Mesenchymal Stem Cells Stop Arthritis in its Tracks – Duke University

Researchers at Duke University announced a promising new stem cell therapy aimed at osteoarthritis prevention after a joint injury.

The probability of developing arthritis after injury (post-traumatic arthritis – PTA) greatly increases after injury. Currently, the US FDA has not approved any drugs that slow or eliminate the progression of PTA.

However, at Duke researchers are beginning to confirm mesenchmal stem cell (MSCs) therapy in arthritis treatment. The treatment is similar to that which professional athletes and others have been seeking abroad in places like Panama and Germany for the past few years.

Ref: Pro/Am Dancer is “Dancing with the Stars” Again After Stem Cell Therapy in Panama

In the study, mice sustaining fractures that commonly lead to arthritis were treated with MSCs. “The stem cells were able to prevent post-traumatic arthritis,” said Farshid Guilak, Ph.D., director of orthopaedic research at Duke and senior author of the study.

The study was published on August 10 in Cell Transplantation.

Lead author Brian Diekman, Ph.D said the scientists observed markers of inflammation and noted that the stem cells affected the joint’s inflammatory environment following injury.

“The stem cells changed the levels of certain immune factors, called cytokines, and altered the bone healing response,” stated Diekman.

The Duke team used mesenchymal stem cells isolated from bone marrow. Bone marrow stem cells are very rare; making isolation difficult and requiring that the isolated cells be cultured in the lab under low-oxygen conditions.

“We found that by placing the stem cells into low-oxygen conditions, they would grow more rapidly in culture so that we could deliver enough of them to make a difference therapeutically,” Diekman said.

A richer source of mesenchymal cells is adipose (fat) tissue. Therapeutic doses of MSCs are routinely harvested from fat tissue and do not require culturing in the lab. However, it does takes 5 five days to thoroughly test the adipose cell samples for aerobic bacteria, anaerobic bacteria and endotoxins.

Ref: Stem Cell Therapy for Osteoarthritis

Why does fat (adipose) stem cell therapy take more than one week?

Intravenously administered adipose-derived stem cells will tend to migrate back to the fresh wound site if it is not given an adequate time to heal. Therefore, it is essential to allow about one week after the mini-liposuction before administering any stem cells intravenously. Otherwise, there is a likelihood that the treatment will not be as effective. Additionally, it takes 5 five days to thoroughly test the adipose cell samples for aerobic and anaerobic bacteria as well as endotoxins.

In order to ensure that no patient receives an infected sample, at least 5 days must transpire before the cells can be confirmed safe and injected back into the patient.

Lastly, this 5-day waiting period enables our scientists to culture a small sample of each patient’s stem cells in the lab to observe how they are likely to proliferate once they are inside the body. If a patient’s cells show low viability, Stem Cell Institute doctors will supplement the treatment with additional cord-derived cells to compensate. The same can be done in cases of low cell yield.

Endometrial Stem Cells Yeild Postive Clinical Trial Results for Heart Disease

More progress reported on the treatment of heart disease with endometrial stem cells. Neil Riordan, PhD is one of the early pioneers of endometrial stem cell technology. Dr. Riordan is also the Founder and President of the Stem Cell Institute in Panama City, Panama.

Positive Two-Month Data From RECOVER-ERC Congestive Heart Failure Trial

SAN DIEGO, CA–(Marketwire – Jun 4, 2012) – Medistem Inc. (PINKSHEETS: MEDS) announced today positive safety data from the first 5 patients enrolled in the Non-Revascularizable IschEmic Cardiomyopathy treated with Retrograde COronary Sinus Venous DElivery of Cell TheRapy (RECOVER-ERC) trial. The clinical trial uses the company’s “Universal Donor” Endometrial Regenerative Cells (ERC) to treat Congestive Heart Failure (CHF).

According to the study design, after 5 patients enter the trial, they must be observed for a two month time period before additional patients are allowed to enter the study. Patient data was analyzed by the study’s independent Data Safety Monitoring Board (DSMB), which concluded that based on lack of adverse effects, the study be allowed to continue recruitment.

“Medistem is developing a treatment for CHF that uses a 30-minute catheter-based procedure to administer the ERC stem cell into the patients’ hearts. The achievement of 2 month patient follow-up with no adverse events is a strong signal for us that our new approach to this terrible condition is feasible,” said Thomas Ichim, CEO of Medistem.

