• Previous research has shown that heart disease and cancer may be linked through common risk factors such as smoking, diabetes, and obesity. However, a newly published study reveals a potential link between extracellular bubbles released after a heart attack and an increased risk of developing cancer.

Researchers from the Leviev Cardiothoracic Vascular Center at Tel Aviv University (TAU) and Sheba Medical Center have discovered a mechanism: small extracellular bubbles, or vesicles (sEVs), that may be responsible for an increased risk of developing cancer in patients with heart disease. did. , a self-healing secretion from the diseased heart that is released into the bloodstream and promotes the growth of cancer cells throughout the body. The researchers estimate that this important discovery could improve treatments for heart disease and allow clinicians to take into account the increased risk of cancer. The study was funded by the Israel Cancer Society and the Israel Science Foundation.

The research was carried out under the guidance of Professor Jonathan Leor of the Neufeld Heart Institute, Faculty of Medicine and Health Sciences, Tel Aviv University and the Taman Institute of the Leviev Center in Sheba, and his student Tal Kohler, a medical and research student at Tel Aviv University. It was carried out in Aviv University School of Medicine.The study was published in an important medical journal Circulation.

Kohler explains: “In 2013, Israeli cardiologist Tal Hasin was the first to show that there is a link between heart failure and cancer. Patients with heart disease are at increased risk of developing cancer, and heart disease is already a leading cause of death. It ranks first in the United States and second in Israel, which means more people are at risk for cancer. In our study , it was revealed that diseased hearts secrete cancer-promoting factors, which were identified as small extracellular vesicles (sEVs). These are tiny particles wrapped in a simple membrane. , secreted by all cells, but damage to the heart causes the release of large numbers of these vesicles, which contain factors associated with inflammation, healing, growth, new blood vessel formation, and changes in the immune system. . These vesicles travel through the circulatory system and eventually reach tumors or precancerous tissue.”

Caller added, “After myocardial damage and deterioration into heart failure, sEVs containing growth factors and small nucleic acid molecules that promote cell division are released. These sEVs contribute to the healing of damaged heart tissue. However, these vesicles released from the damaged heart travel within the body’s circulatory system and ultimately target cancerous growths.”

Professor Jonathan Leor: “Many theories have been proposed to explain the increased risk of cancer in heart patients. Or ended up with molecules. We showed for the first time that diseased hearts secrete sEVs containing thousands of different growth factors. These bubbles directly promote the growth of specific tumors and It modulates the immune system and makes the body more vulnerable to tumor growth.”

To test their hypothesis, TAU researchers inhibited sEV formation in an animal model of heart disease and found that cancer risk was reduced along with inhibition of vesicle production. However, this is not a viable treatment option as inhibiting vesicle production results in severe undesirable side effects.

Prof. Leor: “Systemically inhibiting sEV formation reduces cancer incidence, but it also causes collateral damage in the process. That’s why we tried a different strategy. The idea was to treat the patient’s heart to reduce damage to the heart tissue and secrete fewer sEVs. We used spironolactone, an ancient and effective drug used to treat heart failure. It is well known as a drug. We found that when animals were treated with spironolactone at a very early stage of the disease, the heart secreted sEVs decreased by 30% and cancerous tumors grew more slowly. OK. Our experiments show that we can intervene in heart disease in a way that reduces the risk of cancer in heart patients.”

Regarding the clinical implications of this study, Kohler is cautious: “Existing treatments for the heart may need to be adjusted so that they also take into account the risk of cancer. Additionally, not all patients are at high risk for cancer, so there is a risk of cancer among heart patients. It is also possible to find biomarkers that indicate an increased risk of. This is basic research and there is still a lot of work to be done to understand the relationship between the two.”

Moshe Barheim, CEO of the Israel Cancer Society, added: “Thanks to public donations and earmarked funds, the Israel Cancer Society Research Committee reviews and selects dozens of studies each year and provides funding to researchers and physicians at research and treatment centers around the world. Israel. These studies have led to the development of new methods for the diagnosis, treatment, and rehabilitation of cancer patients. Research knows no territorial boundaries, so any research results here in Israel are global. We hope that this new study, which reveals that heart disease secretes extracellular gas bubbles and increases the risk of cancer, will be immediately applied in Israel and around the world to help accurately treat patients. hoping. ”

Link to article:

https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.123.066911