Reverse Remodeling

When the heart is put under certain stresses, it adjusts its mass and chamber wall thickness to compensate for the stress.  For instance, when someone suffers a heart attack, the area of the heart tissue that has been deprived of oxygen (due to vessel blockage, etc.) dies.  

The dead area then undergoes 'remodeling', where the normal heart cells are replaced with scar tissue, which is not the normal heart muscle.  This area thins out and is unable to contract properly, which often leads to heart failure.  In the meantime, in the shrunken area, the blood vessels which once fed the dead tissue disappear, and the blood flow to that heart tissue is then reduced.

This is the heart's way of fixing the problem, since the heart has no other way to repair or replace this damaged tissue. As scientists, we are trying to reprogram this repair, to result in 'reverse remodeling'-one such therapy that is being researched is stem cell therapy.  The patients own bone marrow stem cells can be taken out and injected into the patient's dead heart tissue.  These stem cells can then change into heart cells, or even become part of new blood vessels to the region.


Reverse remodeling with stem cells is a very real option that is being pursued in all kinds of studies to work out any bugs, but patients in trials have already shown promising results.


When we get fat, a kind of remodeling also occurs-maybe you have heard about the 'hydrated' fat on this season of The Biggest Loser...


As we add to our fat depots, the body must feed these growing fat cells by creating a network of blood vessels into the area.

When you see the dead adipocyte (fat cell) in the obese adipose tissue (AT), this is NOT a good thing.  See the fat cell gets so full that is explodes-and it becomes an 'angry fat cell'.  This dead angry fat cell serves to recruit in more macrophages (immune cells) to clean up the mess...  These immune cells then release inflammatory chemicals which regulate how the surrounding fat functions-stimulating them to release their own proinflammatory hormones.
These angry fat chemicals then affect a WIDE array of tissues (FFA=free fatty acids)...

This remodeling turns this fat tissue into endocrine organs-organs which release chemicals (like hormones) that affect the function and survival of other organs/tissues.  So the fat chemicals affect blood vessel functions (think atherosclerosis), immune cell inflammation (think autoimmune diseases), fatty liver which can lead to cirrhosis, insulin resistance of the skeletal and heart muscle (leading to the remodeling of the heart), beta cells in the pancreas die=prediabetes-this increasing metabolic syndrome and change in blood vessels lead to a 3 times greater risk for Alzheimers.


Who knew one little angry fat cell could be so powerful?  Truth is, as obese people, we have millions of angry fat cells.  


The good news?  Unlike the heart, reverse remodeling is VERY possible in the fat tissue.  How?  Lose weight.  Even a 10 pound loss makes a difference in circulating angry fat chemicals.  There is no research needed on this therapy-we have the tools within ourselves.  Diet and exercise and lose the weight already-because you don't want to make the fat angry.  You won't like them when they're angry.  


And neither will your organs.