Help for the Heart

A new drug treatment for cardiology patients? The answer may lie in bacteria.

A medical genius:
Zbigniew Religa

Despite receiving the new drug plasmid, from Prof. Zbigniew Religa Aug. 27, a 62-year-old heart patient died the morning of Sept. 2. "I am grateful to Prof. Religa anyway," said the son of the deceased. "All heart specialists had long given up rescuing my father and Religa was the only one to try. My father was informed about the risk involved. It turned out that his heart was too badly damaged and could not be helped, but the drug may be new hope for someone else with a less severe case."

The victim, recovering from a heart attack, suffered from advanced coronary disease and an extreme cardiac insufficiency. Although he qualified for surgery, the prognosis was poor. Religa then made the decision to administer plasmid, a drug which stimulates the generation of new blood vessels.

Plasmid had just successfully passed the animal testing phase and was not yet permitted for use on heart patients by the Ethics Commission. During surgery, Religa performed a by-pass, operated on the damaged valve, and administered plasmid directly to the cardiac muscle. The operation was successful but, according to doctors, the patient's heart was simply too weak.

Plasmids are small DNA-containing cytoplasmic elements that exist outside the chromosome that are able to self-replicate. Some plasmids called episomes can merge with the chromosome. They are found in organisms with no nucleus such as bacteria and blue-green algae, and also in some yeasts, as circular structures that contain the genes determining adaptation and sex.

In genetic engineering, plasmids are used as so-called vectors, enabling the introduction of an isolated DNA section into the recipient cell's chromosome. This property was key in the heart surgery performed by Religa. The plasmid injected into the heart muscle is responsible for stimulating blood vessel regeneration.

Religa was born in 1938 in Miedniewice, in Mazovia province. A heart specialist, educated at the Medical Academy in Warsaw, he has been director of the Institute of Cardiology in Anin near the capital since this March. For many years, Religa headed the cardiosurgical clinic in Zabrze, where he performed the first successful heart transplant in Poland Nov. 5, 1985. One year later, he was the first in Poland to use the artificial heart ventricle and heart. In 1988, Religa established the heart valve bank and has also created a biological valve model.

In 1992, together with a group of businesspeople and scientists, Religa established the Heart Surgery Development Foundation, where he leads work on the artificial heart implant construction program and a project to design a new heart valve model made from animal tissue. The foundation organizes well-known fund-raisers during which Heart Oscars are presented to both individuals and institutions that finance research. Religa, often called a genius and a showman, is able to convince others to participate in seemingly unfeasible projects. The creator of the Polish Transplantological Association and the Association of Heart Transplant Surgery Patients, Religa was also a senator and adviser to the Polish president.

Iwona A. Czerwińska

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