The RECOVER-ERC trial will treat a total of 60 patients with end-stage heart failure with three concentrations of ERC stem cells or placebo. The clinical trial is being conducted by Dr. Leo Bockeria, Chairman of the Backulev Centre for Cardiovascular Surgery, in collaboration with Dr. Amit Patel, Director of Clinical Regenerative Medicine at University of Utah.

“As a professional drug developer, I am very optimistic of a stem cell product that can be used as a drug. The ERC stem cell can be stored frozen indefinitely, does not need matching with donors, and can be injected in a simple 30-minute procedure into the heart,” said Dr. Sergey Sablin, Vice President of Medistem and co-founder of the multi-billion dollar NASDAQ company Medivation.

Currently patients with end-stage heart failure, such as the ones enrolled in the RECOVER-ERC study, have no option except for heart transplantation, which is limited by side effects and lack of donors. In contrast to other stem cells, ERC can be manufactured inexpensively, do not require tissue matching, and can be administered in a minimally-invasive manner. Animal experiments suggest ERC are more potent than other stem cell sources at restoring heart function. The FDA has approved a clinical trial of ERC in treatment of critical limb ischemia in the USA.

About Medistem Inc.
Medistem Inc. is a biotechnology company developing technologies related to adult stem cell extraction, manipulation, and use for treating inflammatory and degenerative diseases. The company’s lead product, the endometrial regenerative cell (ERC), is a “universal donor” stem cell being developed for critical limb ischemia and heart failure. A publication describing the support for use of ERC for this condition may be found at http://www.translational-medicine.com/content/pdf/1479-5876-6-45.pdf.

Cautionary Statement
This press release does not constitute an offer to sell or a solicitation of an offer to buy any of our securities. This press release may contain certain forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements are inherently subject to risks and uncertainties, some of which cannot be predicted or quantified. Future events and actual results could differ materially from those set forth in, contemplated by, or underlying the forward-looking information. Factors which may cause actual results to differ from our forward-looking statements are discussed in our Form 10-K for the year ended December 31, 2007 as filed with the Securities and Exchange Commission.

Medistem Contact:

Thomas Ichim
Chief Executive Officer
Medistem Inc.
9255 Towne Centre Drive
Suite 450
San Diego
CA 92122
858 349 3617
858 642 0027
www.medisteminc.com
twitter: @thomasichim

Fat Stem Cells are not affected by weight or age

Mojallal et al. Aesthetic Plast Surg.
Fat represents a potent source of autologous stem cells. Historically, the majority of research using autologous stem cells involved stem cells collected from the bone marrow. This source is associated with a painful extraction procedure and relatively low concentrations of mesenchymal stem cells. In contract, mini-liposuctions represent a less invasive extraction approach. Additionally, adipose tissue has been shown to contain substantially higher number of mesenchymal stem cells as well as hematopoietic stem cells and endothelial progenitor cells.
The use of fat derived stem cells has grown exponentially in recent years for numerous indications. Perhaps the largest data set for fat derived stem cells is possessed by Dr. Bob Harman from Vet Stem, who has treated a total of more than 10,000 large animals with this procedure. The Cellmedicine clinic has had an excellent track record of success using autologous fat for treatment of multiple sclerosis having treated more than 200 patients.
One of the major limiting factors of stem cell therapy using your own stem cells (autologous) is that the potency and number of stem cells is believed to decrease with age and disease. These studies, however, have been performed primarily from bone marrow sources of stem cells. Any hematologist will tell you that with age the bone marrow becomes drier and possesses less cells. Studies have shown that bone marrow stem cells from patients with diabetes or from obese patients have less activity as compared to age matched controls. There has been some thought that the stem cells in the adipose tissue are protected from age and disease. A current study (Mojallal et al. Influence of Age and Body Mass Index on the Yield and Proliferation Capacity of Adipose-Derived Stem Cells. Aesthetic Plast Surg. 2011 May 26) from the Service de Chirurgie Plastique, Reconstructrice et Esthétique in Lyon France sought to address this. The investigators assessed 42 women who were divided into two groups: age ≤ 40 or >40 and BMI ≤ 25 or >25. Fat tissue was harvested via manual lipoaspiration from the abdominal region. After centrifugation, 100 ml of lipoaspirate was sent to the laboratory for isolation and cultivation of ASCs. The investigators found that average cell yield was 0.380 × 10(6)/ml. Cell yield and proliferation capacity did not show statistically significant correlation to the age and BMI of patients, nor was there a statistically significant difference between cell yield and proliferation capacity between the different groups.
The study looked at some very basic parameters: cell number, viability and proliferative ability. It may be that adipose stem cells may exhibit differences in immune modulatory potential or differentiation potential between donors. This was not assessed. Additionally, the adipose derived cells were not assessed between donors suffering from different conditions. Despite these shortcomings, the data appears to support the hypothesis that adipose derived stem cells may have some advantages as compared to bone marrow stem cells, at least for autologous uses.

