The Best Gamble in Las Vegas: Bet on Your Stem Cells

Neostem, a company formerly known as Phase3Med, based in New York (USA) which collects and stores adult stem cells has been around for quite a while. One of their directors was here in Malaysia 3 years ago at one of the locally organized biotech symposiums and expressed a certain interest and admiration for the work that we have accomplished thus far.


LAS VEGAS MEDICINE

After a short hiatus about two years ago where there was a change in management and ownership, the company has started to make regular press announcements about their expansion of collection services in the US in collaboration with aesthetic doctors. Neostem held a press conference last Friday (Oct 23rd) which was sponsored by the Nevada Development Authority and the University of Nevada and a few local companies. Neostem used the opportunity to present to the Nevada Biotechnology and Bioscience Consortium to educate the region's medical and scientific community.


The collection site is apparently sited near the Nevada Cancer Institute and the Nevada Neurosciences Institute. Its CEO Robin Smith said that its expansion in Las Vegas was quite obvious given the large size of the city's population, its tourist attraction status and that tourists also visit for the health and spa-oriented services offered by the hospitality industry. Neostem's target clients for adult stem cell banking include anyone concerned with their long term health or well-being. They are also targeting people concerned about possible exposure to radiation.



MONEY MATTERS

Neostem listed on the American stock exchange on the same day as the Nevada announcement, is unfortunately already trading down and has a market capitalization of 14 million USD. The rapid expansion over the last three years has been loss-making for Neostem (approx. twenty million US dollars) according to its last audit in March. Most of it was operating expenses (expensive infrastructure and qualified personnel requirements).


However, medical director of the Las Vegas facility, Dr. Ivan Goldsmith expressed his enthusiasm to target both residents and tourists and convince them that storing their own stem cells for their future might be a better bet than the gaming tables.


He said: "The odds are far greater that you will eventually be a winner having your stem cells banked"



StemLife offers adult stem cell collection and banking in Malaysia and Thailand. If you're in the region and interested in this service, give us a call. :)

Hip Replacements- Made Real by Surgery and Stem Cells

When my friend's mum fell and broke her femur about 3 years ago, she had to have almost complete bed rest for six months and physiotherapy and rehabilitation for close to three months after that. With a metal screw pin in her thigh bone and a cast around her leg, it was probably the most uncomfortable and frustrating experience for someone who was living a very active lifestyle (tai chi, walking in parks, overseas travel etc.) prior the incident. She has since recovered from the injury but mentions feeling occasional discomfort and tightness in her thigh.

Most people live their early and active life not expecting any bone surgery (unless it is cosmetic) and most fractures tend to happen in osteoporosing elders over sixty. However, hip fractures are far worse than femur fractures the incidence of hip fractues increase with age, doubling for each decade after fifty. Most people who fracture their hips in old age have a poor quality of life and often get depressed and there are estimates that one in four people who fracture their hips completely heal while 20% of those who fracture their hips do not survive the year of their injury.

Given these considerations, it is therefore not surprising that doctors and bio-engineers are often looking at ways to make prostheses more natural and better accepted by the body. In the reported work that is currently being done at University College London (UCL), the doctors are keen on ensuring that people who require a second hip replacement (about 25% undergo a second surgery) will have a better outcome rather than suffer a crumbling joint with a high probability of trauma (apart from a nasty scar) and protracted recovery period involved.


Professor Gordon Blunn's team at UCL's Institute of Orthopaedics collaborates with Dr. John Skinner's group from the Royal National Orthopaedic Hospital in Stanmore, are conducting a trial with a GBP 130,000 (approx. RM 897, 150) grant from the UK Stem Cell Foundation and the Medical Research Council for a preliminary trial -to boost patient's bone growth by 75%- which will lead to a larger trial of 80 patients next year.

The current method of surgery requires bone chips to be packed into damaged hip joints to rebuild, followed by the insertion of the artificial replacement hip. What the research team will do is to improve the quality of the implants by infusing the bone chips with the patient's own stem cells, which they believe might act as a better cement and cause less inflammation.

