A Dangerous Game: Some Athletes Risk Untested Stem Cell Treatments

Image: Peter Ryan

In 2005, at the age of 32, then Los Angeles Angel Bartolo Coln won the American League Cy Young Award for best pitcher, one of professional baseball's top honors. He stumbled through subsequent seasons, however, after a series of rips and strains in the tendons and ligaments of his throwing arm, shoulder and back. In 2009 he all but quit baseball. Desperate to reclaim his career, Coln flew home to the Dominican Republic in 2010 for an experimental procedure not vetted or approved by the U.S. Food and Drug Administration. Doctors centrifuged samples of Coln's bone marrow and fat, skimmed off a slurry containing a particular kind of stem cellimmature, self-renewing cells that can turn into a variety of tissuesand injected it into his injured shoulder and elbow. Within months of the procedure the then 37-year-old Coln was once again pitching near the top of his game for the New York Yankeescommanding a 93-mile-per-hour fastball.

Whether the injected stem cells rejuvenated his arm is an open question. The fda and the International Society for Stem Cell Research warn that no rigorous studies have demonstrated that such treatments safely and effectively repair damaged connective tissue in people. The results of related animal studies, though promising, have raised more questions than answers. The term stem cell makes it sound cutting edge and exciting, says Paul Knoepfler, a cell biologist at the University of California, Davis, who also writes frequently on policy surrounding stem cells. But the role of these cells in sports medicine is essentially all hype.

No matter, apparently, to the aging, injured athletes who have followed Coln's lead. Lefty pitcher C. J. Nitkowski, who underwent the same procedure in 2011, told readers of his personal blog that he did not mind the lack of carefully controlled research. My attitude is I don't have the time to wait for the five- or 10-year study to come out, the then 38-year-old relief pitcher wrote, so I'm taking a chance now. Besides, Nitkowski figured, even if the treatment did not work, any health risks ought to be slight because the cells involved were his own.

That might not be such a safe bet. Numerous studies suggest that Coln, Nitkowski and others trying untested stem cell treatments may be risking more than they think. Even a syringe of one's own stem cells taken from one part of the body and squirted into another may multiply, form tumors, or may leave the site you put them in and migrate somewhere else the fda warns on its Web site. More clinical research is needed to define safety procedures, as well as how many cells of which types and what other tissue factors produce the desired results. In some animal studies, for example, the regenerated tissue is not as strong or flexible as the original. In other cases, an overgrowth of scar tissue makes the injected tendon or ligament adhere to the overlying skin. By preventing different tissues from gracefully sliding past one another, these adhesions sometimes pull an even bigger tear in an already serious wound.

In addition, Knoepfler worries that high-profile sports testimonials by Coln, Nitkowski and others will encourage joggers with blown-out knees and the parents of sore-armed Little Leaguers to demand the procedure before it has been thoroughly tested. When celebrities take to a new treatment, many other people follow suit, he says. Such premature enthusiasmor an unforeseen tragedy that results from proceeding too fast too sooncould also prevent serious researchers from getting funding to do the kinds of careful experiments that might eventually lead to safe and reliable treatments.

Seeds of Repair

The need for better ways to reknit damaged tendons and ligaments is painfully apparent to the roughly two million Americans in a given year who seek medical help for tears in their shoulder's rotator cuff, for example, or the 100,000 patients in the same year who undergo surgery in the U.S. to repair a ripped or ruptured anterior cruciate ligament (ACL) of the knee. Tendons and ligaments are tough, fibrous bands, made mostly of collagen, that anchor networks of muscles to a bone or link bones and cartilage across crucial joints. They lend strength, flexibility and stability to your daily twists and turns, whether you are rocketing a baseball across home plate or hefting a suitcase into an overhead bin. Once frayed or snapped, they can take many months or longer to mendeven with surgery.

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A Dangerous Game: Some Athletes Risk Untested Stem Cell Treatments

Body fat good source of stem cells, say doctors

By Philip C. Tubeza Philippine Daily Inquirer

Health Secretary Enrique Ona said that the Department of Health would come out in the coming weeks with the rules to regulate stem cell therapy in the country. INQUIRER FILE PHOTO

MANILA, PhilippinesHealth buffs may abhor body fat but it is actually a good source for stem cells that can be used to help treat diseases ranging from athritis, diabetes, or even HIV/AIDS in the future, according to a stem cell expert.

