Treating Fibrosis of the Heart Post-Stroke with Umbilical Cord Tissue-Derived Mesenchymal Stem Cells
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The term "cardiac fibrosis" refers to an excess of deposition of extracellular matrix (ECM) by cardiac fibroblasts (CFs), which can eventually result in cardiac dysfunction and heart failure. Cardiac fibrosis is a common pathophysiologic process that is associated with the majority of heart diseases.
This unfortunately common occurrence is generally noted in patients who suffer from ischemic heart disease, diabetes, and inherited cardiomyopathy mutations. It can also result from the heart's natural aging process. Patients who suffer from severe strokes often experience this debilitating condition as well.
In general, there are four types of cardiac fibrosis that patients can be diagnosed with. These include:
- Replacement fibrosis
- Reactive interstitial fibrosis
- Infiltrative interstitial fibrosis
- Endomyocardial fibrosis
Statistics surrounding fibrosis of the heart in the United States show that approximately 6 million people in the United States suffer from some form of heart failure. When heart failure develops, it causes a decrease in cardiac output and activates a compensatory mechanism. One of the mechanisms that is activated is cardiac fibrosis. Over time, this scoring process can impact nearly every aspect of the cardiac structure and its functionality. Millions of people globally suffer from fibrosis of the heart.
Every year, more than 800,000 people across the world lose their lives as a result of fibrotic diseases. Unfortunately, there are many instances where people suffer fibrosis of the heart following a major stroke. However, patients who suffer from this debilitating condition have several treatment options available. Let’s explore them and their effectiveness.
What Treatment Options are Available for Fibrosis of the Heart?
Patients who suffer from fibrosis of the heart have several treatment options available to help alleviate the symptoms that they experience. In most cases, patients will be administered medications that will help combat some of the effects that they face. Some of the most common types of medication that patients take include:
- Lisinopril: This type of medication is an angiotensin-converting enzyme (ACE) inhibitor. It works to help patients by decreasing certain chemicals in the blood that lead to the tightening of the blood vessels. As a result, blood is able to flow more smoothly, and the heart is better able to pump blood more efficiently.
- Losartan: This medication is typically used to treat high blood pressure in patients. It is used for patients who suffer from fibrosis of the heart by reducing the collagen volume fraction and serum in patients who are hypertensive. In addition, this medication is used to reduce stiffness in patients who suffer from severe fibrosis.
- Spironolactone: This diuretic is designed to slow the progression of heart failure. It does so by decreasing the amount of serum markers of fibrosis associated with 1 and type III collagen metabolism.
- Eplerenone: This highly selective aldosterone receptor antagonist is designed to improve the myocardial formation and reduce the pro-peptide of type 1 pro-collagen and pro-peptide of type III pro-collagen levels in patients who suffer from this disorder. This medication is in a class called the mineralocorticoid receptor antagonist, and it works by preventing the actions of aldosterone in the body, which increases blood pressure.
In addition to these medications, patients can also be treated with the Ang II vaccine. This can help to improve the blood pressure in patients and reduce cardiac fibrosis that patients experience.
More recently, we have seen patients undergo treatment with Ace2 agonists. However, more studies surrounding this use of treatment are needed in order to prove its efficacy and whether it is safe to be utilized.
Even though these medications may be able to reduce some of the negative effects that patients experience as a result of fibrosis of the heart, none of these medications have been proven effective in curing the disease.
Recently, scientists and medical professionals have turned to the use of umbilical cord tissue-derived mesenchymal stem cells to treat patients who suffer from fibrosis of the heart.
What are Umbilical Cord Tissue-Derived Mesenchymal Stem Cells?
Umbilical cord tissue-derived mesenchymal stem cells, also known as UCT-MSCs, are a type of adult stem cell that is typically isolated from the tissues that are located within the umbilical cord. In particular, scientists generally isolate the UCT-MSCs from Wharton's jelly, which is a thick substance used for the purpose of preserving and protecting the umbilical cord.
