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MENAFN - Arab News - 08/11/2012

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(MENAFN - Arab News) American cardiologist and researcher Dr. Yerem Yeghiazarians is currently on a visit to the Kingdom to gauge interest in the establishment of a stem-cell research facility here.

Leading Saudi businessmen Hamad and Khalid Al-Zamil are interested in advancing the research initiative and invited Yeghiazarians to meet business leaders, arranged lectures and toured him around various hospitals to garner support for his pioneering project.

Dr. Yeghiazarians believes stem cell treatment may be the only hope for thousands of people worldwide who suffer from heart problems. Dr. Yeghiazarians speaks to Arab News journalist Siraj Wahab on the latest developments in the field.

Dr. Yeghiazarians, welcome to Saudi Arabia. Is this your first visit? Please tell us more about yourself and your medical background.
Yes, this is my first time in Saudi Arabia. It is truly an honor being in the Kingdom. I am a cardiologist. I also do interventional cardiology, meaning I do procedures in patients who have blockages in their arteries or who have heart attacks. I did my training mostly in the United States. My medical school training was at Johns Hopkins Medical School in Maryland. After that I spent eight years at Harvard Medical School at the Brigham and Women's Hospital, one of their main teaching hospitals. It is one of the most respected training institutions in the country, if not the best. I finished my internal medicine training there and decided to do cardiology training. When I completed my clinical training in cardiology, I was asked to go back and take a chief residency for the whole Brigham and Women's Hospital internal medicine residency program. I was the chief resident in charge of training 170 trainees in internal medicine that year. I finished my training for interventional cardiology and did my research at Harvard and in 2003 was recruited to the University of California, which is a world-renowned medical and research institution. I was doing interventional cardiology and started a cardiac stem cell program.

What was the level of interest in 2003 to stem cell research and what exactly is it?
Back in 2003, it was a very new research endeavor. The basic idea of our research is to use stem cells to improve heart function after a heart attack. What tends to happen to patients who suffer from a heart attack is because of the lack of blood flow and the blockage that develops in the heart artery, the heart muscle becomes damaged and scarred. The heart, unlike the other organs in the body, doesn't have enough capacity to regenerate itself. Once you have a heart attack that muscle is damaged. It is replaced by scar tissue. Over time the heart loses its pumping capacity and is unable to pump blood out of the heart to rest of the body. It is like pouring water into a balloon. The balloon gets bigger and loses its pumping capacity. Blood or fluid builds up in the lungs and leads to congestive heart failure or cardiomyopathy. It is the number one killer in the developed world and results from risk factors such as diabetes, smoking or high blood pressure.

How do you treat congestive heart failure?
Over the last 20 to 30 years, a lot of effort has been made to develop medications to improve heart function after a heart attack. None of the therapy we have is adequate to help all our patients. Some make progress but they need mechanical devices like heart pumps. Sometimes even that fails. The only way is to do a heart transplant. But even in the United States we do less than 3,000 heart transplants a year. Thousands of patients need advanced therapy. Unfortunately, none of the drugs today can replace heart scar tissue with a beating, functional muscle cell. The only hope we have is to use stem cells to regenerate the scar tissue and replace it with a heart muscle cell and improve heart function. This will eliminate the need for mechanical intervention or a heart transplant. Heart transplants are very rare and in many parts of the world it is impossible for patients to have them.

How far are we into stem cell research?
There are different types of stem cells we can use for treating ailments. There are adult stem cells and there are embryonic stem cells. There is a new development called induced pluripotent stem cells, otherwise known as IPS cells. This was an amazing discovery. Last month the Nobel Prize in Medicine went to the two people who discovered it. The scientists took a skin cell and genetically manipulated it and make this cell into a stem cell or a younger cell. We all come from a young cell. This discovery meant we can turn the clock back to an immature cell from which different types of cells can be created, enabling us to treat all conditions in the future. It is still early days but there is a lot of promise. We have come a long way using adult stem cells in ongoing clinical trials, which appear to show a lot of promise. In the future the hope is to use these cells to replace the scar tissue with a viable heart muscle cell.

Do you intend to establish a research facility in Saudi Arabia?
From my understanding there is not much research going on in this field here or in the region. So it is an honor for me to come here and introduce the research we are doing at the University of California and to extend our knowledge to the folks here in the Middle East and Saudi Arabia specifically. The idea is to garner interest and to see if people are interested in collaborating with us in starting a similar project here. We are very hopeful that in the future we can collaborate to advance the research we have for the treatment of heart patients.

What kind of laboratory do you have in California?
We do basic research that involves growing cells at my laboratory. We also have small-animal models and large-animal models whereby we can study them before we introduce them to patients. It would be fantastic if we could set up a similar research program here. I am trying to monitor the interest among people here. I need to know what facilities are currently available and find out how we can introduce larger facilities to the region advance the research collaboratively.

What is the cost to set up a similar one here?
It is hard to put a figure on it. It depends on how big a program people here would be interested in. We are talking about millions of dollars. I will give you an example. At the University of California about two or three years ago, we created a whole new building specifically to study stem cells and that cost about 200 million. We have more than 20 investigators who study stem cells for different disease conditions, not just the heart but for other conditions too. Stem cells could some day potentially be used for patients following a stroke and for patients with diabetes, kidney disease and liver failure. There are endless possibilities." This is the time to invest in it, to put a program together, because it is not that we are going to discover it over the next year or two. This is going to help our future generation, our medical students, create novel treatment for all kinds of diseases.

Are you saying since heart failure is a universal problem the whole world needs to collaborate in finding a viable solution?
This is a very big problem globally and it is getting even bigger. The first restaurant I noticed when I landed in Dubai was McDonald's. Westernization of our diet has led to people gaining weight. More and more people in the region and worldwide are developing diabetes. There are significant numbers of people who smoke. There are significant cases of high blood pressure. All these are going to increase the risk of cardiovascular diseases around the world and result in more heart attacks and more congestive heart failure in people.

How significant are the numbers?
In the United States alone there are about 1.5 million heart attacks every year, and one in five people are going to die from heart disease. There are over three million people in the United States with some degree of congestive heart failure now. In the Middle East, I don't know the numbers, but they must be equally staggering. We all have to be careful about our diet. We all have to be careful about the lifestyle choices we make. We should not smoke; we should exercise and constantly watch our weight. My mission is to educate people here about stem cell research, heart diseases, heart failure and the potential treatment we can offer our patients.

Do you have any advice to the Saudi medical fraternity and medical students?
Yes. I get a lot of interest from all over the region, from Saudi Arabia, Pakistan, Afghanistan, and India, from students who are interested in stem cell research. They send me their CVs, their applications to come to the United States, to come to our laboratory to study in this particular field. I think it would be a tremendous achievement if we can establish a facility here to give these students the ability to become better scientists, better doctors and better teachers for our future generation.


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