Stem Cell Treatment for MS and Arthritis Enhanced by New Approach

Scientists have discovered a way to alter the immune system and in the process, given new hope to the thousands of individuals who suffer from multiple sclerosis and arthritis.

A faulty immune system that attacks the body is responsible for the condition. The condition can be effectively cured by replacing the existing immune system with a healthy one. This is accomplished by taking stem cells from a healthy donor, and transplanting them via injection into the patients body.

Before providing new cells from bone marrow, umbilical cord blood, or another suitable source, the existing immune system was traditionally destroyed using an aggressive form of radiotherapy. This was the only way doctors could proceed: until now.

In the new method, the healthy immune system is still established after the unhealthy immune system is destroyed, but a toxin is used to clear out the old system instead of radiotherapy. The stem cells are injected after the initial purging is complete.

The benefits are potentially enormous for humans and could be used to treat MS and rheumatoid arthritis according to scientists at Stanford University School of Medicine in California. However, the procedure has only been utilized on mice thus far.

In the UK, one out of every 5 individuals is afflicted with arthritis. And Multiple Sclerosis affects about 85,000 people as well.

The journal Science reported the research results of Agnieszka Czechowicz, Dr. Deepta Bhattacharya, and Professor Weissman. Stem cells attached to bone marrow, and a new blood and immune system was established when the 3-person team transplanted new, blood-forming stem cells into mice.

So with this method, the new immune system will no longer attack the nerves of the body, when stem cells are taken from a donor and implanted into a person with a good tissue match who has an auto-immune disease such as multiple sclerosis.

In order for the technique to work on humans, researchers must first work out the kinks with more animal testing.

Dr. Laura Bell, the research communications officer at the MS Society, said: “Stem-cell studies are an important avenue of research that hold promise in terms of treatments for MS. This early-stage study is interesting and we look forward to seeing how the work translates into studies in people with MS.”

Professor Edward Tuddenham, of the Royal Free Hospital, London, said: “For those whose blood stem cells contain a severe genetic defect such as that causing sickle cell anaemia, replacing them with normal stem cells would enable restoration of normal blood.”

“Bone marrow transplantation has been used for sickle cell anaemia with good results in children, but in adults it is difficult to get the new stem cells to take in the face of rejection by the resident stem cells and their progeny – the immune system.”

Professor Lars Fugger, of the Medical Research Council Human Immunology Unit, Oxford University, said: “This study has great potential.”

Systematic Approach to Stem Cell Treatment for Brain Damage Being Developed

Caring for babies suffering from cerebral palsy or those who suffer a stroke may soon follow a protocol similar to what Dr. Tadashi Masuda and Dr. Mina Maki are performing today. They are preparing for a transplant, the first step: placing two syringes inside an ice packed plastic foam box.

Protocols that could be followed in any clinic in the country are being developed by Cesar Borlongan and his team inside the laboratory at the Augusta Department of Veterans Affairs Medical Centers. While establishing a systematic method, they hope to also prove that adult bone marrow-derived stem cells are effective in helping repair the brain damage.

This particular stem cell therapy is being studied in animal models by Dr. Borlongan, also an associate professor at the Medical College of Georgia, and Dr. David Hess, MCG chairman of neurology. The research is being facilitated by a $4.2 million dollar grant which will span five years. The same therapy will be studied for use in babies who, due to lack of blood or lack of oxygen around the time of birth, suffer brain damage. 10 percent of the cases of cerebral palsy can be attributed to this this circumstance. This second study will funded by an additional $1.8 million dollar grant spanning three years, and the research will be carried out with James Carroll, chief of pediatric neurology at MCG.

The research on cerebral palsy may be approved for human trials sooner since the procedure has already been proven to be relatively safe and there is a lack of existing therapies for the condition as well.

“I would hope we would get a start on this in a year,” Dr. Carroll said.

The researchers were looking for methods that could be duplicated easily, such as shipping the cells in a liquid nitrogen container to thawing them and loading them into syringes for injection into an IV. Just as if they were trying to get the FDA to approve a new drug, the approach for the stroke model has been standardized said Dr. Borlongan.

“This is the same way we’re going to do it in the clinic,” he said. “Once the cells arrive in the clinic, all the clinicians will do is thaw the cells and then inject them into the patient.”

