by admin | Jun 10, 2019 | Lupus
Systemic lupus erythematosus, also known as SLE or lupus, is a chronic inflammatory condition that can affect almost every organ in the body. Commonly, patients with lupus suffer from fatigue, fever, muscle pains, and fluctuations in weight. Perhaps the most noticeable feature of lupus is a butterfly rash that affects the nose and cheeks. In its most severe form, lupus can be life-threatening. As many as half of all patients with systemic lupus erythematosus experience some sort of kidney involvement. One feared manifestation of lupus is an inflammation of the kidney called lupus nephritis. Patients can also experience blood clots in the arteries and veins, and serious inflammation of the gastrointestinal tract, lungs, and/or heart.
There is no cure for lupus. The goals of treatment are to reduce the severity of lupus symptoms, prevent damage to organs, and improve patient quality of life. Many treatments for lupus are merely preventive. For example, patients with lupus know that staying out of the sun or using sunscreen can help prevent skin rashes that often occur during the disease. Unfortunately, the treatments that are commonly used for SLE cause serious side effects. For example, steroids can help control flares, but they are not suitable for long-term use. Immunosuppressants are sometimes helpful, but they can increase a patient’s risk of infection. Newer biologics such as belimumab and rituximab are more selective treatments, but are not helpful for most patients and remain relatively expensive.
Not surprisingly, many patients with systemic lupus erythematosus are unsatisfied with their current treatments. This is frustrating for patients, families, and doctors. Thus, researchers have started testing stem cell therapy to determine if this novel treatment could be effective for treating lupus.
In one such clinical study, scientists collected mesenchymal stem cells from umbilical cord tissue (the substance that usually gets thrown away as medical waste after a baby is born). They then infused the purified stem cells into patients with SLE who had a difficult-to-treat disease (i.e., patients had failed to find relief of SLE symptoms from standard treatments or had life-threatening complications from the condition). The scientists then followed the patients for about eight months on average, though some patients were followed for as many as 28 months after stem cell treatment.
Patients treated with mesenchymal stem cells showed dramatic improvements in a measure of lupus disease activity called the SLEDAI. In fact, patients enjoyed significant improvements in as little as one month after mesenchymal stem cell treatment. This effect lasted for up to two years in some patients. Moreover, patients treated with umbilical cord-derived stem cells had improvements in kidney function and lost less protein in their urine. Impressively, patients treated with stem cells showed improvements in various markers associated with active lupus including serum antinuclear antibody (ANA), anti-double-stranded DNA (anti‐dsDNA) antibody, serum complement C3 and C4, and albumin levels. Patients with lupus know that these blood markers are used to track the severity of the condition.
While one person had severe nausea during stem cell infusion, this passed quickly, and no other treatment-related side effects occurred. In fact, stem cell treatment was well tolerated by all patients in the study. These remarkable results will, of course, need to be repeated and verified in larger clinical trials. Nevertheless, the dramatic improvements seen with umbilical cord mesenchymal stem cells in patients with difficult-to-treat lupus are impressive. While more work needs to be done, patients and doctors are now looking toward stem cell treatments in the hope that this terrible disease can finally be treated effectively.
Reference: Lingyun, S. et al. (2010). Umbilical cord mesenchymal stem cell transplantation in severe and refractory systemic lupus erythematosus. Wiley Online Library. 2010 https://doi.org/10.1002/art.27548.
by admin | May 22, 2019 | Bone Marrow, Mesenchymal Stem Cells, Stem Cell Research, Stem Cell Therapy, Umbilical Stem Cell
Mesenchymal stem cells have two unique and powerful properties that make them the focus of intense scientific research. First, mesenchymal stem cells can escape recognition by the immune system. In other words, when mesenchymal stem cells are infused into the body, the immune system does not recognize them as foreign and does not react to them. If the immune system did respond to the stem cells, it would cause an aggressive and potentially deadly allergic or immunologic response. Second, mesenchymal stem cells have the power to inhibit the immune system. This means mesenchymal stem cells could be used to treat immunological and autoimmune diseases such as Rheumatoid Arthritis, Systemic Lupus Erythematosus, Multiple Sclerosis, and Crohn’s Disease, among others. In essence, mesenchymal stem cells can affect the immune system without triggering an inflammatory response making them an ideal treatment for these diseases.
