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The Basics About Stem Cell Treatments & Stem Cell Facts

A patient-focused guide to The Basics About Stem Cell Treatments & Stem Cell Facts, with clinical context, evaluation considerations and supporting information.

Over the last 20 years, the term “stem cells” has become relatively popular on TV and the news and is often discussed extensively in the scientific community. Debates and heated discussions about the role of stem cells can be found everywhere; unfortunately, much of the reasoning is not based on science. Religious, political, or governmental policies about stem cell research often create more confusion about a subject that is usually quite misunderstood.

Introduction to Stem Cells

Introduction to Stem Cell Therapy

For most ordinary citizens, regenerative medicine and stem cells become confusing. The Cellular Regeneration Center would like to take this opportunity to discuss at length the what, where, when, and why of stem cells to better educate the public about the benefits and pitfalls of stem cell science and the relevance it can have on daily life, well-being, and ongoing health management.

History of Stem Cells

The phrase “stem cell” first appeared in the scientific literature around 1868, when a biologist from Germany, Ernst Haeckel, used it to describe the process of a fertilized egg becoming a living, breathing organism.

The history of blood-forming stem-cell research is distinct from research on mesenchymal stromal/stem cells. A developmental tissue name, a blood-forming cell and an expanded stromal-cell preparation are not interchangeable identities. Historical terminology should not be used to infer the properties of a current clinical product.

Who Discovered Stem Cells?

The first known bone marrow stem cell transplant was performed in 1959 by French oncologist Georges Mathé. The experimental procedure was performed on 5 Yugoslav nuclear plant workers whose marrows had been severely damaged in an accident. Dr. Mathé later pioneered stem cell therapy in bone marrow transplants to treat leukemia.

Bone marrow contains blood-forming stem cells and other cell populations. Blood-forming-cell transplantation can reconstitute blood-cell production in defined clinical settings. Its established uses do not demonstrate that another cell preparation can regenerate unrelated organs. Stem cells also occur in tissues outside bone marrow.

Thailand has a history of research on blood disorders, including thalassemia. The cited 1992 paper discusses that disease burden; it does not identify the country’s first stem-cell procedure. Institutional information from the Faculty of Medicine at Siriraj Hospital and individual research papers should be read within their actual scope.

What are Stem Cells?

Stem cells are defined by their capacity for self-renewal and for producing specialized daughter cells. Their differentiation range depends on the cell population. A tissue-specific adult stem cell should not be described as able to become any human tissue.[5]

Stem cells are often called “Adult Stem Cells,” but the colloquial term is slightly misleading. “Adult Stem Cells are found in infants, children, and adults. The opposite of Adult Stem cells is known as Embryonic stem cells. Adult stem cells are sometimes also called somatic stem cells.

Stem Cell Facts

Self-renewal produces cells that retain stem-cell properties. Differentiation produces more specialized cells. These are different processes. The capacity for continued division depends on the cell population and its environment; it does not establish unlimited renewal in a patient.

The terms stem cell and progenitor cell describe related but different populations. Their capacity for self-renewal and the range of daughter cells they produce must be assessed for the actual population rather than inferred from a label.

Two Defining Properties of Stem Cells

  1. The cells must be able to self-renew. Self-renewal is the ability of a cell to undergo multiple cycles of normal cell division while maintaining an undifferentiated state.
  2. Potency describes the range of specialized cells a stem cell can produce. Pluripotent cells can generate derivatives of the three germ layers, including mesoderm and ectoderm. Adult tissue-specific stem cells generally have a more limited range. Endothelial cells should not be listed as an endoderm example. Neither potency nor self-renewal alone establishes clinical benefit.

What is Stem Cell Therapy?

A stem-cell-based intervention uses a defined cell preparation for a defined clinical purpose. The biological ability to divide or differentiate does not establish permanent repair of an organ or reversal of a degenerative disease. Evidence must address the actual product, condition, outcomes and risks.

The following topics cover different kinds of research and clinical care, including gene therapies. Listing a condition does not establish that a particular stem-cell preparation is effective or appropriate for it:

The first cited report describes allogeneic blood-forming-cell transplantation in one patient with refractory Burkitt’s lymphoma. A case report in that setting does not substantiate general claims about motor neurons, all somatic cell types or unrelated regenerative treatments. [1]

Mesenchymal stromal/stem cells, blood-forming stem cells and neural stem cells are different populations. Laboratory differentiation and cell-signaling observations must be distinguished from replacement of functional tissue in a patient. MSC secretome research studies released factors and their effects; those observations do not by themselves establish an effective treatment for a listed disease.

Where are Stem Cells Found?

Autologous and allogeneic describe the relationship between the donor and recipient, rather than two biological cell types. Autologous cells come from the recipient; allogeneic cells come from another donor. The cell identity and preparation still need to be specified.

