Transplanting gene into injured hearts creates biological pacemakers

Heart diagram. Credit: Wikipedia

Cardiologists at the Cedars-Sinai Heart Institute have developed a minimally invasive gene transplant procedure that changes unspecialized heart cells into "biological pacemaker" cells that keep the heart steadily beating.

The laboratory animal research, published online and in today's print edition of the peer-reviewed journal Science Translational Medicine, is the result of a dozen years of research with the goal of developing biological treatments for patients with rhythm disorders who currently are treated with surgically implanted pacemakers. In the United States, an estimated 300,000 patients receive pacemakers every year.

"We have been able, for the first time, to create a biological pacemaker using minimally invasive methods and to show that the biological pacemaker supports the demands of daily life," said Eduardo Marbán, MD, PhD, director of the Cedars-Sinai Heart Institute, who led the research team. "We also are the first to reprogram a heart cell in a living animal in order to effectively cure a disease."

These laboratory findings could lead to clinical trials for humans who have but who suffer side effects, such as infection of the leads that connect the device to the heart, from implanted mechanical pacemakers.

Eugenio Cingolani, MD, the director of the Heart Institute's Cardiogenetics-Familial Arrhythmia Clinic who worked with Marbán on biological pacemaker research team, said that in the future, pacemaker cells also could help infants born with congenital heart block.

This video is not supported by your browser at this time.
This animation explains how researchers created biological pacemaker cells in pigs using gene therapy. Credit: AAAS/Carla Schaffer

"Babies still in the womb cannot have a pacemaker, but we hope to work with fetal medicine specialists to create a life-saving catheter-based treatment for infants diagnosed with congenital heart block," Cingolani said. "It is possible that one day, we might be able to save lives by replacing hardware with an injection of genes."

"This work by Dr. Marbán and his team heralds a new era of , in which genes are used not only to correct a deficiency disorder, but to actually turn one kind of cell into another type," said Shlomo Melmed, dean of the Cedars-Sinai faculty and the Helene A. and Philip E. Hixson Distinguished Chair in Investigative Medicine.

In the study, laboratory pigs with complete heart block were injected with the gene called TBX18 during a minimally invasive catheter procedure. On the second day after the gene was delivered to the animals' hearts, pigs who received the gene had significantly faster heartbeats than pigs who did not receive the gene. The stronger heartbeat persisted for the duration of the 14-day study.

"Originally, we thought that biological could be a temporary bridge therapy for patients who had an infection in the implanted pacemaker area," Marbán said. "These results show us that with more research, we might be able to develop a long-lasting biological treatment for patients."

If future research is successful, Marbán said, the procedure could be ready for human clinical studies in about three years.

More information: "Biological pacemaker created by minimally invasive somatic reprogramming in pigs with complete heart block," by Y.-F. Hu et al. Science Translational Medicine, stm.sciencemag.org/lookup/doi/… scitranslmed.3008681

add to favorites email to friend print save as pdf

Related Stories

Leadless pacemaker showing promising results after one year

May 09, 2014

Vivek Reddy, MD, Director of Arrhythmia Services for The Mount Sinai Hospital, reported his promising12-month follow-up data showing the world's first leadless pacemaker is demonstrating overall device performance comparable ...

Recommended for you

Study: Removing clot helps limit stroke disability

Dec 17, 2014

For the first time in several decades, a new treatment has been shown to limit the damage from a common type of stroke. Researchers in the Netherlands found that mechanically removing a clot in addition to using a clot-busting ...

User comments

Adjust slider to filter visible comments by rank

Display comments: newest first

fahmbo
not rated yet Jul 16, 2014
simply badass.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.