Stem cell research forges ahead these days on too many fronts to keep up with more than the high points. It's still enormously, unnecessarily expensive and time consuming to bring perfectly serviceable cell therapies into clinical practice in the US, so the medical tourism market continues to grow. The bulk of practical experience in the use of early stage stem cell therapies is at this point distributed to less regulated parts of the world, I believe. Work in the laboratory continues to advance in leaps and bounds, meanwhile, ever further ahead of what government regulators are willing to let pass their increasingly ridiculous testing processes. Researchers are moving closer to using stem cells to build useful amounts of tissue, and in programming stem cells to behave as we'd like them to behave: more active involvement in tissue regeneration, for example. There is a still a great deal yet to learn about how stem cells are programmed, however.
Here is a selection of recent news, a cross section of the average state of progress in stem cell research and the business of moving discoveries into clinical practice.
The market growth is majorly attributed to therapeutic research activities led by government support worldwide owing to the growing number of patients with chronic diseases across the globe. In addition, rising awareness of regenerative treatment options and growing importance of stem cell banking services are also fostering the growth of the market. Apart from these, development of medical tourism hubs in developing nations such as India and China and in turn migration of patients from developed nations such as the U.S. and Europe for quality treatment at significantly lower prices will also serve the market as a driver especially for the Asian stem cells market.
Adult stem cells held majority share of the overall stem cells market in 2011 at over 80%. This is due to less laborious procedure of harvesting, and less probability of contamination during expansion and sub-culture of adult stem cells. However, fewer post-transplant complications and lesser risk of graft vs. host reaction from the recently introduced induced pluripotent stem cells will lead to its rapid inclusion in research activities and help the global induced pluripotent stem cells market to grow at a relatively faster [rate] during the forecast period.
Starting with the skin cells of mice in vitro, [Katsuhiko Hayashi] created primordial germ cells (PGCs), which can develop into both sperm and eggs. To prove that these laboratory-grown versions were truly similar to naturally occurring PGCs, he used them to create eggs, then used those eggs to create live mice. He calls the live births a mere 'side effect' of the research, but that bench experiment became much more, because it raised the prospect of creating fertilizable eggs from the skin cells of infertile women. And it also suggested that men's skin cells could be used to create eggs, and that sperm could be generated from women's cells.
[Researchers] have for the first time highlighted the natural regenerative capacity of a group of stem cells that reside in the heart. This new study shows that these cells are responsible for repairing and regenerating muscle tissue damaged by a heart attack which leads to heart failure. The study [shows] that if the stem cells are eliminated, the heart is unable to repair after damage. If the cardiac stem cells are replaced the heart repairs itself, leading to complete cellular, anatomical and functional heart recovery, with the heart returning to normal and pumping at a regular rate. Also, if the cardiac stem cells are removed and re-injected, they naturally 'home' to and repair the damaged heart, a discovery that could lead to less-invasive treatments and even early prevention of heart failure in the future.
[Working with zebrafish] researchers have demonstrated for the first time why the molecular cocktail responsible for generating stem cells works. Sox2 and Oct4 are proteins whose effect on cells resembles that of an eraser: They remove all of the cell's previous experiences and transform it into a so-called pluripotent stem cell. The Oct4 protein in the zebrafish embryo, which is initially provided by the mother, is responsible for switching on the embryo's genes for the first time, thus initiating the animal's independent development.
Using the regulatory network discovered in the zebrafish, developmental biologists can now study how particular cell types in the body are created from stem cells and what makes them stable. Scientists require reliable processes for forming stable tissue before it can be used for applications in medicine.
Until now, the belief was that the skin's stem cells were organized in a strict hierarchy with a primitive stem cell type at the top of the hierarchy, and that this cell gave rise to all other cell types of the skin. However, our results show that there are differentiated levels of stem cells and that it is their close micro-environment that determines whether they make hair follicles, fat- or sweat glands.
Our data completes what is already known about the skin and its maintenance. Researchers have until now tried to fit their results into the old model for skin maintenance. However, the results give much more meaning when we relate them to the new model that our research proposes. We have marked the early skin stem cell with shining proteins in order to map stem cell behaviour in the outer layer of the skin. The stain is inherited by the daughter cells, so that we can trace their origin and make a family tree. The fine details of the family tree can be used to infer the stem cell's role in normal maintenance of the skin, as well as in wound healing.
The FDA has in recently years tried to shut down US clinics offering very simple forms of autologous stem cell therapy, those that do very little in the way of refining or altering or culturing the patient's cells, but these services are spreading nowadays. There was a ruling last year in which the FDA, for a change, decided not to continue to block new forms of therapy. There are of course no apologies for the costs incurred by groups like Regenerative Sciences due to government legal actions taken against their practices. So perhaps there is a useful erosion of FDA authority at this point and in this matter - more of that can only be a good thing. I would imagine that this has a lot to do with the ubiquitous availability of these therapies outside the US: competition and regulatory arbitrage between regions is the only thing that will generate sufficient pressure to make the FDA and other portions of the US medical regulation edifice back down.
"Knee replacements typically last 10 to 15 years on average," said Welsh. "If you're somebody in your 40-50s that has to have a knee replacement, and that's your only option, then you're having a big revision surgery in your 60s or 70s when your health may be starting to fail." So what to do? Welsh recommended a far less invasive procedure called stem cell knee injection. Welsh takes stem cells from the patient's own body that are generally found in the pelvis. Those stem cells are removed with a syringe and placed into a centrifuge where they're spun and mixed together for 15 minutes. Welsh then injects the stem cells into the knee.
"There was absolutely no pain involved in taking the stem cells out of my hip and putting them into my knee," said Hall.
"The benefit is we can postpone that knee replacement surgery hopefully for many years if we can truly regenerate cartilage," said Welsh.
"I know that it's working because I'm already exercising," said Hall. "I am so excited about feeling healthy again."
Emory Orthopedic Specialists take the stem cells from a patient's own bone marrow, process them, and inject them back into the patients' joint, causing the pain to go away. "We have also seen regeneration of cartilage," Dr. Mason said. Patients are able to walk or drive immediately after the procedure and should experience significant overall improvement within six weeks.
"The implant was a little intense for a few seconds, nothing you couldn't deal with. It was a whole lot less painful than a root canal," Lunsford said. Out of 50 patients, only one needed surgery. "We basically turbo charged that site to heal itself and so far so good," Lunsford said.
Stem cell injections are being used mainly in the larger joints: knees, hips, and shoulders. However, because this treatment is so new, doctors don't know how long it will last. After three to four years patients will need to have another injection, or the replacement surgery, and because of that most health insurance plans will not cover it.