Nature’s most recent “Insight” supplement is devoted to a topic near and dear to our hearts, even when spelled with that superfluous UK “e”: Ageing. From the introductory editorial:
Ageing, the accumulation of damage to molecules, cells and tissues over a lifetime, often leads to frailty and malfunction. Old age is the biggest risk factor for many diseases, including cancer and cardiovascular and neurodegenerative diseases. … Ageing research is clearly gaining momentum, as the reviews in this Insight testify, bringing hope that at some time in the future we will be able to keep age-related diseases at bay by suppressing ageing itself.
The five reviews are all by prominent scholars — many of whose work we’ve discussed here — and cover a wide range of subjects within gerontology and biogerontology:
As always, Nature Insight supplements are free-access, so even if you don’t have access to a university subscription, you can still read these articles.
(For a previous aging-related Nature Insight on DNA repair, see here.)
Ouroboros
A total of 23 patients took part in the ”Scipio” trial, all of whom had suffered heart failure due to a previous heart attack. Sixteen were assigned to the stem cell therapy while the other seven received standard care.
…The ground-breaking new treatment involved extracting cardiac stem cells (CSCs) - self-renewing cells that rebuild hearts and arteries - from patients during bypass surgery.
The cells were purified and grown in the laboratory before being injected back into damaged regions of the patients’ hearts four months later.
A million CSCs were infused into each patient via a balloon catheter, an expandable device used to open up arteries.
Heart pumping efficiency is assessed by measuring the fraction of blood expelled or ”ejected” from the left ventricle with each beat.
At the start of the study, the patients had an average left ventricular ejection fraction (LVEF) of 40% or lower. Normal LVEF is 50% or higher.
Over a period of four months patients who underwent the treatment saw an 8.5% improvement in LVEF. After one year, this increased to 12.3%. LVEF did not change in the seven ”control” patients who did not receive the therapy.
The findings were published today in an online edition of The Lancet medical journal. They were also presented at the American Heart Association’s Scientific Sessions meeting in Orlando, Florida.
Magnetic Resonance Imaging (MRI) scans conducted on a number of patients showed that scarring in their hearts had been reduced.
The small Phase I study was primarily designed to assess safety rather than effectiveness. _Telegraph
As noted, the study was a “Phase I” clinical study meant to determine the safety of the treatment. In later, Phase II studies, efficacy will be looked at more closely. The results from this trial are quite encouraging — modest but significant — allowing a greater range of activity for the treatment group, post trial.
More from Genetic Engineering News:
Stage A of the ongoing open-label Phase I SCIPIO (Stem Cell Infusion in Patients with Ischemic cardiOmyopathy) study, by investigators at the University of Louisville and Brigham and Women’s Hospital, is evaluating CSC transplantation in patients with severe heart failure secondary to ischemic cardiomyopathy. The target population includes patients who underwent coronary artery bypass grafting (CABG), had LV ejection fraction (EF) of less than or equal to 40%, and a previous myocardial infarction.
Treated patients were administered with about a million autologous CSCs by intracoronary infusion, at a mean of 113 days after CABG. To generate the cardiac stem cells, tissue from the right atrial appendage was harvested from the patients at the time of CABG, and CSCs were isolated and expanded at the Brigham and Women’s Hospital.
…The trial has been led by Roberto Bolli, M.D., at the University of Louisville and Piero Anversa, Ph.D., at Brigham and Women’s Hospital/Harvard Medical School in Boston. “The results are striking,” Dr. Bolli states. “While we do not yet know why the improvement occurs, we have no doubt now that ejection fraction increased and scarring decreased. If these results hold up in future studies, I believe this could be the biggest revolution in cardiovascular medicine in my lifetime.”
The published paper in The Lancet is titled “Cardiac stem cells in patients with ischaemic cardiomyopathy (SCIPIO): initial results of a randomised Phase I trial.” _GenEngNews
Heart muscle is relatively uncomplicated, as far as vital organs go, so it is not a great surprise that such a simple stem cell replacement therapy might work. Liver and pancreas may be similarly amenable to simple stem cell infusion. But other organs will require more clever designs for creating replacement tissue from stem cells and scaffolding.
In terms of numbers of persons potentially affected by this therapy for heart failure, the number will easily go into the millions in North America alone. Optimal therapy may require multiple infusions over time, to allow the heart to assimilate the new cells. More will be known as the research progresses into further stages.
This is just the beginning.
Al Fin Longevity
From the mailbag, news of a new aging-related peer-reviewed journal, currently in its first issue: Pathobiology of Aging & Age-related Diseases. I haven’t had to check it out yet, but it looks like it will be of broad interest to biogerontologists from a variety of disciplines. The editorial board includes quite a few luminaries of the field, so it seems promising.
In their own words:
Aims: Pathobiology of Aging & Age-related Diseases (PBA) is a new peer reviewed journal serving as a forum for researchers to communicate pathology data as a primary scientific focus of aging; data that might be of less interest in other journals more focused on generic aging or specific scientific disciplines. We are especially interested in developing a focus for advancing the pathological basis of aging in mammalian systems, in particular the mouse and humans.