Dr. Borlongan said that they now believe the benefit to stroke victims might be from growth factors secreted by the cells as opposed to the former theory that the benefit was derived from the replacement of damaged cells.

“Once they release these beneficial substances, they help rescue the dying cells from the host tissue,” he said. “And they also increase the production of new cells.”

Dr. Carroll said that neonatal patients could also benefit from the treatment.

“We think it may have some additive effect in terms of new brain cells, but the main effect has to do with assisting with brain repair,” he said.

Many stroke patients arrive at the hospital too late to meet the deadline of a three-hour window in which a clot-busting drug must be given. The possibility of creating a treatment that could provide benefits past this point of no return has sparked the interest of many. Even days after stroke, observations from animal models showed that the treatment made a difference according to MCG researchers.

“What we have seen with the stem cells, even after seven days post-stroke, you can get functional benefit,” Dr. Borlongan said. “But because most stroke patients are discharged after a few days, they chose a two-day time frame to deliver the stem cells. And because these are adults cells, and not the embryonic stem cells that have generated much controversy, they can sidestep some of those ethical concerns,” Dr. Borlongan said.

Dr. Borlongan said that prior to using human cells, rodent cells will be the focus in order to prove safety and effectiveness. Human trials could follow in the fifth year, when the team plans to apply to the Food and Drug Administration.

“Hopefully, after the five-year project, we’ll have something to give to the patient,” he said.

Revolutionary Stem Cell Discovery Made by Wichita, Kansas, Doctor

A dramatic stem cell discovery has been made in Wichita, Kansas, that could potentially influence the balance of stem cell research and treatment as we know it today.

Dr. Xiaolong Meng of the Bio-Communications Research Institute has discovered that at least nine different types of human tissue can be developed from adult stem cells harvested from women’s menstrual fluid.

Meng said that, “ERC cells can be converted into basically all the major tissues of the body, including the liver, lung, pancreas, brain, heart, blood vessel, and muscle. Additionally, these cells produce 100,000 times the number of growth factors found in cord blood, opening the door to numerous regenerative applications.”

The finding is particularly promising given the controversial climate surrounding embryonic stem cells. The menstrual blood stem cells, which have been named Endometrial Regenerative Cells (ERC), are a type of adult stem cell and non-controversial. Additionally, not only were adult stem cell markers present in the cells, but a few embryonic markers were observed as well, particularly, the “master” marker Oct-4.

Adult stem cells are found in abundance in the endometrium, or uterine lining. But despite the rich source, actually harvesting the cells is a similar process as is involved with other sources such as bone marrow: the process is invasive. However, Meng’s discovery has opened a new door in stem cell research and treatment since menstrual blood contains these same endometrial stem cells.

Dr. Meng collaborated with Medistem Laboratories, Inc. (OTC BB:MDSM.OBNews) (Frankfurt:S2U.FNews in making the discovery. Their paper which is titled, “Endometrial Regenerative Cells: A Novel Stem Cell Population”, has been published in the Journal of Translational Medicine. The paper can be viewed at www.translational-medicine.com/content/5/1/57

Medistem Laboratories, Inc. own the intellectual property rights to the discovery.

“The ability to take a cell and differentiate it into the tissue type needed by the body creates a world of opportunity in the world of organ and tissue regeneration,” said Neil Riordan, PhD, President and CEO of Medistem. He added, “With IP filed around the cell line, we have begun taking the next steps in the commercialization process. Currently, our collaborators at Western Ontario, Alberta, and the Bio-Communications Research Institute are doing a series of pre-clinical studies to establish efficacy data in a variety of indications. The indications currently being assessed include diabetes, liver cirrhosis, lung fibrosis, organ rejection, and multiple sclerosis. Should the data gathered prove strong in one or all the indications the next step will be to file INDs with the FDA and move into clinical trials,” said Riordan.

Using the stem cells for future applications in the field of regenerative medicine is the hope for researchers. The outlook is promising once the cells are cultured in large scale.

“If there is a part of the heart that is damaged, that is dead, you can inject some of the stem cell, which will repair the damaged part,” Dr. Meng said. “Then you have whole new heart again.”

