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Thread: Stem cells are not necessarily *stem cells* when you see them in media reports

  1. #1

    Stem cells are not necessarily *stem cells* when you see them in media reports

    I am troubled by people jumping to the conclusion that stem cells are being used everywhere but in spinal cord injury clinical trials. It is not true for the following reasons:

    First, stem cells are and have been used in spinal cord injury clinical trials. For example, the cells that were used in the Diacrin trial are neural stem cells obtained from fetal pigs. This trial was carried out at Washington University in St. Louis and at Albany Medical Center in Albany. Fetal spinal cords were transplanted in patients at the University of Florida at Gainesville trial; the cords very likely contained human spinal cord stem cells (ependymal and other cells). It is likely that nasal mucosa transplants contain stem cells and those trials are being carried out in Lima and also in Brisbane. Although most of the reports of the Lima and Brisbane trials emphasize olfactory ensheathing glia, there is not much information available concerning the identity of the cells that were transplanted and it is likely that the transplants included stem cells. Finally, the Russians have been transplanting fetal stem cells for some time now in Moscow and Novosibirsk. In fact the Moscow group claimed to use the technique of Evan Snyder to isolate fetal neural stem cells from aborted fetuses and transplanted them into patients.

    Second, many reports in the literature concerning "stem cell therapies" of various diseases are referring to hematopoietic stem cells. These are cells from adult bone marrow, adult peripheral blood which were cultured and expanded, and umbilical cord blood being used to replace blood-producing cells. Bone marrow transplants are frequently used to treat people with immunodeficiency problems, sickle cell anemia, leukemia, and other hematological disorders Please note that the bone marrow cells are transplanted to replace red and white blood cells. This is not the same as getting the cells into the spinal cord and getting them to produce new neurons or to produce tissue that would bridge the injury site.

    Recently, there were several reports of use of "stem cells" to repair the eyes and heart. The first is related to use of corneal cells from underneath the cornea and that apparently have the ability to produce new cornea (part of the eyeball surface). The second is related to use of a population of cells called mesenchymal stem cells usually from bone marrow. These cells are known to form and stimulate blood vessels. This is likely to be the mechanism by which these cells repair acute injuries of the brain and spinal cord, through the promotion of angiogenesis (or formation of new vessels).

    Wise

  2. #2
    Senior Member Max's Avatar
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    Wise,

    Second, many reports in the literature concerning "stem cell therapies" of various diseases are referring to hematopoietic stem cells. These are cells from adult bone marrow, adult peripheral blood which were cultured and expanded, and umbilical cord blood being used to replace blood-producing cells. Bone marrow transplants are frequently used to treat people with immunodeficiency problems, sickle cell anemia, leukemia, and other hematological disorders Please note that the bone marrow cells are transplanted to replace red and white blood cells. This is not the same as getting the cells into the spinal cord and getting them to produce new neurons or to produce tissue that would bridge the injury site.

    Recently, there were several reports of use of "stem cells" to repair the eyes and heart. The first is related to use of corneal cells from underneath the cornea and that apparently have the ability to produce new cornea (part of the eyeball surface). The second is related to use of a population of cells called mesenchymal stem cells usually from bone marrow. These cells are known to form and stimulate blood vessels. This is likely to be the mechanism by which these cells repair acute injuries of the brain and spinal cord....
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    But it still doesn't make sence -Why this therapies applied to humans without proper protocols (mice, rats, cats, dogs ,monkeys...and then hopefully many years after human trials)?

    Why sci is a "foster child" of biomedical research??

    Its either Da style conspiracy or it does not make any sence at all....

  3. #3
    max, I don't know where this idea comes from that bone marrow cells are being transplanted without proper protocol. Bone marrow stem cells have been transplanted into humans for over 30 years! Thousands of people are getting these transplants. It has proven safety. So, it is just like giving an approved therapy for a new indication. There are literally thousands of animal studies supporting the therapy for hematopoietic application. The treatments of myocardial infarcts were supported by dozens of animal studies before they were started. Wise.

  4. #4
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    Wise,

    I understand your frustrations, but I still think SCIs are getting the short end of the stick in the U.S.

    Human cells, whatever the origin, don't seem to be used for regenerative therapies for SCI in the U.S. like they are in other countries. The U.S. seems to be lagging in this area and I can only hope our competitive nature(wanting to be the best at everything) kicks in and we catch up SOON.

  5. #5
    Senior Member Max's Avatar
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    Wise,

    What about unbilical cord bloud stem cells therapies?

  6. #6
    Good points, Dr. Young. You could add that adult bone marrow stem cells are being clinically used in Italy (for SCI and ALS) and Brazil for SCI. Also, regarding the olfactory mucosa work in Lisbon, Portugal, it's my understanding that the surgical team considers neural stem cells and progenitors (in olfactory mucosa) key components of the mucosa's regenerative capacity.

    Perhaps some on this forum are expressing frustration that adult regenerative options for SCI are readily explored overseas. Whereas the U.S. is seemingly fixated on embryonic options, despite the basic research hurdles that need overcome before they can be safely and effectively used, and on fetal options, despite indifferent results in the Florida SCI trial and in two Parkinson's clinical studies.

  7. #7
    Max, Umbilical cord blood cells are being used for replacing hematopoeitic cells. There are few, if any studies, of umbilical cord blood cells shown to be useful in spinal cord injury. In the meantime, there is some controversy whether umbilical cord blood cells are pluripotent. This is something that needs to be worked out in the coming months.

    Iacapo, I should include the work transplanting bone marrow stem cells in Brazil. I know the researchers who are doing it. I have not been free to announce information that has been given to me confidence and therefore have not been putting it in most of the announcements. However, I think that they have been talking about the trial to others.

    cjo, yes, I understand the frustration at the slow pace of clinical trials starting in the United States. However, there have just been too many postings saying that there have been no clinical trials assessing stem cells. There have been trials. Of course, we need more trials but at the same time we must understand that the reason why the trials have been slow. It takes time to raise money for the trials. If the trials are funded by NIH, a significant amount of preclinical data is required and such data is lacking for many of the therapies that people think should be tried in people.

    Wise.

  8. #8
    I thought we already had this discussion.

    Bottom line . . . Neuronyx is doing their work with ASC bone marrow. Others are as well. University of Minnesota just came out with a report suggesting that they've made a huge breakthrough showing ASC's can be manipulated like ESC. Neuronyx has now announced plans for initial human trials in the next year.

    Further, we have the trials taking place now in South America involving bone marrow. And we've had numerous omentum surgeries already performed that show anywhere from a 20 -30 percent functional recovery rate that would prabably be much higher if proper rehab techniques had been undertaken. Keeping in mind that many researchers believe that success with the omentum are probably related to 1) the revascularization of the spinal cord; and 2) the existence of primitive cells (i.e. ASC) in the omentum itself.

    As compared to other fields of neuro-science the advances of ASC appears slow . . . but that now appers to be changing rapidly as we have seen in just the past few weeks.

    One thing is for sure. We need to raise money to support hman clinical trials and that won't happen unless we make it happen.

  9. #9
    Larwatson, I think that the claim that omentum transplants improve function by 20-30% is still controversial. Several clinical trials have reported little or no improvements of function after omentum transplants in people with spinal cord injury. It is possible that these trials did not use the appropriate surgical techniques. Wise.

  10. #10
    Lar, have you been hanging out with Meeker down there in AZ?

    Are you considering having an omentum transplant?

    [This message was edited by seneca on 05-06-03 at 11:45 AM.]

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