Multiple Sclerosis Treatment Success Using Mesenchymal Stem Cell-Secreted Factors in Animal Model

Stem cell researchers at Case Western Reserve have reported in Nature Magazine that the functional deficits caused by multiple sclerosis can be reduced by administering mesenchymal stem cell secreted factors.

While previous studies have shown promising results using mesenchymal stem cells, this is the first time that such results have been reported without using the stem cells themselves.

The Stem Cell Institute’s Founder, Neil Riordan PhD, originally cited the potential therapeutic role of mesenchymal stem cell trophic factors in the 2010 Cellular Immunology publication: Mesenchymal Stem Cells as Anti-inflammatories: Implications for Treatment of Duchenne Muscular Dystrophy

In addition to reducing functional deficits, the development of new myelinating oligodendrocytes and neurons, release of inflammatory cytokines, and suppression of immune cells influx were also observed in the Case Western study.

Details can be found here: http://www.nature.com/neuro/journal/vaop/ncurrent/full/nn.3109.html

Hepatocyte growth factor mediates mesenchymal stem cell–induced recovery in multiple sclerosis models

Lianhua Bai, Donald P Lennon, Arnold I Caplan, Anne DeChant, Jordan Hecker, Janet Kranso, Anita Zaremba Robert H Miller

Nature Neuroscience (2012) doi:10.1038/nn.3109
Received 18 January 2012 Accepted 17 April 2012 Published online 20 May 2012

Abstract

Mesenchymal stem cells (MSCs) have emerged as a potential therapy for a range of neural insults. In animal models of multiple sclerosis, an autoimmune disease that targets oligodendrocytes and myelin, treatment with human MSCs results in functional improvement that reflects both modulation of the immune response and myelin repair. Here we demonstrate that conditioned medium from human MSCs (MSC-CM) reduces functional deficits in mouse MOG35–55-induced experimental autoimmune encephalomyelitis (EAE) and promotes the development of oligodendrocytes and neurons. Functional assays identified hepatocyte growth factor (HGF) and its primary receptor cMet as critical in MSC-stimulated recovery in EAE, neural cell development and remyelination. Active MSC-CM contained HGF, and exogenously supplied HGF promoted recovery in EAE, whereas cMet and antibodies to HGF blocked the functional recovery mediated by HGF and MSC-CM. Systemic treatment with HGF markedly accelerated remyelination in lysolecithin-induced rat dorsal spinal cord lesions and in slice cultures. Together these data strongly implicate HGF in mediating MSC-stimulated functional recovery in animal models of multiple sclerosis.

Adult Stem Cell Therapy Successfully Treats Spinal Cord Injury

An interesting spinal cord injury study was published last week. The Turkish researchers tested two types of stem cells on spinal cord injured mice. The two cell types were native bone marrow cells and cultured repair stem cells called Mesenchymal stem cells. Native bone marrow cells contain bone marrow forming stem cells as well as a small number of Mesenchymal stem cells.

After injuring the spinal cords, the stem cells were implanted at the site of the injury. The control mice that received no cells had no improvement in neural activity. The mice that received both cell types had improved neural activity. The cultured Mesenchymal stem cell group improved significantly more than the native bone marrow stem cell group.

Stem Cell Rev. 2012 May 3. [Epub ahead of print]
Stem Cell Therapy in Spinal Cord Injury: In Vivo and Postmortem Tracking of Bone Marrow Mononuclear or Mesenchymal Stem Cells.
Ozdemir M, Attar A, Kuzu I, Ayten M, Ozgencil E, Bozkurt M, Dalva K, Uckan D, Kılıc E, Sancak T, Kanpolat Y, Beksac M.