For some time, mesenchymal stem cells extracted from bone marrow were thought to be the only type of mesenchymal stem cells capable of beneficially affecting the immune system. This fact is not necessarily bad, but it does mean that mesenchymal stem cell donors must undergo a bone marrow procedure, which can be painful and expensive. It would be far better if doctors could use mesenchymal stem cells taken from easier-to-get tissues such as fat (adipose), umbilical cord blood, or Wharton’s jelly (umbilical cord tissue). Most people have adequate amounts of fat just under the skin, and umbilical cord blood and tissue are thrown away as medical waste every day.
Fortunately for patients, Dr. Yoo and colleagues showed that mesenchymal stem cells taken from fat tissue, umbilical cord blood, and Wharton’s jelly exhibit the same immunomodulatory properties as mesenchymal stem cells taken from bone marrow. The researchers showed that these types of mesenchymal stem cells were able to suppress T-cell proliferation as effectively as those cells taken from bone marrow. T-cell proliferation, it should be pointed out, is a key step in autoimmune inflammation that occurs in diseases such as rheumatoid arthritis and others.
In short, mesenchymal stem cells taken from easier-to-get tissues were just as effective at suppressing inflammation (in vitro) as those taken from bone marrow. These results will need to be confirmed in clinical studies; however, this approach will be much more convenient and less expensive for patients and donors if they can use mesenchymal stem cells taken from fat or umbilical cord rather than bone marrow and yet reap the same benefits.
Reference: Yoo KH et al. (2009). Comparison of immunomodulatory properties of mesenchymal stem cells derived from adult human tissues. Cell Immunology. 2009;259(2):150-6.
by admin | May 16, 2019 | Mesenchymal Stem Cells, Multiple Sclerosis, Stem Cell Research, Stem Cell Therapy
A new study has shown that a protocol for treating Multiple Sclerosis with stem cells is safe. According to the researchers, the potential for using stem cells in Multiple Sclerosis therapy warrants further investigation. The results of the study were published in the Journal of Translational Medicine.
Stem cells – and specifically, mesenchymal stem cells, have been increasingly used in the treatment of immune and inflammatory conditions. Based on the success that has been seen in these areas, scientists reasoned that mesenchymal stem cells may also represent a useful approach to treat Multiple Sclerosis, a neurological disease that involves the abnormal attack by the immune system on the myelin sheath that insulates nerves and allows nerve cells to communicate effectively and efficiently with one another.
To test this idea, the scientists used umbilical cord mesenchymal stem cells in 20 Multiple Sclerosis patients. The patients were given intravenous injections of the stem cells each day for seven days. The researchers evaluated the patients – with both neurological testing and nervous system imaging – at baseline, one month after treatment, and one year after treatment. The researchers found that the stem cell treatment improved neurological scores in patients and that lesions in the brain and cervical spinal cord were inactive one year after the stem cell injections. There were no serious adverse side effects associated with the treatment.
Based on these findings, it is possible that stem cells will provide a useful treatment option for those with Multiple Sclerosis. With more research, we will better understand exactly how stem cells can be used to help this population of patients.
Reference: Riordan, N.H. et al. (2018). Clinical feasibility of umbilical cord tissue-derived mesenchymal stem cells in the treatment of multiple sclerosis. Journal of Translational Medicine, 16(57), 1-12.
by admin | May 13, 2019 | Mesenchymal Stem Cells, Stem Cell Research, Stem Cell Therapy
Erectile dysfunction is the most common sexual disorder among men. During an erection, blood enters the tissues within the penis and is temporarily trapped there. In erectile dysfunction, however, this process does not occur. A man who suffers from this condition is unable to achieve a penile erection sufficient for sexual intercourse.
Erectile dysfunction has many causes ranging from neurological conditions to vascular (blood vessel) conditions to psychological conditions. In most men, erectile dysfunction is caused by a problem in blood flow and nitric oxide production, which is why drugs like the Viagra and Cialis are effective for some men because they temporarily reverse these problems.
