Stem Cells, Nanoparticles Appear to be an Antidote to Atherosclerosis

MUNICH, Germany—A novel technique using nanoparticles and stem cells rivals stenting as a way to treat coronary artery disease (CAD), according to early clinical data presented in an oral abstract August 27, 2012, at the European Society of Cardiology Congress.

Alexander N. Kharlamov, MD, of the Ural Institute of Cardiology (Yekaterinburg, Russia), shared preliminary findings from several studies: NANOM FIM, NANOM PCI, and NANOM CABG.

For the NANOM FIM study, researchers led by Alexander N. Kharlamov, MD, of the Ural Institute of Cardiology (Yekaterinburg, Russia), looked at 180 CAD patients who had stable angina and indication for PCI. Against a background of dual antiplatelet therapy and heparin as needed, patients were randomized to 1 of 3 treatment groups:

• Nanophotodestruction (Nano; n = 60): 60/15-70/40 nm silica and gold nanoshells plus autologous CD73+ and CD105+ progenitor cells delivered intracellularly from a bioengineered on-artery patch after endoscopic cardiac surgeryFerro-Magnetic (Ferro; n = 60): 60/15-70/40 nm silica and gold iron-breaking nanoshells delivered by magnetic field
• Stenting (n = 60): implantation of everolimus-eluting stents

Based on intention-to-treat, the primary endpoint of reduction in total atheroma volume at 12 months was greatest in the nano group at 60.3 mm³, followed by 47.9 mm³ in the ferro group and 0.4 mm³ in the stenting group (P = 0.047). Minimal lumen diameter also increased significantly more in the nano group, Dr. Kharlamov reported. Clinical outcomes at 12 months showed a similar advantage for the nano therapy (table 1).

Table 1. NANOM FIM: Twelve-Month Results

The additional NANOM studies enrolled a total of 120 patients aged 45 to 65 who required PCI or CABG. Patients indicated for PCI received catheter-delivered injections of stem cells and nanoparticles (n = 30) or received everolimus-eluting stents (n = 30). Those indicated for CABG received the bioengineered patched with stem cells and nanoparticles via minimally invasive cardiac surgery (n = 30) or underwent conventional CABG (n = 30). Nanoparticles were activated by laser. Follow-up is planned for 12 months.

Preliminary 24-week outcomes showed that patients who underwent nano PCI had the lowest total plaque volume and highest total lumen volume.

The method now challenges the place of angioplasty, Dr. Kharlamov said, but more research is needed. “Tested delivery approaches are really effective and safe, but still aggressive. We have to find the optimal methods for the delivery of nanoparticles and also a solution for acute [cases].”

Session co-chair David R. Holmes Jr., MD, of the Mayo Clinic (Rochester, MN), concluded the presentation by referring to the technology and findings as “exciting.”

‘New Opportunities for Targeted Treatments’

In an e-mail communication with TCTMD, Warren Sherman, MD, of Columbia University Medical Center (New York, NY), described the methods as “highly innovative with considerable potential” but questioned their applicability.

“[It is] difficult to understand the methods from the presentation, especially those related to the ferromagnetic strategy,” he said. “That and issues regarding costs lead me to question the feasibility.”

But interventional cardiologists should be aware that emerging technologies may offer a way “to reduce plaque burden in a population of stable angina patients,” Dr. Sherman emphasized. Such therapies could provide “a path to ameliorating disease progression, and perhaps [leading to] reversal, in patients refractory to current therapies. Moreover, that this might be accomplished without surgery or the insertion of endoprostheses.”

Because mechanisms of progression and regression are cell based, he said, “knowledge regarding specific disease pathways and adult stem cell function has provided new opportunities for targeted treatments.”

Despite his reservations, Dr. Sherman said the methods presented on NANOM likely deserve further study.

 

---

Source:
Kharlamov AH. Two novel approaches of plasmonic photothermic angioplasty with nanoparticles and stem cells as an alternative to current cardiac intervention. Presented at: European Society of Cardiology Congress; August 27, 2012; Munich, Germany.

 

 

Related Stories:

• Pilot Study Suggests Safety of Cell Therapy for Ischemic Stroke
• Meta-analysis: Bone Marrow Cell Transplantation Effective for Ischemic Heart Disease