Dr Mukesh Hariawala: Angiogenesis can Revolutionize Heart Therapy

This year's 7th World Congress of Clinical, Preventive Cardiology and Imaging at Shantivan in Mount Abu, Rajasthan was dominated by the promise provided by angiogenesis. Renowned Heart Surgeon Scientist, Dr Mukesh Hariawala delivered the prestigious Keynote lecture by graphically displaying the entire research journey beginning with animal experiments in 1995 , which was marred with several initial failures. The breakthrough came almost at the end of year one over which he quoted the pioneer as saying " Since a model of heart failure which replicates progressive human coronary artery disease has never been successfully created, it was indeed challenging to find a good starting point and make an optimum choice of basic science model. The research experience was like driving a car without wheels in a dark lonely tunnel . I have been fortunate to see light at the end of it, as Angiogenesis now has become a clinical reality ".

Cardiac Angiogenesis vision was inspired from early gene therapy and isolation of growth factors work done by Dr Judah Folkman at Boston's Children Hospital. It is a novel science of triggering the birth of micro blood vessels in the heart muscle from existing dormant vessels which can help salvage reduced blood flow situations including in acute heart attacks. The utilization of native VEGF ( Vascular Endothelial Growth Factor ) acts as a precursor to the entire process of regeneration which responds to low energy laser stimulation. Although preliminary studies showed early promise, the potency of Angiogenesis alone was very limited since it was weak for a high energy demanding muscular organ like the heart. This has necessitated incorporation of Stem Cells in the revised clinical trial protocols. The larger promise is in its economicity which could lower the healthcare burden worldwide, Dr Hariawala told ANI.

Currently, Stem Cells are extracted during open heart surgery from the hip bone which is a good reservoir, subsequently filtered from other cells in the operating room. A third element of using an Internal Mammary artery conduit completes the triad which is termed " Triple Heart Therapy " . This is found to be most useful in diabetic patients with diffused disease not amicable to routine angioplasty, stent or bypass surgery. This is very commonly seen in the ethnic Indian population who are predisposed to strong genetic inheritance of heart disease.

The pioneering work of 2012 Nobel prize winners John Gurdon and Shinya Yamanaka on Stem Cells was also recognized in the lecture, which focuses on reprogramming and amplification of the potency of existing cells which will be a tremendous boost to all future cellular therapies. This work will eventually have multi organ therapeutic ramifications and benefit all of mankind, concluded Dr Hariawala.

At the event , Boston-based Dr Hariawala was awarded the " 1st National Angiogenesis Award " by Tripura Governor Padmashree D Y Patil. Former President Abdul Kalam who presided over the previous year is a founding patron of the organization.

Source-ANI