SCIENTISTS CREATE FIRST-EVER BIOLOGICAL PACEMAKER USING GENE THERAPY

Researchers say they've found a way to transform ordinary pig heart muscle cells into a
"biological pacemaker," a feat that might one day lead to the replacement of electronic
pacemakers in humans.
"Rather than having to undergo implantation with a metallic device that needs to be
replaced regularly and can fail or become infected, patients may someday be able to
undergo a single gene injection and be cured of slow heart rhythm forever," said senior
study author Dr. Eugenio Cingolani, director of the Cedars-Sinai Heart Institute's
Cardiogenetics-Familial Arrhythmia Clinic, in Los Angeles.
Using gene therapy, the researchers altered a peppercorn-sized area in the heart
muscle of pigs to create a new "sino-atrial node" -- the bundle of neurons that normally
serves as the heart's natural pacemaker.
The technique kept alive a handful of pigs suffering from complete heart block, a
condition in which the heart beats very slowly or not at all due to problems in the heart's
electrical system.
The biological pacemaker also appeared to function as well as an original sino-atrial
node and better than typical electronic pacemakers, said study co-author Dr. Eduardo
Marban, director of the Cedars-Sinai Heart Institute, in Los Angeles.
"When we exercise, our hearts go faster. When we rest, our hearts slow down," Marban
said. "The pigs with the biological pacemaker faithfully reproduced these responses,
which were absent in 'control' pigs that had been treated only with an electronic
pacemaker."
The key to the new procedure is a gene called TBX18, which converts ordinary heart
cells into specialized sino-atrial node cells, Marban said.
The heart's sino-atrial node initiates the heart beat like a metronome, using electric
impulses to time the contractions that send blood flowing through people's arteries and
veins, the scientists explained. People with abnormal heart rhythms suffer from a
defective sino-atrial node.
Researchers injected the gene into a very small area of the pumping chambers of pigs'
hearts. The gene transformed the heart cells into a new pacemaker.
"In essence, we create a new sino-atrial node in a part of the heart that ordinarily
spreads the impulse, but does not originate it," Marban said. "The newly created node
then takes over as the functional pacemaker bypassing the need for implanted
electronics and hardware."
Pigs were used in the research because their hearts are very similar in size and shape
to those of humans, said lead study author Dr. Yu-Feng Hu, a fellow at the Cedars-Sinai
Heart Institute.
Within two days of receiving the gene injection, pigs had significantly stronger
heartbeats than pigs that did not receive the gene. The effect persisted for the duration
of the 14-day study. Toward the end of the two weeks, the treated pigs' heart rates
began to falter somewhat, but remained stronger than that of the pigs who did not
receive the gene injection.
The research team hopes to advance to human trials within three years, Cingolani said.
However, results from animal trials often can't be duplicated in humans.


http://www.cbsnews.com/news/gene-therapy-could-create-biological-pacemaker/
Prepared by:
Pineda, Chrisshalyn S.
BSEd-Science 4B