“I was always a very active person,”

Narracci says. “But all of a sudden, my energy level started waning. The simplest physical activity—showering—wore me out.”

A battery of tests confirmed that the then 67-year-old was living with cardiomyopathy, or heart failure—a condition affecting about 5 million Americans—which leaves the heart weakened and unable to pump blood efficiently. One clinical tool used to assess heart function is the ejection fraction—a measurement of how well the heart is pumping. Normal ejection fraction is greater than 50 percent. However, if the heart is damaged, it can be significantly lower.

“I had an ejection fraction of 20,” the former teacher says. “My heart was not pumping enough blood or oxygen. I couldn’t do anything and lived like that for four years.”

Narracci was at a crossroad.

“I was in such a state of depression that I felt life just wasn’t worth living anymore,” he recalls. “I told my wife that I had to find a better way to live—if one even existed.”

The road to recovery began on the Internet, where he discovered that scientists were utilizing adult stem cells to treat heart failure, and that this promising approach was under way close to his Florida home. Moreover, the lead researcher—Zannos Grekos, M.D.—was delivering a seminar in nearby Naples. Narracci eagerly attended the presentation, spoke with former patients, then called that same day to schedule an appointment.

Adult Stem Cells: A Primer

More than a decade ago, Dr. James Thomson, director of regenerative biology at the Morgridge Institute for Research of the University of Wisconsin, derived the first stem cells from human embryos. At the time, scientists said the cells could be induced to turn into any type of tissue in the human body, and the medical world was abuzz with talk of a “human spare-parts kit.” Futurists predicted that repairing hearts and regenerating withered brain regions would be as easy as snapping LEGO bricks into place.

But because the extraction of those cells destroyed the embryos, an ethical and political firestorm arose. Since then, researchers like Dr. Grekos have worked to develop regenerative therapies from adult stem cells harvested from mature human tissue—no embryo required. What’s more, patients can often be treated with their own adult stem cells so there is little danger that their immune systems will reject the cells. If adult stem cells live up to their potential, that vision of snapping new body parts into place might not be so farfetched after all.

There’s a lot of high-profile back-and-forth between proponents of different types of stem cells. But where do various lines of stem cells come from, and what distinguishes them from one another?

Embryonic stem cells. Regenerative science’s basic building blocks, embryonic stem cells are extracted from a cluster of cells which gives rise to an embryo. Some think the cells will revive dying brain cells, repair damaged heart tissue, and mend damaged spinal cords. Critics say mining a developing embryo for stem cells is equivalent to murder.

Cord blood stem cells. Originally touted as a way to bypass ethical concerns associated with embryonic stem cells, stem cells extracted from babies’ umbilical cords haven’t panned out as researchers hoped. In part, that’s because the cells can’t be used in as many therapies as other types. But cord blood stem cell transplants can be a welcome alternative when doctors can’t find a bone marrow donor match for patients who suffer from leukemia.

Induced pluripotent stem (iPS) cells. Though not naturally occurring stem cells, these cells are proof that time travel is possible—at least in a biological sense. Here, scientists train regular adult cells to behave like stem cells. The recipe: Take a culture of normal adult cells (skin or blood cells, for example) and use a modified virus to insert one of several pluripotency genes that are active in embryonic stem cells, turning the developmental clock back to zero. When these modified adult cells are cultured, they can—like embryonic and adult stem cells—turn into other kinds of tissue, including cardiac cells.

Nonembryonic stem cells (adult stem cells). Our body produces these cells for use in everyday processes—fracture healing, tissue regeneration, and new skin growth. Researchers are finding ways to harvest these cells from patients, multiply them in culture, and use them to induce targeted regrowth of failing body tissues.

It was Leonard Narracci’s hope that research in this area could help his weakened heart.

Renewed Hope

In November 2008, Narracci met Dr. Grekos, associate clinical professor at Nova Southeastern University and director of the cardiology and vascular disease branch at Regenocyte—an independent biotechnology firm exploring the potential of adult stem cells. By treating the patient’s stem cells with specific growth factors that the body already uses, the research team was creating a new cell population “educated” to target the damaged area.