Speaking at the first national convention of the Philippine Society for Stem Cell Medicine, Vasilis Paspaliaris, a stem cell expert from Greece, said body fat or adipose tissues have been proven to be rich sources of mesenchyme stem cells, used for regenerative medicine.

Why fat? Whats the interest in fat? Theres a lot more mesenchyme stem cells in adipose tissue, Paspaliaris said during the convention at the Manila Hotel.

Many of you cosmetic surgeons know that fat has been used as a filler for breast enhancements. Everyone knew there was a therapeutic use for fat. And plastic surgeons were quite aware of it. They have seen its rejuvenative effects, he added.

He said that while mesenchyme tissues could also be found in the skin and the kidneys, there is 10,000 times more mesancyme stem cells in adipose tissue.

And what is a big deal in adipose tissue is that (its) easily accessible with a minimal invasive procedure. More importantly, we can take a little amount of fat and we already have enough numbers of cells that we can take back straight to our patients, he added.

However, Paspaliaris said that the fat person would not necessarily have more mesenchyme stem cells than someone thinner.

The bigger you are does not mean that you have more stem cells. It just means you have more lipids (or stored energy), he added.

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Body fat good source of stem cells, say doctors

Stem Cell Therapy Guidelines Readied

MANILA, Philippines --- The Department of Health (DOH) is preparing guidelines for the use of stem cell therapy in the treatment of diseases in the Philippines.

This was announced by DOH Secretary Enrique T. Ona yesterday in a convention on stem cell therapy at the Manila Hotel.

Ona said a bio-ethics advisory board will develop the guidelines which will include ethical standards in the application of stem cell therapy to treat diseases such as malignancies, blood disorders and metabolic disorders, among others.

"The institutional board will review and approve Stem Cell therapies based on guidelines by the advisory board," Ona said.

He added that the board will also include ethical and legal issues surrounding stem cell therapy.

Last week, the Philippine Medical Association (PMA) and the Philippine Society for Stem Cell Medicine (PSSCM) issued a joint statement that warned against the dangers of receiving stem cell transplants that came from another source other than the patient's body.

"If the stem cell that you received is not from your own body, it could lead to fatal complications," Philippine Society for Stem Cell Medicine (PSSCM) and the PMA said.

The doctors warned that complications arising from stem cell transplants include graft-versus-host disease, stem cell (graft) failure, organ injury, infections, cataracts, infertility, new cancers, and even death.

Ona said a public hearing will be held on January 18 regarding the preliminary draft of the guidelines.

He said the guidelines will ensure the minimum quality of service and application in the use of stem cells in health settings.

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Stem Cell Therapy Guidelines Readied

Ben-Gurion U. establishes stem cell research fund in honor of inventor Jordan Baruch

Public release date: 14-Jan-2013 [ | E-mail | Share ]

Contact: Andrew Lavin andrewlavin@alavin.com 516-944-4486 American Associates, Ben-Gurion University of the Negev

CHEVY CHASE, MD, January 15, 2013 -- American Associates, Ben-Gurion University of the Negev (AABGU) received a substantial donation from Rhoda Baruch, wife of the late Dr. Jordan Baruch, to fund stem cell research at Ben-Gurion University of the Negev (BGU) in Beer-Sheva, Israel.

The Jordan Baruch Stem Cell Research Fund was dedicated at the University on December 30 in the presence of Rhoda Baruch and 20 members of her extended family.

"Jordan recognized that here at Ben-Gurion University are the people who walk the extra mile and who are dedicated to the less fortunate. What the people of BGU have in addition to their brilliance and creativity is a sense of compassion and dedication that touched us so much. If anyone can do it, you guys can do it," Baruch declared.

The donation will support scholarly collaboration between specially selected medical and pharmacological researchers, stem cell biologists and tissue engineers. It will support the work of BGU's new Center for Regenerative Medicine, Cellular Therapy and Stem Cell Research.

"Jordan was a passionate supporter of Israel and especially BGU," says Keren Waranch, director of the Washington-Baltimore Region of American Associates, Ben-Gurion University of the Negev (AABGU), who also attended the dedication.

"He and Rhoda founded the local AABGU chapter in the 1980s and funded the Mendel Wasserman Career Development Chair in Desert Studies, named in memory of Rhoda's father.