Source
School of Medicine, Department of Neurosurgery, Pamukkale University, 20070, Kinikli, Denizli, Turkey, drmevci@hotmail.com.

Abstract
OBJECTIVE:
The aim of this study was to address the question of whether bone marrow-originated mononuclear cells (MNC) or mesenchymal stem cells (MSC) induce neural regeneration when implanted intraspinally.

MATERIALS AND METHODS:
The study design included 4 groups of mice: Group 1, non-traumatized control group; Groups 2, 3 and 4 spinal cord traumatized mice with 1 g force Tator clips, which received intralesionally either no cellular implants (Group 2), luciferase (Luc) (+) MNC (Group 3) or MSC (Group 4) obtained from CMV-Luc or beta-actin Luc donor transgenic mice. Following the surgery until decapitation, periodical radioluminescence imaging (RLI) and Basso Mouse Scale (BMS) evaluations was performed to monitor neural activity. Postmortem immunohistochemical techniques were used to analyze the fate of donor type implanted cells.

RESULTS:
All mice of Groups 3 and 4 showed various degrees of improvement in the BMS scores, whereas there was no change in Groups 1 and 2. The functional improvement was significantly better in Group 4 compared to Group 3 (18 vs 8, p = 0.002). The immunohistochemical staining demonstrated GFP(+)Luc(+) neuronal/glial cells that were also positive with one or more of these markers: nestin, myelin associated glycoprotein, microtubule associated protein or myelin oligodendrocyte specific protein, which is considered as indicator of donor type neuronal regeneration. Frequency of donor type neuronal cells; Luc + signals and median BMS scores were observed 48-64 % and 68-72 %; 44-80 %; 8 and 18 within Groups III and IV respectively.

DISCUSSION:
MSCs were more effective than MNC in obtaining neuronal recovery. Substantial but incomplete functional improvement was associated with donor type in vivo imaging signals more frequently than the number of neuronal cells expressing donor markers in spinal cord sections in vitro. Our results are in favor of functional recovery arising from both donor MSC and MNCs, contributing to direct neuronal regeneration and additional indirect mechanisms.

Legendary Texas Football Coach and Stem Cell Recipient Sam Harrell Returns to Coaching

Sam Harrell Stem Cell Patient for MS

Coach Sam Harrell at Ennis High School

In 2010, the debilitating effects of multiple sclerosis forced Sam Harrell to retire from his position as Head Football Coach at Ennis High School. But after receiving 3 courses of stem cell therapy at the Stem Cell Institute in Panama, Sam is returing to the gridiron once again.

Brownwood Lion Head Coach, Bob Shipley announced that Harrell will be joining the team as quarterback coach.

Sam coached all three of his sons at Ennis High School, most notably his son Graham Harrell. Graham was a standout quarterback at Texas Tech and now plays for the Green Bay Packers.

During his career at Ennis, Harrell pioneered the spread offense that led the team to three Texas state championships.

“I told the kids this morning,” said Coach Shipley when asked about how he addressed the team, “And I didn’t have to explain who Sam Harrell was, they knew. And they just erupted in applause and they were just looking at each other with their jaws dropped open, like they couldn’t believe that Coach Harrell was going to come and be apart of our staff.”

“Sam just really liked the thought of coming and not being the head coach and not being the offensive coordinator, but just coaching the quarterbacks, which is really what his passion is.”

The Stem Cell Institute was founded in 2005 by Neil Riordan PhD and has treated over 1,500 patients to-date. Find out more about stem cell therapy for MS at www.cellmedicine.com

Quality time: Former Ennis coach Sam Harrell is counting his blessings despite having multiple sclerosis

ENNIS, TX — Sam Harrell’s three state football championships are celebrated in his home office. He has pictures, trophies and balls, and even more memories.

For 32 years, Harrell worked in a profession where success is measured by a scoreboard in front of thousands.

These days, life’s little victories — unaccompanied by cheers or Gatorade showers — are just as satisfying.

Harrell can jump up and down in his living room. He can walk across a parking lot without a cane or a walker. He can spend hours at Kolache Depot Bakery without getting fatigued.

Harrell hasn’t beaten multiple sclerosis, but he is successfully living with it.

