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    Stem Cells From Adipose Fat Tissue May Mean Hope For Multiple Sclerosis Treatment
    By News Staff | April 24th 2009 12:00 AM | 2 comments | Print | E-mail | Track Comments
    A preliminary study on the use of stem cells obtained from a patient's own adipose tissue in the treatment of multiple sclerosis (MS) has shown promising results. The three case studies, described in BioMed Central's open access Journal of Translational Medicine support further clinical evaluation of stromal vascular fraction (SVF) cells in MS and other autoimmune conditions.

    Thomas Ichim, from Medistem Inc., and Dr. Boris Minev, from the Division of Neurosurgery, University of California San Diego, worked with a team of researchers to demonstrate the possible effectiveness of SVF cells in MS treatment. Minev said, "All three patients in our study showed dramatic improvement in their condition after the course of SVF therapy. While obviously no conclusions in terms of therapeutic efficacy can be drawn from these reports, this first clinical use of fat stem cells for treatment of MS supports further investigations into this very simple and easily-implementable treatment methodology".

    MS is an autoimmune condition, in which the body's own defences attack nerve cells, resulting in loss of their fatty myelin sheath. The first symptoms usually occur in young adults, most commonly in women. It is believed that SVF cells, and other stem cells, may be able to treat the condition by limiting the immune reaction and promoting the growth of new myelin. According to Minev, "None of the presently available MS treatments selectively inhibit the immune attack against the nervous system, nor do they stimulate regeneration of previously damaged tissue. We've shown that SVF cells may fill this therapeutic gap."

    Minev and his colleagues provided the SVF treatment to three patients with MS. The first had suffered frequent painful seizures for the previous three years; after treatment he reported that the seizures had stopped completely and that he had seen significant improvements in his cognition and a reduction of spasticity in his arms and legs. The second patient reported improvements in his sense of balance and coordination, as well as an improved energy level and mood. The final patient had been diagnosed with MS in 1993. After SVF treatment in 2008, his gait, balance and coordination improved dramatically over a period of several weeks. According to Minev, "His condition continued to improve over the next few months and he is currently reporting a continuing improvement and ability to jog, run and even bicycle".

    Article: 'Non-Expanded Adipose Stromal Vascular Fraction Cell Therapy for Multiple Sclerosis' 
    Neil H Riordan, Thomas E Ichim, Wei-Ping Min, Hao Wang, Fabio Solano, Fabian Lara, Miguel Alfaro, Jeorge P Rodriguez, Robert J Harman, Amit N Patel, Michael P Murphy and Boris Minev 
    Journal of Translational Medicine (in press)

    Comments

    quiact

    It has been reported that Multiple Sclerosis (MS) is a disease that occurs with sudden onset- normally when one is in their early 30s of their lifespan.  The fact that the disease presents itself after decades of their lives already completed adds further mystery to MS. 

    First observed in Holland nearly 600 years ago, a French neurologist was the first to recognize MS in the 1800s.  MS can take the forms of being mild with the symptoms from MS, or MS can be quite brutal for a few with MS.

    While the average age of initial acquisition of MS is when one is in their early thirties, however MS has been known to be diagnosed from those as young as 2 years old, and those at the age of 75 years old as well.

    Ms affects mostly white females, and the disease is most prevalent in Northern America, but not in the Southern part of the United States.  In the U.S., about 200 new cases of MS are diagnosed every week. 

    MS is also frequent with others in Northern Europe, Australia, and New Zealand.  About two and a half million people in the world have MS.

    MS is a chronic and slowly progressive neurodengenerative disorder, and believed to be an autoimmune disease that at times results in serious physical and cognitive disabilities of the MS patient in time.  This means that the one who has MS has a defect with their immune system, likely, and this immune system determines aspects of their physiology to be foreign invaders, and as a result, attacks such tissues.

     There are 4 classifications of MS that exist, along with 7 different forms of MS.  The most common is the type is the remission followed by relapse of MS.  Remission occurs due to remyelination that occurs after the destruction of the myelin sheath by the immune system of the MS patient, it is believed.  This is ultimately followed by an increase in disease progression with MS.  About half of all MS patients develop increased disabilities within ten years of the initial onset of the disease.

    With MS, the myelin sheath that is the covering of their neurological make-up as with others composed of lipids and proteins is attacked by auto antibodies of the immune system of the MS patient, it is believed.  As a result, and in time, the myelin sheath is destroyed, and replaced with scar tissue.  This is what is called scoliosis.  The process that occurs during this destruction is called demylenation.  The nerve damage that occurs as a result is due mainly to inflammation from this process.

    The cause of MS is unknown, which makes an accurate or likely prognosis for the MS patient nearly impossible.  Suspected etiologies for this disease have been viral infections, the Epstein-Barr virus in particular, as well as a genetic dysfunction. 

    Smoking is believed to increase the risk of acquiring MS.  Vitamin D deficiency has been suspected as the cause of MS as well. Also, damage to what is known as the blood/brain barrier in humans has been suggested as a cause of MS. The duration of MS lasts about 20 years with most who have the disease.

