Stem cells are undifferentiated or partially differentiated cells.  Therefore they are capable of dividing, renewing themselves and also giving rise to specialized cell types, a phenomenon known as plasticity or transdifferentiation. Stem cells can be obtained from many sources such as embryo, fetal, umbilical cord blood, bone marrow or peripheral blood. The adult stem cells are the stem cells found in the mature tissue. Some scientists use the term ?somatic stem cell? instead of adult stem cell. Most fetal and adult stem cells are considered to be multipotent and therefore capable of producing a small range of differentiated cell lineages appropriate to their location. Some adult stem cells or progenitor cells with the least differentiation potential such as skeletal myoblasts, angiogenic precursor cells (APCs) or epidermal stem cells in the basal layer of the skin are designated as unipotent.

The Bangkok Heart Hospital is now treating the patients with heart failure and patients with damaged heart muscle from blockage of the coronary artery using angiogenic precursor cells produced from the patient's own peripheral blood. The treatment is in collaboration with Theravitae Ltd. and the University of Pittsburgh. The patient will have his/her medical history and physical examinations taken as usual. A number of blood tests will be screened for the blood concentration, infection (e.g. hepatitis, HIV, bacteremia) and general health (e.g. liver and kidney function). The Six-Minute method will be used used to assess the physical status of the patient before and after surgery. In addition, the magnetic resonance imaging of the heart will be used to assess the heart muscle viability. If the patients are eligible for the therapy, a 250 cc of autologous blood will be collected from the patients and it will be then sent to the laboratory for cell selection and expansion. These processes take about 1 week. Then the final cell product will be sent back to the Bangkok Heart Hospital for the administration.

The cardiac surgeon will make a small incision at the left side of the chest wall. The thoracoscopic camera will be placed though a small hole into the thoracic cavity to assist with the procedure. Basically the cells will be injected directly into the cardiac muscle where the damaged heart muscle is located by the magnetic resonance imaging of the heart.

What are the results of the treatment?

Up to date, the cell therapy from various kinds of cell origins and from various types of administrations demonstrates that this cell therapy is feasible and improves the function of the damaged heart muscle. These APCs are capable of generating new vessels and perhaps new heart muscles. This new area in medicine and rapid evolving field is in need of more comprehensive research.

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