“It puts everything in perspective,” Harrell said. “Now, I’d rather play catch with my grandson in the back yard than win a state championship. When that gets taken away from you, you realize how precious it is.”

Harrell was 153-51 in 16 seasons at Ennis, winning Class 4A state titles in 2000, ’01 and ’04. He coached all three of his sons — Graham, now a backup quarterback with the Green Bay Packers; Zac, the offensive coordinator at Van High School; and Clark, who finished his college career at Abilene Christian in 2010 and now works as a financial planner.

It was in 2005, while he was on the tennis court, that Harrell’s vision in one eye became blurry. An eye specialist sent him to a neurologist, who, after running tests, gave Harrell the best possible diagnosis: He had MS.

“I didn’t know whether I was supposed to cheer or cry,” Harrell said. “I got the best of the three things it could be, but the bad news is: I have MS.”

Multiple sclerosis is a chronic, unpredictable disease that affects the central nervous system. The immune system eats away the myelin sheath surrounding the nerves. Symptoms vary from person to person. Mild symptoms include numbness in the limbs, weakness, fatigue and blurred vision. Severe symptoms include paralysis and loss of vision.

There is no known cure for MS.

Harrell chose to keep the news a secret from everyone except his wife, Kathy. He didn’t reveal the diagnosis for four years, though, as his condition worsened, those close to Harrell knew something was wrong.

“We’d go to practice, and he had to take a golf cart,” Graham Harrell said in a phone interview after a recent Packers practice. “Sometimes he was off balance a little bit, or shaky walking. So there were times we knew something wasn’t quite right, but we didn’t know exactly what was going on until he finally told us.

“It was hard to watch, obviously, especially with him wanting to coach, and yet not being able to do it like he used to. But recently, he’s seen great improvement, and that’s huge encouragement not only to him, but to us, and hopefully he’ll continue to get better.”

Sam Harrell knew his MS wouldn’t kill him, but he thought not coaching might.

Sam’s father, Jake, established the family business at Seminole, where he spent 20 seasons, including 10 as the head coach. But Sam Harrell’s health forced him to quit coaching before the 2010 season.

“That’s all I’d done my whole life,” Harrell said, “so I was sick about it. I just didn’t know what I was going to do.

“I do wish I could still do it, but I haven’t died from not coaching.”

Harrell, in fact, is alive and well. He credits three trips to Panama for his improved health.

After he retired from coaching, Harrell began researching regenerative medicine. Stem cell treatment is not approved in the United States, but Dr. Neil Riordan, who lives in Trophy Club, is the founder of the Stem Cell Institute in Panama.

Riordan is one of the leading stem cell scientists in the world.

Harrell talked to several of Riordan’s patients, including Richard Humphries, a golf coach out of Diamond Oaks Country Club in Fort Worth. Humphries was diagnosed with MS in 2005. He began stem cell treatments in 2008.

Stem cell treatments introduce new cells, which have regenerative potential, into damaged tissue to treat disease or injury.

“After talking to Richard, I didn’t have the money, but I knew I was going to go,” Harrell said. “I mean, what did I have to lose? I knew where I was headed if I didn’t go. I was going downhill fast. So why wouldn’t I go try this?”

Friends, family and fellow coaches held fundraisers for Harrell’s treatments. Harrell’s first trip to Panama, which was four weeks, cost $40,000. He has been back twice more, the last time in September.

It wasn’t until the third visit that Harrell saw dramatic results.

“MS is like a two-hump camel,” Humphries said. “You can get over the first hump of active T-Cells fairly easily, but the second hump, the memory T-Cells, sometimes bring our MS symptoms back, as it did with Sam.

“He was extremely disappointed for taking the two steps back after three steps forward. I told him it may take another two or three treatments to really get you going again. Needless to say, he could not stop smiling and was greatly relieved. Now, he is seeing the results.”

Harrell is a strong Christian and is quick to credit God and prayer for his recovery. But he also is a big believer in stem cell therapy. Kathy Harrell is a more recent convert.

She was skeptical until seeing the change in Harrell.

“I just feel really grateful that these are good days and good months, and I’m not going to worry about next year,” Kathy Harrell said. “It just makes you thankful that things are good right now, and he’s pretty mobile. This disease reminds you to just be thankful for the day, so that’s what we’re doing. I realize now it can be worse.”

