Lucknow: Researchers at the Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS) have successfully isolated and grown human heart valve interstitial cells (VICs) in the laboratory, a development being viewed as a significant step toward tissue-engineered human heart valves and improved treatment options for patients needing valve replacement.
VICs are critical for maintaining the structure of heart valves, preserving their flexibility and strength, and repairing small injuries.
The work was led by Dr Shantanu Pande and Dr Alok Kumar from the departments of cardiovascular and thoracic surgery (CVTS), and molecular medicine and biotechnology, and was undertaken with support from the department of biotechnology, Govt of India. The findings have been reported in high-impact medical journals.
Prof Pande said that they began by obtaining consent from patients undergoing valve replacement surgery to save their discarded valve. “The tissue was used to isolate valve interstitial cells (VICs) and grow new living cells in the laboratory,” he said.
The lab-grown VICs were then used to study how rheumatic heart disease (RHD) damages heart valves.
India carries a major share of the global burden, accounting for an estimated 40%-50% of RHD cases and 30%-40% of RHD-related deaths worldwide. Studies among schoolchildren have reported prevalence ranging from 1-5 per 1,000 children, while in Uttar Pradesh estimates vary between 0.5-4.5 per 1,000 children.
Dr Alok Kumar said the team identified two key biological pathways linked to inflammation and fibrosis in diseased valves.
“One of them involves the Transforming Growth Factor-beta (TGF-β) and its messenger called SMAD3. This protein pathway helps heal injuries but if switched on for too long, it causes scarring and fibrosis,” he explained.
“The second pathway involves Extracellular Signal-Regulated Kinases (ERK) 1 and 2 – which are enzymes that act like messengers inside a cell. This is also a cellular communication network that anchors cell to grow, divide, survive or repair tissue. We now know that in RHD patients, this pathway aids scarring and eventually damages the valve by stiffening it,” he said.
SGPGIMS authorities said the research could support future work on therapies aimed at slowing or preventing valve scarring, preserving valve function and delaying or reducing the need for replacement surgeries, while also aiding biomarker discovery and drug testing.
Team members included Charan Sai Ramireddi and Anjali Singh (molecular medicine and biotechnology), Mohit K Rai and Vikas Agarwal (clinical immunology), Prof SK Agarwal (CVTS), and Dr Vinita Agrawal (pathology). SGPGI director Prof RK Dhiman lauded the team and assured institutional support.
