Panama City, Panama
The premiere orthopedic practice in the Raleigh-Durham area, Triangle Orthopedic Associates, is trying to see if cartilage in the knee, the torn meniscus specifically, can be repaired using stem cells. Developed by Osiris Therapeutics, a stem cell product called Chondrogen for the treatment of this common knee injury is being evaluated by Triangle Orthopedics as part of a clinical trial.
Thanks to a breakthrough stem cells treatments being offered in India, those individuals who have complete paralysis of the lower half of the body could potentially walk once again.
Many paraplegics have been able to return to normal life after being treated at the Lifeline Multi-Specialty Hospital (LMSH). The hospital has nearly perfected the treatment they use to give paraplegics that ability to walk.
The U.S. was among the technologically advanced countries that deemed the use of autologous bone marrow fluids containing stem cells as a futile treatment for paraplegics. But the research and development division of LMSH, The Lifeline Institute of Stem Cell Therapy and Research (LISTR), was able to achieve this very “impossibility” using the self generated stem cells.
The treatments provide a path away from embryonic stem cells and away from controversy.
It was not long ago that the lack of a cure for paralysis confined the man who once played “Superman” on the big screen to a wheelchair. Hollywood star Christopher Reeves supported the research while waiting and hoping during the last part of his life for a cure.
“Using the money provided by the late movie icon to improve the lot of paraplegics throughout the world, we have turned four ordinary people who faced a dismal future into supermen,” said J. S. Raj Kumar, the chairman of LMSH.
After losing the ability to be mobile as a result of rare medical disorders or due to accident, all four of these men had no hope.
But now, with no signs remaining of his debilitating condition, 25-year-old Akbar has made a full recovery. After being involved in a construction accident in Dubai last year, he was brought to LMSH on a stretcher while in a coma. His parents are now searching for a bride so that Akbar can be wed because his recovery has been so encouraging.
“We harvest between 100 and 200 ml of stem cells in fluid form from the afflicted patients themselves and inject them into their spinal cords carefully to bring about this ‘miracle’ that has been cleared by statutory health bodies not only in India, but also in all major premier medical institutions abroad including the US.”
“We have the highest global rate of success of 34 percent after sustained treatment to 50 select patients,” said Raj Kumar.
More remarkable results can be found when one studies the cases of Transverse Myelitis (a devastating inflammation of the spinal cord that can cause irreversible paralysis) sufferer Srinivas, who an aspiring accountant from Chennai, and also Prabhdeep, a musician from Punjab who was paralyzed following a motor accident. Both patients are 19-years-old.
“I had no feeling from the chest downwards after the mishap. Now I can walk with a little help,” said Singh, whose legs were encased in braces and moved with the assistance of attendants and a metal contrivance.”
In his lower abdomen, Srivnivas has now regained feeling. He has also regained bladder control.
The treatment has not been limited to only the young either despite Dr. Kumar’s preference to treat “quicker and better healing” younger patients. After falling on his back from a height of 11 feet about two months ago, 46-year-old A. R. K. Reddy opted for the treatment. He was rendered completely immobile after his lumbar spine was fractured in multiple places.
Today, after the stem cell treatment, the engineer who was employed in a multinational company, has regained sensation in the lower body as well as control over his bladder. He can now stand up and move using a walker.
Paraplegics aren’t the only patients who can benefit from stem cell treatment.
Stem cells can be a viable alternative for cardiac bypass surgeries and liver transplants. LISTR worked on developing stem cell treatments for these other conditions in conjunction with Japan’s Nichi Centre for Regenerative Medicine (NCRM).
“Stem cell therapy can cure disabled livers, rejuvenate tired hearts, and make the pancreas of chronic diabetes patients secrete insulin to reduce dependency on injections and pills for a lifetime,” said Raj Kumar.
The cost is another appealing aspect. With a success rate of below 15 percent and a cost of almost 20 times more, regular treatments like transplants are a waste considering only Rs.150,000 ($3,700 U.S. dollars) is needed for a stem cell treatment.
17 patients have shown marked improvement out of the 50 who are under intensive treatment. Another 100 are waiting in line to benefit from the remarkable stem cell treatments after being inspired by the recovery of so many other patients.
The debate over stem cell research is enough for people to think that the science is tinted
Within one month after being treated with adult stem cells in Cologne, Germany, Calvin who is a retired Fire Captain from New Jersey is reporting lower blood glucose levels and decreased insulin doses. Calvin traveled to Germany with peripheral artery disease and erectile dysfunction resulting from his type 2 diabetes.
Using small amounts of his bone marrow, Calvin was treated at the XCell-Center with adult stem cells derived from his own body. Via the femoral artery, a minimally invasive procedure was used to introduce the stem cells to Calvin’s pancreas directly. Stem cells were also introduced into the arteries that supply the penis and into his calves and thighs in order to alleviate the erectile dysfunction and peripheral artery disease that is common amongst complications associated with diabetes.
