Bile acid might prevent deadly heart ‘scars’

There’s currently no treatment for cardiac fibrosis, a leading cause of heart failure. But new research suggests there may be a way to prevent it.

The study found specific triggers that activate the development of fibrosis. Blocking the triggers through the use of a bile acid prevented cardiac fibrosis from occurring, according to results in a pre-clinical model.

“The bottom line is that this shows for the first time that cardiac fibrosis is preventable.”

“This is something that nobody has ever seen before,” says Marek Michalak, co-principal investigator and a professor in biochemistry at the University of Alberta. “Cardiac fibrosis is considered a permanent remodeling of the heart. Inevitably it leads to heart failure and eventually death.

“The bottom line is that this shows for the first time that cardiac fibrosis is preventable.”

Luis Agellon, co-principal investigator and a professor at McGill University’s School of Dietetics and Human Nutrition, says the findings offer hope to those who are living with heart failure.

“Prevention of fibrosis will extend the ability of the heart to continue to function, even if at a reduced capacity. Currently patients with heart failure have poor quality of life and a dismal prognosis. Improving their quality of life will do wonders for these individuals,” says Agellon.

Fibrosis is an early step on the path to heart failure. Once a person is diagnosed with heart failure, about 30 percent will die within the first year.

Next step: clinical trials

Cardiac fibrosis itself is caused by a variety of factors, including high blood pressure, overwork of cardiac muscle, and long-term consumption of a diet that is high in both saturated fat and sugar—all cause increased stress to heart cells. Individuals with diabetes, cancer patients undergoing chemotherapy, and heart transplant recipients are also known to be at high risk.

“It’s almost like building a scar,” says Michalak. “It’s exactly the same type of biological activity but it’s happening in the tissue in the heart. It destroys the ability of the heart to function normally.”

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The team is now pushing forward with additional studies to see if the same therapeutic effect can be achieved in humans. They also aim to gain a better understanding of exactly how bile acids can prevent cardiac fibrosis from occurring.

“We don’t yet have a full understanding—nobody does—of how the bile acid actually does what it does in heart cells,” explains Michalak. “So, another phase of the work is to find out what actually happens within heart cells at the molecular level. How can this bile acid affect the heart in such a dramatic way?”

Once that occurs, the team hopes to work with cardiologists to quickly move the research into clinical trials involving chemotherapy and heart transplant patients.

“If cardiac fibrosis can be stopped, then that could substantially improve the outcome for people at risk,” says Agellon. “This would be a significant advance in the fight against heart disease.”

The Canadian Institutes of Health Research funded the study, which appears in PLOS ONE.

Source: McGill University