These stem cells are very unique because of their ability to differentiate into a wide variety of different cell types, including but not limited to the following:
- Adipocytes
- Osteoblasts
- Chondrocytes
- Hepatocytes
- Myocytes
UCT-MSCs also have significant anti-inflammatory qualities, which make them a prospective therapeutic alternative for a wide range of disorders, including autoimmune illnesses. These characteristics make UCT-MSCs a potential treatment for an impressive array of conditions.
The technique for sourcing these stem cells is considered to have a higher level of moral legitimacy than others due to the fact that no human lives are sacrificed in the process of extracting mesenchymal stem cells from an umbilical cord. In addition, the removal of these tissue cells from the umbilical cord does not present any kind of danger to human health.
Using UC-MSCs to Treat Fibrosis of the Heart
In addition to the fact that umbilical cord tissue-derived mesenchymal stem cells have the ability to differentiate into various cells and possess significant regenerative capabilities, they have now demonstrated the successful ability to help patients who suffer from fibrosis of the heart by repairing the damaged area and improving the function of the affected area. This has been evidenced in various studies that have been performed over the years.
One study published in 2021 found that the use of mesenchymal stem cells was effective in improving cardiac alterations in rodents who had streptozotocin (STZ)-induced diabetes. Additionally, the stem cells were able to migrate to myocardial tissue and reduce cardiomyocyte apoptosis in the rat subjects. This study found that the use of mesenchymal stem cells was effective in decreasing collagen expressions and deposition by inhibiting the signal pathways in the heart related to TGF-β1/Smad 2/3 in the test subjects.
Another study published in 2021 also found that umbilical cord tissue-derived mesenchymal stem cells were effective in helping patients who suffered from cardiovascular diseases by improving their heart conditions. This study concluded that the use of mesenchymal stem cells is effective for repairing infarcted myocardium. This study also found that the use of umbilical cord tissue-derived mesenchymal stem cells within rat subjects was effective in increasing the levels of the cardiomyocytes transcription factors Mef2c and GATA4.
In 2022, a study was published in China by a group of scientists that focused on the use of human umbilical cord tissue-derived mesenchymal stem cells for recovering cardiac function. This study effectively found that the use of the stem cells positively contributed to the recovery of cardiac functionality. It also contributed to attenuated cardiac remodeling post-myocardial infarction.
In 2017 a study was published surrounding the use of umbilical cord tissue grab mesenchymal stem cells in patients who suffer from heart failure. This study evaluated the safety and efficacy of using stem cell infusions in patients who suffer from this chronic disease. The study was effective in demonstrating that the use of stem cells was especially safe for patients who suffer from heart conditions. Not only did it help improve the quality of life of patients, but it also significantly improved the functional status in the left ventricular function of the heart in observed patients.
Overall, the study surrounding the use of UCT-MSCs for treating patients who suffer from fibrosis of the heart was incredibly successful. One of the most important factors to consider is that these specific stem cells are known to greatly reduce inflammation. Fibrosis, in itself, is the end result of chronic inflammation within a patient. It only makes sense that these stem cells would be effective in reducing the inflammation within the affected area. Stem cells can enter the affected area and immediately begin to repair it. In addition, they can also help to rebuild the damaged part of the heart. Since umbilical cord tissue-derived mesenchymal stem cells have the ability to differentiate into a variety of stem cells, they have incredible potential for treating conditions of the heart, such as fibrosis, to a degree previously unseen in medical history.
Without a doubt, Umbilical cord tissue-derived mesenchymal stem cell therapy is a promising new method of treating fibrosis of the heart that brings back hope for the ability to truly heal from some of these debilitating conditions. The use of these stem cells to treat patients who suffer from fibrosis of the heart has shown positive efficacy when it comes to preventing further damage to vital cardiac tissues and increasing the chance of successful outcomes in those affected by this life-threatening condition.
The potential for umbilical cord tissue-derived mesenchymal stem cells to treat a wide variety of heart conditions as well as many other disorders and diseases is vast, and more studies should be conducted as soon as possible in an effort to make these treatments widely available.
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