“In the past 10 years, we realized that the body’s stem cells possess the ability to regenerate damaged

tissue,” Dr. Grekos explains. “We’ve applied this technology to patients with heart damage.”

The procedure, which is international in scope, takes about one week. “We do the blood draw,” explains Dr. Grekos, who has performed more than 400 of these procedures. Five days after a blood draw, the transplant team reintroduces the stem cells back into the patient’s heart.

In December 2008, Dr. Grekos released findings from a small trial on the potential of adult stem cells in heart failure. “Before treatment, the average ejection fraction in participants was roughly 28 percent,” Dr. Grekos says. “After treatment, ejection fraction reached 40 percent or more. I should add that we have found that patients treated in the early course of their disease fare better.”

Some patients may require additional treatment, but to date, no harmful side effects have been noted.

Quality of life also improved.

“Patients now can walk to the beach, go grocery shopping, and play with grandkids,” Dr. Grekos reports. “We also reduced hospitalization due to congestive heart failure in treated patients by more than 80 percent.”

As with any new radically different approach, reaction from professionals in the field is mixed.

“At first, patients sought us out because they had no other options and nothing to lose,” Dr. Grekos says. “More recently, we’re getting referrals from cardiologists and pulmonologists. It’s becoming more mainstream.”

Because the procedure remains experimental, patients must pay out of pocket for the procedure, which can cost about $64,500—and there’s no guarantee of results.

Delivering on the Promise?

While some specialists talk of adult stem cells as a biological and moral holy grail—able to perform regenerative feats without the ethical baggage that drags down embryonic stem cell research—others disagree. They argue that adult stem cells are less “programmable” than embryonic stem cells, for instance—less conducive to being transformed into a variety of different tissue types.

Scientific results, as always, will tell the story. In the next few years, expect to see large-scale human trials of adult stem cell therapies. Those trials will be the ultimate acid tests, determining whether adult stem cells will go down in history as a failed experiment or as the foundation for a golden age of regenerative medicine.

But Leonard Narracci isn’t waiting for the next few years to tell the tale. For him, the future has already begun.

“One week after the procedure, I was absolutely astounded,” he says. “I felt my energy coming back. At my one-year follow up, my ejection fraction was 52 percent. Now, I trim palm trees, do yard work, and exert myself without getting tired. Life is worth living again.”

To learn more about the promise of adult stem cells in treating Crohn’s disease and reconstructive surgeries, as well as Dr. Grekos’ research, visit saturdayeveningpost.com/stemcell..

Post Investigates: Adult Stem Cells The Saturday Evening Post

1. “For Dr. Craig Venter, Discovery Can’t Wait!” [PDF]

Sequencing the human genome signals one of the greatest biological accomplishments of our time.

2. “Tobacco: Making a Killing” [PDF]

Anti-tobacco forces wage war against the powerful tobacco lobby and the rising pandemic of cardiovascular and other smoking-related diseases in the world.

3. “An Emergency Room in Your Chest” [PDF]

Dick Cheney is protected by one, as are thousands of other Americans. Implantable cardioverter defibrillators reduce the risk of having sudden cardiac death to almost zero.

4. “The Other Stem Cells” (See the Jan/Feb 2010 issue on newsstands) and “Breakthroughs on the Brink: Turning the Tide on MS”

Adult stem cells may represent the future of regenerative medicine—minus the controversy.

5. “The Post Investigates Cancer Vaccines”

Cancer researchers are working on “personalized” vaccines that prime the body’s immune system to go after a unique biological tag found only on tumor cells.

6. “Women at Risk” [PDF]

Findings on hormone replacement therapy bring clarity to a longstanding debate, but for the millions of women on hormone therapy, questions remain.

7. “A Cutting-Edge Surgery for Prostate Cancer” [PDF]

Robotic procedures are revolutionizing surgery and rapidly becoming the gold standard for minimally invasive surgery.