The cells would be obtained from each individual patient's bone marrow which is extracted from the patient's hip bone under anaesthesia, isolated and grown in the laboratory and used to seed the bone chips.

The cell culture is estimated to cost approximately GBP 2,000 (approx. RM 14,000) and this probably excludes the cost of the surgery and any ancillary medical care.

The Chief Executive of the Medical Research Council, Sir Leszek Borysiewicz summarized this work most clearly when he said:

"The idea is to use autologous stem cells [taken from the patient themselves] to accelerate healing and outcome."



QUESTIONS AND THOUGHTS

I thought that there were a few interesting points to take from the concept and the trial.


APPLICATION IN OTHER BONES

Firstly, that marrow stem cells were being infused into the interior of artificial bone as seeding for normal bone structures to form.
-This is not the first time that stem cells have been used to seed bone growth and to kickstart the healing process. It would be interesting to see this method applied in other bones too.


AGE IS NOT AN ISSUE

Secondly, that the autologous stem cells harvested from the patient (usually 60-80 years of age) would still be clearly functional for this purpose, demonstrating that stem cells obtained from an older individual is still useful.


ENOUGH FROM THE SOURCE?

Thirdly and curiously, I wondered where the stem cells would be harvested from in these patients. One has to bear in mind that marrow stem cells are usually collected by puncturing the hip bone. Hence, if these patients are already having their second hip replacement, there can't be much left after all the inflammation and debris to harvest. This might provide the reason why stem cell isolation and growth in the lab becomes an important factor.

The number of stem cells infused needs to be optimal in order for the healing to accelerate and outpace the degenerating tissue, by signalling the required repair factors. I would be most interested to know what that optimal number might be in these cases.



*An renown South African orthopaedic surgeon that I spoke to recently told me that at a recent medical convention, he asked the audience (all doctors) who would undergo and prefer a prosthesis vis-a-vis a natural joint. The answer? Nobody raised their hands for a prosthesis.

Verdict: 100% of doctors themselves would opt for a natural method of joint salvage than have a prosthesis inserted.


If you'd like to watch a hip replacement procedure, here's one I found which gives you an idea of what happens but is censored so that there is none of the gore...

Peripheral blood insulin-producing cells (PB-IPC)

Wonderful news for diabetics! Researchers from the Section of Endocrinology, Diabetes & Metabolism, Department of Medicine at the University of Illinois have discovered a novel cell population from peripheral blood that looks like it is capable of becoming islet cell and produce insulin if in the right place! This novel cell population demonstrated characteristics of islet beta cell progenitors including the expression of beta cell-specific insulin gene transcription factors and prohormone convertases, production of insulin, formation of insulin granules, and the ability to reduce hyperglycemia and migrate into pancreatic islets after transplantation into the diabetic mice.

These findings just published in the Biochemical and Biophysical Research Communications 360 (2007) 205–211 can explain our and other researchers findings that when diabetic ulcers are treated with the patients own peripheral blood stem cells other effects are evident apart from the complete healing of the ulcers, that is IMPROVEMENT of their diabetes. It is very probable that this cell population migrates to the pancreas and restarts insulin production!

Autologous Stem Cells (Peripheral or Bone Marrow)

In my first contribution to the blog I would like to give you some information I have gathered from new research studies around the world on Autologous Stem Cells collected either from the Bone Marrow via a bone marrow aspiration or from the Peripheral Blood after stimulation with G-CSF and the effects of those cells in treating conditions that in the past were considered UNTREATABLE!