Medistem Announces Discovery: Menstrual Blood Yields Novel Stem Cell Population

A paper describing a novel stem cell population derived from menstrual blood has been published by Medistem Laboratories, Inc. (OTC BB:MDSM.OBNews) (Frankfurt:S2U.FNews) in collaboration with the Bio-Communications Research Institute in Wichita, Kansas, the University of Alberta, and the University of Western Ontario. The Journal of Translational Medicine has published the paper which is titled, “Endometrial Regenerative Cells: A Novel Stem Cell Population”. The publication is free to read at www.translational-medicine.com/content/5/1/57

“I view the discovery of the Endometrial Regenerative Cell (ERC) as a great step forward in providing an ethical, easily accessible, and potentially highly useful adult stem cell for treatment of numerous degenerative conditions,” said Dr. Xiaolong Meng, head of the research team. He continued, “ERC cells can be converted into basically all the major tissues of the body, including the liver, lung, pancreas, brain, heart, blood vessel, and muscle. Additionally, these cells produce 100,000 times the number of growth factors found in cord blood, opening the door to numerous regenerative applications.”

The study has exhibited that menstrual blood stem cells possess special cellular and molecular characteristics. This is the first publication in a peer-reviewed medical journal demonstrating these facts.

“The ability to take a cell and differentiate it into the tissue type needed by the body creates a world of opportunity in the world of organ and tissue regeneration,” said Neil Riordan, PhD, President and CEO of Medistem. He added, “With IP filed around the cell line, we have begun taking the next steps in the commercialization process. Currently, our collaborators at Western Ontario, Alberta, and the Bio-Communications Research Institute are doing a series of pre-clinical studies to establish efficacy data in a variety of indications. The indications currently being assessed include diabetes, liver cirrhosis, lung fibrosis, organ rejection, and multiple sclerosis. Should the data gathered prove strong in one or all the indications the next step will be to file INDs with the FDA and move into clinical trials,” said Riordan.

About Medistem Laboratories, Inc.
Medistem Laboratories is a biotechnology company that discovers, develops, and commercializes adult stem cell products that address serious medical conditions. Medistem’s primary focus is drug discovery and development, however, Medistem also outlicenses proprietary technology from their growing intellectual property portfolio to commercial entities in markets where stem cell administration is permissible. Medistem believes it is well positioned to be a leading developer of adult stem cell products given its licensee relationships and collaborative efforts with respected institutions.

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Reconstructing the Spinal Cord with Stem Cells

Critical information has been unveiled that could lead to novel therapies for repairing previously irreversible nerve damage in the injured spinal cord. Key elements in the in the body’s reaction to spinal cord injury have been discovered in this seminal study which has been published in this week’s Proceedings of the National Academy of Science.

Why the adult nervous system is unable to repair itself following spinal injury is still unknown. This is unlike a skin wound for example, where the repair process is well documented.

Even following severe injuries, repair and regeneration is common place in non-mammals and the developing brain. The role of stem cells and their potential to develop into different cell types has been suspected to play a major role in the rejuvenation of these cases.

“Because of their regenerative role, it is crucial to understand the movements of stem cells following brain or spinal cord injury,” says Dr. Philip Horner, co-lead investigator and neuroscientist at the University of Washington. “We know that stem cells are present within the spinal cord, but it was not known why they could not function to repair the damage. Surprisingly, we discovered that they actually migrate away from the lesion and the question became why – what signal is telling the stem cells to move.”

The migratory pattern of stem cells following injury is controlled by a key molecule called netrin-1. This was discovered after scientists tested numerous proteins. Guiding nerve cells to their proper targets, netrin-1 acts as a repulsive or attractive signal in the developing nervous system. Preventing stem cells from replenishing nerve cells, scientists found that netrin-1 specifically repels stem cells away from the injury site in the adult spinal cord.

“When we block netrin-1 function, the adult stem cells remain at the injury site,” says Dr. Tim Kennedy, co-lead investigator and neuroscientist at the Montreal Neurological Institute of McGill University. “This is a critical first step towards understanding the molecular events needed to repair the injured spinal cord and provides us with new targets for potential therapies.”

The National Institutes of Health and the Craig H. Nielsen Foundation funded the study.

Brain Stem Cells Can Now be Tracked

U.S. researchers report that brain stem cells can now be tracked for the first time with the identification of a new marker.

