Stem cell research is ongoing at the David Geffen School of Medicine at UCLA. The latest announcement described a clinical trial in which angina patients were treated with stem cells. Angina is chest pain due to restricted blood flow to the heart muscle. The clinical trial was designed to evaluate treatment for angina patients who have not responded to other procedures.

After UCLA patient Marty Greenfield, age 64, suffered a heart attack, he underwent a coronary bypass procedure and angioplasty. However, they did not relieve his severe angina. Every day he suffered crushing chest pain. His physician referred him to UCLA for heat transplant consideration; however, he was not accepted because his heart muscle function was not poor enough to meet the requirements. UCLA cardiologist Dr. Jonathan Tobis suggested that Mr. Greenfield consider enrolling in a multicenter Phase 3 clinical trial that uses a patient’s own blood-derived stem cells in an attempt to restore heart circulation. The procedure involves using the latest technology to map the heart in three-dimension and guides the cardiologist to deliver the stem cell injections to targeted sites in the heart muscle.

Mr. Greenfield became the first UCLA patient to participate in the trial. The trial was double-blind, meaning that neither the patient nor the physician knew whether stem cells or a placebo were injection. Despite the fact that he had a 50% chance of receiving non-treatment, Mr. Greenfield was eager to participate. He explained, “This just isn’t about me. If I can help move this research forward so that it helps just one person, it will be worth it.”

The researchers note that the clinical trial is one of the most advanced studies using stem cells to treat cardiac patients who are either unable to receive Food and Drug Administration (FDA)–approved standard of care therapy or have already received standard of care therapy but did not improve. “We’re hoping to offer patients who have no other options a treatment that will alleviate their severe chest pain and improve their quality of life,” explained co-principal investigator Dr. Ali Nsair, an assistant professor in residence of cardiology at the David Geffen School of Medicine at UCLA.

For the procedure, Mr. Greenfield’s heart was first mapped with colored three dimensional images. This enabled the doctors to study motion of the muscle and the voltage it generated. Less movement and energy is produced by damaged areas of the heart. His heart was then injected with a solution that contained either the stem cells or placebo. Dr. Tobis explained, “We are able to tell by the voltage levels and motion which area of the muscle is scarred or abnormal and not getting enough blood and oxygen. We then target the injections to the areas just adjacent to the scarred and abnormal heart muscle to try to restore some of the blood flow.”

For the study, researchers take blood from the patient and isolate stem cells that express the CD34 protein, known as CD34+ cells. These cells are known as pluripotent cells, which means that they have the capability to develop into any type of cells. After purification, the cells are injected into the patient’s heart via a catheter inserted into the femoral artery in the groin area. The goal of the treatment is that the cells will either become new and healthy heart muscle cells or that they will stimulate the growth of new blood vessels. This process is known as angiogenesis. The result would be improved blood flow, which provides oxygen, to the heart muscle adjacent to the abnormal tissue.

Mr. Greenfield and the other patients in the study will be followed to determine the response of the treatment. The goal of the study is to enroll 444 patients nationwide; 222 will receive receiving stem-cell therapy, 111 will receive a placebo, and the remaining 111 comprise patients who are being treated according to the current standard of care.