Stem cell therapy for myocardial infarction | Overview including symptoms and causes

Myocardial infarction is a serious disease in which a blockage in the coronary arteries in the heart interrupts blood flow, causing oxygen deficiency in the myocardium. This condition is more serious than angina pectoris, and urgent action is required when an attack occurs. In Japan, the number of patients with myocardial infarction is increasing due to population aging and changes in lifestyle. In fact, myocardial infarction is ranked as one of the top causes of death.
Conventionally, coronary artery recanalization or drug therapy has been performed to suppress symptoms. In recent years, however, myocardial regeneration using stem cell therapy has been considered as a promising therapeutic option. Here, we explain the symptoms and causes of myocardial infarction, along with the advantages and treatment flow of stem cell therapy as part of regenerative medicine.

What is myocardial infarction?

Myocardial infarction is a disease in which a coronary artery, which supplies oxygen and nutrients to the heart, is completely or almost completely blocked by a thrombus or atherosclerosis, resulting in necrosis of the downstream myocardial tissue. The occlusion results in dysfunction of myocardial cells in just 10 to 20 minutes, and if left untreated for an extended period, the risk of irreversible deterioration of cardiac function and death increases. Myocardial infarction has a high case-fatality rate, and failure to provide appropriate treatment in the acute phase can lead to severe sequelae or put patients at risk of losing their lives; therefore, it is important to take prompt action. *1

*1 Reference:Tokyo Stemcell Research Institute

Symptoms of myocardial infarction

Symptoms of myocardial infarction vary from patient to patient, but typically, the following symptoms are observed.

• Severe chest pain: Intense oppressive pain or burning pain occurs in the center or slightly left of the center of the chest, lasting 30 minutes or longer.
• Cold sweat, facial pallor: Cold sweat due to shock caused by intense pain, and paleness of the face due to decreased blood pressure, are observed.
• Dyspnea: Patients feel suffocated because of decreased cardiac function and insufficient blood supply to the whole body.
• Arrhythmia, disturbance of consciousness: The heart rhythm becomes irregular, and patients may become half-conscious.

In some cases, myocardial infarction occurs without much pain. It occurs more frequently in older people and patients with diabetes mellitus. *2
*2 Reference:Tokyo Stemcell Research Institute

Causes of myocardial infarction

The main causes of myocardial infarction are atherosclerosis and thrombosis in the coronary arteries. Atherosclerosis is a condition in which plaques (buildup of fats) accumulate in the intima of a blood vessel. When the plaque ruptures, the blood clots to form a thrombus, which clogs the coronary arteries. Risk factors for the progression of atherosclerosis include the following factors:

• Hypertension: The higher the pressure applied to the blood vessel, the more likely the vessel wall is burdened.
• Dyslipidemia: Atherosclerosis progresses when LDL cholesterol and triglyceride levels are high.
• Diabetes mellitus: Hyperglycemia damages the vascular endothelium, thus promoting atherosclerosis.
• Smoking: Hazardous substances in tobacco damage the blood vessels and promote plaque formation.
• Obesity, lack of physical activity: Excessive energy intake or lack of physical activity leads to increased blood viscosity and blood pressure.

The combination of these factors results in stenosis/occlusion of the coronary arteries, leading to the onset of myocardial infarction. *3
*3 Reference:Japanese Association of Cardiovascular Intervention and Therapeutics

Stem cell therapy as a promising radical treatment for myocardial infarction

“Stem cell therapy,” which aims to regenerate the myocardium, holds promise as a new therapeutic option.

What is stem cell therapy?

Stem cell therapy is a type of regenerative medicine to repair and regenerate damaged tissues using stem cells, which possess the ability to both self-renew and differentiate into multiple cell types.
There are two main ways:

• Using autologous stem cells: This method involves harvesting stem cells from the patient’s own adipose tissue, culturing them, and then injecting them at the affected site. There is a low risk of rejection.
• Using allogeneic stem cells: Stem cells provided by a third party are used. This method is applied in cases where collection from patients is difficult; however, immune intolerance and other issues are a concern.

Current research is focused on investigating how stem cells can be administered to the site of tissue defect after myocardial infarction, thereby promoting the production of new myocardial cells and angiogenesis and possibly leading to recovery of cardiac function.

Advantages of stem cell therapy

The following possible advantages are the reason for the recently increased interest in stem cell therapy in the context of myocardial infarction.

• Possibility of myocardial regeneration: It may offer a means to compensate for necrotic myocardium, which has been considered difficult to recover by conventional treatment.
• Angiogenesis, improvement in microcirculation: Cytokines secreted by stem cells may promote the formation of new blood vessels and improve blood flow.
• Reduced risk of side effects: When autologous stem cells are used, rejection will be less common, without any serious adverse reactions.
• Broad applicability: It has been studied as a highly promising technology that can be applied to other cardiovascular diseases and tissue damage.

