An International First At The CHUM Promising Treatment In Regeneration Of The Myocardium Through The Use Of Stem Cells

The Centre hospitalier de l'Universite
de Montreal (CHUM) announces the beginning of a phase II randomized
double blind trial with the potential of providing a therapeutic
alternative after a first acute myocardial infarction. One patient has
already undergone this technique, which consists of implanting immature
stem cells from the bone marrow to regenerate heart muscle. The procedure
went smoothly and the patient is doing well. This worldwide first,
conducted in collaboration with Hopital Maisonneuve-Rosemont (Montreal,
Canada) follows in the footsteps of successful phase I clinical trials
carried out in Europe. To date, these preliminary studies have revealed no
complications in the subjects treated, after five years of follow-up. These
encouraging findings confirm the results of many preliminary experiments
carried out on animal models.


Some facts


- Did you know that cardiovascular disease is the primary cause of death
in Western countries?


- Did you know that one hospital bed in five is occupied by someone
suffering from heart disease?


- Did you know that myocardial infarction (heart attack), the most
frequent cause of heart failure, affects over 250,000 patients in
Quebec?



"Drug treatment and heart transplant are among the various techniques
that can improve heart function. But because the paucity of organs
available remains a major problem, CHUM researchers have worked together to
set up this innovative research protocol," states Dr. Samer Mansour,
cardiologist at the CHUM, and principal investigator for the trial. One of
the aims of this trial is to understand the effect of immature stem cells
(CD133+), extracted from the patient's bone marrow in the iliac crest, on
the healing process of the heart after a first heart attack. The experiment
protocol involves intracoronary injection of CD133+ cells against placebo,
in addition to standard medical treatment. The entire process takes place
during the same period of hospitalization.



"The study of cell therapy in the case of myocardial lesions is
relatively recent and we still have a great deal to learn in this trial,"
adds Dr Guy Leclerc, head of the CHUM's cardiology service. "Previous
studies have demonstrated significant improvement of 7 to 10 % in heart
function after implanting several types of bone marrow stem cells. In this
trial, we will study these immature cells using the most advanced
technologies and state-of-the-art imaging techniques to prepare and
transplant these cells into the patient."



Bone marrow cells extracted at the CHUM are transferred to the
Laboratoire de therapie cellulaire at Hopital Maisonneuve-Rosemont (HMR) to
isolate the most immature stem cells. According to Dr. Denis-Claude Roy,
director of the hospital's research centre, "The fact that the stem cells
that have been isolated are immature should improve their capacity to
repair the heart muscle."
















This clinical trial is one of a body of research projects in
regenerative medicine and cell therapy currently being carried out at the
CHUM. In these studies, Dr. Mansour and Dr. Nicolas Noiseux,
co-investigator for the trial and cardiac surgeon, are attempting to better
characterize the mechanisms behind the beneficial effects of stem cells
used for the treatment of cardiovascular diseases.



Anticipated impact of the procedure



Currently, this procedure applies to patients who have suffered a first
extensive infarction and are at risk for complications such as heart
failure. The target population could be broadened once the technique has
been further refined and the laboratory protocols perfected. The ultimate
goal of this minimally invasive and inexpensive technique, compared to
heart transplant, is for it to become more commonly performed in hospitals,
in the medium term.



The research team includes the following investigators: Drs. Samer
Mansour, Denis-Claude Roy, hematologist (HMR), Guy Leclerc, Nicolas
Noiseux, cardiac surgeon, and Francois Reeves, cardiologist (CHUM). Stem
cell preparation is carried out at the cell therapy laboratory of HMR under
the supervision of Dr Roy. "The contribution of HMR is another good example
of complementarity and cooperation in research between the institutions of
the RUIS de l'Universite de Montreal (UdeM)," states Dr. Denis R. Roy,
Director General of the CHUM and president of the UdeM RUIS.



This research protocol was made possible through the collaboration of
the Laboratoire de therapie cellulaire of the Hopital Maisonneuve-Rosemont,
Miltenyi Biotec, the CHUM Research Centre, its radiology and nuclear
medicine departments and its cardiology service, notably through its
interventional hemodynamics development fund. Health Canada, Fonds de la
recherche en sante du Quebec, and Boston Scientific also contributed to the
trial.


CENTRE HOSPITALIER DE L'UNIVERSITE DE MONTREAL
chumontreal.qc.ca