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Stirring the Pot of Hope with Stem Cells

I am reposting this because knowledge is power.

The European Medicines Association (EMA- Europe's equivalent of US's FDA) approved a stem cell treatment for Crohns disease last year. Please see https://www.pharmaceutical-technology.com/news/eu-allogenic-crohns-alofisel/

Regenerative medicine is stirring hope in the medical communities for both doctors and patients alike. Unlike conventional medicine which, sometimes may simply mask symptoms, regenerative medicine emphasizes repair of damaged tissues and cells, thus eliminating the root cause of pain and simultaneously improving a patient’s quality of life. Regenerative medicine, using cell-based therapies to treat disease, encompasses many modalities but stem cells have taken center stage in the regenerative medicine field, and the limelight is very bright.

Stem cells are specialized cells that “have the remarkable potential to develop into many different cell types in the body during early life and growth. Also, in many tissues, they serve as a sort of internal repair system.” [i] . Stem cells have the innate ability to divide and multiply as well as the ability to become other types of tissue such as cartilage, muscle, and even nerve cells. All stem cells “have three general properties; the ability to divide and renew for long periods; they are unspecialized; they can give rise to specialized cell types.”[ii]

Stem cells are generally divided into two distinct categories: embryonic and adult stem cells. Embryonic cells are obtained from a pre-implantation embryo and have ethical and legal considerations, so they are not used in regenerative medicine. Adult stem cells also called mesenchymal stem cells (MSCs) “are stromal cells that can self-renew and also exhibit multi-lineage differentiation. MSCs can be isolated from a variety of tissues, such as umbilical cord...bone marrow, adipose tissue, etc.”[iii]

The MSCs ability to differentiate into many different types of tissues (multipotency) is what makes regenerative medicine therapy with stem cells so intriguing. Although MSCs have an enormous capacity to maintain their self-renewal capacities while keeping their ability to remain multipotent, they must also not elicit an immune response from the host in which they are being transplanted. Luckily, MSCs from umbilical cord blood do not express specific cytokines (chemical messengers from cells) that elicit an immune response making them ideal candidates for regenerative medicine modalities. Besides not activating an immune response in the recipient, MSCs are able to travel to sites of injury, quell inflammation, initiate regenerative mechanisms, and decrease pain.

Luckily, scientists have developed an understanding of the critical biological characteristics of MSCs contributing to their therapeutic effects, allowing human-involved research to expand safely. The following properties are considered essential for the clinical application of stem cells: (1) the ability to home to sites of inflammation following tissue injury when injected intravenously (2) the ability to differentiate into various cell types (3) the ability to secrete multiple bioactive molecules capable of stimulating recovery of injured cells and inhibiting inflammation (4) the lack of immunogenicity and the ability to perform immunomodulatory functions.[iv]

The first clinical trial using MSCs occurred in 1995 when 15 patients received autologous (derived from the receiving patients) stem cells grown in a lab. Since then, according to the public clinical trials database http://clinicaltrials.gov, nearly 2,000 clinical trials using stem cells have been completed around the globe. Currently, there are approximately 1,700 clinical trials around the world evaluating stem cells and their efficacy on subjects ranging from autism to chronic kidney disease to pulmonary fibrosis to Lupus and multiple sclerosis (MS).

Although more work is needed to employ stem cell therapies to the masses, research in reputable journals is showing promise. An article in January 15, 2019, Journal of the American Medical Association (JAMA), considered to be one of the top medical journals in the world, gives more hope to those suffering from MS. MS is an insidious disease and over time can lead to irreversible nerve damage with progressive disability for which there are no effective treatments. The randomized clinical trial results showed that treatment with stem cells compared to current disease-modifying therapy “resulted in prolonged time to disease progression.” For those suffering this horribly debilitating and potentially fatal disease, this is excellent news. Stem cells may not be the magic bullet everyone in medicine is hoping for, but they may offer hope to those suffering debilitating and incurable disease who have failed conventional treatments. As a healthcare provider, I believe patients have a right to, and should look into all potential options including those that are experimental. As a patient, it is your responsibility to perform your due diligence and research all available options thoroughly.

For more information on clinical trials with stem cells visit http://clinicaltrials.gov.

For more information on stem cell treatment options please email me directly at drrtfloyd@protonmail.com

REFERENCES:

[i] https://stemcells.nih.gov/info/basics/1.htm

[ii] ibid

[iii] Ding, D.C, Shyu, W,C & Lin, S.Z. (2011). Mesenchymal Stem Cells. Cell Transplantation, 20(1), 5-14.

[iv] Wang et al, Journal of Hematology & Oncology 2012, 5:19

 

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