Reasons why stem cell therapy is effective

Stem cells not only have the potential to differentiate into cardiomyocytes but also activate surrounding cells by secreting growth factors. They work in a multifaceted manner on inflammation and inadequate blood flow after myocardial infarction, thereby promoting functional recovery.
Moreover, stem cell therapy may cause more comprehensive therapeutic effects when performed in combination with lifestyle modification, drug therapy, or existing interventions such as PCI and bypass surgery.

Flow of treatment at the Regenerative Medicine Division of Korokai Medical Corporation

At the Regenerative Medicine Division of Korokai Medical Corporation, the following steps are taken when administering stem cell therapy for myocardial infarction.

• Initial consultation and tests: We assess the patient’s cardiac function (e.g., echocardiography, MRI), check for complications, and comprehensively judge the indication for stem cell therapy.
• Stem cell collection and culture: Stem cells will be harvested from autologous fat and grown in culture under strict quality control.
• Design of the treatment plan: The frequency and method of administration (e.g., catheter, intravenous infusion) will be determined according to the patient’s health condition and cardiac condition.
• Stem cell administration and follow-up: Following the actual delivery of stem cells to the cardiac muscle, additional treatment or rehabilitation will be performed as needed while checking the degree of recovery of cardiac function and adverse reactions.

Possibility of treating myocardial infarction using stem cells

Myocardial infarction is a disease in which a blockage of a coronary artery due to atherosclerosis or thrombosis results in necrosis of the myocardium. The treatment mainly involves PCI aimed at resuming blood circulation, drug therapy, and lifestyle improvements, but there is a problem: it is difficult to regenerate the necrotic myocardium. Stem cell therapy holds promise as a new regenerative medicine approach to compensate for the lost myocardial tissue and promote angiogenesis. The Regenerative Medicine Division of Korokai Medical Corporation proposes the administration of stem cell therapy according to the pathological condition of each patient to support the recovery of cardiac function and improve their quality of life.

The Regenerative Medicine Division of Korokai Medical Corporation offers stem cell-based regenerative medicine as a medical institution approved by the Ministry of Health, Labour and Welfare. *4

If you are interested in stem cell therapy, please contact our hospital for consultation.
The Regenerative Medicine Division of Korokai Medical Corporation carefully selects evidence-based treatment and offers regenerative medicine according to each individual’s concerns based on novel comprehensive treatment strategies. To optimize the results, oral therapies such as bioidentical hormone replacement therapy or peptide therapy may be combined with stem cell therapy according to the patient’s needs.

*4 Source: Ministry of Health, Labour and Welfare

The Regenerative Medicine Division of Korokai Medical Corporation – a stem cell therapy clinic in Tokyo
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[1] Therapeutic Method
The treatment involves harvesting and culturing stem cells from the patient’s adipose tissue and then injecting them locally to the affected area or administering them via intravenous infusion.
[2] Risk of side effects
At the time of fat collection: Adverse reactions such as internal bleeding, swelling, postoperative infection, postoperative scar, and pain at the injection site may be observed.
At the time of stem cell administration: Adverse reactions such as pain at the injection site, allergic reaction, and pulmonary embolism may be observed.
[3] Contact information
The Regenerative Medicine Division, Korokai Medical Corporation
Precious 18 5F, 4-14-6 Minami-azabu, Minato-ku, Tokyo
TEL:03-6277-4650
[4] Pricing
This treatment is a private therapeutic strategy that is not covered by public health insurance. It will cost about 1.65 million yen including tax (which may vary depending on diagnosis).
Please consult us for further details.
[5] Route of acquisition
Stem cells are cultured at the affiliated CPC.
[6] Presence or absence of devices/drugs approved for the indications in Japan
No approved drugs for the indications are available in Japan.
[7] Safety information from other countries
There are no reports on safety in other countries.
*Significant risks may not have been identified.
[8] The fact that it has not been approved
Drugs used in this treatment are yet to receive approval in accordance with the Pharmaceutical and Medical Device Act.
[9] Unapproved drugs/devices
Public aid systems (such as Relief Systems for Adverse Drug Reactions and Infections Acquired through Biological Products) are not applicable to unapproved drugs and devices.
[10] Notification of regenerative medicine provision plans
To perform this treatment, we have submitted the notification of regenerative medicine provision plans to the Ministry of Health, Labour and Welfare in accordance with the Act on the Safety of Regenerative Medicine.
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3210146
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3230187
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3240017
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3230218