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Compositions for regenerating defective or absent myocardium

a technology of myocardium and composition, applied in the field of tissue engineering, can solve the problems of affecting the survival rate of heart failure victims, and affecting the survival rate of heart failure victims, and achieve the effect of inducing angiogenesis

Inactive Publication Date: 2007-01-18
CORMATRIX CARDIOVASCULAR INC
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

[0011] The invention contemplates a method of inducing angiogenesis in myocardium at a site of ischemia, comprising contacting said ischemic myocardium with a composition an emul

Problems solved by technology

The results of all the effort and cost are disappointing with a 75% five year mortality rate for the heart failure victims.
Treatments for chronic heart failure include medical management with pharmaceutical drugs, diet and exercise, transplantation for a few lucky recipients, and mechanical assist devices, which are costly and risk failure and infection.
Medical researchers have transplanted human hematopoetic stem cells, mesenchymal stem cells, endothelial precursor cells, cardiac stem cells, and skeletal myoblasts or bone marrow cells to the myocardium, with however little or mixed success in satisfactory regeneration of the myocardium.
As yet, the experiments to prove these theories have not worked sufficiently to be attempted in humans.
Meanwhile, typical structural abnormalities or damage to the heart that would lend itself to tissue regenerative therapies, were they available, include atrial septal defects, ventricular septal defects, right ventricular out flow stenosis, ventricular aneurysms, ventricular infarcts, ischemia in the myocardium, infarcted myocardium, conduction defects, conditions of aneurysmic myocardium, ruptured myocardium, and congenitally defective myocardium, and these defective conditions remain untreated in humans by any current tissue regenerative techniques.
Although tissue regeneration has been accomplished by transplantation in mammalian tissues such as the endocranium, the esophagus, blood vessels, lower urinary tract structures, and musculotendinous tissues, heart tissue regeneration by foreign tissue explant has remained a challenge.
One problem exists in the preparation of extracellular scaffolds in that they must be non-immunogenic and thus acellular before implantation.
Getting rid of the cells in the matrix may also inadvertently strip the scaffold of key bioactive proteins.
No experimentation has been conducted to date on regenerating mammalian myocardium using an emulsified or injectable extracellular matrix formulation.
The disadvantage of using intact, non-emulsified extracellular matrix compositions such as patches or strips is that placement of the material requires open surgery, with its coordinate risk of infection, challenge of access to the site, and longer recovery for the patient post-procedure.

Method used

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  • Compositions for regenerating defective or absent myocardium
  • Compositions for regenerating defective or absent myocardium
  • Compositions for regenerating defective or absent myocardium

Examples

Experimental program
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Effect test

example 1

[0105] An emulsion of urinary bladder submucosa (UBS) is prepared using standard emulsifying techniques. The emulsion is free of endogenous cells. This preparation is maintained as an emulsion by controlling the pH during storage of the emulsion before it is admininstered to the patient. In a minimally invasive procedure, a percutaneous catheter device is loaded with sufficient quantity of the emulsified UBS to address a defect in a human heart, the defect having been identified previously by imaging. The catheter is directed to the site of the myocardium in need of tissue regeneration using sonographic or radiographic imaging. Upon contact with the site, the emulsion is released and the catheter is withdrawn. The tissue regeneration process is monitored by sonography for several weeks or months post-delivery of the emulsion.

example 2

[0106] An emulsion of decellularized immunogenic liver basement membrane (LBM) is prepared using standard known techniques. While maintaining the emulsion state of the LBM, adult stem cells are co-cultured with the emulsion using standard stem cell culturing techniques. When the cells are ready, the entire composition is loaded into a catheter for percutaneous delivery to a human patient in need of tissue regeneration at a site of defective or absent myocardium. The emulsion with the co-cultured cells is delivered to the patient: a percutaneous catheter is loaded with the emulsion and directed to the site of the myocardium in need of tissue regeneration using sonographic or radiographic imaging. Upon contact with the site, the emulsion is released and the catheter is withdrawn. The tissue regeneration process is monitored by sonography for several weeks or months post-delivery of the emulsion.

example 3

[0107] An injectable emulsion of decellularized immunogenic stomach submucosa (SS) is prepared using standard known techniques. An aliquot of glycoaminoglycan (GAG) protein is covalently linked to some of the molecules of the matrix emulsion using standard covalent linking procedures for proteins. While maintaining the emulsive state of the SS, bone marrow progenitor cells are co-cultured with the emulsion using standard progenitor cell culturing techniques. An aliquot of transforming growth factor protein is added to the co-culturing composition before delivery to the human in need of myocardial tissue regeneration. The emulsion complete with cells and proteins is loaded into a percutaneous catheter which is directed to the site of the myocardium in need of tissue regeneration using sonographic or radiographic imaging. Upon contact with the site, the emulsion is released and the catheter is withdrawn. The tissue regeneration process is monitored by sonography for several weeks or m...

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Abstract

Compositions of the invention for regenerating defective or absent myocardium comprise an emulsified or injectable extracellular matrix composition. The composition can also have an extracellular matrix scaffold component of any formulation, then including also added cells, proteins, or other components to optimize the regenerative process and restore cardiac function. Methods for regenerating defective or absent myocardium apply a composition to a site of myocardium in need of regeneration using a delivery mode appropriate for the particular formulation.

Description

CROSS-REFERENCES TO RELATED APPLICATIONS [0001] The present application is a divisional of parent application Ser. No. 11 / 182,551 filed Jul. 15, 2005.FIELD OF THE INVENTION [0002] The invention relates to tissue engineering generally, and more specifically to compositions and methods for regenerating defective or absent myocardium. BACKGROUND OF THE INVENTION [0003] Heart failure occurs in nearly 5 million people a year in the U.S. alone at a combined cost of about $40 billion annually for hospitalization and treatment of these patients. The results of all the effort and cost are disappointing with a 75% five year mortality rate for the heart failure victims. Treatments for chronic heart failure include medical management with pharmaceutical drugs, diet and exercise, transplantation for a few lucky recipients, and mechanical assist devices, which are costly and risk failure and infection. Thus the landscape for cardiac treatment is turning in recent years to transplantation of tissu...

Claims

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Application Information

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IPC IPC(8): A61K35/38A61K35/34A61K35/37A61K35/44
CPCA61K9/0019A61K38/39A61L27/3633A61L27/367A61L27/3683A61L27/3873A61L2400/06A61K35/34A61K35/545A61L27/40A61K35/38A61K38/1741A61K38/1841A61L2430/20A61K35/37A61K35/407A61K35/22A61K31/726A61K38/1825A61L27/54A61K31/7088A61K48/00A61L2300/414A61L2430/30A61K35/50A61L2300/426A61L27/3834A61L27/3804A61L27/3629A61L27/58A61L2300/412A61L2300/45A61L2300/64A61L27/3687A61L27/227
Inventor MATHENY, ROBERT G.LEWIS, BEECHER
Owner CORMATRIX CARDIOVASCULAR INC
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