The team’s senior author said that for the conditions of and involving multiple sclerosis, early childhood development, and depression, the accomplishment is opening doors to new research.

“This is a way to detect these cells in the brain, so that you can track them in certain conditions where we suspect that these cells play a certain role,” explained Dr. Mirjana Maletic-Savatic, an assistant professor of neurology at the State University of New York, Stony Brook.

“This is also very applicable for situations where people envision the transplantation of stem cells into the brain,” the researcher said.

The breakthrough “is very important, because it now allows us to look and see ways in which to measure changes in endogenous [natural] neural stem cells,” agreed Paul Sanberg, director of the Center for Excellence for Aging and Brain Repair at the University of South Florida, in Tampa. He was not involved in the research.

The study was published in the November 9th issue of Science, and was funded by the U.S. National Institutes of Health.

The human brain and/or nervous system sustains critical damage in individuals who suffer from Parkinson’s, stroke, multiple sclerosis, traumatic injury, Alzheimer’s, and other conditions. Scientists believe they might be manipulated to repair or replace lost cells and tissues because stem cells have the potential to develop into other types of cells.

Stem cells called progenitor cells are already produced by key parts of the brain.

“There are two major areas where you can find them in the brain — one is the center for learning and memory, called the hippocampus, and the other is around the brains’ ventricles,” Maletic-Savatic explained.

So they can develop into new or replacement cells, these brain cells, like other adult stem cells in the body, are held in reserve.

Since humans keep collection memories, the stem cells found in the hippocampus are particularly useful. In order to interpret and store memories, the brain needs new cells.

“Memories always change,” Sanberg pointed out.

Since scientists haven’t had any means of tracking neural stem cells, research in this area has been slow. Because scientists discovered molecular markers that reliably identify them on MRS, two dominant cell types — glial cells and neurons — have been tracked for some time using a non invasive technology called magnetic resonance spectroscopy (MRS).

Now, brain stem cells can be marked for the first time.

A chemical signature that distinctly characterizes neural stem cells has been discovered by Maletic-Savatic’s team. The discovery was made using computer and state-of-the-art scanning technology.

“We think that it’s a complex lipid or lipoprotein,” the Stony Brook researcher said. Further investigation is under way to define and describe the molecule’s identity, she added.

The researchers tracked the quantity and location of neural progenitor cells in the brain using MRS imaging on mice, rats, and human volunteers who were healthy. They also used MRS to verify the transplant location after implanting some of these cells into an adult rat’s brain.

The concentration of neural progenitor cells in the brains of adult humans, adolescents, and young children was compared by Maletic-Savatic’s team. This marked another first. Their findings revealed that the number of these cells in the brain decreases markedly with age. This confirmed suspicions that arose during animal studies.

“We were actually really surprised that there was such a dramatic decline,” Maletic-Savatic said.

The researcher said she’s already planning to use the new tracking technology in a variety of neurological studies.

For example, it is suspected that antidepressants work by boosting the creation of new brain cells. With that in mind, Maletic-Savatic’s team will use MRS to “clarify whether abnormalities in these progenitors have any role in causing depression,” she said.

Maletic-Savatic said she is also planning a study looking at the cells’ role in early brain development because she is primarily a pediatric neurologist.

“Particularly in premature babies who can develop cerebral palsy and mental retardation,” she added.

MRS-guided research into neural stem cells may also benefit multiple sclerosis patients.

“We are now doing a study that already started a year ago on patients with MS, and we plan to prospectively follow them and see whether we can use this bio-marker as a prognostic tool,” Maletic-Savatic said.

She added that this type of stem cell research could also benefit research on a wide range of brain disorders. Maletic-Savatic said breakthroughs in that area are probably years away, but that tracking stem cells in the brain has obvious implications for research into stem cell transplantation.

“On the other hand, if we find drugs or ways that can stimulate your own endogenous cells, that would be even better,” she said.

Sanberg agreed that brain research would enjoy a marked boost with scientists being able to track neural stem cells.

“To be able to show that you are increasing neurogenesis in the brain through your treatment — through drugs that induce neurogenesis — that’s going to be very important,” he said. “This is a really strong first step.”

Only 50% Effectiveness Required in Stem Cell and Gene Therapy to Yield Healthy Heart

The length and quality of life for individuals with specific forms of muscular dystrophy is greatly affected by heart disease, which is also the leading cause of death in the United States.

