Washington: An Indian origin surgeon has performed a historic first retrograde gene therapy, a novel procedure designed to deliver stem cells to the heart to repair damaged muscle and arteries in the most minimally invasive way possible. Dr Amit Patel, M.D., director of Clinical Regenerative Medicine and Tissue Engineering and an associate professor in the Division of Cardiothoracic Surgery at the University of Utah School of Medicine performed the therapy on American actor, Ernie Lively. Patel started investigating cell and gene-based therapies for the treatment of heart disease 12 years ago, but only recently received FDA approval to try the therapy on Lively, who was the first of several patients anxious to receive the treatment.
Patel and his team came up with the idea of retrograde heart therapy, a concept that has been discussed for 50 years. "The genes basically act like a light house with a bright signal. They say, How can we help the ships that need to get to the port - which is the heart -get there. When the signal, or the light from the SDF-1, which is that gene, shows up, the stem cells from not inside your own heart and from those that circulate from your blood and bone marrow all get attracted to the heart which is injured, and they bring reinforcements to make it stronger and pump more efficiently," Patel said.
The 66-year-old actor has credentials that include a long list of TV and film appearances, including Passenger 57 and the Sisterhood of the Travelling Pants. He had suffered a massive heart attack in 2003, which left him functioning on half a healthy heart. As time marched on, his ejection fraction - the measurement of the percentage of blood leaving the heart each time it contracts - continued to decline. Lively became a patient of Patel's in February, when Patel saved Lively's life after a complication with an angiogram left the actor with a severed aorta and problems with his coronary arteries.
This month, Lively got his wish when he became the first patient in the world to undergo retrograde gene therapy at University of Utah Hospital, a novel procedure designed to deliver stem cells to the heart to repair damaged muscle and arteries in the most minimally invasive way possible. The first successful procedure was performed on Lively on November 7. "It's incredible. Imagine having a heart procedure that can potentially regenerate or rejuvenate your heart muscle — and it's done as an outpatient procedure," said Patel. Patel uses a minimally invasive technique where he goes backwards through a patient's main cardiac vein, or coronary sinus, and inserts a catheter. He then inflates a balloon in order to block blood flow out of the heart so that a very high dose of gene therapy can be infused directly into the heart. The unique gene therapy doesn't involve viruses (a rarity for gene therapy, Patel notes) and is pure human DNA infused into patients.
