About

First Name
Stephen

Last Name
Rowley

Groups

Member not yet following any Groups.

Posts (16)

Wed, Dec 5 8:57am · Discussion: Autologous vs. Allogeneic in HLHS

heart

My name is Stephen Rowley and I work within the Todd and Karen Wanek Family Program for HLHS. I sat down with Brooks Edwards, MD to discuss the difference between autologous and allogeneic cells and what it means for those with HLHS. Dr. Edwards is a cardiologist who has been working in heart transplant for 30 years. For 8 years he was the director of Mayo Clinic’s transplant center which oversees heart, lung, liver, kidney, pancreas, bone marrow, face, and hand transplant. He currently works at Mayo Clinic as a transplant cardiologist.

 

Stephen: Currently our lab has been focused on our umbilical cord blood clinical trial. There has been much talk about our “autologous” product, versus an “allogeneic” product. Can you define those terms for me?

Brooks: Sure. With our study we collect umbilical cord blood in order to deliver stem cells back to the same patient who provided the stem cells. Autologous means those cells came from the same person. If we were doing an allogeneic study, it would mean those cells came from a different person than the one that will receive the cells. Most blood transfusions are allogeneic.

 

Stephen: So why are we so focused on providing an autologous product?

Brooks: Ultimately we are using an autologous product because it decreases the risk for potential antibody formation that could  limit a patients future  eligibility for a transplant. But let’s pause and define a few things to better answer that question.

We’ll start with the human leukocyte antigen – HLA. It is a protein that resides on all cells and helps our immune system distinguish our own cells from foreign cells. When you have cells in your body that match your HLA type, your immune system recognizes it as self. When you have cells that do not match your HLA type, it potentially sets off a cascade of reactions to rid your body of the non-self cell.

Our immune system, once exposed to something potentially unfriendly (ex. a bacteria or virus or even a foreign blood cell), will produce antibodies so that we can better defend ourselves in the future. An antibody is a protein that helps our immune system recognize foreign particles in our body. We produce antibodies for HLA proteins in the same way we do for the common cold. These are called anti-HLA antibodies.

 

Stephen: How would we get anti-HLA antibodies?

Brooks: The most common way is through blood transfusions. Those who have had multiple blood transfusions are at a higher risk to develop some anti-HLA antibodies. This is called “allosensitization” – developing antibodies to non-self.

 

Stephen: Okay, so what does HLA have to do with transplant?

Brooks: We have to be very careful about matching appropriate donor organs for the most appropriate recipients. There are about 200 types of HLA proteins in humans, but some are more common than others. If a patient has a high level of anti-HLA antibodies matching the HLA type of the organ donor, we likely won’t transplant that organ due to a higher risk of rejection.

Low-levels of antibodies are less of an issue than high levels, and we’re still learning about thresholds for risk on these levels.

 

Stephen: Rejection. What do you mean by that?

Brooks: The immune system is activated to reject the organ. Your body treats the organ like it would the common cold – white cells invade the organ, antibodies get made, and the donor organ can be seriously injured. This is something we want to avoid.

 

Stephen: Okay. I think we are ready to take on that earlier question. What makes autologous the better option for patients in our clinical trial?

Brooks: There are two reasons. One is in terms of long-term risk. With an autologous product, you aren’t building anti-HLA antibodies because you are not introducing the body to foreign tissue. And in terms of more immediate impact, your body will identify allogeneic cells as foreign and there will be an upfront immune reaction that you avoid completely with an autologous product.

 

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.

Wed, Oct 10 8:47am · Asking the Expert: Frank Secreto PhD in HLHS

 

frank

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.

Wed, Oct 3 9:58am · Asking the Expert: Susana Cantero Peral MD, PhD in HLHS

regenerators

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 Susana Cantero Peral, the umbilical cord blood expert in the program to learn more about the work being done here.

 

Gabrielle: How long have you been in the program?

Susana: I’ve been with the program since 2011. The program had just started so it has been seven years already.

 

Gabrielle: What exactly do you study?

 

Susana: I focus on umbilical cord blood. I study how to process and store cells for future use and the cord blood’s composition. For example, I study what types of cells we have, which types of cells that we can use for our program, and the mechanisms of these cells. I explore why certain cells can be used for our clinical trials and look to better understand their biological activity.

 

Gabrielle: How do you collect the cord blood?

 

Susana: This is actually a very straight forward process. When the baby is born, and the baby is with mom, we clamp the umbilical cord and cut it. We then collect the cord blood while the placenta is still in utero. We sterilize the surface of the cord tissue, find the vein and we stick it with a needle that is attached to a bag. We are able to collect whatever is in the vein that way. Other people collect the cord blood while the placenta is no longer in utero.