By Charean Williams

First patient to get stem cell therapy identified

By Rob Stein, The Washington Post
Embryonic stem cells have numerous pitfalls in addition to the ethical dilemmas. While the concept of a “blank slate” cell is extremely attractive in terms of generating new tissues for transplantation and organ replacement, the problem is that these cells are so young that they do not properly “know” how to integrate with existing tissues. This causes the problem of possible dysfunction of the cellular products made from the cells, but also causes the issue of cancer formation. Many studies have demonstrated that administration of embryonic stem cells, or products made from them form cancers when injected into mice that lack an immune system.
Because of the risks associated with embryonic stem cells, the FDA has been historically reluctant to allow initiation of clinical trials with them. The leader of the field of embryonic stem cells is Geron, the company that funded the research that lead to the discovery of human embryonic stem cells, as well as the company that has the exclusive license for their commercial use. The business of embryonic stem cells is associated with large financial investments. Specifically, patents are not only associated with the cells themselves but one methods of growing the cells and methods of selecting the cells to reduce the possibility of cancer formation. In some ways people believe that embryonic stem cells are an exercise in science because adult stem cells have been demonstrated to elicit numerous therapeutic effects without the risks.
Last year a monumental study was initiated in that the FDA allowed for the first human use of an embryonic stem cell product. The company Geron was granted approval to treat patients with spinal cord injury using embryonic stem cell derived oligodendrocytes, the cells that generate the myelin that lines the nerves.
Today, information was released on the first patient that was treated with these cells. The patient was a partially paralyzed young man, Timothy J. Atchison, 21, known to family and friends as T.J.
T.J. was a student at the University of Alabama College of Nursing when he was partially paralyzed in a Sept. 25 car accident, his aunt and father said. He agreed to let doctors infuse more than 2 million cells made from stem cells into his spine 13 days later at the Shepherd Center in Atlanta, according to his aunt and a family friend.
While the primary endpoint of the trial is to demonstrate safety, doctors are also testing whether the cells restore sensation and movement. It was too soon to tell whether the cells were helping T.J., Angela Atchison said. “They said it would be about a year before they’ll know if there’s any difference — if it takes,” she said. “We’re just hoping and praying that it works.”
T.J.’s father, Timothy Atchison of Millry, said his son had maintained a positive attitude, beginning when he was in the emergency room after the accident. and understood how seriously he was injured.
“He said, whatever the Lord leaves him with, he’ll do the best he can with it,” the father said in a phone interview Monday. He would not directly acknowledge that his son was in the stem cell study, but confirmed details including his Shepherd Center treatment. “I’ll put it this way, they tested a lot of folks, and only one made the cut,” he said during another interview Tuesday. “You can read between the lines.”

“The fight to walk” – spinal cord injury patient improving after stem cell therapy in Panama

Daniel-Leonard-1-StemCell

Daniel Leonard working out at physical therapy

Published March 31, 2012
By Sue Guinn Legg – Press Staff Writer

Daniel Leonard is doing all he can to walk again, and after a recent course of stem cell treatment he’s as close as he has been since a few months after the 2005 injury that put him a wheelchair.

He was 22 years old and about to begin his third year of college when he woke up one August morning on the floor at his family’s Johnson City home unable to move and struggling to breathe.

While the cause of his injury remains a mystery, what is known is that three vertebrae near the top of his spine had been crushed, leaving him paralyzed from the neck down, on a ventilator and not expected to never walk or even breathe on his own again.

Six months after undergoing surgery to remove the bone fragments from his spinal cord, Leonard, who had played several sports in high school and was boxing at the Johnson City Athletic club prior to his injury, was exceeding all expectations.

In treatment at the Patricia Neal Rehabilitation Center in Knoxville, he was not only breathing independently, he was pulling himself up on parallel bars and being fitted with leg braces to help him take his first steps.

Then the unthinkable happed, again. Because there had been nothing done to stabilize his damaged vertebrae, his spine collapsed at the site of his injury and all of his progress was lost.

“I worked my butt off to get to the point I was about to start walking,” he said. But the gains he had made in upper body strength were erased and there was no longer any movement in his legs.

After a second surgery to fuse the bones, his condition was labeled as “incomplete paraplegia” characterized by limited movement and sensation in all the muscles below his neck and none at all in his legs. Doctors told his family he would never be able to move his legs, and for many years he could not.

