When it comes to stem cells, there are lots of questions out there about them. Some of our Stem Cell Therapy Frequently Asked Questions are more research based, some are more healthcare based, and some involve a desire for basic understanding of what stem cells are. With the help of the National Institute of Health, we have compiled a Stem Cell Therapy Frequently Asked Questions list to help you stay informed on this emerging science and treatment.
Simply put, stem cells are cells with the potential to develop into many different types of cells in the body. They are part of the repair system for the body.
The two main stem cell types are embryonic stem cells (ES) cells and adult stem cells (i.e., somatic stem cells). Other types, such as induced pluripotent stem cells (iPSCs), are produced in the lab by reprogramming adult cells to express ES characteristics.
Pluripotent stem cells offer the possibility of a renewable source of replacement cells and tissues to treat a myriad of diseases, conditions, and disabilities including: Parkinson’s disease, blindness, spinal cord injury, burns, heart disease, diabetes, and arthritis.
The reason scientists want to use stem cells is twofold: 1) They hope to grow these stem cells into tissues, afflicted by certain diseases, to better assess what causes these diseases and how to create effective treatments; and 2) scientists can use stem cells to repair or patch damaged cells in people with various diseases.
Some stem cell research requires the use of human embryonic stem cells (HESCs). To obtain embryonic stem cells, the early embryo has to be destroyed. However, induced pluripotent stem cells offer an alternative approach to stem cell research and treatment that doesn’t involve HESCs. An ongoing debate also revolves around the ethics of cell/tissue cloning to create transplants for those suffering from disease. How to monitor and regulate cloning is an issue of much discussion.
The biggest reason that human embryonic stem cells are arguably more effective for stem cell research and treatment is because embryonic stem cells are pluripotent and can become all cell types of the body. Adult stem cells are more limited in their differentiation. Furthermore, embryonic stem cells can be grown with relative ease in culture. Adult stem cells are harder to find in mature tissues. This complicates the isolation process. The mechanics behind expanding adult stem cells in cell culture are still problematic. Since a large number of cells are required for stem cell replacement therapies, this makes adult stem cell harvesting more challenging.
Experimental tests and clinical trials have had success with certain conditions and diseases. Consider the following:
On July 12, 2011, scientists injected retinal cells, derived from embryonic stem cells, into the eyes of two patients suffering from progressive blindness. The patients who received the therapy currently exhibit no signs of adverse effects from the treatment and are reporting small improvements in their vision. The transplanted retinal pigment cells have integrated into the eye tissue and are aiding photoreceptor cells to function again.
Scientists are currently treating some patients with Parkinson’s disease with stem cell therapy. So far, the two patients treated to date are showing no ill effects from the therapy, which is being studied in a phase 1 trial involving 12 Parkinson’s disease sufferers conducted by researchers at the Royal Melbourne Hospital in Australia.
In the June 2017 issue of Forbes magazine, they disclose a couple of the current findings in the field of stem cell science and medicine. As part of a 2016 trial, neurologist Charles Liu, infused ten million stem cells into a paralyzed patient’s spinal cord. Within months, the patient could lift weights, write his name and feed himself. Although Liu’s study is not complete, and the treatment is not standard therapy, researchers were encouraged enough by the results to extend the treatment to people with less-severe spinal injuries who would have been too risky to include in initial tests.
Recent research has shown that stem cells implanted in arthritic cartilage can produce healthy cells to replace defective tissue. For arthritis patients, enough progress has been made in cell transplant therapy that autologous chondrocyte implantation (ACI), a cell transplant therapy using the patient’s own cells, is now widely used to replace cartilage between joints.
Scientists are hopeful that replacing diseased cells with healthy ones made from embryonic stem cells will offer a standard treatment protocol for conditions such as diabetes, Alzheimer’s or spinal cord injury in the future.
In 2006, researchers at Kyoto University in Japan established conditions that resulted in specialized adult cells that could be genetically “reprogrammed” to assume a stem cell-like state. These adult cells, called induced pluripotent stem cells (iPSCs), were successfully reprogrammed to an embryonic stem cell-like state. This was achieved by introducing genes important for maintaining the essential properties of embryonic stem cells (ESCs). Since then, scientists have greatly improved the techniques to engineer iPSCs, creating a powerful new way to “de-differentiate” cells. iPSCs give scientists an alternative, pluripotent cell to human embryonic which could help with some of the ethical concerns surrounding ESCs.
The National Institutes of Health maintains a registry of current clinical trials, including trials that are recruiting new volunteers. The FDA recently approved the first clinical trial in the US using hESC-derived cells. However, this trial uses cells derived from hESCs; hESCs themselves have not yet been approved for use in clinical trials.
Umbilical cord stem cells have been shown to help with treating nearly 80 diseases, such as: genetic diseases, a wide range of cancers and blood disorders. Cord blood transplants infuse stem cells into a patient’s bloodstream, tasking them to heal and repair damaged cells and tissues (Viacord.)
Stem cell research employs stem cells, or cells grown from stem cells, to replace or regenerate damaged tissue. Researchers can also utilize stem cells to understand disease and to test/create/locate drugs to treat the condition. Embryonic stem cells can be applied to regenerate any type of specialized tissue that has been lost to disease and injury.
The main obstacles for stem cell therapies are: 1) identifying stem cells in adult tissues; 2) stem cell integration; and 3) immunological rejection.
Identifying stem cells in adult tissues is tricky because adult tissues house many different types of cells and trying to locate these scarce number of stem cells, in tissues that house thousands of different cells, is difficult.
Once researchers identify, isolate and trigger the appropriate stem cells, the cells still must be implanted into the patient and accepted among the native body cells. This success of this procedure relies on effective integration into the patient’s body systems and other cells.
Immunological rejection is a major barrier to successful stem cell transplants. At times, a patient’s immune system will treat the transplanted cells as ‘foreign’ rather than ‘self,’ triggering the immune system to attack the newly transplanted cells. Strong immunosuppressive drugs have shown to help reduce rejection, but these drugs then leave the patient vulnerable to other foreign viruses or microbes making them susceptible to infection.
The available stem cell therapies today are still few in number as research and development is still underway. However, blood stem cell transplantation to treat blood and immune system diseases or to assist with rebuilding the blood system after cancer are currently available. Along with these stem cell procedures, some bone, skin and corneal (eye) injuries and diseases can be treated by grafting or implanting tissues, and the healing process relies on stem cells within this implanted tissue. These procedures are widely accepted as safe and effective by the medical community.
Stem cell injections are widely used to help with chronic pain management including issues like arthritis, osteoarthritis and other joint pain/dysfunction. Cell transplant therapy using the patient’s own cells, is now widely used to replace cartilage between joints.