Results from a review of 54 research studies showed that stem cell-based therapies may be able to reverse these effects on a more permanent basis. For example, mesenchymal stem cells were able to increase the number of enzymes that produce nitric oxide. Likewise, mesenchymal stem cells increased the size of penile tissue in older rats. Indeed, stem cell injections were able to restore erectile function in rats with diabetes.
Based on these laboratory results, researchers have conducted clinical trials using stem cells to treat men with erectile dysfunction. In one such trial, researchers used a person’s own fatty tissue (adipose) to generate stem cells. They then injected those cells into men with erectile dysfunction. Eight out of 11 men treated with stem cells regained erectile function. In another small study, eight men with profound erectile dysfunction in whom oral ED treatments failed received placenta-derived stem cells. Two of the patients were able to achieve and sustain erections six weeks after treatment while an additional patient was able to do so after three months.
Laboratory studies of stem cells in the treatment of erectile dysfunction are extremely promising. The clinical studies in this area are limited, and the results are somewhat less impressive. Nonetheless, as improvements and refinements are made to stem cell technology, this approach could offer hope to men with erectile dysfunction, especially those men who have not been helped by ED drugs.
Reference: Albersen, M. et al. (2013). Stem-cell therapy for erectile dysfunction. Arab Journal of Urology. 2013 Sep; 11(3): 237–244.
by admin | May 3, 2019 | ALS, Mesenchymal Stem Cells, Stem Cell Therapy
Amyotrophic lateral sclerosis or ALS is a neurological disease that causes muscle weakness, profound disability, and ultimately death. ALS is sometimes referred to as Lou Gehrig’s disease, named for the New York Yankee baseball player who developed the condition later in his life. Notably, physicist Stephen Hawking long suffered from the condition.
ALS affects the nerves that control movement. As nerve cells become dysfunctional and die, a person’s muscles become weak. The disease often starts with weakness in one part of the body before moving to other parts. In 4 out of 5 people with ALS, the first symptom is a weakness of one limb but not the other. Over time, however, the disease spreads to virtually all motor neurons (nerve cells) in the body. Eventually, patients are unable to walk because of muscle weakness and are usually confined to a wheelchair. The condition becomes particularly difficult to manage and potentially life-threatening when it starts to affect lung muscles, which make it hard for patients with ALS to breathe.
There is no cure for amyotrophic lateral sclerosis. For the most part, however, treatment for ALS focuses on reducing the symptoms of the condition rather than treating it. Patients often undergo intensive physical, occupational, and speech therapy regimens to help manage symptoms of ALS. Physicians may prescribe drugs to reduce muscle spasms, sleep problems, and pain associated with the condition. Researchers are constantly looking for ways to improve ALS treatment.
Dr. Petrou and co-authors recently reported clinical trial results in the highly regarded medical journal, JAMA Neurology. The researchers started their research by altering mesenchymal stem cells in the laboratory so that they produce neurotrophic growth factors. In other words, they engineered stem cells to release substances that help nerve cells grow and survive. Then they tested these stem cells in two clinical trials. In the first clinical trial, the doctors used these stem cells to treat six patients with early-stage ALS and six patients with advanced ALS. In the second clinical trial, they tested the stem cells in 14 patients with early-stage ALS.
All patients in both trials tolerated the stem cell treatments very well. There were no serious side effects related to treatment. 87% of the patients responded positively to treatment, which means they showed at least 25% improvement in physical function and/or lung function. These positive results from stem cell treatment are particularly impressive because ALS gets worse over time. Patients generally either stay the same or get worse—it is quite unusual for them to get better. Encouraged by these results, the researchers who worked on this study will now confirm these results in larger clinical trials. The hope is that this stem cell treatment will be available for patients with ALS in the coming years.
Reference: Petrou P. et al. (2016).Safety and Clinical Effects of Mesenchymal Stem Cells Secreting Neurotrophic Factor Transplantation in Patients With Amyotrophic Lateral Sclerosis: Results of Phase 1/2 and 2a Clinical Trials. JAMA Neurology.2016 Mar;73(3):337-44.
St. Petersburg, Florida
