Researchers from the Leviev Cardiothoracic Vascular Center at Tel Aviv University (TAU) and Sheba Medical Center have discovered a mechanism responsible for the increased risk of developing cancer in patients with heart disease. It is a small extracellular bubble, or vesicle (sEV), secreted by the heart. The diseased heart releases it into the bloodstream to heal itself, promoting the growth of cancer cells throughout the body.

Research results will be published in a magazine Circulation.

The researchers estimate that this discovery could improve treatments for heart disease and lead clinicians to consider the increased risk of cancer.

The research was carried out under the direction of Professor Jonathan Reoa of the Taman Institute at the Neufeld Heart Institute and Sheva Leviev Center, Faculty of Medicine and Health Sciences, Tel Aviv University, and his student Tal Kohler, a medical and research student. Ta. Tel Aviv University School of Medicine.

Professor Kohler said: “In 2013, Israeli cardiologist Tal Hassin first showed that there is a link between heart failure and cancer. Patients with heart disease have a higher risk of developing cancer; It is already the leading cause of death, ranking first in the United States and second in Israel, meaning many people are at risk.

“Our research reveals that diseased hearts secrete cancer-promoting factors, which we identify as small extracellular vesicles (EVs), which are wrapped in simple membranes. All cells secrete these vesicles, but when the heart is damaged, these vesicles are released.” Factors associated with inflammation, healing, growth, new blood vessel formation, and changes in the immune system are released. Contains large amounts.

“These vesicles travel through the circulatory system and eventually reach tumors or precancerous tissue,” Caller added. “Following 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, damage Once released from the infected heart, these vesicles travel through the body’s circulatory system and ultimately target cancerous growths.”

Professor Leor said: “Many theories have been proposed to explain the increased risk of cancer in patients with heart disease. They begin with common risk factors such as smoking, diabetes and obesity, and they range from single proteins or molecules to “This is the first time a diseased heart secretes sEVs containing thousands of different growth factors. These bubbles directly promote the growth of certain tumors and also regulate the immune system.” and make the body more vulnerable to tumor growth.”

To test their hypothesis, the 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.

Professor Leor said: “Systemically inhibiting sEV formation reduces cancer development, but causes collateral damage in the process. That’s why we tried a different strategy. “The reason is to treat the patient’s heart and reduce damage to the heart tissue.” Therefore, fewer sEVs are secreted. ”

“We used spironolactone, which is an old and well-known effective drug used to treat heart failure. When we treated animals with spironolactone at the very early stages of the disease, we found that We found that there was a 30% reduction in sEVs secreted by cancerous tumors, and a 30% reduction in secretion in cancerous tumors. “Tumors grew more slowly.” This shows that we can intervene in heart disease in ways that reduce

Regarding the clinical implications of this study, Dr. Kohler said, “Existing cardiac treatments may need to be adjusted to also take into account cancer risk. Additionally, among cardiac patients, It is also possible to find biomarkers that indicate “Not all patients are at high risk, which increases the risk of cancer. This is basic research, and there is still a lot of research needed to understand the relationship between the two.”

“Thanks to public donations and earmarked funds, the Israel Cancer Society’s research committee reviews and selects dozens of studies each year,” said Moshe Barheim, CEO of the Israel Cancer Society. “We fund researchers and doctors in 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 results. We have shown that heart disease secretes extracellular bubbles, which increases the risk of cancer. We hope that our new research will yield results that will allow for immediate application in Israel and around the world in order to provide precise treatment to patients. ”