Life-Threatening Blood Disorders Effectively Treated with Autologous Cord Blood Stem Cells

Highlighting the increasing therapeutic use of autologous (one’s own) cord blood stem cells for transplant and regenerative medicine, including treatments for neurological repair, juvenile diabetes, and blood and immune disorders, two separate data abstracts were displayed today at the annual scientific meeting of the AABB. The advancement of these treatments was part of the focus as well, and the important role of family (or private) cord blood banks was demonstrated. The international association of medical professionals and institutions focused on transfusion, transplantation and cellular therapy.

In order to treat aplastic anemia, an individual’s own cord blood stem cells were released in the first study which analyzed four cases. The transplants were conducted at three different institutions: Children’s Hospital in Seattle, City of Hope (Los Angeles), and the University of Minnesota. Cord Blood Registry was responsible for processing and storing the cord blood prior to treatment.

The cases demonstrate that this approach is amenable to use at different treatment centers across the United States and also suggests that autologous cord blood transplantation for aplastic anemia is a safe and effective treatment protocol.

“Aplastic anemia is a life-threatening disease with no known cause that can be acquired at any time in life and is difficult to treat,” said lead study investigator Dr. David T. Harris, Ph.D., professor of immunology at the University of Arizona and scientific director of Cord Blood Registry. “This study offers evidence that transplant physicians have a safe and effective weapon for combating this disease for patients who have access to their own cord blood stem cells.”

The analysis also showed that:

— The average time to engraftment (the point at which the stem cells start to generate new blood cells) for cord blood is between 21 and 35 days according to the National Marrow Donor Program (NMDP). Engraftment averaged 22 days across the four cases and in one patient, occurred as early as two day after transplantation.

— Marking the longest period of time a family-banked cord blood sample has been stored prior to use, one of the autologous samples used was stored for 9.5 years.

Use in both regenerative and traditional medicine applications was documented in a second report involving 13 cases of autologous cord blood stem cell use. An increase in samples requested for regenerative medicine applications was indicated by the data and a rising demand for autologous cord blood over the last 10 years was also suggested.

The report documented nine samples released for regenerative therapies in addition to the four cases of aplastic anemia (reviewed in detail in the first study).

— Stem cell infusions were conducted at Duke University and Children’s Memorial Hospital in Chicago. Six samples were released to treat neurological conditions, including traumatic brain injury (one sample), anoxic brain injury (one sample), and cerebral palsy (four samples). Some anecdotal reports of improvement in quality of life, and anecdotal evidence by physicians involved with these cases suggests that the treatments were safe. This was because these six samples were not released as part of any specific clinical trial. Two more samples were released for treatment of cerebral palsy since the study period ended.

— As part of an ongoing clinical trial at the University of Florida, two client samples were released for type 1 diabetes. Possibly slowing the destruction of their insulin-producing cells and resetting the immune system, preliminary data from the first seven patients in the trial show the stem cell infusion appears to have reduced their disease severity.

— To treat a diagnosis of a rare immune disorder, one additional sample was released for an experimental autologous stem cell infusion.

“Cord blood stem cells are increasingly being used by transplant physicians in regenerative medicine because of their demonstrated ability to produce almost all of the cell types of the body,” said Harris. “These cases provide physicians and researchers with additional insight into how cord blood stem cells may be used to treat more conditions and ultimately benefit more patients.”

Regenerative medicine therapies could provide benefits to approximately one in three Americans according to current estimates. Currently, the U.S. alone is conducting more than 200 National Institutes of Health (NIH) funded clinical trials with cord blood.

Existing as the most recommended cord blood bank by obstetricians for eventual familial use in transplantation and regenerative medicine, Cord Blood Registry(R) (CBR(R)) is the largest cord blood stem cell processing and cryopreservation service. For more than 190,000 newborns throughout the world, Cord Blood Registry preserves cord blood stem cells. Amounting to a number eclipsing any other family cord blood bank, the AABB accredited CBR has released more than 55 client cord blood units for specific therapeutic use. Focusing on the collection, processing and storage technologies to optimize quality and cell yield, the company

Difficult to Heal Fractures Get Enormous Healing Boost from Stem Cells

Patients with previously hard-to-heal breaks in the long bones of their thighs, shins or arms, achieved repair in 91 percent of fracture cases due to stem cell therapy stated Aastrom Biosciences Inc.

