Friday, August 10, 2007

Take Heart

When Bob Grinstead landed in Bangkok in March with his wife and daughter, he might have been mistaken for a typical tourist. But the 70-year-old retired computer salesman from Atlanta wasn't in any shape for sightseeing. Since suffering a massive heart attack in 1990, he'd undergone two bypass surgeries and two dozen angioplasties. By last year, any physical effort brought on chest pains even taking a shower left him exhausted. After his doctors told him there was nothing more they could do, Grinstead turned to the Internet for ideas. Countless searches and phone calls later, he was on a plane to Thailand in a quest for the Holy Grail of 21st century medicine: stem-cell therapy. Today, eight months after having stem cells injected into one of his coronary arteries, Grinstead's heart is operating more efficiently and he's leading a life his U.S. doctors thought impossible. "I can go for a 30-minute walk," he says. "I've taken trips to Antigua and Florida. I feel like living life again."

Grinstead owes his turnaround to TheraVitae, a 2-year-old American- and Israeli-run company that, in conjunction with local hospitals, offers treatment for heart disease with stem cells taken from the patient's own blood. (Bangkok was chosen as the firm's base because of its good medical facilities and relatively permissive policies governing medical procedures.) Using these cells carries several advantages. In contrast to stem cells taken from a human embryo, they're ethically uncontroversial. And because they're derived from blood, they appear better suited to forming heart and artery tissue. What's more, there's no risk of rejection by the immune system, according to University of Pittsburgh cardiologist Amit Patel, who has collaborated with TheraVitae to treat patients.

The process is surprisingly simple. After arriving in Bangkok, the patient has about 250 cc of blood drawn�less than a standard blood donation. This is sent to the company's laboratory in Israel, where stem cells that occur naturally in the blood are isolated and multiplied through a patented process. A week later, a batch of several million stem cells is returned to Bangkok. These are inserted by surgeons into the patient's arteries or heart, using procedures that Patel helped to develop in the U.S. Patel says that when the cells are released into coronary arteries using an angioplasty catheter, they appear to form new vessels and improve blood flow; when injected directly into the heart with a syringe, they seem to grow into new tissue and improve pumping efficiency. He believes the lab-grown stem cells used by TheraVitae are as safe as ones taken directly from the patient's bone marrow the most common source of stem cells for this kind of therapyand safer than cells derived from bone or muscle tissue. "The results are promising and we don't see the complications that we see with other cell types," he says. Piero Anversa, a heart expert at New York Medical College who pioneered a similar procedure in mice, agrees that placing blood-derived stem cells in the heart and arteries poses "no danger for the patients," although he says that the therapy still hasn't been proven effective.

In clinical trials reported in U.S. medical journals, Patel's procedures have improved the heart's pumping ability by 20-70%. But that doesn't mean you should book a ticket to Bangkok the minute you start feeling chest pains. As the therapy is still experimental, only those classified by doctors as "no option"meaning that conventional solutions such as angioplasty and bypass surgery have been exhausted are eligible. "These patients are really sick," says TheraVitae spokesman Jay Lenner Jr. "We can give people a second chance." Those interested in the treatment, which costs about $30,000 (including most expenses in Bangkok) and requires a 12-day stay, can find out more at For some, it could be the trip of a lifetime.

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