 

Gabrielle: What do you do with the cord blood and how do you store it?

 

Susana: Once we collect the cord blood, we process it. Processing means separating the cells that we want for the trial and getting rid of the cells that we don’t need. Cord blood is composed of red cells, white cells, platelets and plasma. Those are the main components of the blood. We want to keep those monocytes and lymphocytes because we know that the stem cells are in that population. We don’t need root cells, platelets and we don’t need granulocytes. Once the cells are processed then we store them in nitrogen for further use. You freeze them and you can keep them like that for years. When you thaw them you can use them anytime. So we purify the blood and keep the cells that are important for the clinical trial.

 

Gabrielle: What about if you collect cord blood from somewhere else. Can you use that?

 

Susana: Unfortunately, because of the way that we process the cord blood, it has to be collected through our program.  We also store our differently in small vials, because we keep the cells in a specific concentration for our clinical trials.

 

For anyone interested in learning more about umbilical cord blood collection, email the program at HLHS@mayo.edu.

 

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.

Wed, Sep 26 9:42am · Asking the Expert: Jeanne Theis PhD in HLHS

jeanne

My name is Gabrielle Wanek and I’m an intern here at Mayo Clinic’s Todd and Karen Wanek Program for Hypoplastic Left Heart Syndrome. I had the opportunity to interview Jeanne Theis, one of the team members within the research program, to learn more about the work being done here.

 

Gabrielle: Thanks for taking the time to chat with me! So, Jeanne, can you please explain what you do?

Jeanne: I study the DNA that comes from humans. I’ve been studying the genetics of cardiovascular disease for the last fifteen years or so. I’ve studied the genetics of cardiomyopathy, different arrhythmias, and even spontaneous coronary artery dissection but right now I am 100% dedicated to studying HLHS. I’ve been working with Dr. Tim Olson for the last ten years. Dr. Olson is the director of the Cardiovascular Genetics lab here at Mayo Clinic.

Gabrielle: What exactly are you looking for in the DNA?

Jeanne: There are three billion letters that make up our DNA sequence. Within those three billion letters, there are about three million that are unique to each person. Those three million are variations that determine hair color, eye color, skin color, height, etc. Half of those come from mom, half come from dad and each individual has some changes that are unique to them. We are interested in looking at all of these changes to identify those that are associated with HLHS. We have a family centric approach, because we also sequence mom and dad to see how the genes are passed along. We look at those changes and we start to explore how common they are and whether there could be a link to HLHS.

Gabrielle: How long does it take to sequence DNA from the participants?

Jeanne: Overall it takes a couple weeks to sequence the DNA fully. The first thing that we do when we get a blood or saliva sample is extract the DNA and ensure we have enough available for genetic sequencing.  If we have the right amount, it is then put on the sequencer and the DNA sits on it for a week where it’s constantly having data collected.

Gabrielle: What do you enjoy most about your job?

Jeanne: I love the people who I work with, not just those who work in our genetics core but with everyone in the program. Our dynamic team is made up of a group of brilliant people which includes physicians, geneticists,  stem cell biologists,  bioinformaticians and many additional areas of expertise. What’s refreshing to me is that it’s a very collaborative environment. Here in this program, it’s nice knowing that you can be vulnerable, admitting something that you just don’t know. It’s just being in the midst of amazing people and being able to interact with each other without much tension.

My second favorite thing about this job is teaching. I’ve been really lucky within the program to be able to teach not only at lab meetings, but also giving genetics 101 talks to people that want to understand more. I had a young girl come up to me after one of these talks and say that she understood everything that I said which was a gratifying moment for me. I feel really lucky that I have those opportunities.

Gabrielle: What do we know about the genetics of HLHS?

Jeanne: In a nutshell, there is no single common gene. With HLHS there’s no single change that’s going to be accountable. I think there are multiple changes that come together to cause it. We have sequenced the entire genome for over 150 participants with HLHS to help us further our understanding of key genetic changes related to HLHS. It’s very complicated, but we are getting a lot smarter. We have a lot of data that needs to be looked at and tested with the fruit flies, and we continue to learn more with each additional sequence.

For anyone interested in learning more about HLHS and the genetics research, email our program at HLHS@mayo.edu.

Thu, Sep 13 8:36am · Thanks for attending Feel the Beat 2018! in HLHS

Hi Michelle – we will be sharing photos from the event, but it will take a few weeks to a month to get them out.

Wed, Sep 12 11:59am · Thanks for attending Feel the Beat 2018! in HLHS

318

Thank you so much for attending Feel the Beat 2018! We had a total of 176 guests at the event, many of whom traveled far and wide to join us.

