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ISIS Press Release 13/01/05
Bone Marrow Cells Repair Heart Damaged by Chagas’
Disease
Dr. Lilian Joensen reports
Two women whose hearts were severely damaged by Chagas’ disease
(see Box) showed remarkable recovery three months after stem cells from their
own bone marrow were transplanted into their heart.
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Chagas disease is caused by the protozoan parasite
Trypanosoma cruzi (T. cruzi), which enters the body through broken skin.
These can be introduced by infected blood-sucking ‘Assassin bugs’
(which live in the cracks and crevices of poor-quality houses in rural areas),
through transfusion with infected blood, or transmitted from infected mother to
foetus. Usually a small sore develops where the parasite enters. Within a few
days, fever and swollen lymph nodes may develop. This acute phase may cause
illness and death, especially in young children. More commonly, the patients
enter phase without symptoms, lasting several months or years, during which
time the parasites invade most organs of the body, often causing damage to the
heart, intestine and oesophagus, and progressive weakness. About 32% of those
infected die from organ damages during the chronic phase.
The geographical distribution of the human T. cruzi
infection extends from Mexico to the South of Argentina. The disease affects
16-18 million people and some 100 million, i.e. about 25% of the population of
Latin America is at risk of acquiring Chagas disease. |
In Argentina there are 2 300 000 people who contracted Chagas’
disease, and at least 40 000 of them suffer from severe heart problems as a
consequence of the disease.
The new treatment on the two patients from San Juan Province offers much
hope.
So much so that the Secretariat of Science, Technology and Productive
Innovation (SeCyT) has contributed 1 200 000 pesos to a group of local medical
doctors directed by Dr. Jorge Carlos Traianini at Presidente Perón
Hospital in Avellaneda (Buenos Aires Province), so they can treat 50 more
patients from all over the country.
Dr. Rubén Carrizo Páez, Chief of the Chagas Programme in
Rawson Hospital in San Juan Province, could not believe his eyes when he saw
one of his patients coming towards him. It was the same woman, who three months
before, had to stop several times just to walk 300 metres to take the bus. But
now, she was arriving by bike, after 5 kms of pedalling, and with no evidence
of over-exertion.
The 51 year-old patient, and another woman, a year younger with the same
disease, are the only two Argentineans on whom the revolutionary therapy has
been tried. This therapy promises to return the hearts of people with this
disease to their full vigour and capacity to contract and deliver blood
properly to the body.
The therapy involves ‘autologous’ transplant (where the donor
is also the recipient) of stem cells from the bone marrow. The cells are
delivered to the walls of the heart through a catheter to the coronary artery,
where, after 50 minutes, the cells start to find their way to the areas that
are most fibrous and scarred, to repair the damage. It looks like magic, but it
is not.
This new treatment was initiated by Dr. Jorge Carlos Traianini, Chief of
the Service of Cardiosurgery of Presidente Perón’s Hospital in
Buenos Aires Province, who, together with his team, co-ordinated by Dr.
Noemí Lagos, have already performed 33 transplants of different kinds of
stem and myoblast cells (muscle precursor cells) to severe cardiac lesions,
including infarcts of long standing, with remarkable recovery of cardiovascular
function.
The new clinical trials involving 50 patients from all over the country,
if successful, will make the treatment generally available to patients in no
more than two and a half years. The intention is to make the treatment
available at a cost as low as U$S 500.
"In reality, we don’t know why these stem cells help the heart
muscles to work better," said Dr. Lagos. "It is possible that new blood vessels
are generated and also new muscle cells, but it is not clear. Our aim is to be
able to know the intrinsic mechanisms of how this happens. But for now the
clinical results overcome all known explanations".
Dr. Traianini added that, contrary to the traditional concept that the
heart was an organ incapable of regeneration, the results show the opposite is
the case; these new therapies take maximal advantage of this auto-repairing
ability of the heart.
Sources
"Regeneración del tejido cardíaco en pacientes con
cardiomiopatía chagásica, mediante el autotransplante de
células madre de la médula ósea". Fatala al día,
año II, nro 6, Diciembre 2004.
http://www.anlis.gov.ar/INP/Fatalaaldia6.ppt
"Crean una terapia para tratar el mal de Chagas" by Gabriela Navarra, La
Nación, 10 December 2004.
http://www.docmedical.com/novedades_veruna.asp?notid=2117
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