests showed the engineered cells formed viable heart tissue. When their ability to handle blood flow and pressure were tested, the valves created from cord blood stem cells showed capabilities similar to natural heart valves.(4)

Similar results from a pre-clinical study showed cord blood endothelial stem cells demonstrated excellent growth potential for tissue-engineered vascular grafts that could replace human heart defects.(5)

The research presented at this meeting – as well as those pre-clinical findings – offer a compelling reason why parents with a child diagnosed intrauterinely with congenital defects should consider preserving their child’s cord blood, since it may offer a treatment option in the future.

About Cardiovascular Disease

Cardiovascular disease is the leading cause of death for both men and women in the U.S. Approximately one million people die of cardiovascular disease annually despite medical intervention, with coronary artery disease claiming 50 percent of those lives.(6) Although heart disease impacts an older population whose heart muscle, arteries and pumping function have deteriorated over time, heart ailments also strike the very young. According to the National Institutes of Health, congenital heart disease is responsible for more deaths in the first year of life than any other birth defect.(7) Read more about cardio vascular disease.

About Cardiovascular Disease and Cord Blood

The stem cells found in a newborn’s umbilical cord blood are one type of stem cell holding great promise in cardiovascular repair. Read more about cardiovascular disease and cord blood.

Repairing Blood Vessels and Improving Ventricular Function

The heart demands a large volume of blood flow in order to bring nutrients and oxygen to the muscle tissue after it has been damaged. Research demonstrates that cord blood stem cells are capable of giving rise to vascular endothelial-like cells, which are believed to aid in the repair of heart tissue damage due to myocardial infarction. Read more about how cord blood stem cells repair blood vessels and improve function.

Cardiomyocytes and Cord Blood: In Vitro Studies Show Promise

Permanent loss of cardiomyocytes (heart muscle cells) and the formation of scar tissue following a heart attack result in irreversible damage to cardiac function. Human cord blood contains several different types of stem cells including hematopoietic, endothelial and mesenchymal stem cells. Although still in early stages, four in vitro studies have shown that under certain treatment conditions, cord blood mesenchymal stem cells differentiate into cardiomyocyte-like cells (14,15,16,17) and were able to induce regeneration of healthy cells from damaged cardiomyocytes.(17) This suggests that cord blood stem cells have a high potential to differentiate into cardiomyocytes and aid the regeneration of cardiomyocytes lost due to heart damage.

Advances in Peripheral Vascular Disease

The ability of cord blood stem cells to become vascular endothelial-like cells, and thus, blood vessels, indicates they will likely have potential applications beyond the heart. Read more about vascular disease advances with cord blood stem cells.

The Future of Cord Blood Stem Cell Cardiac Therapy

As a next step to the research presented at the American Heart Association meeting, the study investigators plan to begin experiments next year to test their procedure in animal models. They will implant the heart valves made from cord blood into the hearts of young lambs, observing their ability to grow and function over time.(1)

The growing library of research on cardiac repair suggests an infant’s own cord blood could prove to be a valuable treatment option not just for treating a congenital heart defect, but perhaps later in life if the individual experiences a sudden and serious heart attack.

References

1. Waters R. Cord Blood Stem Cells May Help Repair Babies’ Heart Defects. Bloomberg. November 10, 2008. Accessed November 2008.

2. Centers for Disease Control and Prevention. About Heart Disease Page. http://www.cdc.gov/HeartDisease/about.htm. Accessed April 2008.

3. Arkansas Children’s Hospital. The Heart Center. Heart Conditions, Diagnosis and Treatment. http://www.pediatric-cardiology.com/Heart_Health/heart_health.asp. Accessed November 2008.

4. American Heart Association Press Release. Umbilical cord blood may help build new heart valves. http://americanheart.mediaroom.com/index.php?s=43&item=548. Accessed November 2008.

5. Schmidt D, Breymann C, Weber A, Guenter CI, Neuenschwander S, Zund G, Turina M, Hoerstrup SP. Umbilical cord blood derived endothelial progenitor cells for tissue engineering of vascular grafts. Ann Thorac Surg. 2004 Dec;78(6):2094-8.

6. Harris DT, Badowski M, Ahmad N, Gaballa MA. The potential of cord blood stem cells for use in regenerative medicine. Expert Opinion on Biological Therapy. 2007;7(9):1311-1322.

7. U.S. National Library of Medicine and National Institutes of Health. Medline Plus. Congenital Heart Disease page. http://www.nlm.nih.gov/medlineplus/ency/article/001114.htm. Accessed January 2008.

8.National Institutes of Health. Stem Cell Information Page. http://stemcells.nih.gov/info/scireport/chapter9.asp. Accessed January 2008.

9. Ma N, Stamm C, Kaminski A, Li W, et al. Human cord blood cells induce angiogenesis following myocardial infarction in NOD/scid-mice. Cardiovascular Research. 2005;66(1):45-54.

10. Hu CH, Wu GF, Wang XO et al. Transplanted human umbilical cord blood mononuclear cells improve left ventricular function through angiogenesis in myocardial infarction. Chin Med J (Engl). 2006;119(18):1499-506.

11. Ma N. Ladilov Y, Kaminski A, Piechaczek C. Stamm C. Umbilical cord blood cell transplantation for myocardial regeneration. Transplant proc. 2005;38(3):771-3.

12. Leor J, Guetta E, Feinberg MS et al. Human umbilical cord blood-derived CD133+ cells enhance function and repair of the infarcted myocardium. Stem Cells. 2006;24(3):772-80.

13. Henning RJ, Abu-Ali H, Balis JU, Morgan MB, Willing AE, Sanberg PR. Human umbilical cord blood mononuclear cells for the treatment of acute myocardial infarction. Cell Transplant. 2004;13(7-8):729-39.

14. Cheng F, Zou P, Handong Y. Induced differentiation of human cord blood mesenchymal stem/progenitor cells into cardiomyocyte-like cells in vitro. J Huazong Univ Sci and Tech. 2003;23(2):154-157.

15. Nishiyama N, Miyoshi S, Hida N, et al. The significant cardiomyogenic potential of human umbilical cord blood-derived mesenchymal stem cells in vitro. Stem Cells. 2007;25(8):2017-24.

16. Bonanno G, Mariotti A, Procoli A, et al. Human cord blood CD133+ cells immunoselected by a clinical-grade apparatus differentiate in vitro into endothelial- and cardiomyocyte-like cells. Transfusion. 2007;47(2):280-9.

17. Yamada Y, Yokoyama S, Fukuda N, et al. A novel approach for myocardial regeneration with educated cord blood cells cocultured with cells from brown adipose tissue. Biochem Biophys Res Commun. 2007;353(1):182-8.

18. U.S. National Library of Medicine and National Institutes of Health. Medline Plus. Peripheral Vascular Disease page. http://www.nlm.nih.gov/medlineplus/peripheralvasculardiseases.html. Accessed January 2008.

19. Ikeda Y, Noboru F, Wada M, Matsumoto T, Satomi A, Yokoyama SI, Saito S, Masumoto K, Katsuo K, Mugishima H. Development of angiogenic cell and gene therapy by transplantation of umbilical cord blood with vascular endothelial growth factor gene. Hypertens Res. 2004;27(2):119-128.

20. Cho S-W, Gwak S-J, Kang S-W, et al. Enhancement of angiogenic efficacy of human cord blood cell transplantation. Tissue Eng. 2006;12(6):1651-1661.