Asking the Expert: Frank Secreto PhD

My name is Gabrielle Wanek and I’m an intern here at Mayo’s Todd and Karen Wanek Program for Hypoplastic Left Heart Syndrome. I had the opportunity to interview Dr. Frank Secreto, one of the team members within the research program.

Gabrielle: Thanks for taking the time to chat with me! I’m going to ask a few basic questions to start. How long have you been in the program and what are you studying?

Frank: I have been here for over five years and I study induced pluripotent stem cells (iPSC).

Gabrielle: Can you give us the definition of induced pluripotent stem cells. Where do you get those?

Frank: Induced pluripotent stem cells are cells that have been changed to become something that they wouldn’t normally be. These are stem cells that have the ability to produce, theoretically, any cell in the body. We are interested in having these cells turn into cardiomyocytes which are heart muscle cells.

In our case, we start with a fibroblast cell – a cell that comes from one of your layers of skin. Using a process developed in Japan by the Yamanaka lab, we change these fibroblast cells into stem cells. From there, we push them into the type of cell we want – a cardiomyocyte.

Gabrielle: Cardiomyocytes...are those are cells that are for the heart or in the heart?

Frank: When I say cardiomyocyte, I mean a mature heart muscle cell – it is a cell that beats just like your heart does. We have gotten pretty good at changing IPS cells into cardiomyocytes with recent technological advances.

My first task in this lab was to come up with a test to assess the quality of the IPS cells. That is what we worked on for the first three years in the lab. For the last two years, we have focused on product development for the cardiomyocytes that we are making from the iPSC. Our goal is to initiate a third clinical trial for the program.

Right now we have two clinical trials: a cord blood clinical trial and the bone marrow stromal cell clinical trial. The cord blood trial is only open to people who had their cord blood collected when they were babies, while the bone marrow trial is open to more people. Older people can be a candidate for that because they could be a bone marrow donor. Neither of these clinical trials involves cells that can become cardiomyocytes. Instead, the cord blood and the bone marrow potentially could facilitate your own heart's regenerative capacity or your heart's ability to heal itself.

We can do a lot with cardiomyocytes.  They beat and we can speed them up or slow them down. If we get this third clinical trial, we could theoretically take the cardiomyocytes that we produce from the IPS cells, put them into the heart and have them participate in strengthening the heart itself, specifically the right ventricle, which is the part of the heart doing all the work in people with HLHS.

Gabrielle: So these cells would be autologous?

Frank: To start, autologous means that the cardiomyocytes are made from the patient’s own cells. This is in contrast to allogeneic, which means that they were made from someone other than the patient. For HLHS patients, we would use autologous cardiomyocytes. There are only two IPS trials going on right now and they both are in Japan.

Gabrielle: What does this mean for the future for patients with HLHS?

Frank: At this point, we don’t have enough data to tell you specifically what kind of impact this will have on HLHS patients. I can say that we are going to learn a lot in the next year and I can tell you for sure that we have two clinical trials going on that are impacting patients with HLHS. We have a third one that we are going to learn a lot from and we have a lot of hope it will be as impactful as our first two clinical trials.

The Todd and Karen Wanek Family Program for Hypoplastic Left Heart Syndrome (HLHS) is a collaborative network of specialists bonded by the vision of finding solutions for individuals affected by congenital heart defects including HLHS. The specialized team is addressing the various aspects of these defects by using research and clinical strategies ranging from basic science to diagnostic imaging to regenerative therapies. Email the program at HLHS@mayo.edu to learn more.