Human embryonic stem cell use in treatment of patients with cardiovascular damag

Question

Human embryonic stem cell use in treatment of patients with cardiovascular damage: From Menasche et al. (2018) Transplantation of human embryonic stem cell-derived cardiovascular progenitors for severe ischemic left ventricular dysfunction. Journal of the American College of Cardiology. 71:429-438. Human embryos generated by in vitro (outside of the body) fertilization that were not used for reproductive purposes were donated for use in research. The inner cell mass was removed from the embryos and the cells were grown in the laboratory under conditions that maintained the cells as human embryonic stem cells. After sufficient numbers of cells were produced, the cells were treated with the appropriate set of growth factors and hormones to cause them to differentiate into cardiovascular cells. These cells were then embedded in a patch that was implanted into the ventricles of 6 patients with hearts that had been severely damaged due to heart attacks. 5 out of 6 patients recovered and showed improved contractility of the left ventricles 1 year after the treatment. No tumor formation was observed but three patients developed slight immune responses to the transplanted cells. 1. Explain what "severe ischemic left ventricular dysfunction" means 2. What properties of embryonic stem cells allow them to be converted in the laboratory to cardiac muscle cells? 3. The described research was done in France. Under what condition-.based on current regulations and stipulations regarding use of human embryonic stem cells-could research such as this to be conducted in the United States?

Explanation / Answer

Ischemia is death of tissue due to inadequate oxygen. It usually results from blockage in the arteries. When any blood vessel (branches of coronary artery) that supplies the ventricle of the heart is blocked, it results in ischemia of the ventricle. The region that does not receive blood supply dies, but the remaining healthy muscle tissue continues to contract and relax. As a result, the heart muscle tears off. If it happens in the left side of the heart, it is called ischemic left ventricular dysfunction. The left ventricle is thickest of the heart’s chamber and pumps the blood with more force. It pumps oxygenated blood to tissues all over the body. Failure of the left ventricle due to ischemia has severe consequences. Embryonic stem cells are totipotent, that is, when given appropriate stimulation, they can be converted into any type of cell or tissue. Embryonic stem cells are undifferentiated, can self renew, and can undergo any number of divisions.

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