The problem of heart and circulatory disease is getting bigger and bigger but the answers could just be getting smaller and smaller…
This June, the British Cardiovascular Society Conference 2018 tackled the big issues in heart science. From inflammation to heart attacks, ECGs and sports science, it seemed like every issue was discussed, even those you can’t see.
Nano — what?
Nanomaterials, whether tubes, sheets, patches or wires, have at least one dimension (height, width or depth) in the nanoscale. That is 100,000 smaller than the width of a sheet of paper.
Teeny tiny, in fact.
But don’t underestimate them.
Researchers at the Institute of Biomedical Sciences, Academia Sinica, Taiwan, are exploring how nanomaterials could be used to repair the damage caused by a heart attack by boosting the regenerative power of heart muscle.
Using stem cells to repair damaged heart muscle has previously proven problematic because the cells don’t stay where they are injected, they don’t survive or they don’t truly behave as heart muscle cells. But the Taiwanese team, led by Professor Patrick Hsieh, are creating materials with ‘nano-patterns’ on the surface. These tiny patterns are created with magnets and force stem cells grown on top to align in the same way that heart cells grow. This creates functioning heart patches that better merge with the existing heart muscle and hopefully promote repair once they are grafted into damaged hearts.
BHF Professor David Newby from the University of Edinburgh is using magnetic nanoparticles to improve the imaging and identification of risk for people with heart disease.
Nanoparticles called ultrasmall superparamagnetic iron oxide (USPIOs) are absorbed by immune cells, which then pass into tissue. These magnetic particles can then be imaged using an MRI scan in more detail than traditional methods and his team are exploring whether this modified MRI scan can be used for people with aneurysms, to detect the ones that are most likely to burst.
May the (magnetic) force be with you
Dr Iwona Cicha from University Hospital Erlangen in Germany described how you can coat a magnetic nanoparticle with a drug, and then use an external magnet to direct the drug to exactly where you want it in the body — this is called magnetic targeting. It can concentrate a drug where you need it and improve its effects.
Micro. Nano’s big brother
Compared to such tiny particles, tubes and sheets, the humble bacteria is huge. One bacteria can be a couple of hundred, to a couple of thousand, nanometres wide but that’s still pretty small compared to, well, most things.
We all know that there are lots of bacteria on our skin. Even the clean freaks among us. Most people are probably even aware by now that there are also bacteria in us — particularly in the gut. You can’t get far in a supermarket without coming across pro-biotics, pre-biotics, live-cultured yoghurt and fermented dairy products. We’ve all seen the claims of ‘good’ bacteria, humbly protecting us and keeping us healthy while that pesky ‘bad’ bacteria causes infection. And you could be forgiven for writing this all off as a marketing tactic but more and more research is pointing to the importance of a healthy gut bacteria (or microbiome).
Professor Dominik Muller from the Experimental and Clinical Research Center & Max Delbrück Center for Molecular Medicine, Berlin, is researching how salt is responsible for wiping out one particular kind of bacteria from the guts of mice, what this means for the mouse, and for us.
His team recently showed that Lactobacillus murinus — the mouse version of a human bacteria Lactobacillus, which is present in the healthy human gut — was wiped out by a high salt diet. This caused blood pressure to rise and immune cells called TH17 (which are responsible for triggering inflammation) to be switched on. The mice also had symptoms of salt-induced encephalomyelitis — a neurological condition caused by a disrupted immune system that is a model for multiple sclerosis. Scary stuff.
So does eating too much salt give you multiple sclerosis?
No, it’s not that simple.
We know that eating too much salt has been linked to high blood pressure, chronic inflammation and the faster progression of autoimmune diseases such as multiple sclerosis. But now we know that eating too much salt wipes out certain gut bacteria and turns on some immune cells, we can investigate ways to prevent this.
When the team gave the affected mice a probiotic treatment of Lactobacillus murinus, alongside the high salt diet, their blood pressure returned to normal, decreased the number of TH17 cells and minimised the symptoms of the encephalomyelitis.
They took the next steps and gave twelve healthy men six extra grams of salt every day for a fortnight — doubling their salt intake. It wouldn’t be ethical to continue this long term but at the end of this short trial period, the men’s Lactobacillus was so low it wasn’t detectable in most of them, their blood pressure was higher and they had more TH17 cells in their blood. So it looks like the research stands up in humans, too.
Professor Dominik N. Müller said: “We should start to see our gut microbiome as a viable target for treating conditions that we know are aggravated by salt, such as high blood pressure and inflammation.
“We can’t exclude the possibility that there are other salt-sensitive bacteria that are just as important as Lactobacillus — this could be the tip of the iceberg in targeting gut bacteria for treating serious illnesses.”
Our Associate Medical Director, Professor Metin Avkiran said: “We need more research to better understand the links between gut health and cardiovascular health and to determine if probiotics might be useful supplementary treatments for serious conditions such as high blood pressure.”
At the BHF we’ve also recently funded a breakthrough that linked the level of diversity of the ‘good bacteria’ in our gut to the hardening of the arteries — so it’s definitely on our radar, or perhaps that should be under our microscope.
By Lauren Tedaldi and Stephen Robinson
Want more from the BHF at BCS Conference 2018?
- Rally driving — anyone can do it in the right car. Right?
- Can you really use an App to diagnose your heart condition?
Teeny tiny solutions to one of the world’s biggest heart aches — Honey, I shrunk the science was originally published in British Heart Foundation on Medium, where people are continuing the conversation by highlighting and responding to this story.