    The disease is at times difficult to diagnose, and MS has been mistaken for a psychological disorder in the past. The initial episode of the onset of MS involves the development of brain lesions, as well as optic neuritis. 

    A MRI performed on one suspected to have MS patient clearly shows lesions in the brain of a MS patient at multiple sites.  In addition to at least two separate MRIs performed on the suspected MS patient.  Often, a lumbar puncture may be performed on the patient as well, to obtain cerebral spinal fluid for analysis to confirm the diagnosis of MS.

     Such similar diagnostic evidence can occur in what is known as clinically isolated syndrome as well.  Yet half of all patients with this syndrome progress to the disease state of MS.  And after the initial symptoms of MS, after about 10 years pass, MS patients experience neurological damage that progresses more rapidly.

    The first symptoms that the MS patient experience often include visual dysfunctions, and extreme fatigue, in most cases.  The MS symptoms are both sensory and motor in nature as well.  As the disease of MS progresses in the MS patient, other additional symptoms may occur, such as affective disorders, cognitive dysfunction, muscle spasms, as well as bowel dysfunction and voiding abnormalities due to the damage of their nervous system by MS.

    Depression is present with most patients with MS.  And suicides are unfortunately frequent with the MS patients as well.

    Part of the MS disease process, normally, is alternating between episodes of much welcome relief in the form temporary remission- followed by MS relapses that can last from days to months. 

    As far as the extent of treatment efficacy offered to MS patients, it falls between intuitive and empirical selections for treatment options, which are various pharmacological agents.  Yet treatment should be initiated as early as possible for the MS patient to delay the progression of their disease.  And often multiple medications are needed to control the symptoms of the MS patient.

    Treatment with corticosteroids is standard with MS patients.  Interferon is another selection for management of the MS patient, yet interferon has been believed to be effective in only about half of MS patients  Overall, immunomodulary or immunosuppressive agents should be selected and given to the MS patient, primarily. 

    Other treatments evolving for MS patients include an antibiotic called doxycycline, which has been shown to slow the progression of MS.  Remarkably, parasitic hookworms, which can be damaging to humans when they reside in the human intestines, which leads to anemia, actually may be beneficial for the MS patient as well, as these parasites have been shown to decrease the activity of the immune system of the MS patient that is responsible for the damage it causes the MS patient.

    Daily niacin injections have been shown to be advantageous for the MS patient by offering protection from the inflammation that occurs, which causes both damage and pain for the MS patient.

    Some biologic agents, such as Compath which is an agent often used for Leukemia patients, have been shown to decrease and delay the progression of MS, and relapse episodes as well.  Tysabri is another beneficial biologic agent for MS patients that is given intravenously once a month for MS patients.  Tysabri decreases the frequency of the symptoms of MS patients, it has been observed by others who have used this biologic for MS treatment.

    SSRI antidepressants and statin drugs, which are prescribed for high cholesterol mostly, have been shown to decrease the progression of MS.  Testosterone therapy for men with MS has been linked with decreased brain degeneration in this MS patient population. 

    Overall, treatment of the MS patient is rather expensive, with the biologic agents in particular.

    Presently, there are many promising treatments for MS that will be available in the future.  This would include  bone marrow stem cell transplantation, which has been proven to reset the immune system of the MS patient to within normal limits, as well as improves their neurological state.

    Fortunately, most MS patients have a fairly mild expression of this disease, and are quite capable of living normal lives, with a normal human lifespan.  Most MS patients do not become severely disabled as well.  If death occurs with the MS patient, it typically is due to secondary complications.

    For over a decade, I’ve done what is called the MS-150, which is a two day bicycle ride with thousands of others to raise money for multiple sclerosis.  And we ride 150 miles in those two days.  I did not know much about this disease until recently, and I hope improved treatment options become available for MS patients,

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    Dan Abshear

    quiact

    Over 100 years ago, a Russian histologist suggested stem cells be applied for scientific research. They are the human body’s equivalent of a generator, as they can renew, regenerate, and replicate under the right conditions.

    The apex of cellular therapy and regenerative/reparative medicine has been reborn after an 8 year moratorium that basically halted federal funding for stem cell research with most states in the U.S.

    Now the NIH can award grants to scientists involved with biomedical research involving stem cell therapy through the CMS to each state in the U.S.

    While never banned, stem cell research had limited funding during this time. And this was unfortunate, because there are several likely uses of stem cells.

    These uses include the replacement of tissues in the human body, as well as repairing cell types that are defective. Also, stem cells can deliver genetic therapies that are needed in certain patients.

    ESCs are totiplotent if obtained from the morula which is a pre-blastocyst stage. Normally, the stem cells are acquired from the blastocyst itself. From this source, the stem cells can be any cell in the human body except for the placenta, and are pluripotent.

    Embryonic stem cells are obtained from a 4 day old embryo called a blastocyst, and are pluripotent from this source. The blastocyst contains about 100 cells, and is not suitable at this stage for implantation into the uterine wall.

    The inner core of the blastocyst has about 20 cells, and this is where stem cells are obtained.

