Promising Research on Aging

Projects include three that focus on the heart

The work now under way in the laboratories of Cleveland Clinic’s Lerner Research Institute will shape medicine in the future. “Our laboratory discoveries today represent the new therapies, the new drugs and the new treatments for patients five, 10, 15 years from now,” says Paul E. DiCorleto, PhD, Chair of the institute. “In a sense, our mission is to treat the patients of tomorrow.”

Those who are relatively young today may well benefit from some of the promising projects in aging research being conducted at the institute. These include the following research studies having to do with the heart:

Predicting Major Cardiac Events

It’s a scene played out many times. A patient seeks medical care because of chest pains. Tests rule out a heart attack and the patient is released – only to suffer a cardiac event or require bypass surgery weeks or months later. Could the patient’s risk for a future cardiac event have been predicted when the first chest pains occurred?

In many cases, the answer is yes. Stanley Hazen, MD, PhD, Cell Biology and Section Head of Preventive Cardiology and Rehabilitation, has identified an enzyme called myeloperoxidase (MPO) as a reliable predictor of future cardiac events.

“Plaque that builds up in the blood vessels is enriched with MPO and causes injury to the protein and lipids in atherosclerotic plaque,” Dr. Hazen says. “Atherosclerosis is a form of chronic inflammation in the vessel wall, so it’s logical that MPO would be present as the body responds to that inflammation. Detecting the presence of MPO is proving to be a reliable indicator that a patient who presents with chest pain has a cardiac cause for the pain and is ‘vulnerable’ to suffering from a heart attack, requiring angioplasty or bypass surgery, or dying of cardiac causes. We’ve seen that the higher the MPO level, the higher the mortality rate. MPO enables physicians to identify the potential of cardiac events before they actually occur.”

Dr. Hazen has helped to develop a test, approved by the U.S. Food and Drug Administration, which can be used to evaluate patients with histories of chest pain for their subsequent risk of major cardiac events.

Unraveling Hypertension

More than 20 years ago, researchers discovered a hormone in the cells that make up heart tissue that is essential to regulating blood pressure. It remained unclear, however, what was responsible for activating the hormone. Qingyu Wu, MD, PhD, Molecular Cardiology, identified one of the mystery “keys” – a discovery that could help people with cardiac hypertrophy and high blood pressure.

Cardiac hypertrophy occurs when the muscle of the left ventricle (the chamber that pumps blood to the body) enlarges and obstructs blood flow. High blood pressure contributes to strokes and other diseases. Regulating blood pressure is a delicate balancing act for the human body. Any disruption or inefficiency in cardiac hormone function can lead to cardiac hypertrophy and other hypertensive disorders.

Dr. Wu discovered that corin – an enzyme readily made and found in heart tissue – is the only enzyme able to activate a hormone that controls hypertension and enlarged hearts. “Knowing how this [process] works and which enzymes and hormones are essential to its function can lead to new treatments or therapies for people who are corin deficient. It might be therapies to preemptively correct the corin deficiency, or it might be treatments to encourage corin production after diagnosis as a way to treat or prevent diseases.”

Heart, Heal Thyself

After a person suffers a heart attack, the body sends out a distress signal directing the patient’s own as-yet-undefined stem cells to go to the heart. There they “differentiate” into heart tissue cells and start to repair the damage. The trouble is, after a short period of time, this homing signal ends and the body stops repairing itself. Is there a way to keep that signal on – or even to turn it back on later – so a patient’s heart heals more naturally, efficiently and quickly?

AcelleRX Therapeutics, a Cleveland Clinic spin-off company specializing in biopharmaceuticals for treatment of cardiovascular disease, develops technologies discovered by Marc Penn, MD, PhD, Stem Cell Biology and Regenerative Medicine and Cleveland Clinic’s Department of Cardiovascular Medicine, to influence a patient’s own stem cells to travel to the site of the injured heart tissue. The stem cells then continue the tissue healing.

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