For a while, he lived independently with the assistance of a caregiver. When his caregiver left, he moved to a nursing home, expecting to stay only long enough to find another place and another caregiver. But without money to finance that plan, months turned into years and the Four Oaks Health Care Center in Jonesborough became his home for the long term.

Early last year, things took a turn for the better when for reasons unknown he began to regain some movement in his legs. Encouraged, Leonard once again threw all his effort into physical therapy. In October, he began working out regularly with Amy Caperton, a personal trainer at the Tri-Cities Lifestyles fitness center in Johnson City, and coupled that with physical therapy at the new Mountain States Rehabilitation Center.

His family, who had long believed stem cell treatment would provide his best chance at recovery, stepped up their efforts to pay for the treatment.

His sister, Rachael Leonard, a business consultant who had been following the progress of stem cell research and exploring treatment options since a few days after Daniel was injured, zeroed in on The Stem Cell Institute, a reputable facility in Panama founded by Neil Riordan PhD, that concentrates on treatment of spinal cord injuries, muscular sclerosis, rheumatoid arthritis and heart disease.

His mother and siblings pooled their resources and came up with about half the $45,000 needed for the $35,000 cost of his first four-week course of treatment and travel expenses for Daniel, Rachel and their mother, Diane, to make the trip to Panama.

The balance was raised through a series of small benefits — dinners at area restaurants, a concert and an auction, and through many individual gifts and online contributions to Daniel’s fundraising page, www.givefoward.com/danielleonardstemcells.

“People we know around here and businesses were very generous and there was a lot of money raised,” his mother said.

To clear up any misconceptions about the treatment, the family emphasized to everyone interested that the stem cells used at the institute come from umbilical cords donated by new parents and the patients’ own bone marrow and referred them to www.cellmedicine.com for specifics.

“I’m not trying to tell people what to do with their own bodies, but for me, if it had been kill a baby to walk again, there’s no way I would have,” Daniel Leonard said.

The family finally made it to Panama in February. The treatment began with two weeks of daily cord blood cell injections into his spinal fluid and two hours of “intense interval” therapy that requires Leonard to work his muscles as hard as possible for one minute, rest for two minutes and repeat the process over the course of an hour.

“One hour is what they do, but with what I had been doing with Amy already, I thought I needed more,” he said.

The injections were painful and the workouts exhausting, so Leonard was relieved when Panama’s annual carnival week celebration gave him a week of rest before the treatment resumed with another two weeks of daily injections of cells drawn from his hip bones.

On the second day of his fourth week of treatment, Leonard experienced his first noticeable improvement when he flexed the right calf muscle he had not been able to move in years. The following day he felt himself contracting the pectoral muscles in his chest.

Day by day he’s regaining strength and there have been many small, but encouraging, gains that have also been obvious to caregivers. At Four Oaks, his aides are changing the way they handle things. While transferring Leonard from bed to a chair, it’s easier for them to raise him to his feet to pivot, which can now be done with one person’s assistance rather than two.

“These are all little things, but they are huge for us,” Leonard said.

Caperton, who with help from a client at Lifestyles spent a few days in Panama learning all she could from doctors and therapists at the institute, is equally encouraged.

“I am trying to be objective, but I must say he is making drastic improvements and it excites me,” she said.

The next six months before the stem cells die hold Leonard’s greatest opportunity for improvement, and continuing his physical training will play a critical role in the treatment’s effectiveness.

Optimum recovery will come with repeat treatments, and the fundraising for Leonard’s next trip to Panama is under way. There’s a three-on-three basketball tourney being planned at the Lifestyles center, and Leonard is searching for a local business to put up a prize worthy of the tournament’s entry fee.

He’s inviting everyone to follow his progress at his Facebook page, Daniel Leonard Search for a Cure (http://on.fb.me/H6sAtf). And for anyone who wishes to help, online donations may be made at www.giveforward.com/daniellenoardstemcells.

Donations to the “Daniel Leonard Search for a Cure Fund” can also be made at any First Tennessee Bank location or by mail to First Tennessee Bank, 1500 W. State of Franklin Road, Johnson City, TN 37604.

“Hopefully, with the next treatment I’ll be able to stand,” he said. “I’m excited about it. I can’t wait to see the results.”