Stem cells got a bad reputation in the beginning, because it was thought that embryonic stem cells would be required to treat degenerative conditions. Immediately this raised an ethical flag, as embryonic stem cells would have been derived from a dying fetus. This created a lot of unnecessary division among the public and scientists. It turns out that for most treatments there are enough stem cells in the body, as I will explain below, but initially this was not known.
The next bad rep came from Dolly, the sheep that was born on July 5, 1996. She only lived for 6 years, because the telomeres were short like that of an old animal and she died of a progressive lung disease. To create Dolly a complicated stem cell technique was used called “somatic cell nuclear transfer”. Three animals were required to achieve this. One animal provided an unfertilized egg cell from which the nucleus was extracted. From the second animal a breast gland cell was used to donate a cell nucleus and a third animal was used as a surrogate mother. After some cell divisions the blastocyst was transferred into the uterus of the surrogate mother who carried baby Dolly until birth.
Fast forward to 2013. We now know that stem cells are fragile cells that do not like too much manipulation. Stem cells have long telomeres so they are younger than the typical cells of the body. We know that stem cells can be found in the bone marrow, in fatty tissue and many other organs. In the last few years a lot of research has been done and this has already translated into practical applications. Originally stem cells were considered to be cells that could develop into any variety of body cell. At that time they were thought to only derive from the bone marrow or from fetal tissue. Scientists called these cells “pluripotent cells”. In the last years it was noted that turning off a gene called SP100 could also prompt a body cell to become such a versatile, pluripotent stem cell. They are called “induced pluripotent stem cells” to distinguish them from embryonic stem cells, which have been highly contentious with religious groups. In recent years matters have been simplified with the observation that mesenchymal stem cells are distributed freely throughout the body and can be harvested fairly easily from fatty tissue by liposuction. This latter technique is preferred, as it does not involve any manipulation of the stem cells themselves.
Here are a few examples of what is being done now and what is expected to come:
Minimal invasive face-lift, called “space lift”
The fact that mesenchymal stem cells are freely available in fatty tissue has already been employed by plastic surgeons in the US and elsewhere for a minimal invasive plastic surgery called “space lift” where fat is removed by liposuction, the fat graft is separated with a cell separator into a fat cell fraction and into a mesenchymal stem cell rich fraction, which are injected together into various areas of the face where subcutaneous tissue is needed. The mesenchymal stem cells enable the fat cells that were transplanted to latch on to the small vessels in the transplanted area so that they survive permanently, and the result is a more youthful appearance of the face (see image). This is the secret of film stars in Hollywood. Nowadays the plastic surgeons in Beverly Hills do not do the conventional facelifts so much as they lead to artificially looking faces, but rather do the minimal invasion space lift for the natural look.
Knee problems, hip problems and lower back problems
Why wait with degenerative diseases of the knees, hip or of the lower back until there is permanent scarring and disabilities? With a similar technique described under point 1 above one can inject the mesenchymal stem cell rich fraction (without the fat cells this time) into the joints that are affected with degenerative changes (knee joints, hips, facet joints along the spine). The result is that cartilage is recreated by the transferred mesenchymal stem cells and the patient becomes pain free and regains mobility! But as with other diseases it is important to intervene early enough before permanent damage has set in.
Another exciting development is intravenous injection or injection via an arterial catheter into failing organs. Heart failure is an end-stage heart disease, where conventional medicine has nothing to offer other than symptomatic supportive medication. However, mesenchymal stem cells can be injected into the blood and the pluripotent stem cells will find the weak areas in the heart muscle where they transform into heart cells and give the existing heart cells a boost.
The result is that the heart pumps more forcibly and the symptoms of heart failure disappear. Similarly, there are trials that show that Parkinson’s disease can be positively influenced with injections of the mesenchymal stem cell rich fraction.
Treatment of patients with liver failure using mesenchymal stem cells is being investigated, but is still in its infancy.
With regard to mesenchymal stem cell treatment of chronic kidney failure early human experiments on 30 patients showed very encouraging results.
Although this field is very promising, more caution is in order with regard to laboratory-manufactured stem cells. More trials are needed to show that they are ready for use in regenerative medicine. In other words they have to show similar or even better successes as the present results achieved with mesenchymal stem cells that were directly harvested and left unchanged as described above.
More information on:
1. stem cells for stroke victims: http://nethealthbook.com/news/stem-cells-help-stroke-victims/
2. stem cells for knee osteoarthritis: http://www.askdrray.com/joint-replacement-for-osteoarthritis-of-the-knee-will-become-obsolete/
Last updated Nov. 6, 2014