Читать книгу The Stem Cell Cure - Kerry Johnson MBA PhD - Страница 12

CHAPTER 3

How Stem Cells Work

We are powered by our stem cells from conception to death.

Understanding Fundamentals

Wonder how many people would get a haircut if our hair could not regrow! That cut on your finger—a surgeon can stitch it up to bring the skin edges together, but ultimately the skin closes up because of cell growth and multiplication. Though we may not be aware of it at all times, cell multiplication and replacement is a fundamental process that goes on in our body 24/7. Unfortunately, the dreaded disease cancer only exists because our cells replicate. Cancer is just a manifestation of the regeneration and replication process gone awry! There happen to be too many cells in one place; cell multiplication is out of control. In most cases, a pathologist can only determine cancer when the cells are compared with an area of normal cells. Cancer cells actually look like their own host cells.

Stem Cells Can Form Other Cells

Let’s expand further by exploring this question: What is a stem cell? And the answer is that a stem cell is a cell capable of self-renewal and capable of forming other cells. We all start our journey as a stem cell. The self-renewal capability of your stem cells is maintained throughout your life. It is the ability to grow into other cells that varies at different stages of your life. At the embryonic stage, the stem cell is capable of growing into any kind of cell or organ system. As you mature, your stem cells are able to grow only into cells they are surrounded by. This is what unfolds in their natural state. Of course, a stem cell can be programmed in a laboratory to grow into a particular type of cell. The process involved in reprogramming a stem cell is currently an area of tremendous research. Also, different tissues have different regenerative capacity. That means different stem cells behave differently. Within the world of stem cells, there are different types. Various stem cells may be required depending on the particular condition being treated. A stem cell that heals your knee will not cure your diabetes! Stem cell treatments are most effective when they replace or repair cells that are missing. So when the cartilage in your joint is worn out, you need stem cells that are capable of regenerating the cartilage. When you have diabetes due to lack of insulin production, you will need stem cells that are capable of producing insulin.

In the past, healing has been largely dominated by chemicals that can suppress the symptoms of pain. Anti-inflammatories such as NSAIDs and steroids have been commonly used. Drugs that are designed to suppress the inflammation end up suppressing the function of those very same cells that are in need of healing, causing further harm. Our symptoms may resolve in the short run, but at the same time, these medications can be very toxic. These medications interfere with cell function rather than promote regeneration and repair. There is a reason why most medications stop working after a while; the cells become so damaged they become resistant.

As we have learned, the presence of inflammation takes away the ability of your cells to multiply and replace themselves. That is why inflammation is the basis of most conditions that take root in your body. This inflammatory state then diminishes the ability of the local cells to perform any meaningful repair or healing. Common conditions such as joint pain, tendinitis, asthma, arterial blockage, and hepatitis are all examples of chronic inflammation. Uncontrolled inflammation is the root cause of many conditions that afflict us.

Your Body Naturally Heals Itself

Your body naturally heals itself daily. When you sprain an ankle or suffer a minor injury, repair and regeneration sets in, and you heal. That is how you survive. Your body fixes minor issues and renews cells. But when the injury is more profound or repetitive, the local cells are not able to perform continued meaningful repair or regeneration. For example, let’s take tennis elbow. This is an initial sprain or inflammation at the site of the muscle attaching to the elbow bone. When that early inflammation does not get a chance to heal, the inflammatory process becomes chronic. Slowly it gets to a stage that will require some form of treatment to get relief. Sometimes we make the process worse by not resting. This is seen very commonly among athletes. Without providing rest to the body part that’s hurting, inflammation persists and can become chronic.

Regenerative treatment is the basic fundamental concept that aims to jump-start your local cells to help repair cell damage. And, of course, as you know by now, one major tool in the box of regenerative treatments is stem cells. The single most important property of stem cells is that they can exert a strong anti-inflammatory effect. Stem cells can clean up inflammation at the cellular level without causing any side effects. This is contrary to what you have experienced with NSAIDs and steroids. Stem cells exert a major impact on healing by not only growing new cells, but also secreting certain growth compounds that make the local environment at the site of injury healthy. That allows new cells to form and start functioning normally. This is how regeneration and repair happens and you ultimately heal. Nature’s best gift to us!

Five Important Stem Cell Functions

Besides being powerful anti-inflammatories, stem cells perform many functions that aid in regeneration and repair. There are five important functions a stem cell performs. These five main actions are how stem cells help you in fighting injury and disease:

1. They replace dead cells by forming new cells.

2. They release growth factors and compounds that promote cell growth.

3. They promote blood flow in the area of healing by forming tiny new blood vessels.

4. They cancel out the body’s own inflammatory responses.

5. They slow the breakdown process.

All of the above mechanisms lead to a healthy local environment among the cells. An environment that is more conducive to repair and regeneration.