Autologous cells can be obtained from different tissues; they are not all born in bone marrow and then distributed throughout the body. Homing describes migration and retention processes studied for particular cell populations. A proposed homing mechanism does not guarantee delivery to an injured organ or repair of that organ.

Natural reduction of Circulating Mesenchymal Cells in Humans as we age

Four Viable Sources of Autologous Stem Cells

  1. Human Bone Marrow – harvesting is very invasive and requires drilling into the femur bone or iliac crest
  2. Peripheral Blood – Blood-forming cells may be collected by apheresis. The collection method and the clinical use of the collected cells are separate questions. For Thailand-specific background on a blood disorder, the cited 1992 paper discusses thalassemia; it is not a study establishing an apheresis protocol. [2]
  3. Dental Pulp – The dental pulp of young adolescents comprises soft living tissue. Scientists have found that dental pulp is a rich source of mesenchymal stem cells and can be obtained without invasive extraction procedures.
  4. Adipose-derived or Fat stem cells – Acquired through mini-liposuction, Adipose stem cells are used primarily in cosmetic treatments such as stem cell facelifts or stem cell breast reconstruction after cancer.

Donor selection for autoimmune disease depends on the actual intervention, rather than a blanket rule that an autoimmune diagnosis requires donor cells. Blood-forming-cell transplantation and MSC administration have different matching and risk considerations. Wharton’s jelly is connective tissue within the umbilical cord; it should not be identified as placenta. The cited paper concerns biotechnology policy in Thailand, not a patient-selection rule. [3]

Stem Cell Scams & Warnings

In recent years, stem cell tourism has taken off in many parts of the world. The promise of functional regenerative medicine is being tarnished by ethically problematic and unproven therapies from untrustworthy sources. Many of these experimental treatments and therapies have never undergone proper clinical trials but are being marketed directly as therapies or, worse yet, “Cures.” These “same-day” experimental stem cell therapies are not carried out by licensed or professional medical staff and often do not comply with the framework of an approved treatment protocol, which is used to ensure ethical standards and proper protocols are met. Please use caution and exercise sound judgment when contacting unscrupulous stem cell clinics globally, which often over-promise but under-deliver. Other signs to watch out for include unlicensed doctors who promise “no risk” treatments or treatments that offer no post-treatment care or assistance.

Some people may think/claim that stem cells are some “magic bullet” or “miracle cure” for everything.

This is NOT TRUE!

Clinical evidence is specific to the product, condition and treatment setting. Blood-forming stem-cell transplantation has established clinical uses, but that evidence cannot be transferred to a different cell preparation. Discuss current standard care, alternatives, uncertainty and risks when assessing a proposed intervention.

Stem Cells in Asia

Laboratory studies, animal studies and human clinical studies answer different questions. When reading medical journals, check the actual cell preparation, study population and measured outcomes. A result in a laboratory does not establish replacement of functional organs in patients.

In 2006, Takahashi and Yamanaka reported reprogramming mouse fibroblasts under defined laboratory conditions. The resulting induced pluripotent stem cells (iPS cells) were a research advance. The paper does not establish safe or effective transplantation of reprogrammed cells into any human patient. [4]

For an iPS-derived product, differentiation, product purity, unwanted cell growth and clinical outcomes are separate questions. Evidence for one derived product or indication should not be represented as proof for every use of pluripotent cells.

When considering a research claim, ask which cells were studied, whether the work involved patients, what was measured, and how the result applies to the proposed intervention.

To learn more, please contact us today.

Published Clinical Citations

[1] ^ Ungkanont A, Mongkonsritrakoon W, Jootar S, Srichaikul T. Allogeneic stem cell transplantation in a patient with refractory Burkitt's lymphoma using non-myeloablative conditioning regimen. Bone marrow transplantation. 2000;26(12):1351. doi: 10.1038/sj.bmt.1702730. PubMed: 11223978.

[2] ^ Panich, V, M Pornpatkul, and W Sriroongrueng. 1992. The problem of thalassemia in Thailand. The Southeast Asian journal of tropical medicine and public health. https://www.ncbi.nlm.nih.gov/pubmed/1298980

[3] ^ Velasco, Román Pérez, Usa Chaikledkaew, Chaw Yin Myint, Roongnapa Khampang, Sripen Tantivess, and Yot Teerawattananon. 2013. Advanced health biotechnologies in Thailand: redefining policy directions. Journal of translational medicine (January 2). doi:10.1186/1479-5876-11-1. https://www.ncbi.nlm.nih.gov/pubmed/23281771

[4] ^ Takahashi K, Yamanaka S. Induction of pluripotent stem cells from mouse embryonic and adult fibroblast cultures by defined factors. Cell. 2006;126(4):663-676. doi: 10.1016/j.cell.2006.07.024. PMID: 16904174.

[5] ^ National Institutes of Health. Stem Cell Basics. Basic definitions of self-renewal, differentiation and tissue-specific adult stem cells.