“Before scuba diving this past Sunday morning, I injected only 32% of my normal insulin dose. During the day, I ate normally – for a diabetic – without injecting any more insulin. That evening, I measured my blood sugar and I was astounded that it was only 126. A month ago, even with my full insulin doses, I never had readings below 170,” said Calvin.
Calvin is not new to the process, over the past two years his current conditions are in fact the third, fourth, and fifth conditions he has received stem cells for. He was featured in Business Week Magazine after a January 2005 stem cell infusion for coronary artery disease. Then, using minimally invasive surgery he was treated again for ischemic cardiomyopathy in September of the same year.
“Actually, what really got my attention this past weekend was that I also felt a regeneration of heart function
According to Singapore-based pediatric hematologist-Oncologist consultant Dr. Anselm Chi-wai Lee, stem cell transplant therapy has made the treatment of cancer affected children less complicated.
Dr. Anselm told a press conference over the weekend that “Children with leukemia or other cancers, as well as some severe inherited immunodeficiency diseases and blood disorders, may benefit from a transplant of hematopoietic stem cells commonly known as a bone marrow transplant. The term hematopoietic stem cell transplant acknowledges the fact that the stem cells that are necessary to regenerate blood and immune functions can now be obtained from peripheral or umbilical cord blood as well as from bone marrow.”
Claiming to be the first person who used a person
A new study has found that the regeneration of tissue is enhanced when stem cells from the muscles from female mice are used as opposed to male mice.
The development of stem cell treatments for many conditions and diseases could be affected by this new discovery.
After almost exclusively using stem cells from female mice without giving it a second thought, scientists who had been conducting numerous studies with the cells made the interesting connection. They decided to investigate if there was any disparity between male and female cells and designed an experiment based on this premise.
Capable of developing into any type of cell in the body, embryonic stem cells are versatile. But more limited in what they can become, muscle stem cells are more specialized and instead of coming from an embryo, they are derived from adult tissue.
According to the U.S. Centers for Disease Control and Prevention, out of 3,500 to 5,000 young boys in the United States, at least one is affected by Duchene muscular dystrophy. Using mice that had been engineered to have a similar disease, researchers injected stem cells from healthy mice into those that were sick.
In humans, the muscle’s cell structure collapses because the disease involves the deficiency of a crucial protein called dystrophin.
The early aging and loss of stem cell reservoirs in adult mice is dependent on the deletion of a gene important in embryo development. The discovery was made by researchers at the Abramson Family Cancer Research Institute of the University of Pennsylvania.
Specific varieties of cancer and other disorders in humans are consequences of protein mutations that transpire during DNA damage response. Critical for this response to damaged DNA is a gene called ATR. The inaugural issue of Cell Stem Cell has published the new findings.
“The reason we’re seeing the early signs of aging in these mice is that we’re exhausting their ability to renew tissues,” says Eric J. Brown, PhD, Assistant Professor of Cancer Biology. “We believe these findings may be helpful to the aging and oncology fields since premature aging syndromes and many cancers involve the loss of DNA repair genes.”
Within three to four months, the mice used in the study began to exhibit signs of osteoporosis, graying hair, and hair loss. These were obvious characteristics of premature aging. All the symptoms occurred when the researchers deleted ATR in the adult mice tissue.
A reservoir of specific adult stem cells exists in most tissues for the function of self-renewal. Since multiple divisions lead to natural breaks in DNA, in order to preserve the integrity of the DNA, these stem cells don’t divide as frequently as other cell types. However, to replenish tissue with new cells, they are capable of rapid division when necessary.
Initially, 10 to 20 percent of cells that escaped ATR deletion were able to reconstitute tissues in the engineered mice explained Brown. But overall, the majority of mouse cells without ATR had an overwhelming amount of DNA damage and could not contribute to tissue renewal.
“Think of aging as a slow loss of stem cells, a deterioration of pools of cells that reside in each tissue type,” says Brown. We accelerated the aging process by wiping out a large fraction of these cells prematurely, in one fell swoop. Essentially, these mice start their young adulthood with two strikes against them in terms of long-term tissue maintenance, and so, they subsequently age before their time.”
Brown, first author Yaroslava Ruzankina, and Amma Asare will be using the new knowledge of how stem cells, DNA repair, and the aging process interconnect in the mouse model to discover compounds that preserve stem cells and may, consequentially, suppress aging.
Observing bone-marrow-derived stem cells, separate groups of U.S. and British scientists have shown that premature aging is caused by DNA damage.
The practice of adult stem cell transplantations will be affected by the discovery.
Small pools of slowly dividing stem cells are something that long-lived multi-cellular organisms depend on to replenish lost tissue. With negligible mutations throughout life, it is imperative that the reserves are maintained and self-renewed.
