Regenerative medicine has become an enticing field of study for doctors and patients alike. 30% of physicians in California are over 60 and the senior citizen population (prospective patients) is estimated to grow between 2015 and 2035 from 19% to 26% respectively. On the one side, patients potentially experience permanent improvement. On the other side, doctors experience the satisfaction of radically improving patients' lives and the compensation isn't bad either.
I originally became interested in stem cell therapy through a fellow scleroderma patient and 1990er, Chanel White (TubeFedWife Blogspot):
In 2016 she received life-saving autologous hematopoietic stem cell transplantation treatment (from her own bone marrow) in a clinical trial in Chicago for severe autoimmune patients. $125,000 out of $150,000 was covered under insurance and the rest by community efforts. I was thrilled for her upon learning she was apparently cured and living life again (she went private on Instagram and blog posts ceased -- a good sign), whereas previously she was dying (unfathomably painfully).
In 2018, the dream collapsed; Chanel was diagnosed with autologous graft versus host disease. My heart fell. Fighting scleroderma is one thing, but fighting a disease that her doctor has only been seen once before? I'm rooting for Chanel. She may not have scleroderma anymore, but she'll always be a #sclerodermawarrior. She's a voice for us all.
Stem cells pose promise in restoring vitality to aging and age-concerned patients as well. On a Lufthansa transfer flight through Switzerland in 2014 (was an Asia health insuratech frontend engineer at the time), I remember leafing through a pamphlet advertising for osteoarthritis patients and spa enthusiasts. In Singapore, placenta (from human, horse, sheep and goat) stem cells are widely available as supplements (Wisma Atria nearby Etude House in Singapore). Apple stem cells are available at local American malls in high-end skincare. Clinics offer to save umbilical cords for later use in stem cell therapies.
Inclusion of (unknown) plant-stem cells and arguably scientifically appropriative wording like epigenetics, DNA, epidermal, extracellular, glycation, viscoelasticity, regeneration, biologic, cell, genes, aging and matrix help this OTC skin cream command $846 (pre-tax) for 1.7 oz (HowToSpendIt and EmbassyOfBeauty):
For that amount of money for a tiny jar of face cream (just a little more volume to knock back than a shot of whiskey), one might expect to age backwards. Lucky for me, I physically produce excess collagen so I do that already -- sort of.
Hematopoietic Stem Cell Transplantation
Use of stem cells from bone marrow or peripheral blood for hematopoietic reconstitution is well-established at this point. The FDA furthermore offers that doctors routinely use allogenic and autologous HSCT to treat cancers and disorders of the blood/immune system.
Yet the FDA also warns of potential risks after mounting evidence of patients experiencing side effects (FDA):
Bone loss/degenerative condition(s) secondary to the patient's illness before treatment, angiomyeloproliferative lesions, allogenic graft-versus-host, autologous graft-versus-host, tumor growth, cancer, nose cells growing in the spine, blindness have been consistently -- though inoften -- reported. Particularly troublesome (and NOT recommended by the FDA) seems stem cells extracted from adipose tissue and other non-studied sites.
