13 ms·
Stem cells shown safe, beneficial for chronic stroke patients
- rpedela 10y agoI hope the next trial works too, this is amazing. I wonder if this technique would work for other brain disorders like Alzheimer's?
- willholloway 10y agoAutologous mesenchymal stem cells are turning out to be one of the most underappreciated advancements in medicine today, and scandalously the FDA is slowing progress in the field by seeking to prevent doctors from harvesting and reintroducing one's own stem cells back into the body. MSC's can be harvested from one's own adipose tissue with a little bit of liposuction. The process of separating the stem cells from fat is called stromal vascular fraction. It's an astoundingly easy process to do [1]. The equipment is inexpensive, and so far the procedure has been shown to be safe. MSC's have been shown to improve COPD, and reduce the allergic response that triggers asthma. Skin damage healed, cartilage and joint injuries repaired, and even MS put in to remission, MSC's administered via IV flock to areas of inflammation and damage and begin to repair it. The cells know what to do. Local administration is even better, as in this study or in cases of back pain and joint injuries. Autologous treatments should not be considered biological drugs and subject to monopolization by biotech companies through decade long clinical trials and FDA approval. These are our own cells from our own bodies. Doctors should be free to practice and innovate in this sphere, and in this case innovation is mostly just dosage, frequency and delivery method because the cells know what to do. I believe that in the next decade or two, autologous stem cell treatments will be basic preventative care for everyone, a treatment each year will repair damage before it becomes pathology. [1] https://www.miltenyibiotec.com/~/media/Files/Navigation/Research/Stem%20Cell/SP_MSC_lipoaspirate_protocol.ashx https://www.miltenyibiotec.com/~/media/Files/Navigation/Rese...
- echelon 10y agoWouldn't there be the concern that the cells would regulate themselves differently when introduced into a new environment?
- willholloway 10y agoThe procedure has been done tens of thousands of times all over the world, so far it's been incredibly safe.
- mrfusion 10y agoAre there other countries that are starting to specialize in this? Do you think we might see a black market form in the us?
- mernster 10y agoThere are companies in the US that will set you up in Mexico or the Cayman islands where the regulations are more favorable (in that they do not exist). It's pretty exciting. FDA is lagging, but it's hard to blame them for caution given all the troubles they've experienced since the 90s.
- willholloway 10y agoThere are still clinics in the US that will perform this procedure, despite FDA pressure. I am not an expert in the specifics of why or how, but I do know that this is reducing the number of doctors treating patients with MSCs and increasing the cost. I don't want to travel to Mexico or Thailand or even Europe to have this simple procedure, and I don't want to wait 10 or 15 years and then have to pay monopolist, proprietary pricing for what would be an inferior technique compared to what a free, open source medical science would inevitably produce.
- reasonattlm 10y agoNot autologous in this case. http://www.san-bio.com/product/ http://www.san-bio.com/product/ The brain is immune privileged, so there is more leeway to use donor cells if that is the destination. Which isn't the case in most uses of stem cell transplants, as you point out.
- markkat 10y agoActually, the brain is not as immune privileged as was long thought. Only last year, lymphatic vessels were identified in the brain. https://www.nih.gov/news-events/nih-research-matters/lymphatic-vessels-discovered-central-nervous-system https://www.nih.gov/news-events/nih-research-matters/lymphat...
- markkat 10y agoI've been working with MSCs for more than 15 years, mostly in stroke, and I agree completely. It's worth noting that this trial used donor cells, and that might be part of the reason they don't remain after a couple of months. There is evidence that autologous cells persist longer, likely because they aren't swept up by immune rejection. What we and others have found is that age of the donor inversely correlates to their therapeutic potential. For that reason, I founded Forever Labs, Inc. http://www.foreverlabs.co/ http://www.foreverlabs.co/ We bank young MSCs so that they can be preserved for therapy later in life. I banked my own two months ago. We prefer bone marrow MSCs as the BM also contains blood progenitor and stem cells, whereas adipose tissue does not. *We are fast expanding and raising; email in bio. ;)
- willholloway 10y agoI think you just landed yourself a customer :) MSC benefits are fantastic at replacing lost or damaged cells, however they are not bio-rejuvenation in the sense of turning back the clock with younger cells, unless one were to bank one's own younger cells? If that is true, it would be, in a sense, an early SENS hack. Very interesting. Will contact.
