Not just Covid-19. Research on messenger RNA, which quickly led to vaccines for the Sars-CoV-2 virus, could in the future lead to a drug capable of protecting and – hopefully – regenerating the heart after a heart attack. Obviously with genetic “instructions” targeted for this purpose. To revive this hope, already cherished for a long time in recent years, is a research presented at the scientific congress of the European Society of Cardiology (ESC) Frontiers in CardioVascular Biomedicine 2022, by experts from the University of Utrecht.
Heart door
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Let me be clear: we are only at the beginning of a path that promises to be long and complex. But the good news is that Dutch experts have devised a method to provide the human body with specific genetic material to reduce the risk of heart attack. The idea follows what happened for the development of mRna vaccines to counter Covid-19 infection, which, as the authors explain, use lipid nanoparticles to supply mRna to the body’s cells. These are then able to produce the spike protein of the virus, mimicking that of the pathogen. Thanks to this approach, the body is able to activate an immune response by producing specific antibodies. In the case of possible future treatments for heart attack, the working hypothesis is similar.
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The researchers designed a particular mRNA drug capable of instructing heart cells to repair themselves following a heart attack and performed the first extremely preliminary tests. In animal models, several formulations of this “therapy” have been injected directly into the left ventricular wall. Then, after 24 hours from the administration of the drug, the ability to translate, and therefore to provide the correct information, of the mRna was examined. Result: the goal has been reached, with the molecule actually reaching the heart of the mice. But that’s not enough: it has also been seen that, in terms of “circulation” of mRna in the body, higher quantities are observed in the liver and spleen.
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“The liver metabolizes lipid nanoparticles – he notes Clara Labonia of the Dutch university – so we knew that the expression in the liver would be large, but we have identified a translation of the mRna in the heart tissue. This suggests that lipid nanoparticles could function as delivery systems for mRNA therapy. For the next steps we plan to test new formulations and choose the one able to reach the heart tissue in the most efficient way. Subsequently, we will also evaluate the effectiveness of a possible treatment “.
At first, but there are strong hopes
Hope, in short, is strong even if the study path is really only at the beginning. It must be said that the idea of ”teaching” the heart to regenerate cells killed by ischemia is certainly not new, even by exploiting these technologies. But so far no appreciable results have been obtained in humans. “First of all it should be noted that this is not a real” vaccine “, which acts by preventing an infection, but rather the hypothesis of new therapies for the protection and regeneration of heart tissue after a heart attack – he comments Giulio Pompilio, Scientific Director of the Monzino IRCCS Cardiology Center. This study represents further proof of the impact that RNA technologies can have in various fields of medicine: much work is being done not only for the heart and the cardiovascular system, but also on other fronts and in particular in oncology. However, it is necessary to clarify that several pieces are still missing to reach a possible application on humans “.
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On the scientific front, it is necessary to ensure that the effect of administering mRNA with the right instructions for myocardial regeneration is concentrated on the heart, where it is needed. “We need to identify the right path to have the desired effect at the local level and above all, if this were possible, we need to think about putting in place platforms for the validation and production of these drugs, together with the necessary regulatory steps – specifies Pompilio. truly at the beginning of a sector in great ferment, which in the future may offer us further treatment options for heart disease “.