This year’s theme was evolution at Feel the Beat. The event included a patient/parent panel with speakers Gabrielle Wanek, Michelle Waletzko, and Elizabeth Raszka. We also had physicians speak on how caring for HLHS patients has evolved with presentations from Dr. Tim Nelson from Mayo Clinic, Dr. Wernovsky from Children’s National in Washington D.C., and Dr. James Tweddell from Cincinnati Children’s Hospital. You can find videos of this panel and of these presentations on our Facebook.

It was an exciting day and we are all happy you could be a part of it!

Stay tuned for the date for next year’s Feel the Beat!

The Todd and Karen Wanek Family Program for Hypoplastic Left Heart Syndrome (HLHS) is a collaborative network of specialists bonded by the vision of delaying or preventing heart failure 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.

Wed, Aug 29 2:42pm · This year's agenda for Feel the Beat! in HLHS

hlhsemblem

Feel the Beat agenda – September 8, 2018 – Gonda building

8:00 am to 9:00 am – Registration and breakfast

 

9:00 am to 9:25 am – Welcome message, Dr. Timothy Nelson, Geffen Auditorium

 

9:25 am to 9:55 am – Dr. James Tweddell, Geffen Auditorium

 

10:00 am to 10:30 am – Dr. Gil Wernovsky, Geffen Auditorium

 

10:35 am to 10:45 am – break

 

10:45 am – 11:45 am – Patient/parent panel, Geffen Auditorium (Moderator: Dr. Timothy Nelson)

  • Michelle Waletzko
  • Gabrielle Wanek
  • Elizabeth Raszka

11:45 am – 1:30 pm – Lunch and science fair, Nathan Landow Atrium

  • Science Fair – “Evolution” How the program has evolved, lessons learned from studies/research participation

11:45 pm – 3:00 pm – Afternoon activity benefitting the Ronald McDonald House in Rochester, MN

  • Blanket tying
  • Card creating

Registration is now live for the sixth annual Feel the Beat event on September 8 in Rochester, Minnesota. We look forward to seeing you there!

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.

Wed, Aug 22 9:11am · Gabrielle Wanek and Michelle Waletzko Speaking at Feel the Beat 2018! in HLHS

ftb_guest_speakers

Gabrielle Wanek
Gabrielle is a twenty-three-year-old with hypoplastic left heart syndrome. She was born in Genolier, Switzerland and has had multiple surgeries including the Norwood procedure, directional Glenn procedure, the Fontan procedure, and three catheter procedures. She grew up in a small town in western Wisconsin with her parents and her older brother.

Gabrielle lives in North Carolina where she is currently attending High Point University. She will graduate in December of 2018 with a degree in communication and a focus in video game design. She worked as a resident assistant in her dorm on campus this past year.

 

In her free time, she loves to write, ski, and play video games. This past summer, Gabrielle interned at Mayo Clinic’s Todd and Karen Wanek Family Program for HLHS and wrote a series of blog posts about living with HLHS.

She believes that it’s important to understand what those who have a congenital heart disease have gone through. Our past proves the trials that we have been able to overcome. HLHS doesn’t define who she is but it most certainly has shaped some of it, however, it has never stopped her from doing the things that she has tried to do. Understanding the past allows you to prepare for the future.

 

Michelle Waletzko
Michelle resides in Kasson MN with husband Andy, daughter Teagan (5) and heart warrior Isaac, almost 3 years old.  Isaac had his first heart surgery before he was born, at 21 weeks gestation at Boston Children’s Hospital.  Doctors there performed a fetal aortic balloon angioplasty, attempting to prevent Isaac from developing HLHS; however, he was still born with HLHS and near intact atrial septum at 35 weeks.

Michelle found it difficult to find local support dealing with Isaac’s HLHS diagnosis. This drove her to use social media to reach out and lend support to other heart moms and families.  Today Michelle has made connections with heart families locally and nationwide. Michelle makes time to actively be a part of the heart community, sharing her family’s story and helping other families get through the many unique circumstances only heart moms have been through.

Michelle, along with an abundance of family and friends, call themselves Isaac Williams’s Warriors. Together they have raised funds to support CHD and HLHS research. Through Lasting Imprint, they have provided hospital bags for families.  For the past 2 years, they have participated in toy drives for the cardiac ICU “toy closet” at St. Mary’s Hospital, Mayo Clinic and is available for heart families.  Recently, Isaac William’s Warriors have been able to provide 2 hospital wagons for the cardiac ICU as well.

Looking forward to seeing you on September 8!

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.