Stem Cell Therapy Essay
Abstract
Damaged cardiac tissue will have long term effects on overall cardiac function and right now if cardiac tissue becomes necrotic there is no guaranteed recovery of the tissue. Although studies are being done to explore possibilities in regenerating new cardiac cells to replace the damaged cells. Since 1956 experimenting with multiple types of stem cells have resulted in various amount of outcomes in improving cardiac function. Stem cell therapy has not yet been perfected and still have unanswered questions in the procedure of administrating therapeutic amounts of stem cells, the best route in delivery of the stem cells, and how long proper admission should consist of. As well the controversy of the use of embryotic stem cells still …show more content…
stands and play a large role in the approval of stem cell research. Both ethical and political issue have been brought to attention which reduces research productivity. Patient safety is always the main concern so performing human trial are scares in regions that are stricter like the US.
Stem Cells Use in Infarcted Myocardial Tissue
In order for the heart to function it requires oxygen within the oxygenated blood which comes from the coronaries that are attached to the ascending aorta. The right coronary artery comes of the right coronary cusp which is positioned on the right anterior portion of the aorta which feeds the posterior and inferior wall segments of the heart. Looking on electrocardiogram the leads the represent electro activity of the right coronary artery are II, III, and AVF. The coronaries the feed the left side of the heart comes off the left coronary cusp which is position on the left anterior side of the aorta. The coronaries of the left side branch off into three major vessels from the left main truck, the left anterior descending which feeds the anterior portion of the heart and the septum, and apical walls. In leads V1-V4 represent the electrical activity of the left anterior descending artery. The circumflex comes off the left main truck to feed the posterior and lateral walls of the heart. Leads 1, AVL, V5 and V6 represent the circumflex artery electrical activity. If any of the vessel are restricted from feeding the heart a domino effect happens which leads to one outcome, death. When somebody has a heart attack this is due to a clot within the artery that is redistricting blood flow to the cardiac tissue, because of the clot the tissue is unable to receive the oxygenated blood it needs to survive and will undergo necrosis which is known as a myocardial infarction (MI). When the cardiac tissue has become necrotic there is nope hope in recovering normal cardiac function.
Cells
When we are in development within our mothers, our organs, hair, and eye color everything that makes you, you is written within your genetic code.
The way a hair cell knows to become a hair cell is through a genetic code known as DNA. That being said when your heart is being develop myocyte cells are what makes up the myocardium because within the cell the genetic code instructs the cell to grow as myocardial tissue. As well there are genetic instructs that tell the cells when to stop growing myocardial tissue this genetic protein is known as TGFB-1 which is responsible for control of growth and division of myocyte …show more content…
cells.
Stem Cells
Stems cells are unspecialized cell that have the ability to self-replicate and transform into many different specialized cells. Stems cells can be used to regrow new cardiac cells, maintain or repair damage cardiac cells known as neovascularization to restore normal cardiac function.
Types of Stem Cells
Both embryonic and adult stem cells are undifferentiated cells that have the ability to repair or regenerate damaged cardiac tissue. Embryonic stem cells come from the inner cell mass of the blastocyst-stage embryo, so late in the first week after fertilization. Embryonic stems cells and umbilical cord blood stem cells are in a greater amount and able to regenerate myocyte. Although there is ethical and political controversies with the clinical use of these cells embryonic stem cells hold promise for myocardial cellular therapy in patients with necrotic tissue from a recent MI. Adult stem cells consist of human adult bone marrow-derived stem cells that primarily used to maintain and repair tissue in patients have damaged tissue from ischemia.
Routes of Delivery Several routes can be used to deliver the stem cells to the damaged areas. Using a intracoronary approach is one way, this when a micro-catheter is placed with body through the femoral artery that flows the route from the aorta to the coronary arteries and is positioned to the damaged area and the stems cells are then injected. Other approaches such as direct injections in the ventricular wall of the damaged tissue is another way of delivery the stem cells.
Complications
Patient safety takes priority over everything, which is why postulated safety issues about cell therapy are researched.
Concerns regarding intracoronary delivery are that with this route the cells that are administered have a potential to cause a blockage in the coronary arteries which would further damaged the myocardium. Further concerns with stem cell therapy are that instead of enhancing neovascularization are that a formation of myoma or tumor would be the result. If the stem cells become infected or contaminated and are injected into the heart the potential for the patient to develop endocarditis or myocarditis (inflammation of the endocardium or myocardium) can be a devastating consequence. Major concerns about the dosage, and timing of the stem cells are still unclear and many questions are still
unanswered.
Follow-up
Patient what have undergone stem cell therapy will have a rigorous follow-up, the doctors will have the patient on an event monitor in case of arrhythmias to occur. If the stem cells are rejected and are unable to treat the damage tissue ST segment elevation will occur in the specific leads of which coronary artery has the damage tissue, this representing injury to the myocardial tissue. If it necrotic tissue the ECG will show large wide Q waves which represents infarcted tissue.
Conclusion
Patients with necrotic tissue from a recent MI will have to receive embryotic stem cells because those cells have the ability to regenerate new cardiac cells. Those patients with damage tissue from ischemia will be receiving adult stems cells because the purpose of those cells are to maintain and repair damage tissue. There are still testing that is being done to perfect the genetic coding of the stem cells so that they are less likely to be rejected. There are still unanswered question like what is the correct dosage of stem cells to give to a patient. Although this is medicine and nothing is ever certain and every day is a new day to answer the unanswered question. Using stem cells has it positives and negatives like anything in medicine. It just comes down to do the benefits out way the risk?
