Heart disease affects the quality of life and shortens life expectancy in a significant proportion of the adult US population. Erratic and failing heartbeats are a major part of the problem, requiring expensive and invasive surgery to install electronic pacemakers to keep the heart beating steadily.
But now a new study carried out by scientists at Cedars-Sinai Heart Institute shows that regular heart cells can easily be reprogrammed to become highly specialized pacemaker cells, simply by the injection of a single gene.
This is the first study to show that a single gene can create pacemaker cells that generate electrical impulses spontaneously - an exciting result that promises to be a major step forward in the long search for a biological pacemaker.
What’s more, once reprogrammed the newly created pacemaker cells had all key features of native pacemakers, as shown both in cultured laboratory cells and in guinea pig studies.
Of the roughly 10 billion or so cells in the human heart, fewer than 10,000 are pacemakers. Their job is to generate regular electrical activity that spreads to other heart cells in an orderly pattern so that various heart chambers beat in the right sequence, keeping blood flowing to the lungs and the rest of the body.
If pacemakers don’t do their job properly, the heart starts to beat erratically - and only patients who’re healthy enough to undergo surgery can be given an electronic pacemaker, which is their only option for long-term survival.
Previous efforts to generate pacemaker cells resulted in heart muscle cells that could beat on their own, but they were still just ordinary muscle cells. Embryonic stem cells were also tried, but there was always a constant risk of them turning cancerous.
If subsequent research confirms and supports the novel and revolutionary Cedars-Sinai findings, patients with failing heartbeats could be treated by directly injecting the same gene into their hearts - or by creating pacemaker cells in the laboratory and transplanting them.
However, before it gets to the point of being used as therapy, many studies on the safety and effectiveness of biologically reprogrammed pacemaker cells are needed, even before human clinical trials can begin - so there’s still a long ways to go yet.
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