While stem cell therapies have been on the radar for decades, the recent successes in this breakthrough area of medicine are remarkable. Twenty years ago, these accomplishments would have sounded fantastic and otherworldly. But now they’re a reality.
The science is moving very quickly. It seems like every day doctors are announcing yet another advance in stem cell therapies. These successes will revolutionize the way that medicine is practiced.
Stem cells have now been used to…
• Build a new bladder. It’s now possible to grow a new bladder in a laboratory—stem cells are removed from the patient’s injured organ and “seeded” in a bladder-shaped mold. In one patient, a made-to-order bladder continues to function more than 15 years after it was implanted.
• Create insulin-producing cells. Type 1 diabetes is an autoimmune disease in which the body’s immune system destroys insulin-producing beta cells in the pancreas. Patients can survive only with daily injections of insulin, a treatment that’s expensive and time-consuming—and not optimally effective.
There are a variety of ways to produce beta cells that can be implanted in a patient—existing beta cells can be induced to multiply using medications…non-insulin-producing cells can be manipulated to convert into beta cells…and stem cells from the patient, or more often a donor, can be induced into beta cells. The cells do not necessarily have to be injected into the pancreas, but they do need to be protected from destruction by the autoimmune system.
• Aid in heart failure recovery. In the largest study of this type, the University of Utah found that heart failure patients whose hearts were injected with stem cells had a 37% lower rate of death/hospitalization than those given a placebo. The stem cells, extracted from the heart patient’s bone marrow, helped existing heart cells work more efficiently.
• Repair an esophagus. In an experimental procedure, a patient who had a damaged section of esophagus was given metal stents that were then populated with stem cells from the patient’s muscle and donated skin. Four years later, the cell therapy had caused all five layers of the esophageal wall to regenerate. The patient could swallow normally, and the stents were removed.
• Speed stroke recovery. Even when patients survive a stroke, they often suffer from permanent neurological damage. A study conducted by researchers at Stanford University and University of Pittsburgh found that stroke patients who were injected with modified stem cells had significant improvements.
Details: Stem cells were genetically manipulated to secrete chemical factors that have been shown to support and protect damaged cells. Patients were given a onetime injection of these stem cells into an area of the brain damaged by stroke. Patients saw improvements in mobility—for example, weakened legs began to work better and some patients in wheelchairs reported the ability to walk again. It’s possible that the stem cells (which began to die off a month after the treatment) secreted chemicals that improved neural circuits and reactivated impaired sections of the brain.
Outlook for the future: Right now, there are thousands of ongoing clinical trials involving stem cells.
Hundreds of private clinics throughout the US are getting ahead of science and offering stem cell treatments that have not been FDA-approved for conditions as varied as Parkinson’s disease, spinal cord injuries and multiple sclerosis.
Some of the treatments might be helpful, but many others won’t pan out…and may draw a patient away from standard treatment that could be helpful. In some cases, stem cell treatment at private clinics can be dangerous, since the source and purity of cells aren’t known—for example, cells that have been multiplied in unknown labs may have been transformed into cancer cells. Also, without FDA approval, the treatments are not likely to be covered by insurance…and the cost can be enormous.
My advice: Avoid private clinics. If your doctor determines that you have a condition that might be improved with stem cell therapy, ask him/her to help you enroll in a clinical trial in your area. ClinicalTrials.gov is a good place to review ongoing stem cell clinical trials. In many cases, the sponsors of the study will pick up some or all of the costs.
Most serious diseases—heart disease, diabetes, cancer and arthritis, among many others—are caused by damaged (or aging) cells in the body’s tissues. The theory behind stem cell therapies is that these diseases can be cured by replacing defective cells with pristine, disease-free cells. With this groundbreaking approach, stem cells can be extracted, isolated, purified and multiplied in a lab and then implanted in the body, where they continue to divide and differentiate to regenerate healthy adult tissues. Stem cells also can act as natural healers, rather than actually replacing aging cells.
Early in your body’s development, embryonic stem cells are undifferentiated. Each has the potential to eventually become any of the different types of cells that your body needs—for example, skin cells, brain cells, heart cells, etc. For medical research, embryos have either been created in the lab or obtained from in vitro fertilization clinics. But this practice is controversial—to obtain the cells, an embryo has to be destroyed.
For practical as well as moral and ethical reasons, most researchers now work with adult stem cells—stem cells that persist after birth and are found in virtually every tissue of the body. Adult stem cells have probably lost some of the potential to become any type of cell, but they can be manipulated. Example: Adult stem cells taken from fat tissue can be coaxed to become cartilage, bone or even heart cells.
Another source of stem cells: Induced pluripotent stem cells (iPSCs). These are fully differentiated adult cells that can be transformed into embryonic-like cells via genetic manipulation in a lab.