Damaged cardiac tissue will have long term effects on overall cardiac function and right now if cardiac tissue becomes necrotic there is no guaranteed recovery of the tissue. Although studies are being done to explore possibilities in regenerating new cardiac cells to replace the damaged cells. Since 1956 experimenting with multiple types of stem cells have resulted in various amount of outcomes in improving cardiac function. Stem cell therapy has not yet been perfected and still have unanswered questions in the procedure of administrating therapeutic amounts of stem cells, the best route in delivery of the stem cells, and how long proper admission should consist of. As well the controversy of the use of embryotic stem cells still …show more content…
stands and play a large role in the approval of stem cell research. Both ethical and political issue have been brought to attention which reduces research productivity. Patient safety is always the main concern so performing human trial are scares in regions that are stricter like the US.
Stem Cells Use in Infarcted Myocardial Tissue
In order for the heart to function it requires oxygen within the oxygenated blood which comes from the coronaries that are attached to the ascending aorta. The right coronary artery comes of the right coronary cusp which is positioned on the right anterior portion of the aorta which feeds the posterior and inferior wall segments of the heart. Looking on electrocardiogram the leads the represent electro activity of the right coronary artery are II, III, and AVF. The coronaries the feed the left side of the heart comes off the left coronary cusp which is position on the left anterior side of the aorta. The coronaries of the left side branch off into three major vessels from the left main truck, the left anterior descending which feeds the anterior portion of the heart and the septum, and apical walls. In leads V1-V4 represent the electrical activity of the left anterior descending artery. The circumflex comes off the left main truck to feed the posterior and lateral walls of the heart. Leads 1, AVL, V5 and V6 represent the circumflex artery electrical activity. If any of the vessel are restricted from feeding the heart a domino effect happens which leads to one outcome, death. When somebody has a heart attack this is due to a clot within the artery that is redistricting blood flow to the cardiac tissue, because of the clot the tissue is unable to receive the oxygenated blood it needs to survive and will undergo necrosis which is known as a myocardial infarction (MI). When the cardiac tissue has become necrotic there is nope hope in recovering normal cardiac function.
Cells
When we are in development within our mothers, our organs, hair, and eye color everything that makes you, you is written within your genetic code.
The way a hair cell knows to become a hair cell is through a genetic code known as DNA. That being said when your heart is being develop myocyte cells are what makes up the myocardium because within the cell the genetic code instructs the cell to grow as myocardial tissue. As well there are genetic instructs that tell the cells when to stop growing myocardial tissue this genetic protein is known as TGFB-1 which is responsible for control of growth and division of myocyte …show more content…
cells.
Stem Cells
Stems cells are unspecialized cell that have the ability to self-replicate and transform into many different specialized cells. Stems cells can be used to regrow new cardiac cells, maintain or repair damage cardiac cells known as neovascularization to restore normal cardiac function.
Types of Stem Cells
Both embryonic and adult stem cells are undifferentiated cells that have the ability to repair or regenerate damaged cardiac tissue. Embryonic stem cells come from the inner cell mass of the blastocyst-stage embryo, so late in the first week after fertilization. Embryonic stems cells and umbilical cord blood stem cells are in a greater amount and able to regenerate myocyte. Although there is ethical and political controversies with the clinical use of these cells embryonic stem cells hold promise for myocardial cellular therapy in patients with necrotic tissue from a recent MI. Adult stem cells consist of human adult bone marrow-derived stem cells that primarily used to maintain and repair tissue in patients have damaged tissue from ischemia.
Routes of Delivery Several routes can be used to deliver the stem cells to the damaged areas. Using a intracoronary approach is one way, this when a micro-catheter is placed with body through the femoral artery that flows the route from the aorta to the coronary arteries and is positioned to the damaged area and the stems cells are then injected. Other approaches such as direct injections in the ventricular wall of the damaged tissue is another way of delivery the stem cells.
Complications
Patient safety takes priority over everything, which is why postulated safety issues about cell therapy are researched.
Concerns regarding intracoronary delivery are that with this route the cells that are administered have a potential to cause a blockage in the coronary arteries which would further damaged the myocardium. Further concerns with stem cell therapy are that instead of enhancing neovascularization are that a formation of myoma or tumor would be the result. If the stem cells become infected or contaminated and are injected into the heart the potential for the patient to develop endocarditis or myocarditis (inflammation of the endocardium or myocardium) can be a devastating consequence. Major concerns about the dosage, and timing of the stem cells are still unclear and many questions are still
unanswered.
Follow-up
Patient what have undergone stem cell therapy will have a rigorous follow-up, the doctors will have the patient on an event monitor in case of arrhythmias to occur. If the stem cells are rejected and are unable to treat the damage tissue ST segment elevation will occur in the specific leads of which coronary artery has the damage tissue, this representing injury to the myocardial tissue. If it necrotic tissue the ECG will show large wide Q waves which represents infarcted tissue.
Conclusion
Patients with necrotic tissue from a recent MI will have to receive embryotic stem cells because those cells have the ability to regenerate new cardiac cells. Those patients with damage tissue from ischemia will be receiving adult stems cells because the purpose of those cells are to maintain and repair damage tissue. There are still testing that is being done to perfect the genetic coding of the stem cells so that they are less likely to be rejected. There are still unanswered question like what is the correct dosage of stem cells to give to a patient. Although this is medicine and nothing is ever certain and every day is a new day to answer the unanswered question. Using stem cells has it positives and negatives like anything in medicine. It just comes down to do the benefits out way the risk?