SPINAL CORD INJURY
In a recent article of Prof. Eva Sykova from the Czech Republic entitled "Autologous Bone Marrow Transplantation in Patients With Subacute and Chronic Spinal Cord Injury" in Cell Transplantation, Vol. 15, pp. 1–13, 2006 very interesting results were shown. The research team split the patient group (20 patients) in 2 subgroups according to the duration of the spinal cord injury (7 with subacute: 10-30 days and c13 with hronic: 2-17 months) and compared the results of injecting the patients own bone marrow stem cells either intra-arterially (in the artery supplying the injured area) or intravenously (in the peripheral vein). Improvement in motor (movement) and/or sensory (feeling) functions was observed within 3 months in 5 of 6 patients with intra-arterial application, in 5 of 7 acute, and in 1 of 13 chronic patients. This case study showed that the implantation of autologous bone marrow cells appears to be safe, as there have been no complications following implantation to date (11 patients followed up for more than 2 years). The outcomes following transplantation in acute patients, and in one chronic patient who was in stable condition for several months prior to cell implantation, are indeed promising. Further studies are necessary to confirm those results and to evaluate how to administer the stem cells. It seems that administering the cells closer to the injury site, such as through the catheterization of a. vertebralis, or into the cerebrospinal fluid, or even intraspinally at the lesion border, might be important for a better outcome.

Indeed very promising results and we at THAI StemLife can report the preliminary outcome of one patient in Thailand that in August 2007 received autologous (his own) PBSC that his treating neurosurgeon injected in the spinal canal during open spinal surgery. This patient was involved in an accident 2 years ago, was in a stable condition and could not move or feel anything from neck and below but 2 months after the Stem Cell injection he can move his right arm! Follow up injections are planned by the treating physician and we will be reporting the progress here!

Lou Gehrig's Disease

I don't know anyone personally who has Lou Gehrig's disease (amyotrophic lateral sclerosis) but it does sound like pure suffering as the mind might still be sound but due to the nervous degenerative condition, the muscles in the body gradually waste away (the paralyzed would probably empathize).

The plight of a lady by the name of Pam Penley Schuelke was just so and there was an article that reported her battle with the disease that eventually took her life at the age of 44. You can read more about her life and her deteriorating condition in the article but I thought it might be interesting to pick out a few key points about the treatments that she sought and what her closest kin thought of as results.


Experimental Therapy

The article reports that having raised money through local newspapers highlighting her plight, she and her partner traveled to Tijuana in Mexico for a cord blood stem cell injection which contained 1.5 million stem cells costing USD 20,000. They acknowledge that the procedure is not one that is proven in medical circles, but her partner Chuck Greenwalt believes that the injection might have put his fiancee into a remission and given her a quality of life that she didn't have when she first was diagnosed five and a half years ago.


The body works in mysterious ways

A week before she passed away, according to her fiance, Ms. Penley-Schuelke was able to eat her dinner and was even able to stand up for short periods. Even more incredibly, just hours after her stem cell treatment, she was able to use her hands to grab, which she apparently wasn't able to do for some time. They were even considering opting for another stem cell injection just 3 weeks ago. Her fiance said: "I guess, when I look back, getting the stem cells gave us the opportunity to be active participants in this and not just on the sidelines. We were able to fight this disease that everyone said was so hopeless.."


An important point to note is that there is no cure for this condition, there is a drug undergoing clinical trials now by the name of Rilutek which is said to have "modest" improvements for ALS patients. Additionally, we should also note that Mr. Greenwalt and Ms. Penley-Schuelke knew that there was no cure and looked to stem cells merely as a possible way to improve her quality of life by perhaps stimulating the regeneration of some neurons or slowing the disease process.

I doubt that there will ever be a way to conduct any sort of real randomized controlled trial for conditions such as these, simply because disease progress is fast and providing placebos might just not be fair. Perhaps instead of decrying it as useless treatment, doctors could design some way of measuring quality of life before and after stem cell injections for the patient, these might provide some objectivity which can be presented reasonably at a medical meeting.


*The picture above is interesting as it cites excessive glutamate as a possible cause of ALS, and that Rilutek which acts to slow the bodies' production of glutamate, only keeps patients alive for another 2-3 months.