The genetic pacemaker is powered by light. Free Technical Library News

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Genetic pacemaker powered by light

16.07.2015

Although pacemakers save many lives - according to statistics, more than 3 million people worldwide carry such devices - their use is associated with certain inconveniences. A pacemaker, or an artificial pacemaker, helps to restore the normal frequency and periodicity of heart contractions - otherwise, rhythm disorders can lead to rather serious consequences for the whole organism, up to death. But in order for the pacemaker to work, its electrodes must be implanted in the heart, the wires from them must be connected to a pulse generator, which is implanted under the skin.

Over time, pacemakers became smaller, and it became possible to insert electrodes with wires into the heart using a catheter simply through the veins. However, no matter how small the stimulator is and no matter how thin its wires are, it still needs to change the batteries, which means an inevitable operation, albeit a small one. In addition, the wires with electrodes that reach the heart can wear out and need to be changed from time to time. On the other hand, due to the need to pull the wires, we cannot place the stimulator anywhere we want, and we cannot use many points for stimulation. The heart itself does not always "like" being stimulated by an external device. Finally, if we are talking about children, then it is not always possible for them to put an artificial pacemaker at all.

Udi Nussinovitch and Lior Gepstein of the Technion Israel Institute of Technology have come up with a kind of pacemaker model that has no wires, no electrodes, no batteries, and that literally works in the light. In fact, there is no stimulant in the form of an external device at all - the researchers introduced an optogenetic modification into the heart cells, which made it possible to control heart contractions. The general meaning of optogenetic methods is that a photosensitive protein gene is introduced into the cell - such a protein, having integrated into the cell membrane, opens ion channels in the membrane in response to a light pulse. And as we know, it is the redistribution of ions on both sides of the membrane that creates an electrochemical impulse. Optogenetics has found the widest use in neurobiology: by introducing a light-sensitive protein into a neuron, we can arbitrarily, using light signals, generate a signal in a chain of neurons.

But after all, the heart rhythm also depends on electrochemical impulses (recall that, although there are fibers of the autonomic nervous system in the heart, some special myocardial cells can themselves generate rhythmic signals, forming the so-called conduction system of the heart). And nothing prevents the introduction of an optogenetic mechanism in the heart.

The researchers did just that: with the help of a special "domesticated" virus, they introduced the algal light-sensitive protein ChR2 (channelrhodopsin-2), which reacts to blue light, into the ventricles of the hearts of rats. (Single-celled green algae, like Chlamydomonas, use this protein to find brighter places.) The authors write that they could tune the animals' heart rate with blue flashes. The virus allows you to deliver protein to various parts of the heart muscle, so you can control the heart with greater efficiency, because many cells from different places respond to an external signal at once.

To “turn on” the optoprotein, no electrodes are needed: blue light from the outside, although it penetrates living tissues rather poorly, can still reach the heart. But - only if we are talking about a rat. In a more or less large animal, not to mention a person, the heart lies deeper, so here you need to think about how long a light wave can reach it and, accordingly, what light-sensitive protein will be needed. The red and infrared regions of the spectrum could be suitable here, and if it comes to experiments with primates, these are the wavelengths that will be used.

It is worth noting, however, that there are other approaches to the creation of a wireless pacemaker. About a year ago, we wrote about the development of Stanford University employees who proposed to support the work of the pacemaker using an electromagnetic wave generator located just on the surface of the body. Another idea belongs to researchers from the University of Illinois at Urbana-Champaign - they were able to make the pacemaker work from the heart muscle itself, due to the energy of its contractions. But, of course, the optogenetic approach looks the most radical - there is no need to implant any device in the heart at all.

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