- markkat 10y agoSounds great! :) There has been some animal work that suggests transplantation may have that effect: http://www.ncbi.nlm.nih.gov/pubmed/23967009 http://www.ncbi.nlm.nih.gov/pubmed/23967009 http://www.ncbi.nlm.nih.gov/pubmed/25707248 http://www.ncbi.nlm.nih.gov/pubmed/25707248 There is much research to be done, but the technology to transplant young bone marrow stem cells to one's older self exists today. To be honest, that is part of my personal motivation. 'Autologous stem cell time travel' is low hanging fruit. We preserve the cells in multiple aliquots with the assumption that they might be used for multiple purposes, including expansion.
- msane 10y agoIf you banked your cells today at the age of 30, how much therapy can be hypothetically produced from that in the future? Is it a store that depletes as you use it? Or can banked stem cells be replicated to create more reserves?
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- jessriedel 10y ago> and scandalously the FDA is slowing progress in the field by seeking to prevent doctors from harvesting and reintroducing one's own stem cells back into the body. According to this article, what you're referring to is just the FDA putting stem cells under the same regulatory burden as most drugs. https://www.statnews.com/2016/02/08/fda-crackdown-stem-cell-clinics/ https://www.statnews.com/2016/02/08/fda-crackdown-stem-cell-... They have escaped this previously because the stem cells came from the patient, and not much was done to the cells before re-injection, so it's closer to plastic surgery. I happen to think that that FDA is probably way too conservative (both on stem cells and drugs) and seriously inhibits progress, but I think it's misleading to suggest that they are slowing progress in a way specific to stem cells. The FDA has always had a mission to not just protect patients from harm, but also from being fleeced by useless sham therapies.
- willholloway 10y agoIn this case the therapy is not useless or a sham, and it is autologous which has traditionally been an exempt area in this respect. That the FDA has overturned its own history and precedent is the scandal, imho. A benefit has been shown, to what degree and in which circumstances is being ironed out. There is some hope, the FDA has liberalized to some degree in recent years and biotech has been a top performing sector. We live in miraculous times.
- jessriedel 10y agoI don't think you disputed my point. > In this case the therapy is not useless or a sham More precisely, in this case you believe there is enough evidence that the therapy is effective, but the FDA does not yet agree that has been established. Then, in congruence with its policy on unproven medical procedures, the FDA has severely constrained stem cell procedures. > and it is autologous which has traditionally been an exempt area in this respect. It's clear that there was little/no enforcement in this area previously, but now they have announced clarification that it is to be enforced. You may call that a change in the regulatory environment, but it doesn't appear to be a change in general policy. The situation is very similar to 23andMe. 23andMe was flying under the radar and, when the FDA cracked down on them, they experienced a changed in their effective regulatory environment, but this is not reasonably interpreted as the FDA changing its tune (or overturning history or precedent or whatever). Again, I wish the FDA allowed more of these things to proceed (including 23andMe and stem cells) but I don't think this is change.
- mgr86 10y ago> MSC's have been shown to improve COPD My grandfather died of COPD, and likely so will my Dad. He has COPD. And was diagnosed in his 50s. I am fearful of it myself, but thankfully unlike both of them I've never smoked. It is a shot in the dark, but do you know anything off hand of having him participate in something like this in the US?
- willholloway 10y agoThere are clinics and doctors that have been performing the procedure, lowest cost I have seen is $7k for a treatment. They can harvest, isolate and deliver his own MSC via IV and perhaps nebulizer. It seems like the doctors that have been performing are silos of information right now. There is not a lot published on the web of their experience as practicing doctors, some of the best on the ground info I have found is from interviews of doctors practicing. There are also very many published MSC trials showing a benefit. It is a terrible thing to not be able to breathe well. I hope that this can help.
