The human heart has a stem cell population all its own. This stem cell population replaces heart cells at a leisurely rate throughout the life of the heart. Unfortunately, a heart attack overwhelms this repair system, and the heart simply lacks the capacity to heal itself to beyond particular limits.
However, there is the hope that physicians will one day be able to augment the healing capacity of the heart, and a few clinical trials and several animal experiments strongly suggest that this is the possible.
A new paper by Yoshiki Sawa at and his team from Osaka University has examined a way to increase the healing capabilities of human cardiac stem cells (CSCs).
In this paper, which was published in the journal Circulation, isolated CSCs from a 12-year old patient and grown in culture. However, the cells were grown in several different types of culture conditions. The density at which cells are grown can affect their biological characteristics. Therefore, Sawa and his group plated these cells at four different densities; single, low, mid and high densities. The single, low and med density-grown cells divided faster than the cells grown as high density. Also, the cells grown at lower cell densities retained their ability to form either heart muscle or blood vessels whereas the cells grown at high densities stated to make blood vessels en mass.
When scientists from Sawa’s group examined why the cells grown at high densities turned into blood vessel cells, they discovered that these cells activated a signaling pathway called the NOTCH pathway. Activation of the NOTCH pathway turned the cells into blood vessel-making cells and slowed their growth in culture.
Presumably, the faster-growing, more plastic cells would be better for regenerative treatments that the slower-growing, less plastic cells. To test this hypothesis, Sawa and others transplanted cultured CSCs grown as different densities into the hearts of rats that had suffered a recent heart attack. They are used CSCs grown at high densities, but had been treated with a drug that inhibits the NOTCH pathway.
The results were remarkable. The lower the densities at which the cells were grown, the better they repaired the heart. However, the high-density cells grown in the presence of a NOTCH inhibitor (called GSI), were just as good at repairing the heart as the cells grown at low density. While the cells grown in the presence of GSI at high density still grew slowly, they showed an enhanced capacity to induce the formation of new blood vessels in the damaged heart tissue and form new heart muscle.
In conclusion these authors state: “Therapeutic effects of CSC-transplantation for heart disease may be enhanced by reducing NOTCH signaling in CSCs.”