Hope for Brain Injury Victims

Traumatic brain injury (TBI) is a major health problem
caused by a sudden trauma to one or more areas of the brain. Today the
conventional method of treating patients with TBI is based on administration of
supplements to rebalance the brain’s chemistry. In the early phases of TBI
reduction of the ongoing inflammation using various antioxidants and
anti-inflammatory compounds has demonstrated some promise. Unfortunately, after
the injury has occurred there is little that can be done with the exception of
physiotherapy programs to allow the patient to cope with loss of function.

Although the traditional belief has been that once the
brain is damaged, regeneration is non-existent, recent findings suggest that
this may not be entirely true. Specific parts of the brain (subventricular
zone) have been demonstrated to contain stem cells that begin to multiply and
make new brain cells (neurons) after injury. Although this healing process is
often not potent enough to cause a robust effect that can be seen clinically,
the fact that it exists pushes scientists to find ways of amplifying it.

It was discovered more than twenty years ago that pregnant
pigs have areas of the brain in which cells multiply. The more recent finding
of brain stem cells has prompted researchers to ask whether administration of
pregnancy-related hormones can actually accelerate healing of injury brains.
Scientists at the Canadian company Stem Cell Therapeutics have shown that
administration of the hormone human chorionic gonadotrophin (the same hormone
detected by the pregnancy test) to animals with TBI can accelerate recovery. We
have previously discussed here that this company is now in clinical trials with
this approach for stroke, another type of brain injury
www.cellmedicine.com/stem-cell-therapeutics-placement.asp.

Another approach to treating TBI involves administration of
stem cells from outside of the body. This approach has previously been used for
conditions like heart failure

http://www.youtube.com/watch?v=flv0RmzPyLU
, liver failure

http://www.youtube.com/watch?v=DdH6Mm4w98I
, or multiple sclerosis

http://www.youtube.com/watch?v=wIcUaKZWOSE
.

Recent studies have demonstrated that animals in which TBI
was induced, the administration of bone marrow stem cells results in
regeneration of damaged areas. It is currently unclear whether the stem cells
themselves are becoming new neurons, or whether the stem cells are producing an
environment in which the existing brain stem cells may exert their activity.
The University of Texas has recently completed a 10 patient clinical trial of
children with TBI treated with their own stem cells

http://www.clinicaltrials.gov/ct2/results?term=NCT00254722
, however the
results have not been published yet.

One example of the potential of adult stem cells in
treatment of brain damage is illustrated in a scientific report from Russia in
which comatose patients where treated with stem cells and consciousness was
regained (Seledstove et al. Cell therapy of comatose states. Bull Exp Biol
Med. 2006 Jul;142(1):129-32
).

The potential of stem cell therapy for TBI is anticipated
to be promising. Dr. Paul Breen, a specialist in TBI stated ""This new research
in stem cell research is a huge breakthrough and highly anticipated. We hope
that this could help pave the way for future research in stem cell usage for
brain trauma treatment in the coming years. If it works, it could give thousands
of people who have suffered brain injury hope of, if not a complete recovery,
then certainly a much better quality of life and a restoration of many of their
physical and mental functions. It’s a strong case in favour of continued stem
cell research."

Magnetic Attraction of Stem Cells to Injured Heart Creates Potent Treatment

The intracoronary administration of bone marrow stem cells in patients who have suffered a heart attack has been demonstrated to cause beneficial effects in double blind studies, as discussed in this video http://www.youtube.com/watch?v=flv0RmzPyLU. Intracoronary administration has potential side effects since a balloon needs to be expanded in the area where the heart attack occurred, which may cause exacerbation of the existing damage. A more attractive method of stem cell delivery would be via the intravenous route. Unfortunately, intravenous administration has the drawback that some of the cells become lodged in organs such as the lung and liver.
Despite this, intravenous administration has demonstrated positive results, for example in a clinical trial conducted by Osiris (Hare et al. A randomized, double-blind, placebo-controlled, dose-escalation study of intravenous adult human mesenchymal stem cells (prochymal) after acute myocardial infarction. J Am Coll Cardiol. 2009 Dec 8;54(24):2277-86) an improvement in heart pumping
ability was observed.

One way of improving stem cell homing to the area of need is through direct administration of proteins, or genes encoding the proteins, that specifically attract stem cells. This approach has been performed with SDF-1 in animal models, and now the company BioHeart is doing Phase I clinical trials. Other ways include the use of laser therapy to induce expression of stem cell homing molecules as being developed by the San Diego company Entest Biomedical.

Today a new approach was reported in the journal Circulation Research, which is published by the American Heart Association.
Scientists at Cedars-Sinai Heart Institute have loaded stem cells with iron-nanoparticles and administered them intravenously in animals that were induced to undergo a heart attack by ligation of the coronary artery. The scientists found that by
applying magnetic fields to the heart, they could increase the number of injected stem cells that lodged into the heart by 3-times. This was accompanied by functional improvement.

"Stem cell therapies show great promise as a treatment for heart injuries, but 24 hours after infusion, we found that less than 10 percent of the stem cells remain in the injured area. Once injected into a patient’s artery, many stem cells are lost due to the combination of tissue blood flow, which can wash out stem cells, and cardiac contraction, which can squeeze out
stem cells. We needed to find a way to guide more of the cells directly to the area of the heart that we want to heal." Said Eduardo Marban, M.D., director of the Cedars-Sinai Heart Institute.

Commenting on the success of the present study, he stated "This remarkably simple method could easily be coupled with current stem cell treatments to enhance their effectiveness."