These functions are critical to the efficacy and effectiveness of stem cells. They help define the possible applications of stem cells and the role they can play in a variety of conditions. Often stem cells are thought of as something that will create a whole new joint, organ, or even a duplicate copy of your body. And someday we may get there. For now the stem cells’ most important job is regeneration and repair. The stem cells work in conjunction with your local cells to help remove inflammation and promote blood flow. This will allow nutrients to reach the problem area, further aiding the healing process. Better blood flow helps remove toxic waste material and reduce inflammation. In essence, stem cells work to improve the local environment at the site of injury and disease. A healthier environment then jump-starts the local cells to function again.

In order for stem cells to do their job, they need to be delivered precisely to the site of disease or injury. Unless stem cells reach that site, they cannot modify the local environment of the damaged cells. Stem cells continue to multiply and replicate and repair the cells as time goes along. However, we do not have the full capability to do this for every condition. A more realistic application of stem cells for now is in the area of joint pain and sports injury. Stem cells have provided a much-needed alternative for the management of joint pain, tendinitis, plantar fasciitis, back pain, and sports injuries.

CASE STUDY: SAMIR

Samir, a 40-year-old pharmacist, has complained of pain in his feet for years. He has been diagnosed with plantar fasciitis. His profession requires standing for long hours and certainly has contributed to his condition. Samir has tried physical therapy, has had cortisone injections multiple times, and has sought opinions from numerous doctors. Except for a few days of intermittent relief, his pain has always been there. Samir has been told by several doctors that he just has to learn to live with the condition. There may not be any cure.

Samir’s older brother is a primary care physician in the community and knew of a doctor who specialized in stem cell treatments. He referred Samir to his physician friend. Samir was evaluated. Using ultrasound and X-rays for guidance, the doctor gave Samir a single treatment of Samir’s own stem cells. The injections were made at multiple sites within the plantar fascia. Samir noticed a 50% reduction in his pain two weeks after treatment. He was assessed in follow-up and received one more treatment to the plantar fascia. Samir has been pain-free for the past two years.

CASE STUDY: ALBERT AND HIS MOTHER

Albert has been taking care of his mother, who has suffered from Parkinson’s disease for several years. He’s hired the best caregivers to help his mom deal with this disabling condition. She’s had numerous treatments over the years that have seemed to help her. But she still cannot function independently and needs help with daily activities. Between work and taking care of his mother, Albert has very little time for anything else. He’s completely dedicated to making sure that he can do the best for his mother.

Recently Albert noticed a lot of stem cell advertisements targeting people with Parkinson’s disease. He was curious. During the next visit to his mother’s doctor, Albert inquired about the role of stem cells for her.

Parkinson’s is a condition where there is a loss of dopamine-producing brain cells. Dopamine helps brain cells communicate with each other. The lack of dopamine leads to miscommunication among the brain cells that affect the patient’s movement. As you can imagine, stem cells in Parkinson’s should have the ability to grow new cells to replace the ones that were lost. But as we noted earlier in the book, brain cells do not regenerate readily. The use of stem cells in Parkinson’s is a sophisticated process and will have to be studied in a laboratory. After the right stem cells are found, those stem cells will have to be delivered into the specific area of the brain affected in Parkinson’s. One can imagine how complex and risky that procedure could be. There is also the possibility of negative side effects and complications that we may not be aware of. So even though some clinics advertise using stem cells from the patient’s fat or bone marrow or from a newborn baby’s umbilical cord, these cells do not have the sophistication to grow into brain cells. These cells are administered intravenously and never make it to the area of the brain affected in Parkinson’s. This is a total waste of time and money along with unknown risks.

Still, it is important to know that there is significant ongoing research with stem cells especially derived from an embryonic stage or manufactured stem cells, either of which can then be programmed to grow into the brain cells needed for Parkinson’s disease. This research is at its very early stages. You should inquire about clinical trials conducted at academic centers. This at least will assure that you are getting the right stem cell treatment. You can also make sure the risks and side effects are being adequately monitored.

It is understandable why patients and their families feel the desperate need to ease the suffering of their loved ones. We are often willing and tempted to buy into the hype of stem cells. Unfortunately, this only takes away valuable resources that can be used to improve the patient’s quality of life.

One Size Doesn’t Fit All

When it comes to stem cell therapy, one size does not fit all! A stem cell treatment that can alleviate your joint pain will not cure your blindness, your child’s autism, or your grandpa’s Alzheimer’s! It is appalling how commercial clinics oversell the ability of stem cells to be a cure for a myriad of conditions. Unfortunately, this creates public mistrust and brings on the wrath of regulatory agencies.