33 patients with severe bone breaks that had previously failed to join from standard treatments had stem cells surgically inserted at their fracture sites in a study using stem cells developed by Aastrom. Today at a medical meeting in Boston, the Ann Arbor, Michigan-based company reported that the fractures of 30 patients had healed a year following stem cell therapy.

“We are treating patients that have not healed in the past and are unlikely to heal in the future with normal procedures,” said Elmar Burchardt, the company’s vice president of medical affairs, in a telephone interview. “It’s a completely new approach for bone treatment and tissue regeneration with the idea of restoring its original architecture.”

Aastrom has created a technique for expanding and purifying patients’ own stem cells as a therapy, and is one of several U.S. companies working to bring stem cell-based treatments to market.

Establishing efficacy in a disease that restricts blood circulation in limbs is also part of company tests in addition to testing its approach in several orthopedic uses. Spinal cord injuries and heart disease treatment development is also in the works.

Due to a poor blood supply, osteonecrosis is a condition that damages bone in the hips and other areas. The company is furthest along in testing its cells to treat this rare condition. The company has entered the final stage towards regulatory approval. They have recruited 120 osteonecrosis patients for a last phase study. Burchardt said that as soon as 2010, clearance from the U.S. Food and drug Administration could be sought.

The 30 bone-fracture patients who were deemed by the company to have healed all had bone scans that showed “multiple contact points” between pieces of bone that were formerly fragmented, Burchardt said. The patients’ limbs now “are fully weight-bearing and have full range of motion,” he said.

Pulmonary Hypertension Stem Cell Cure

Pulmonary hypertension is high blood pressure in the arteries leading to the lungs. There is no cure for the disease, but there are treatments that help to ease some of the symptoms of the disease. The vessels that carry blood from the heart to the lungs become hard and narrow in patients with pulmonary hypertension.

Over time, the heart will weaken and may result in heart failure since the condition makes it more difficult for the heart to pump blood. Available treatments for the disease range all the way to lung transplant, with oxygen therapy and drugs being less aggressive forms of therapy.

The condition is relatively rare. Among people with the disease, there were 260,000 hospital visits and 15,668 deaths in 2002. 807,000 people with pulmonary hypertension were hospitalized during the two years spanning 200 and 2002. Thirty-four percent of those hospitalizations were younger than age 65, and 61 percent were among women.

Today, their is a great deal of chatter about an innovative approach to treating pulmonary hypertension. Cell therapy is being combined with gene therapy in order to treat patients. No blood vessel or heart disease has ever been treated using combined cell and gene therapy. This approach marks a first.

Using adult stem-like cells called endothelial progenitor cells (EPC), researchers from St. Michael’s Hospital in Toronto are treating patients with pulmonary hypertension. Damage occurs to the endothelial cells which line the blood vessels of the lungs in people suffering from the disease.

“The one thing that all endothelial cells have in common is that they are replaced by circulating endothelial progenitor cells. We all have in our blood a very small proportion of cells that circulate freely in our blood that have the capacity to become healthy endothelial cells when they are in the right environment. We think that those cells are there to repair blood vessels that are damaged,” Dr. Michael Kutryk, from St. Michael’s Hospital, said.

The EPCs are harvested from the patient’s blood by doctors during the study. Endothelial nitric oxide synthase (eNOS) is a gene that is loaded into the cells. These extra copies genetically alter the cells. Maintaining healthy blood vessels is impossible without the gene eNOS. Doctors re-inject the cells into the patient after they have been genetically modified and grown in the lab. The hope is that the damage that has occurred in the patient’s lung’s blood vessels will be reversed by the treatment.

“It’s a very, very novel and first in the world application of this technology. This will be very exciting if we can halt the progression of the disease … we’re hoping we can, in fact, reverse the disease in many cases,” Kutryk said.

Treatment is being administered with increasing doses given to subsequent patients as the study is still in the early phases of testing.

“We’re certainly seeing positive results at the moment, but we expect to see much better results as we increase the doses of genetically modified cells,” Kutryk said.

The study is currently ongoing in Toronto and Montreal.