Inhalation of a peptide in the fight against heart failure

Heart failure affects millions of people worldwide and the search is still on for a drug that can help patients in the long term. A new study by cardiologist PD Dr Alessio Alogna (Deutsches Herzzentrum der Charité Berlin and DZHK partner site Berlin) has provided the first data on peptide transport from the lungs to the heart using nano-in-micro technology (LungToHeartNiM technology). The study was recently published in the Journal of the American College of Cardiology (JACC).

Normally, calcium flows into the heart muscle cells via specific L-type calcium channels, which are transported from the cytoplasm to the cell membrane of the heart muscle cells, and ensures that the heart beats sufficiently. However, this transport is impaired in people with heart failure. The researchers led by Alessio Alogna wanted to understand this in more detail: In their study, they investigated the tolerability and efficacy of an inhalable drug designed to influence the disrupted transport of the L-type calcium channel in the heart muscle cells.

Using an established pig model that closely mimics human heart failure with reduced ejection fraction, the team was able to gather and scientifically substantiate some important findings: The LungToHeartNiM technology used for daily inhalation of the therapeutic peptide is effective. The study also shows improved contractility of the left ventricle and good tolerability of the therapy.

The whole thing is to be tested clinically in the future. In the long term, patients with severe heart failure could live longer with their disease by inhaling the drug spray - if successful, this could also reduce the demand for donor hearts, as the medication combats an important cause of the disease and allows the heart to recover.

"The general tolerability and the positive effects could fundamentally change the treatment of patients with heart failure," said Alessio Alogna. "We have demonstrated an innovative and non-invasive approach to deliver a therapeutic peptide directly to the myocardial cells of the diseased heart. Our approach not only simplifies the treatment process, but also significantly reduces discomfort and potential side effects for patients."

The publication by PD Dr Alessio Alogna on nano-in-microtechnology from the lungs to the heart was selected as "DZHK Paper of the Month" in February 2024.

The study was supported by the European Union through the HORIZON 2020 consortium Cupido, led by Dr Daniele Catalucci from the Humanitas University Hospital - National Research Council (CNR) in Milan. Several centres and companies were involved in the study.

Original publication: Lung-to-Heart Nano-in-Micro Peptide Promotes Cardiac Recovery in a Pig Model of Chronic Heart Failure. Alogna, A., Berboth, L., Faragli, A. et al. J Am Coll Cardiol. 2024 Jan 2;83(1):47-59.

Source: DZHK