- mgr86 10y agoThanks! I will try my best to look into this and hope he is willing. He doesn't talk about it much.
- ancap 10y agoThe FDA has a lot of blood on its hands. Everyone, especially a chronically ill person on their deathbed, should be free to choose whatever experimental medical procedure they want. Not only is this a recognition of self-ownership, but it would provide invaluable medical research and could accelerate getting effective treatments to the ill.
- nbb 10y agoSo every con artist should be unrestricted in selling false hope to the most desperate of us?
- guelo 10y agoIf the cells are already in your body what's the point of extracting them just to reinject them back in?
- smt88 10y agoThe cells are not injected into the same part of the body that they were extracted from.
- rhizome 10y agoIncredible post, thank you so much for a clear and concise overview.
- Natsu 10y agoI suspect that the processes to produce these will get patented if not the results, but it's still encouraging that new treatments can be made by using cells from our own bodies.
- atomical 10y agoWhat about androgenic alopecia? Is there potential there?
- dataangel 10y agoThe FDA is protecting people against sham treatments. The whole reinjecting things that come from your body canard has been around awhile -- look at PRP treatments for example. No compelling evidence exists that it actually works, but tons of clinics offer it because Tiger Woods got it once. There is a legitimate danger with stem cells that you could introduce cancer (this has happened in some studies).
- reasonattlm 10y agoThe primary difference between this and most of the stem cell therapies delivering mesechymal stem cells - which are more or less the standard type of cell to use for the moment, the most studied and most characterized, no-one got fired for using mesenchymal stem cells, etc - such as those widely available via medical tourism is the delivery to the brain. That isn't something clinics do, for all the obvious reasons. So I'm inclined to think that this is one of a number of different studies in recent years to demonstrate that the delivery methodology makes just as much of a difference as the type of cell lineage and any tinkering done to that cell lineage.
- mrfusion 10y agoI wonder why only 7 out of the 18 patients showed improvement? What could that mean?
- lintiness 10y agoit could mean a lot of things, but at the very least it means 7 out of 18 improved.
- thomasrossi 10y agoYou should compare that 7/18 with what happened to other 18 in the same condition. 1 year after stroke, it is quite safe to say that 0/18 would have any improvement in 1 month (the patients were testes also 1 month after).
- davak 10y agoDoc here. Not negative on this story, but it is completely false to say 0/18 would have improvement with standard care. Patients frequently improve from strokes; some quite rapidly. Maybe you had a typo? The next step is intervention versus placebo. Strokes are very common. It should be easy to find patients to enroll. Hopefully this will turn out to work and be worth the cost.
- thomasrossi 10y ago1 year after the stroke, the difference in a month is very limited in my experience. I am not a doc, but I've crunched some numbers related to this topic, what was your experience?
- Malician 10y ago"Significant improvement" is 10 points on a 0-100 scale. Maybe others had what to their family would be significant improvement, but it didn't quite exceed the marker. With one intervention using donor cells in 12 months, for stroke patients, that could be a big deal.. with improvement to the procedure or combining with other treatments maybe more could be achieved.
- Omnius 10y agoThe study seems focused on just motor skill improvements. Was there work done to see if it helped with aphasia? Could this help aphasia?
- umanwizard 10y agoIt makes no sense to me that this is marked dead. Seems like a totally reasonable question.
- mrfusion 10y agoI read they don't turn into new neurons but rather release chemicals that stimulate growth and repair. Am I understanding correctly?
- bronz 10y agoyeah, they say that the stem cells actually disappear after about a month but improvement continues well afterward. and they say its because of growth factors released by these cells.
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- imjustsaying 10y agoWhere's the link to the study?
- paxcoder 10y agoWell, it looks like we can advance science without pretending killing human beings is ok, after all.
- ceejayoz 10y agoNo one was ever performing abortions to obtain stem cells.