Top Medical News Stories of the 2000s The Saturday Evening Post

Regenocyte—an independent biotechnology firm—is exploring the potential of adult stem cells for cardiovascular and severe lung disease. For more about the experimental process from lead researcher Dr. Zannos Grekos and for patient stories, visit Regenocyte – Adult Stem Cell Therapy or call The Heart and Vascular Institute in Naples, Florida, at 866-216-5710.

News Worth Knowing

With so much adult stem cell research underway, it can be tough to keep track of it all. Here are more breakthroughs that are worth keeping an eye on.

Crohn’s Disease: Resetting the Immune System

For sufferers of Crohn’s disease, everyday life can feel like a never-ending bout of food poisoning. The disease arises when the immune system attacks the stomach and intestines, causing abdominal pain, diarrhea, and vomiting. No cure for the condition has yet been found, but Julian Panes, a gastroenterologist at the Hospital Clinic in Barcelona, Spain, thinks he may have hit on the most effective treatment yet: giving chronic Crohn’s patients an infusion of their own adult stem cells to “reset” their immune systems, ending the body’s misguided efforts to attack the digestive system.

The procedure Dr. Panes uses is a straightforward but grueling one. First, patients receive a round of chemotherapy to depress their immune systems, then blood is drawn to obtain a critical mass of adult stem cells. “We check that there is a sufficient number of cells to complete two procedures, just to make sure we are on the safe side,” Dr. Panes says. “After another round of chemotherapy, we infuse the cells into the patient, and the cells populate the bone marrow.” So far, he adds, the treatment seems to result in quick and effective healing of patients’ damaged digestive tissue. “We already have four patients that have been transplanted for more than a year, and three of them are completely without any symptoms. The disease made them miserable, and now they have a normal life.” Dr. Panes plans to begin large-scale clinical trials of the treatment within the next few years.

Reconstructive Surgery: The Next Level

Jeremy Mao, director of the Tissue Engineering and Regenerative Medicine Laboratory at Columbia University’s College of Dental Medicine, thinks he’ll someday be able to do lasting reconstructions of the breast and skin using soft-tissue implants studded with adult stem cells.

In a 2007 animal study, Dr. Mao demonstrated the viability of his technique. First, he inserted adult stem cells that generate fatty tissue into minuscule channels etched in hydrogel implants. He added a growth factor known to promote the development of blood-vessel tissue. Then he transplanted the hydrogel cylinders into mice. He observed that fatty tissue grew in the region of each cylinder—and that it stayed healthy because networks of blood vessels formed to support the new tissue. “When you put micro-channels in the hydrogel, they become a conduit for the blood vessels,” he says.

If Dr. Mao’s technique works in humans, surgeons may be able to perform successful breast reconstructions without silicone and design facial soft-tissue implants that actually hold their shape. Dr. Mao also thinks his method of engineering tissue with its own blood vessel supply will eventually help researchers who use stem cells to build replacement kidneys and livers. “The work we are doing could be informative for more complex organs.”

For more, read “The Post Investigates: The Other Stem Cells,” in the Jan/Feb 2010 issue of The Saturday Evening Post, on newsstands through February.  Subscribe online or purchase the issue at ShopThePost.com.

Adult Stem Cells: Web Extra The Saturday Evening Post

Helping Hearts

Given that heart disease is the leading cause of death in the country for both men and women, it’s no surprise that researchers are always looking for better procedures and devices to assist people with heart trouble. From the University of Michigan comes the recently approved HeartMate II, a device that’s implanted in the chest to help a failing heart pump blood and keep patients alive until they can receive a transplanted heart. The new device is smaller—about the size of a D-cell battery —than earlier versions of heart-assisting implants, making it more suitable for people with smaller bodies, like women and adolescents. According to research published in The New England Journal of Medicine, the HeartMate II helped 75 percent of 133 patients stay alive —and improved heart function and quality of life—for at least six months or until a donor heart became available. One patient even recovered to the point where a transplant was no longer needed.