Using a mouse strain that had trouble repairing DNA damage, Richard Cornall and colleagues at Oxford University studied the bone-marrow-derived stem cells taken from the mouse. The scientists determined that un-repaired DNA damage in stem cells can lead the way to an age-dependent decline in their numbers.
Determining that the blood-forming stem cells from the bone marrow of mice build up DNA damage with age was Stanford University
Researchers from the University of California, San Diego (UCSD) School of Medicine are reporting that six weeks after receiving grafts of human spinal stem cells (hSSCs), paralyzed rats regained almost normal ambulatory function. The animals were paralyzed due to loss of blood flow. The study has been published in the June 29, 2007 edition of Neuroscience. UC San Diego professor of anesthesiology Dr. Martin Marsala, M.D. led the study.
“We demonstrated that when damage has occurred due to a loss of blood flow to the spine’s neural cells, by grafting human neural stem cells directly into the spinal cord we can achieve a progressive recovery of motor function,” said Marsala.
“This could some day prove to be an effective treatment for patients suffering from the same kind of ischemia-induced paralysis.”
Marsala hopes to be prepared to carry out human clinical trials by next year. The current focus is on using animal models to establish effectiveness and safety of the human stem cell therapy.
For those individuals who undergo aortic cross-clamping, 20 to 40 percent of patients experience spinal cord ischemia as a consequence of the surgical procedure. It is a serious complication and causes paraplegia. During the procedure to correct a potentially lethal aneurysm, blood flow from the heart must be temporarily blocked with a clamp as the surgeon works on the aorta. Even though the spinal cord remains intact, loss of muscle control or irreparable rigidity and spasticity of the lower limbs can occur due to the lack of blood flow that results in the death of spinal inhibitory neurons which are specialized spinal cord neurons. After only 30 minutes, the neurons become susceptible to death.
“The important difference between spinal cord ischemia and spinal cord trauma, such as might occur in a diving or car accident, is that in the ischemia model, no mechanical damage has occurred to the spinal cord,” said Marsala.
“The spinal cord and brain motor centers are still partially connected, but there has been a selective loss of inhibitory neurons in the spinal cord. Since these cells are necessary for coordinated motor activity, our research aims to replace these lost neurons by grafting new spinal stem cells, which repopulates the pool of degenerated neurons.”
Human spinal stem cells were injected into nine rats 21 days after spinal cord ischemia was induced. There were a total of 16 rats used in the study and the seven non-stem cell rats were injected with a placebo medium containing no stem cells. Every seven days the motor function was recorded and in the rats that received stem cells, a progressive recovery of ambulatory functions was observed.
In all lower extremity joints, three of the nine rats injected with hSSC’s improved their mobility, but most compelling was that another three actually returned to walking after six weeks. According to Marsala, in all nine rats, the majority of transplanted human spinal stem cells survived and became mature neurons. In the spinal area, all the animals had a constant presence of transplanted cells and compared to the control group the hSSC’s rats all achieved significantly better motor scores. Similar results were achieved during a second study which was conducted over three-months.
“Other human stem cell transplants in the spinal cord have focused on repairing the myelin-forming cells,” said co-author Karl Johe, a researcher at Neuralstem, the company that manufactures the hSSCs used in the study. “In this study, we succeeded at reconstructing the neural circuitry, which had not been done before.”
The researchers believe that the therapy may eventually be confirmed to be even more successful in human patients, who would be able to receive physical therapy once treated.
Saying that the goal is to offer a significant gain in functional mobility of the patient’s legs Johe added that, “physical therapy may accelerate integration of the grafted stem cells and enhance their therapeutic benefit.”
Marsala has a history working with human neuronal stem cells. A previous work also using rat models was published in the October 2004 issue of the European Journal of Neurosciences. 40 to 50 percent of the animals tested in that study had significant improvement in motor function. The progress was measured by recording improved muscle tone and the suppression of spastic movements. In the spinal cords of the rats that received transplanted neuronal cells, a post-mortem study showed an increase in the expression of inhibitory neurotransmitters and a robust maturation of neurons.
Spinal drug treatments using implanted pumps or continuous systemic drugs make up the current and somewhat effective standard treatment for debilitating muscle spasticity. These treatments are susceptible to eventual drug tolerance which lessens their efficacy, and are also accompanied by side effects.
“These research findings could offer great hope to people with spinal ischemic injury who suffer from resulting spasticity and rigidity,” said Marsala.
The equivalent of embryonic stem cells have been produced in mice with the use of skin cells. This advance in stem cell research does not entail the controversial destruction of embryos. The findings were reported Wednesday be three independent teams of scientists.
Without the controversial political and ethical debates surrounding the use of embryos, the method could show the way to breakthrough medical treatments if it can be duplicated in humans. However, that would be a considerable leap.
None the less, the achievement impressed many experts.