- paxcoder 10y agoWhat I referred to is the death of a human early in its development (blastocyst) resulting from the steps necessary to derive embryonic stem cells (as opposed to those necessary for adult stem cell derivation like here and elsewhere)
- ceejayoz 10y agoYou mean the leftover blastocysts that are otherwise disposed as medical waste after IVF treatments? I think I'd prefer they use them for medical treatments instead of fuel for an incinerator.
- xenadu02 10y agoblastocysts aren't human beings so your post makes no sense.
- paxcoder 10y agoAs I understand, the blastocyst is a state of a human being in the early stage of its development, having in turn developed from the morula, and the zygote (the first cell). If you want to argue semantics of the words or the phrase, we can do that. If you want me to use a dictionary to justify my use of the words "human" and/or "being", I'll do that. If you want textbook (medical) definitions, you can have it right away at https://goo.gl/ZFDcbg https://goo.gl/ZFDcbg. And if you'd like more scientific literature backing, consult https://goo.gl/zXpbAu https://goo.gl/zXpbAu. If you are willing to cede that the nomenclature fits, but would like to now rank human beings by worth in relation to stage of development, I would like to provide arguments for why you shouldn't do that. Finally, if you have reconsidered everything, I would invite you to the Way, the Truth and the Life, as scary as that might sound. Peace be with you and yours.
- hangonhn 10y agoIs it possible that the procedure itself, the act of drilling and poking needles into the brain, stimulated the improvement? The stem cells didn't linger and they're precursors to skeletal muscular cells so maybe they actually had no effect on the outcome? Is it possible/ethical to do studies where they drill and poke into the brain without injecting stem cells?
- narrator 10y agoThey've been doing this kind of thing over in China for some time now[1]. Science with a capital 'S' doesn't happen until the U.S does it though, and until that point and time all procedures are considered risky and dangerous. Even if you're going to die before any of it gets approved, you better not do any of this stuff. [1] https://www.reddit.com/r/IAmA/comments/fu2ub/as_requested_i_am_working_in_a_stem_cell/ https://www.reddit.com/r/IAmA/comments/fu2ub/as_requested_i_...
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- jawns 10y agoMany people are aware that soon after President Obama took office, he authorized federal funding of embryonic stem cell research, which President Bush had resisted. The Obama administration made a big deal out of it at the time: https://www.whitehouse.gov/the-press-office/removing-barriers-responsible-scientific-research-involving-human-stem-cells https://www.whitehouse.gov/the-press-office/removing-barrier... What got swept under the rug was that at the same time, President Obama specifically rescinded a previous executive order that directed the HHS to "conduct and support" research using adult stem cells: https://www.cellmedicine.com/obama-executive-order/ https://www.cellmedicine.com/obama-executive-order/ I don't think the Obama administration ever spelled out why, at the same time it was promoting ESCR, it decided to also deprioritize adult stem cell research, but I think this latest news -- along with all of the other advances of the past eight years -- has shown that moral issues aside, adult stem cell research is paying high dividends.
- dragonwriter 10y ago> I don't think the Obama administration ever spelled out why, at the same time it was promoting ESCR, it decided to also deprioritize adult stem cell research It was all part of the same EO, which was accompanied on the same day by a Presidential Memorandum on scientific integrity in government decisionmaking on science and technology, and the rationale for the set of policy changes was explicitly to move toward allowing decisions on what avenues of science to pursue (not the goals, but the routes to the goals) to be guided by science rather than politics. It wasn't deprioritizing adult stem cell research, it was letting the relative priority of adult stem research be set, and adjusted, over time based on science, rather than being set by political directive.
- nialv7 10y agoWhat I found to be worrying is that the researchers seems to be unclear about how MSC is causing the improvements. Also the improvements continues after the stem cells have disappeared. This seems to suggest the effect doesn't come from the MSC, but rather the chemicals the cell produces. Does that mean if we can synthesis the chemicals, we don't need the cell?