Heart attacks are responsible for 80% of deaths caused by heart disease, which is the leading cause of death worldwide. When someone has a heart attack, their heart tissue gets damaged because their cells don't get enough oxygen due to blockage in the blood vessels. To prevent death, it's crucial to restore blood flow and repair the damaged tissue as quickly as possible. Right now, the available options include surgery or medications

Heart diseases accounted for 28.1% of deaths in India​​

In India, heart diseases accounted for 28.1% of deaths in 2016, according to a report from the Indian Council of Medical Research. This report compared the data with 1990 when the figure was 15.2%.

Recently, researchers in China discovered that vesicles, which are small sacs released by stem cells treated with NMN (N-Vs), may help reduce heart damage and dysfunction after a heart attack. 

NMN Improves Heart Function

In their study using rats, they found that injecting N-Vs improved heart function, increased blood vessel formation, and reduced tissue damage. These findings suggest that stem cell-derived vesicles, especially when conditioned with NMN, could be effective in reducing heart damage caused by heart attacks.

Scientists have found that stem cells release extracellular vesicles, which are membrane-bound sacs filled with potentially therapeutic substances. These vesicles possess healing properties similar to stem cells but have certain advantages, such as avoiding rejection by the immune system and not inducing tumor growth. The content of these vesicles can change depending on various factors, which affects their biological effects.

In the study conducted by Pu and colleagues, they induced heart tissue damage in rats by blocking their coronary arteries, simulating a heart attack. They then injected the rats with untreated stem cell vesicles or NMN-treated stem cell vesicles at the damaged tissue border. After four weeks, they observed that untreated vesicles improved the fraction of blood pumped by the heart, known as the left ventricular ejection fraction. Additionally, N-Vs further increased the ejection fraction, indicating enhanced repair of heart function.

The efficiency of the heart's pumping action relies on optimal blood flow through blood vessels. The researchers discovered that untreated stem cell vesicles increased the density of small arteries and capillaries in the heart tissue of rats after a heart attack. 

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N-Vs increase artery and capillary density

Furthermore, N-Vs caused even more increases in the artery and capillary density. These findings demonstrate that NMN enhances blood vessel formation mediated by stem cell vesicles, leading to improved blood flow.

The formation of new blood vessels helps reduce tissue scarring (fibrosis) and cell death in the heart tissue damaged by a heart attack. The researchers observed that fibrosis decreased when untreated stem cell vesicles were used, and it decreased further with N-Vs. Moreover, programmed cell death (apoptosis) was reduced by regular vesicle injections and further reduced with N-V exposure. These findings indicate that NMN enhances cardiac tissue repair mediated by stem cell vesicles.

Stem cells have been used to treat various diseases, including neurological and respiratory conditions, fracture healing, and cardiovascular diseases. 

As more evidence suggests that stem cell vesicles have similar effects and advantages, there might be a shift in research towards cell-free therapy, which refers to using stem cell therapy without the actual stem cells. In fact, cell-free stem cell vesicles have already shown positive effects in alleviating arthritis and age-related effects in rodents.

Pu and colleagues take cell-free therapy a step further by showing that NMN, an NAD+ booster, can enhance the therapeutic effects of stem cell-derived vesicles. Previous studies have demonstrated that NMN can rejuvenate stem cells, which may explain its enhancement effects. If cell-free therapy proves to be successful, it's possible that NAD+ boosters or other compounds that rejuvenate stem cells and their vesicles could improve the effectiveness of this therapy.