    These cells are unspecialized cells that can be developed or morphed into the over 200 cells available in the human body through differentiation, as ESCs are undifferentiated by nature.

    As such, they can become any human cell, as long as they are prevented from clumping or crowding together when explanted into cultures as they are propagated. After stem cells are cultured, they are moved to what are called stem lines.

    Until recently, ESCs were believed to be most beneficial instead of the adult stem cell alternative (ASC), as these stem cells are limited to application to the tissue the stem cells were obtained from only. However ASCs (somatic stem cells) now can be coerced into differentiation through plasticity (trans-differentiation). This likely will reduce if not eliminate those opposed to stem cell therapy because of moral and ethical reasons related to the utilization of ESCs.

    Thanks to molecular biology, four transcription factors control the transfer of genetic information from DNA to RNAS to regulate gene expression. So ASCs can have the same beneficial qualities as ESCs.

    In the past, viral vectors and exotic genes interfered with the purity of ASCs. Now ASCs are re-programmed using plasmids instead of viruses and oncogenes that can become detrimental for the patient treated.

    So now, ASCs can safely become induced pluripotent cells with the same potential as ESCs. As a result, the ASCs are free of genetic artifacts that potentially can interfere with transgene sequences.

    They are capable of, and are able to renew and reproduce with minimal effort, stem cells, under the right laboratory conditions.

    Human blood can be reproduced with stem cells under the right conditions, it has been shown by researchers.

    SCT can also be used to investigate disease states for better treatment options.

    Disease-specific stem cell lines, which are those cells that are pluripotent and are created with the same genetic errors of certain diseases, are studied for this reason.

    So there clearly is a huge potential for stem cell-based therapies. The first FDA approved clinical trial occurred early in 2009. This human trial will involve evaluating primarily the safety of ESCs designed to be used as treatment for spinal cord injury patients. The trial was submitted by Geron Corp.

    Pfizer, the largest drug company, has implemented stem cell research, as they are an asset to drug discovery by creating within the organization a regenerative medicine unit. Other large pharma companies are implemented similar research protocols for the same reasons.

    Geron Corp. in California is the world’s leading esc developer, and financed researchers at Univ. of Wisconsin, who isolated the first human esc in 1998.

    Stem cell therapy potentially can cure multiple sclerosis, among other disases and those with damaged human tissue. The therapy prevents the advancement of disease, as well as reverses the neurological dysfunctions associated with MS. Patients are injected with their own stem cells obtained from their bone marrow, which are called haemopoietic stem cells.

    These particular stem cells are the origin of all blood cells. Further large clinical trials are needed to support these results. Studies have shown between 70 and 80 percent of MS patients who received stem cell therapy did not relapse afterwards.

    Allogenic, or donor transplants, have a risk of graft versus host disease. Autologous, which is the patient’s own stem cells, are preferable and most beneficial. Similar results from this autologous bone marrow transplant cellular therapy are seen with Chron’s disease as well.

    During the procedure, the immune system is reset so it is not in an autoimmune state where it attacks the human body. The process lasts about 2 months, and consists of 6phases:

    1. Initial chemo
    2. Release of stem cells
    3. Acquisition of stem cells
    4. Cells are then frozen until ready for transplant
    5. Second chemo to reduce leukocytes
    6. Autologous stem-cell transplant. Immune system is reset.

    Positive results from stem cell therapy are seen usually within a month, and patients can request another treatment about 6 months after the first treatment presently. This stem cell paradigm of therapy addresses the etiology of a disease state, instead of focusing on the symptoms only. As such, this is the practice of regenerative medicine with the implementation of SCT.

    Some believe ethical restraints are needed regarding the use of ESCs for therapeutic reasons. Yet they improve the quality of life of those with devastating diseases which involves suffering without any relief.

    So stem cell therapy and research may be the most right and ethical thing to do for such patients. Not only is the tremedous suffering relieved with those possessed with devistating diseases, their functional ability is restored for those who receive stem cell therapy.

    Embryos are acquired from fertility clinics (IVFs) that have thousands routinely stored and are abnormally fertilized. This means that they could never go on to become a human, and would be destroyed otherwise.

    Ironically, one could argue it is inappropriate to discard what may be valuable and ethical for others, potentially.

    Most couples with frozen embryos would gladly give them to such research, surveys have concluded.

    These embryos are believed by many to not be morally equivalent to human life, but only have the potential for life. And they are used for therapeutic cloning, known as somatic cell nuclear transfer, and not reproductive cloning.

    Ten states have banned this cloning out of ignorance, it seems. Bioethic principles, which are beneficience, or physician-centered decisions, as well as non-maleficence, which is first do no harm, are not corrupted.

    Furthermore, autonomy, which is the patient’s right to determine their health, and justice or fairness remain intact.

    Stem cells should be utilized for those terminally ill as well, many believe. Many are seeking stem cell therapy overseas due to restrictions that exist in the U.S. presently. The United Kingdom is believed to be the leader in stem cell research presently.<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

     

    Dan Abshear

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