New heart attack drug may be on the horizon

Washington: Scientists, including one of Indian-origin, have found that some scar-forming cells in the heart can turn to blood vessels and help in healing the damaged organ, a finding that paves the way for a new strategy to treat heart attack.

Researchers from the University of California, Los Angeles, have discovered that the scar-forming cells in the heart, known as fibroblasts, have the ability to become endothelial cells – the cells that form blood vessels to heal an injured heart.

In studies involving mice, the team also found that a drug could enhance this phenomenon and improve the repair process after a heart attack.

“It is well known that increasing the number of blood vessels in the injured heart following a heart attack improves its ability to heal,” said Dr Arjun Deb, the study’s senior author and an associate professor of medicine in the division of cardiology at the David Geffen School of Medicine at UCLA.

“And we know that scar tissue in the heart is associated with a poorer prognosis. There is compelling clinical evidence to show that if you have more scar tissue in your heart, you are worse off,” Deb said.

“Our findings suggest the possibility of coaxing scar-forming cells in the heart to change their identity into blood vessel-forming cells, which could potentially be a useful approach for better heart repair,” he said.

Heart attacks typically are caused by a sudden blockage of the blood flow through a vessel in the heart.

The portion of the heart muscle that fails to receive adequate blood dies and is replaced by non-functional scar tissue, a process known as fibrosis. Once a scar forms, it remains in the heart throughout the person’s life.

Several years ago, Deb and his colleagues were investigating the relationship between fibroblasts and blood vessel–forming cells, or endothelial cells, which exist in close proximity in the injured heart.

Through experiments in mice in which scar-forming cells in the heart were genetically labelled, the researchers discovered that many of the fibroblasts in the heart’s injured region changed into endothelial cells and contributed directly to blood vessel formation – a phenomenon they called mesenchymal-endothelial transition, or MEndoT.

The researchers identified a molecular mechanism that regulated MEndoT and found that administering a small molecule  to augment MEndoT led to less scarring and allowed the heart to heal more completely.

They plan to test similar small molecules in other models to determine whether the strategy could potentially be used to benefit humans.

“There are remarkable similarities in the process of scarring in different organs after injury. Our hope is that this approach can be used to treat scar tissue in other organs as well,” Deb said.

The research is published in the journal Nature.

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