June Straight to the Heart of It

NUI Galway collaborative international study develops novel minimally-invasive device that can increase heart function after a heart attack

Imagine being able to deliver therapy directly to the heart multiple times from a port under the skin to heal the heart? A new study led by researchers from NUI Galway, Harvard University, and Massachusetts Institute of Technology among others, describes a novel implantable tool that could make this a reality. The study was published today (11, June 2018) in the internationally respected journal, Nature Biomedical Engineering.

When a patient has a heart attack, additional scarring and remodelling can occur and ultimately lead to heart failure. Multiple therapies are being explored to prevent this disease progression including drugs, proteins and adult stem cells. The problems with delivering these treatments currently are that they don’t stay at their intended site on the beating heart, can cause toxic side effects and often require multiple doses to elicit a clinical effect.

A group of investigators that included eight Irish researchers, have recently designed a device called Therepi that can be placed directly on the heart, comprising of a reservoir for drugs or cells that can be refilled multiple times from a port under the skin. This allows localised, refillable, heart targeted therapy delivery. The researchers showed in a pre-clinical model of myocardial infarction (heart attack) that this device can increase heart function over four weeks when stem cells are repeatedly delivered to the reservoir.

This system has vast potential for advancing research as a tool to characterise optimal targeted drug dosing. Additionally, the study describes the first step towards translating a device to the clinic that allows multiple non-invasive therapy replenishments over time. The published study was the result of a collaboration between Harvard, MIT and Boston Children’s Hospital in the USA, and NUI Galway, RCSI, TCD and AMBER, the Science Foundation Ireland funded materials science centre in Ireland.

Professor Ellen Roche, co-first author of the study and Assistant Professor at MIT, and a former researcher at NUI Galway who won international acclaim in 2017 for her work in creating a soft robotic sleeve to help patients with heart failure, said “Our study demonstrates that Therepi can repeatedly deliver drugs, and increase retention of cells at the heart to increase function. For us, this is only the beginning of multiple ongoing studies that will use this system as a platform device for therapy delivery to the diseased heart, and as a research tool to further scientific understanding of the effects of a localised, refillable treatment regimen at various diseased organs. It was a privilege to work with a talented multi-disciplinary, inter-institutional team to make this study possible.”

Professor Garry Duffy, AMBER Investigator and Personal Professor in Anatomy at NUI Galway and a senior co-author of the study, added: “I have no doubt that the development of Therepi will impact care for patients with heart disease in the future and its main advantage allows for treatment to be tailored to individual patient need. Therepi is a medical device that allows keyhole surgical placement of a depot or pouch to the outside surface of the heart, and this pouch can be topped-up with drugs or stem cells using a port that sits just below the skin.

“Our study shows that this local delivery with top-ups improves heart function after a heart attack in a pre-clinical model. It builds on a strong trans-Atlantic collaboration which has seen multiple researchers train at MIT and Harvard from Irish Institutions. Along with Professor Ellen Roche at MIT we are currently assessing Therepi’s utility in disease conditions where cell therapies can offer potential cures including Type 1 Diabetes. This collaboration builds on the strength of the ecosystem here for translational medicine at NUI Galway, and we hope to see devices like Therepi reach clinical trials over the coming years.”

Professor Peter McHugh, Dean of the College of Engineering and Informatics at NUI Galway, and co-author of the study, said: “This publication in Nature Biomedical Engineering clearly demonstrates the brilliance of Irish researchers and the world-class standing of Irish research, and the benefits of working with the very best researchers internationally. It is also an excellent example of the application of scientific, clinical and engineering excellence to develop new and innovative treatment methods that will ultimately significantly improve patient outcomes.”

Other researchers involved in the study include postdoctoral researchers, Fiona Weafer and Reyhaneh Shirazi from NUI Galway, William Whyte (co-first author) a TCD/AMBER PhD student who spent time at Harvard to work on the study, Hugh O’Neill, RCSI PhD graduate and Bruce Murphy, Associate Professor in Biomechanical Engineering at TCD.

To read the full study in Nature Biomedical Engineering, visit: http://dx.doi.org/10.1038/s41551-018-0247-5

Supporting videos of the Therepi device:

https://www.youtube.com/watch?v=2MyWsPTkgNM 

https://www.youtube.com/watch?v=Slb_CoWQhYY

https://www.youtube.com/watch?v=qBSZ4c5j5Yk 

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