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AS REGULAR READERS KNOW, I CONSIDER AMERICA “THE BANGLADESH OF STEM CELLS. LIKE CHILDREN LOST IN A FOREST, AMERICA WANDERS AROUND, HOPELESSLY CAUGHT UP IN A POLITICAL/RELIGIOUS BATTLE OVER THE SCIENCE FICTION OF EMBRYONIC STEM CELLS. AS FAR AS THE REAL SCIENCE OF ADULT STEM CELLS IS CONCERNED, CHINA AND INDIA ARE SO FAR AHEAD OF THE USA THAT AMERICA MAY NEVER CATCH UP.Â
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HERE IS A FEB.2008 ARTICLE FROM INDIA. IT IS SAFE TO SAY THAT WHILE A PRECIOUS FEW AMERICAN RESEARCHERS KNOW SOME OF THE FACTS IN THIS ARTICLE, NONE OF THEM WILL BE INVOLVED IN THIS CUTTING EDGE RESEARCH DURING THIS DECADE, IF EVER, IN THE LAND OF THE FREE. FURTHER, IN MY OPINION, EMBRYONIC STEM CELLS WILL NOT BE IMPLANTED INTO HUMANS TO HELP CURE THE BELOW DISEASES DURING THE LIFETIMES OF AMERICANS SUFFERING FROM THESE DISEASES TODAY.---DM
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EXTRACTED FROM THE DECCAN HERALD, FEB 5, 2008.
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http://www.deccanherald.com/Content/Feb52008/snt2008020550496.asp
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Stempeutics has been doing some pioneering work on stem cells with a focus on "benchside to bedside", as the manager, Manohar says. "We do not want to be doing research that is too basic to be applied."
At present, four major clinical trials with 100 patients each are ongoing in cerebral strokes (!), limb Ischemia (!), myocardial infarction and multiple sclerosis (!). (OF THESE FOUR, ONLY MYOCARDIAL INFARCTION IS CURRENTLTLY IN CLINICAL TRIAL IN THE USA---DM) These are some diseases for which pilot tests have shown satisfactory to good results. Parkinson's is another ailment that has responded well but as it involves brain surgery, is a bit more complicated.
Calling it experimental therapy, Manohar says that almost 80 patients have been treated using mesenchymal stem cells, found in the bone marrow. "In the last six months alone almost 40 patients have been treated and in 25 per cent of the cases, the results were good. While the Parkinson's patients showed remarkable recovery (TAKE NOTE, MICHAEL J. FOX. AS CHRISTOPHER REEVE DID, YOU ARE WASTING YOUR LIFE CHAMPIONING EMBRYONIC SCIENCE FICTION WHICH EXISTS ONLY BY PRETENDING THAT WHAT CAN HELP YOU NOW---ASC-- DOES NOT WORKDM)Â with many even stopping the drug, with spinal cord injuries there was mixed results," says Dr Totey. It was found that the cells were not migrating to the site.
One of the reasons he cited could be the mode of delivery of stem cells. Usually it is delivered at the site of injury, or through lumbar puncture or the arterial route. The site of injury is the best approach, though in the case of brain diseases, this means complications.
The stem cell treatment works well for fresh injuries but some experts believe that the body sends stem cells naturally in this period. After six months or so, the scar tissue forms and can hinder the migration of stem cells administered.
A patient from Rajkot had been paralysed after falling from a giant wheel at Essel World. After two years the family contacted Manipal hospital in 2006. "We did the MRI scan and identified the injury points on the spine and at these places we made incisions to take out the scar tissue. It became a fresh injury so the stem cells we injected went unhindered to the damaged spot," notes Dr Totey.
Now she has recovered to a large extent, can move around and has control of the bladder, etc. She required two injections so far, of stem cells drawn from her bone marrow.
Unlike usual bone marrow transplants where a litre of the liquid is drawn each time, with mesenchymal adult stem cells, all that is required is 30-60 ml which can be cultured in the lab for future use as well, he says.
Unlike most other adult stem cells, mesenchymal are pluripotent and can grow into any tissue. The other big advantage is that there is no need for matching. Any donor can donate cells from his bone marrow. As it takes 20-25 days to culture the stem cells in lab, this is an advantage as readily available cells can be administered in emergency situations instead of having to draw from the patient's bone marrow and culture.
"The problem is in isolation and culturing. Very small quantities of the cell are present in the bone marrow. We have patented the technology," says Totey.
In the case of cerebral stroke, the problem arises in delivering stem cells due to the blood brain barrier. This is a natural barrier of the body which prevents most antibodies and toxins, even cells, from going into the brain. During an injury, just for very short time the diaphragm is also damaged and allows passage. Unless the patient comes in this time, stem cells can't be delivered through the blood route.
Despite the country still lacking a law on stem cell therapy, the DCGI has allowed Stempeutics to conduct trials at multiple sites. The draft guidelines have been awaiting discussion almost since two years now. It is expected to be tabled in Parliament this summer.
There are plans to add a few more diseases to the present list under study. These include vitiligo (a skin eruption), dilated cardiomyopathy, end-stage liver disease, etc.
"By end 2009, we hope to have the first defined stem cell based drug for standard therapy on the shelf, just like all other medicines. This will be for a few of the diseases studied," says Manohar.
In the area of transplants too, stem cells can do miracles as witnessed when a heart taken from a cadaver came alive when a "stem cell scaffold" was introduced. Essentially, a 3-dimensional makes it easy for stem cells to multiply and form a whole new organ.
"This needs some amount of tissue engineering and we are working with some US universities as also Sri Thirunal Institute in Trivandrum who are experts in polymer science. Using biomimetic material which is also bio-degradable, we introduce a small heart inside the dead one. Eventually the scaffolding falls off and the stem cells have done their job," explains Dr Totey. This will be a big boon for transplants because stem cells can only help repair a damaged tissue if the damage is small but if the whole organ has failed, we need transplants, he adds.