- What are stem cells?
Stem cells are known by two characteristics. First of all, these cells are able to produce the cells which they are the same as themselves. This feature makes it possible to maintain the stem cell resource’s body.
Secondly, the cells can mature and transform into other cells that have a specific function. Like muscle cells of the heart, nerve and skin. This feature is also due to the need for replacement of dead cells by young cells with a special function.
- What is cell therapy and is there any history to use it?
It is a treatment procedure which used stem cells derived from patient body or healthy donor. Cell therapy was first used nearly 50 years ago to treat people with blood diseases, and we now know it as bone marrow transplantation.
- What are the types of stem cells?
There are several types of stem cells that can be classified into three main categories.
A) Embryonic stem cells: These cells are present only in the early developmental stages of the fetus.
B) Somatic or adult stem cells: These cells also called “tissue-specific cells”, are present in various tissues of the adult human body and umbilical cord blood of the newborn baby.
C) Induced Stem Cells with multiple abilities: These cells, produced by methods in the laboratory, have the characteristics of embryonic stem cells, with the difference that they can be derived from differentiation cells instead of embryonic cells such as skin cells.
- Which type of stem cell is used to treat heart disease?
The three main groups of embryonic stem cells, somatic stem cells and induced pluripotent cells are used to treat heart lesions, but only some of the somatic stem cells have human permission and clinical practice.
- Which type of stem cell is used to treat heart disease?
In the clinical trials which has currently used in many research centers in the world, six main types of stem cells are proposed for the cardiovascular tissues. The first type is the skeletal myoblasts that are derived from skeletal muscle, they are considered as first stem cells which used in heart disease (in 2000). But they are used more narrowly todays because of occurrence several cases of mild arrhythmias.
The second type is mononuclear cells derived from bone marrow and are the most commonly used cells from 2001 to the present due to easy processing, the need for cultivation without any side effects. These cell groups consist of heterozygous populations, including hematopoietic stem cells and vascular progesterone cells. These cells are produced in the Cell Tech Pharmed co. with Monu Cell product’s name.
Type III, mesenchymal stem cells, which are derived from bone marrow, are more considerable because of high level of division and differentiation.
Type IV, 34CD+ or CD133+ cells, are isolated from the mononuclear cells of bone marrow and are more noteworthy due to their prominent feature such as high angiogenesis capability.
Type V, cells derived from adipose tissue, whose advantages is the ease of access to resources as well as their abundance.
Type VI, human heart residing stem cells are the newest type of stem cells used in heart disease, which approved for clinical trials in American Food and Drug Administration (FDA) in July 2012. In this approach, these cells are to be used for purpose of repairing the damage caused by heart attacks.
- What resources and how to get the stem cells used to repair heart lesions?
A) Bone marrow: In this method, after anesthetious substance injection in pelvic bone, the stem cell samples are taken by using special syringes for aspiration and sent to the laboratory for further preparation.
B) Adipose tissue: In this method, excess adipose is aspirated from abdomen, thigh and flanks.
C) Heart tissue: In this method, without opening surgery, a few samples of the healthy ears of the patient’s heart tissue are taken in a similar manner to angiography.
- Which way is appropriate to inject stem cell to the patient?
According to studies of different types of injection methods, two methods of intra-muscular injection and intra-arterial injection of the blood vessels will be most effective. Intra-heart muscle injection can only be done in patients who are candidates for open heart surgery, otherwise the injection of the cells is done into the arteries and through angiography.
- How long does it take to have recovery from stem cell injection?
According to studies, the effect of these cells is appeared approximately 3 months after the injection, but this effect can gradually increase to one year.
- Based on which criteria, cell therapy shown the effect of recovery in cardiac function?
This recovery can be found in the three general categories which can be found in following:
A) Prevention of adverse events such as death, recurrent myocardial infraction, frequent admissions due to complications of disease and heart transplantation
B) Improvement of physical activity, quality of life, more effective medication and patient satisfaction after treatment
C) Improvement of paraclinical criteria including examination of cardiac images in echocardiography, scan, MRI and also specific blood tests such as (Pro-BNP)
- Are stem cells useful in the treatment of all cardiovascular disease?
No, these cells are most used for heart ischemic diseases, including heart attack and heart failure.
The use of stem cells are under investigation in patients with acute myocardial infraction, adult ischemic heart failure, adult heart failure, Child heart failure, ischemic mitral valve failure, Ischemia of the lower limb and Inflammation of the lymphatic vessels (lymphedema).
- Does this treatment have a particular complication for the patient?
There have been reported no specific complications.
- Is this method available in all centers?
Currently, this method is used only in Shahid Rajaei heart center, Heart center, Baghiatallah hospital, Lavasani hospital, Massiah daneshvari, Sasan and Bahman hospital in Tehran, as well as Imam Reza hospital, Montasarieh, Razavi and Jawad Alameh in Mashhad.