Histopathological findings reveal multiple cysts lined by respiratory mucosa in the spine (site of stem cell transplantation) of a patient (Journal of Neurosurgery):
- https://www.niaid.nih.gov/news-events/stem-cell-transplant-severe-scleroderma-improves-survival-quality-life : Stem Cell Transplant for Severe Scleroderma Improves Survival, Quality of Life, National Institute for Allergies and Infectious Diseases
- https://www.nih.gov/news-events/nih-research-matters/stem-cell-transplant-helps-people-severe-scleroderma : Stem cell transplant helps people with severe scleroderma, NIH
- https://www.ncbi.nlm.nih.gov/pubmed/10027899 : Mechanisms of bone loss following allogeneic and autologous hemopoietic stem cell transplantation., NIH
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3718921/ : Skin Graft-versus-host Disease Following Autologous Stem Cell Transplantation for Multiple Myeloma, NIH
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5827903/ : Autologous Graft-Versus-Host Disease of the Gastrointestinal Tract in Patients With Multiple Myeloma and Hematopoietic Stem Cell Transplantation, NIH
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5270387/ : How I treat bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation, NIH
- https://www.hindawi.com/journals/bmr/2014/891427/ : Autologous Graft versus Host Disease: An Emerging Complication in Patients with Multiple Myeloma, NIH
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3290125/ : Meet the Corneal Myofibroblast: the role of myofibroblast transformation in corneal wound healing and pathology, NIH
- https://www.nejm.org/doi/full/10.1056/NEJMoa1609583?query=TOC : Vision Loss after Intravitreal Injection of Autologous "Stem Cells" for AMD, New England Journal of Medicine
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2827900/ : TP53 Mutations in Human Cancers: Origins, Consequences, and Clinical Use,
- https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000029 : Donor-Derived Brain Tumor Following Neural Stem Cell Transplantation in an Ataxia Telangiectasia Patient, PLOS Medicine
- https://thejns.org/spine/view/journals/j-neurosurg-spine/21/4/article-p618.xml : Autograft-derived spinal cord mass following olfactory mucosal cell transplantation in a spinal cord injury patient, Journal of Neurosurgery
- https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm286155.htm : FDA Warns About Stem Cell Therapies, FDA
- https://www.nature.com/articles/nature22312 : Human pluripotent stem cells recurrently acquire and expand dominant negative P53 mutations, Nature
- https://www.nejm.org/doi/full/10.1056/NEJMp1613723 : Clarifying Stem-Cell Therapy’s Benefits and Risks, New England Journal of Medicine
Stem Cell Therapy Offers Hope to Poor-Prognosis Patients
Make no mistake: stem cells save lives and improve lives. In a sense, getting autologous-graft-versus-host 2 years after transplantation means living AT LEAST 2 MORE GOOD YEARS than what the patient's disease wants them to live; and remember, aGVHD is treatable. Especially for poor-prognosis autoimmune and blood disorder patients, stem cell therapy provides a promising pathway -- another treatment option for doctors and patients to have in their arsenal:
If we are to leverage stem cells as a versatile treatment against intractable conditions certainly more research is needed.
Best Manufacturing/Treatment Practices
Experimental/regenerative orthopedist Dr. Purita uses a hybrid technique, for the reason he wonders if preserving muse cells and exosomes may play an beneficial role in treatment results (StemCellOrthopedic):
The jury is out whether centrifugation, aspiration at different depths with no centrifugation, enzymatic isolation, field flow fractionation, dielectrophoresis give the most favorable outcomes. Subtle contamination/lossiness of concentrate owing to a particular stem cell isolation method is just one possible concern. Ultimately, stem cell therapy presents an exciting new subfield in experimental medicine. It can permanently change lives for the better. Evidence so far shows stem cells as far from a cure-all, however; and, like other treatments we've seen up until now, it poses side effect risks.
- https://stemcellsjournals.onlinelibrary.wiley.com/doi/full/10.1002/sctm.18-0031 : Intravenous Infusion of Umbilical Cord Blood‐Derived Mesenchymal Stem Cells in Rheumatoid Arthritis: A Phase Ia Clinical Trial, Stem Cell Journals
- https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm405558.htm : Cord Blood: What You Need to Know, FDA
- http://www.bloodjournal.org/content/112/11/4660?sso-checked=true : Analysis of Umbilical Cord Blood Stem Cell Therapy for Regenerative Medicine Applications, American Society of Hematologyhttps://www.terencedelaneymd.com/umbilical-cord-blood-stem-cell-therapy.html : Umbilical Cord Blood Stem Cell Therapy, Terence Delaney MD
- https://medicalxpress.com/news/2017-10-unproven-stem-cell-clinic-curtailed.html : Finally, unproven stem cell clinic practices might be curtailed, Medical Xpress
- https://stemcellorthopedic.com/bone-marrow-centrifugation-important/ : Bone Marrow Centrifugation: Is it Important?, Institute for Regenerative Medicine
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3596831/ : Stem Cell Separation Technologies, NIH
- https://www.ncbi.nlm.nih.gov/pubmed/18632697 : Good manufacturing practice and clinical-grade human embryonic stem cell lines., NIH
- https://www.hindawi.com/journals/sci/2018/1429351/ : Isolation, Culture, and Functional Characterization of Human Embryonic Stem Cells: Current Trends and Challenges, Hindawi
- https://stemcellres.biomedcentral.com/articles/10.1186/s13287-016-0445-6 : Centrifugal gravity-induced BMP4 induces chondrogenic differentiation of adipose-derived stem cells via SOX9 upregulation, BMC