Unless cells grow, stem cell therapy will not be effective. How embryonic stem cells are collected, how umbilical cord blood is collected, and how your own tissues are collected can involve different levels of complexity. How stem cells are gleaned or isolated from their sources has a major impact on your treatment. For example, when your own fat or bone marrow is collected, how is it broken down to get a concentrate of your own adult stem cells? Merely putting fat back into the joint is not stem cell therapy! Two patients getting stem cell treatment for a painful joint, using their own fat stem cells, can end up getting two entirely different treatments. In one, the fat will be injected without being broken down. In the other, the fat will be broken down. Your own stem cells will be isolated and then injected into your joint. An important point to understand is that fat contains many different cells, including stem cells. Fat cells are not stem cells. Therefore, it is very important to break down the fat in order to isolate your stem cells, discarding the remainder of unwanted fat cells. Fat is merely acting as an easily available source of your stem cells. Once you have a concentrate of stem cells ready, the next step is to deliver them to the area needing help. How will this be done? Are the cells getting into the joint space? Are they getting to the area of inflammation? Some clinics give intravenous (IV) injections of stem cells. The majority of stem cells given intravenously can get filtered in the lung. It depends on the condition being treated. But don’t expect an intravenous injection of stem cells to heal your knee joint. Unless the cells reach the area of damage, they won’t be effective. Similarly, cells for conditions affecting the brain may have to be implanted directly into the damaged part of the brain. Research is being conducted to answer some of the questions. Delivery routes and methods for different clinical conditions will vary and have to be clearly established. Until then, we may not be able to predict outcomes or compare results. Unfortunately, there is no apples-to-apples comparison among stem cell treatments yet!

CASE STUDY: MR. KAPOOR AND HIS DAUGHTER PRIYA

Mr. Kapoor is a 65-year-old real estate magnate who has traveled the world and loves to golf. He has played at some of the best-known international courses and even carries his own clubs. About seven years ago, his right shoulder started to hurt after playing. It progressively got worse. He was unable to lie on his right side. Shoulder pain kept him up most nights. He had an MRI evaluation that showed a significant, but not complete, rotator cuff tear. He wanted to avoid surgery or any other toxic medications or injections. He started exploring alternatives. After doing thorough research and getting opinions at three different stem cell clinics, Mr. Kapoor underwent stem cell treatment. He received an injection of his own stem cells harvested from his fat and bone marrow. His recovery was uneventful. Over the next two months he gradually resumed playing.

About two years ago, his 21-year-old daughter Priya was diagnosed with type 1 diabetes. Diabetes and its treatment take not only a physical toll, but a psychological one as well. This diagnosis impacts not only the patient but close family members. Determined to find a better cure for his daughter, and given that Mr. Kapoor had such a good experience with stem cells for his shoulder, he contacted the clinic he had gone to, inquiring about stem cell treatment for diabetes. He was told that his daughter could undergo a similar stem cell procedure like the one for his shoulder. The cells would be administered intravenously. Mr. Kapoor was quoted a price that was three times the cost he paid for his shoulder treatment. Mr. Kapoor trusted the clinic and took his daughter for the treatments. He was also advised that she could stop her insulin since the stem cell treatment would cure her diabetes.

Ms. Priya Kapoor received three treatments over three months. There was no improvement in her blood sugar level. The Kapoors were advised to pay for more treatments. In the meantime, Priya started having dizzy spells, and her vision became fuzzy. She also developed tingling and numbness in her feet. One day out of the blue, she noted an ulcer on her little toe. Over the next two weeks, the toe turned black; it was then Mr. Kapoor got alarmed and rushed Priya to a local hospital. The diagnosis was diabetic ulcer with gangrene of the toe. The dead toe had to be amputated. Tests showed that Priya had sky-high blood sugar levels. Her A1C was 14 (normally between 4 and 5.6) and she was heading into major complications due to uncontrolled diabetes. She had stopped taking her insulin on the advice of the stem cell clinic.

Mr. Kapoor had shown blind faith in the physicians. This highlights the dilemma you’re likely to face. On one hand, your own stem cells are capable of regenerating tissue like bones, joints, muscles, and cartilage. However, the same cells are not going to increase the production of insulin. They are not going to regenerate and repair diabetes. You need insulin from the outside to control your blood sugar level. Uncontrolled high blood sugar levels can lead to deadly complications, which Priya had started to experience. That is the level of complexity we need to understand.

The questions that need to be answered are: What stems cells are necessary for what condition, and how will they be administered? Cells given through a regular IV are probably not going to be effective. Most cells get filtered in the lung. Don’t expect those trapped cells in the lungs to regenerate and repair your pancreas to start making more insulin. This is not a treatment for diabetes, and these are not the stem cells for treatment of diabetes.

Great research is being conducted using embryonic and programmed stem cells that are capable of regenerating insulin-producing cells. Those stem cells can be directly implanted into your body either in the pancreas or at a location where new insulin-producing cells can grow. Again, not all stem cell treatments are the same. They may sound the same in terms of their title, so be careful!

KEY TAKEAWAYS

1. Not all stem cell treatments are the same. The source of the stem cells and the way they are processed prior to you getting them are both critical to the outcome.

2. Different conditions will need different types of stem cells. Your arthritis will not respond to the same stem cells as your diabetes will.

3. In order to be effective, live stem cells must reach the area of damage in your body where help is needed.

4. Multiple stem cell treatments may be required, depending on the nature and extent of your condition.

5. Just like any other treatment, stem cell treatments are most effective when you take care of your body and maintain good general health.