Cool It

Folks in cardiac arrest need to be cooled down —and quickly—to improve their chance of recovery and to avoid brain damage. But how? Methods such as packing unconscious patients in ice can take hours, which makes survival dicey. Now, emergency medical personnel have the Thermosuit, a plastic suit filled with cold water that reduces body temperature in approximately 30 minutes. Survival rates have improved in the hospitals where the Thermosuit is in use; a National Institutes of Health-sponsored trial will soon be underway to test the device further.

Get Your Own Cells

The heart muscle tends to become weaker after a heart attack because it doesn’t regenerate itself well. One day, heart patients may be able to use their own skin cells to repair their hearts, using a new type of stem cells called induced pluripotent stem cells (iPS). Like embryonic stem cells, iPS cells have the potential to develop into any type of cell in the body. A team of scientists at University of California, Los Angeles has grown functioning cardiac cells in the lab using cells from mouse skin reprogrammed with iPS cells. Scientists hope that this will lead to heart patients using their own skin cells to create iPS lines that will repair and regenerate.

Suit Smarts

Fabrics are a basic human need. And now, “smart textiles” do more than the ancient functions of protecting us from the environment and making us look good. They can sense certain stimuli and adapt or respond accordingly, explains Tushar K. Ghosh, Ph.D., a textiles professor at North Carolina State University in Raleigh. Among the many purposes are: protective gear for firefighters; garments that monitor patients’ vital signs like blood pressure and temperature; the delivery of drugs; and to serve as antibacterial or artificial skin for people with severe burns. In the works are fibers that mimic human muscle fibers, which hold promise for prosthetics and robotics. Ghosh and his team are researching a “heatingcooling garment, with fibers that get smaller or larger,” he says. “The idea is to create a piece of clothing that can let the wind come through or tune it closed if it gets too windy or cold.”

“No-Stick” Bandages

In the same vein, an electrical engineering researcher at Mississippi State University has developed a “smart” adhesive bandage that can check cholesterol, insulin, and blood chemistry without needles—a boon to people with diabetes who are used to sticking themselves many times per day. The bandage reads people’s biochemistry right through their skin. The inventor, Ray Winton, expects the bandage to be commercially available in one or two years.

Mag-netting Cancer Cells

Magnets: not just for science fair projects anymore! Scientists at the Georgia Institute of Technology have found a way to use magnets to catch cancer cells in the bodies of mice with ovarian cancer. They hope that this will be useful in diagnosing or slowing the spread of this deadly cancer in women. The way it may work: A peptide (a protein-like molecule) designed to attach to ovarian cancer cells is fastened to very tiny magnetic particles and injected into the abdomen. The peptides latch on to the cancer cells, and a magnetic filtering device outside the body pulls them out. Other researchers have developed magnetic nanoparticles that show promise for spotting and getting rid of harmful.

Crafty Solutions

Gas prices of late have convinced just about everyone that we need better ways to get around. For Leik Myrabo, Ph.D., an engineer-ing physics professor at Rensselaer Polytechnic Institute, one answer is the Lightcraft. “The Light-craft will move goods and people around the planet in more environmentally friendly ways, using power from renewable energy sources, such as the sun or wind,” he explains. The Lightcraft doesn’t carry its own energy or fuel, instead moving by energy beamed to it from remote laser or microwave power plants, either on Earth or in space (hence the name Lightcraft, a hyperenergetic craft flying on a powerful beam of light). That means it can weigh significantly less than conventional vehicles, such as jet planes and rockets with their massive fuel loads. Myrabo has been working on the concept for more than 30 years, but only in the last few years have power-beaming sources become cheap enough to make the Lightcraft feasible. He estimates that in three to five years, his company, Lightcraft Technologies, Inc., will be able to launch something to the edge of space; moving people will follow within a few more years. “This is species-changing technology,” he says, “sustainable global mobility that will enable you to go anywhere on the planet in 45 minutes or to the moon in a few hours.”

The Future of Medicine is Now The Saturday Evening Post