Can stem cells treat hypertension?

Can stem cells treat hypertension?

Apr 2014 , Dr. Nicolo Cabrera

With prominent personalities swearing by stem cells, physicians must keep a close eye on this novel treatment modality. During the 10th Asia-Pacific Congress of Hypertension, Dr. Eva Maria Cutiongco-dela Paz of the Philippine Genome Center and the Institute of Human Genetics at the National Institutes of Health brought physicians up to speed on the basic science on stem cells and how it may be applied to hypertension.

Stem cells are distinct non-specialized cells that can replicate and create multiple identical copies of themselves. They also retain the ability to develop into various specialized cell types.

Embryos and fetuses are obvious sources of stem cells but are hounded by ethical concerns. Alternatively, stem cells may be sourced from amniotic fluid, placenta or umbilical cord. Most recently, adult somatic cells may be induced to become pluripotent stem cells (ie, induced PSCs or iPSCs), making them among the least ethically controversial manner of harvesting pluripotent stem cells.

Despite all the excitement, Cutiongco-dela Paz advocates a cautious approach to stem cell therapy. “[W]e should all recognize that at the present time... [stem cell therapy] has been established as a clinical standard of care for some conditions such as hematopoietic stem cell transplants for leukemia, epithelial stem cell-based treatments for burns and corneal disorders and some rare immune deficiencies. Published clinical evidence has been unable to support the use of these therapies for routine disease treatment.”

With respect to cardiovascular disease in general, Cutiongco-dela Paz determined that there are many ongoing clinical trials for the use of stem cells for heart failure, angina and cardiomyopathy. However, as some are not randomized, findings must be received with a ‘grain of salt’.

The potential use of stem cells to treat hypertension is also being studied since damaged endothelial cells are usually replaced by stem cells mobilized from the marrow that convert into endothelial progenitor cells. In early hypertension, an increase in circulating endothelial progenitor cells has been documented even with good blood pressure control.

Angiotensin has also been shown to reduce telomerase activity and accelerate senescence. Consequently, giving hypertensive cats candesartan, an angiotensin II receptor antagonist, restored the number and function of progenitor cells. Humans given angiotensin-converting enzyme inhibitors showed improved function and increased number as well.

The exact role of these progenitor cells in hypertension has not been sufficiently elucidated, but in the future these may be targets of future treatment options for the disease. Cutiongco-dela Paz, while eagerly awaiting the development of the research, also puts the excitement into perspective, “We should all keep in mind, however, that the use of stem cells in hypertension is still in its infancy.”