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"It is sink or swim for me"

From our editor

Hilde Van den Eynde

AALST (Belgium)

For almost twenty years, Jacques Reygaerts (63) from Twee-Akren (Belgium) has been having problems with his heart. In 1989 he had a heart attack, the following year he underwent a first bypass operation and two years ago he needed another operational bypass. However, the last operation didn't go well, and ever since, Reygaerts is at home with serious heart complaints: because of shortness of breath and severe pain in the chest he regularly ends up in hospital. The heavy medication he takes to support his heart functions works far from properly, and his heart function is worsening.

But Jacques Reygaerts hopes soon to be one of the first to receive the new, experimental treatment in the Onze-Lieve-Vrouwe-hospital of Aalst . Physicians will take bone marrow, from which stem cells are collected.

"Each time Mr Reynaerts came for a checkup, he asked if we had anything new for him," says cardiologist Jozef Bartunek, a physician of slovak origin, who helped to set up the research project in Aalst. "And now we might have the right treatment."

Bartunek builds on earlier attempts of his own and of fellow cardiologists to repair diseased hearts with the help of stem cells. It never really worked well and on the long run, the patient outcome certainly remains uncertain. International research in which heart attack patients were given stem cells, yielded mixed results: solid evidence that this treatment improved the heart function has not been provided yet. If there were any results, the improvements were small and it was not clear whether this was due to the injected stem cells.

Legislators have to give Bartunek the permission to do this experiment. He tries to convince them that, this time, he does have good chances to succeed. Unlike previous stem cell experiments, he prepares the stem cells using a defined cocktail of growth factors (see chart) that should integrate better into the heart tissue. According to Bartunek, this treatment has shown benefit in tests with mice. Together with fellow cardiologists William Wijns, Guy Hendrickx and Marc Vanderheyden, the physician set up a company, Cardio3 BioSciences from the Walloon-Brabant city of Mont-Saint-Guibert (Belgium).

Apart from Aalst, Bartunek also mentions university hospitals in Antwerp and Liège as collaborating centers and a center in Genk. In Germany he contacted Munich, Hamburg and Aachen; in Switzerland Zürich, Lugano and Lausanne would be interested, in the Netherlands Maastricht has been asked and in India Ahmedabad.

Hospitals from the US deliver patients in a later research phase, according to Bartunek. A total of 230 patients would be included in the research. Results are due after 2010.

Bartunek has a list of eligible patients but practical problems delay the elaboration. For example, the financing of his project is not yet arranged. Neither has the government given green light to start this experiment. The most important European legislator EMEA has not yet provided approval for the research protocol. However, Bartunek hopes to be able to start before the end of the year.

If it is so far, Jacques Reygaert will be one of the first to end up on the operating table. Don't you see it as a scary prospect to be the first test subject for a surgery that has never been tried on other people? "Oh well, madam, I already had two open heart operations and I still have blocked arteries. It is sink or swim for me."