No one needs to be told that looking after the heart is of vital importance.
And yet, despite efforts to encourage people to take care of the body’s most precious organ, many of us fail to do so by not exercising, having a bad diet, smoking and indulging in other bad habits.
So severe are the problems in the Middle East that a 2010 conference in Al Ain heard that 45 per cent of early deaths in the region are the result of coronary artery disease. Continuing the theme, a year later a leading consultant in the UAE said that it was not unusual for people here to develop heart problems when still in their mid-40s, a decade or more earlier than is typical elsewhere.
It means that developing better ways to treat heart conditions is all the more important.
Research at Khalifa University of Science and Technology in Abu Dhabi could do just that for people in the Emirates by advancing the use of “personalised medicine” in which, for example, the types of drugs given to a patient are tailored to his or her genetic profile.
Dr Nicolas Christoforou, an assistant professor in biomedical engineering at the university, has been awarded a Dh175,000 research grant by the Ministry of Higher Education and Scientific Research for a project that will involve growing cardiac tissue in the laboratory.
To be carried out in association with Dr Wael Abdulrahman Al Mahmeed, the chief of medical affairs at Sheikh Khalifa Medical City (SKMC), the project will reflect the genetic make-up of the local community because a wide variety of patients from the country will be chosen to take part.
“We’ve identified a basic population of people suffering from cardiac disease, the idea being we would like to mimic cardiac function in the laboratory so we can better understand what the issues are with it and how to treat it,” said Dr Christoforou, who is originally from Cyprus and who has worked in the UAE since 2011 after moving from Duke University, in North Carolina, United States.
To produce cardiac tissue under artificial conditions, the project will take blood samples from the patients and then make use of a stem-cell technique that earned the researcher who developed it the world’s top scientific accolade.
Three years ago, the Japanese scientist Shinya Yamanaka was jointly awarded the Nobel Prize in Physiology or Medicine for finding out that, by adding certain genes to mature specialised adult animal cells, they can be “reprogrammed” into becoming stem cells, which can then differentiate into any of the body’s various cell types.
Dr Christoforou’s project will collect adult cell types from individuals and reprogramme them so they become what are known as induced pluripotent stem cells, or iPS cells, where pluripotent means they can become any other type of cell. The stem cells will then undergo treatment and selection to create a population of cardiac cells, or cardiomyocytes.
“Once we have that, we would like to either study them like that, or use tissue-engineering methods to create ‘functional biosynthetic’ constructs,” he said.
“By doing that, we can mimic the physiology of the heart tissue. We can do that in a patient or ethnicity-specific manner. And we look for different stresses or pharmacological exposures.” This means that scientists could test the effects of various drugs on the cardiac tissues that have been grown in the laboratory.
As an example, Dr Christoforou cites statins, a type of drug that lowers levels of cholesterol in the blood. While “extremely useful” in many patients, they can be “extremely toxic” in others. Testing a particular drug on samples of laboratory-grown tissue could indicate in advance, he suggested, whether that drug will prove helpful or harmful to the patient, allowing that individual’s drug prescription to be altered accordingly. The technique could be used to assess the electrical activity of heart tissue for particular patients and the effects of drugs on this.
“It has great application in personalised medicine and, in particular, screening a huge number of compounds in human tissue,” said Dr Christoforou.
The techniques could also provide a useful method to help speed up and reduce the costs of drug development. Often, Dr Christoforou noted, drugs appear valuable when tested on animals but when clinical trials with people begin, their usefulness is no longer apparent.
Laboratory-grown tissues could be used to screen some of the “thousands and thousands” of compounds in the libraries of pharmaceutical companies to find out which could prove useful in people.
By testing first on tissues grown in the laboratory, researchers might be able to find out when to avoid the expense and time of clinical trials for drugs that are unlikely to reach the market.
Similar techniques of growing tissues in the laboratory could, eventually, prove useful for generating organs for transplant.
Dr Christoforou’s project will continue work begun at Duke University that resulted in the publication in 2013 of a paper by him and several colleagues in the journal Plos One.
In that paper, the scientists described the creation of iPS cells from mice, their differentiation into cardiomyocytes and the subsequent production of cardiac tissue.
Showing that similar techniques are getting closer to being used in a clinical setting, in January, scientists at Duke University announced that they had, for the first time, grown human muscle tissue in the laboratory that responded to drugs such as statins in ways similar to those seen with actual patients.
Dr Christoforou’s new study is in the process of being reviewed by the ethics committee at SKMC, which is standard procedure for research of this kind involving patients. If it receives the go-ahead, Dr Christoforou hopes it could expand over the coming years to become a large scheme with a vast number of samples in it.
This will make the project stand out from similar work undertaken in other parts of the world. While other researchers have used the same methods elsewhere, Dr Christoforou’s results should be of particular value to patients in the UAE.
“Part of this project has been replicated [elsewhere], however one of the novelties is the background population we will be looking at,” he said.
Even now, before the process of obtaining blood samples from patients in the UAE has begun, researchers here will be able to improve their techniques by using sample cells provided by biotechnology companies.
It all means that the era of personalised medicine in the UAE is moving closer.
newsdesk@thenational.ae