Scope: Pathobiology of Aging & Age-related Diseases is interdisciplinary in nature and covers all aspects of pathology of aging related to disease phenotypes including cancer, cardiovascular disease, neurological disorders, metabolic dysfunction, renal and gastrointestinal disorders, endocrine dysfunction, musculoskeletal conditions and skin disorders. The underlying theme is based on the sound scientific principles of the pathogenesis of aging and age-related diseases as well as intervention data with resolution of pathological endpoints. The emphasis will be on preclinical studies as well as clinical studies related to strategies developed in animal models and will be image intensive. Papers on the basic biology of aging in invertebrates will not be considered unless comparative mammalian data is also included.
We welcome Research papers, Review articles, Brief reports, Case reports, New animal models, Technical reports, Images, PhD thesis Summaries, and Commentaries.
Target groups: Anatomical and molecular pathologists, gerontologists, geriatricians, transgenic mouse geneticists, toxicologists, and scientists, veterinarians and physicians focused on basic and clinical research in cardiovascular disease, cancer, gastrointestinal disease, endocrine disorders, metabolic dysfunction, renal disease, neurological disorders including Alzheimer’s disease, skin disorders, and musculoskeletal disease.
PBA is open-access; the publisher, Co-Action Press, is a relatively new entity whose small but growing stable consists entirely of open-access journals spanning a wide range of fields.
My personal feeling is that there are probably already too many journals, mostly because I don’t think I or my colleagues actually interact with journals as entities. Mostly we just do literature searches, and choose papers to read based on titles and abstracts. The exception is when we’re submitting papers, but then the diversity of formats and author requirements creates obstacles to rapid submission (and re-submission, if necessary).
I wouldn’t mind seeing individual journals be replaced by a robust tagging system on a relatively laissez-faire neo-journal such as PLoS ONE (to allow scholars to create communities and filters on the firehose of new papers), and a little time spent teaching everyone how to set up PubMed RSS feeds. That said, if we’re going to start new enterprises, this is probably the right way to go, so good luck to PBA.
Ouroboros
Adipose tissue fat is not simply a reservoir for excess nutrients, but rather an active and dynamic organ capable of expressing biologically active fat-derived peptides (FDPs). At times of acute injury, macrophages contribute to the release of these peptides and the term inflammatory markers is often applied, but in the basal state, adipose tissue is the predominant source of production. Some of these FDPs may have a role in the development of the obesity metabolic syndrome of aging and other obesity-related diseases. (more…)
Not all body fat is equally bad for your health. It is widely known that body fat distribution is extremely important. There is increasing evidence for the deleterious effects of Visceral Fat on aging. Waist-to-hip ratio (WHR) is an epidemiological tool that demonstrates a correlation between Visceral Fat and development of diabetes mellitus, stroke, coronary artery disease, and mortality. This ratio is easily determined by dividing the measurement of waist circumference by hip circumference. (more…)
Pacemaker therapy is indicated in patients with symptomatic bradycardia (syncope, presyncope, dyspnea, and exercise intolerance) correlated to sinus node dysfunction (pauses, persistent bradycardia, or chronotropic incompetence). In elderly patients, sinus node dysfunction is often associated with atrial tachyarrhythmias, including AF. Because of the frequent association of sinus node dysfunction with AF, VVI and VVIR pacing were once considered the preferred pacing modes. Recent studies suggest that atrial-based pacing in patients with sinus node dysfunction is beneficial for preventing progression of AF. (more…)
Carotid sinus hypersensitivity ( more than 3-second pause or a decrease in systolic blood pressure = 50 mm Hg during carotid sinus massage) predominantly affects elderly patients, although the prevalence in the general population has not been precisely defined. In elderly patients with recurrent syncope, carotid sinus hypersensitivity has been reported in up to 35% of cases. Permanent pacing in patients with carotid sinus syndrome (carotid sinus hypersensitivity associated with syncope) is indicated. Observational and randomized studies have shown that recurrent symptoms are significantly reduced after permanent pacemaker implantation in patients with carotid sinus syndrome. (more…)
Aging is associated with progressive fibrosis of the sinoatrial node and AV conduction system, resulting in bradycardia, which may be further exacerbated by disease and medications, resulting in symptoms requiring permanent pacemaker implantation. More than 80% of pacemaker recipients in the United States are older than 65 years, and the median age is 75 years. As the population ages, it is anticipated that the number of older persons requiring permanent cardiac pacemakers, as well as the associated costs, will continue to rise. (more…)
In older patients without apparent cardiovascular disease, the number of cardiac myocytes declines, while residual myocytes enlarge. Concurrently, there is an increase in elastic and collagenous tissue in all parts of the interstitial matrix and conduction system with advancing age. (more…)
Atrial Fibrillation affects approximately 2.3 million people in the United States and is the most common rhythm disorder among U.S. patients hospitalized with a primary diagnosis of an cardiac arrhythmia. The median age of Atrial Fibrillation patients is 75 years; 84% are older than 65 years. Pooled data from studies of chronic Atrial Fibrillation in North America, Britain, and Iceland suggest a prevalence of 0.5% to 1% in the general population. (more…)