"We are extremely grateful to Rhoda for this generous contribution and moving tribute to her husband of 67 years," Waranch adds. "This fund will launch BGU forward in researching the treatment and potential cure for debilitating diseases such as diabetes, ALS, Parkinson's and leukemia."

Dr. Baruch (pronounced Bah-ROOSH), who died in 2011, was considered one of the foremost authorities in the field of acoustics. He held several patents for sound-dampening technology and loudspeaker systems.

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Ben-Gurion U. establishes stem cell research fund in honor of inventor Jordan Baruch

Stem-cell approach shows promise for Duchenne muscular dystrophy

Jan. 14, 2013 Researchers have shown that transplanting stem cells derived from normal mouse blood vessels into the hearts of mice that model the pathology associated with Duchenne muscular dystrophy (DMD) prevents the decrease in heart function associated with DMD.

Their findings appear in the journal Stem Cells Translational Medicine.

Duchenne muscular dystrophy is a genetic disorder caused by a mutation in the gene for dystrophin, a protein that anchors muscle cells in place when they contract. Without dystrophin, muscle contractions tear cell membranes, leading to cell death. The lost muscle cells must be regenerated, but in time, scar tissue replaces the muscle cells, causing the muscle weakness and heart problems typical of DMD.

The U.S. Centers for Disease Control and Prevention estimates that DMD affects one in every 3,500 males. The disease is more prevalent in males because the dystrophin mutation occurs on the X chromosome; males have one X and one Y chromosome, so a male with this mutation will have DMD, while females have two X chromosomes and must have the mutation on both of them to have the disease. Females with the mutation in one X chromosome sometimes develop muscle weakness and heart problems as well, and may pass the mutation on to their children.

Although medical advances have extended the lifespans of DMD patients from their teens or 20s into their early 30s, disease-related damage to the heart and diaphragm still limits their lifespan.

"Almost 100 percent of patients develop dilated cardiomyopathy," in which a weakened heart with enlarged chambers prevents blood from being properly pumped throughout the body, said University of Illinois comparative biosciences professor Suzanne Berry-Miller, who led the study. "Right now, doctors are treating the symptoms of this heart problem by giving patients drugs to try to prolong heart function, but that can't replace the lost or damaged cells," she said.

In the new study, the researchers injected stem cells known as aorta-derived mesoangioblasts (ADM) into the hearts of dystrophin-deficient mice that serve as a model for human DMD. The ADM stem cells have a working copy of the dystrophin gene.

This stem cell therapy prevented or delayed heart problems in mice that did not already show signs of the functional or structural defects typical of Duchenne muscular dystrophy, the researchers report.

Berry-Miller and her colleagues do not yet know why the functional benefits occur, but proposed three potential mechanisms. They observed that some of the injected stem cells became new heart muscle cells that expressed the lacking dystrophin protein. The treatment also caused existing stem cells in the heart to divide and become new heart muscle cells, and the stem cells stimulated new blood vessel formation in the heart. It is not yet clear which of these effects is responsible for delaying the onset of cardiomyopathy, Berry-Miller said.

"These vessel-derived cells might be good candidates for therapy, but the more important thing is the results give us new potential therapeutic targets to study, which may be activated directly without the use of cells that are injected into the patient, such as the ADM in the current study," Berry-Miller said. "Activating stem cells that are already present in the body to repair tissue would avoid the potential requirement to find a match between donors and recipients and potential rejection of the stem cells by the patients."

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Stem-cell approach shows promise for Duchenne muscular dystrophy

Stem Cells May Hold Promise for Lou Gehrig's Disease (ALS)

SAN DIEGO, Jan. 14, 2013 /PRNewswire-USNewswire/ -- Apparent stem cell transplant success in mice may hold promise for people with amyotrophic lateral sclerosis (ALS), or Lou Gehrig's disease. The results of the study will be presented at the American Academy of Neurology's 65th Annual Meeting in San Diego, March 16 to 23, 2013.

"There have been remarkable strides in stem cell transplantation when it comes to other diseases, such as cancer and heart failure," said study author Stefania Corti, MD, PhD, with the University of Milan in Italy and a member of the American Academy of Neurology. "ALS is a fatal, progressive, degenerative disease that currently has no cure. Stem cell transplants may represent a promising avenue for effective cell-based treatment for ALS and other neurodegenerative diseases."

For the study, mice with an animal model of ALS were injected with human neural stem cells taken from human induced pluripotent stem cells (iPSCs). iPSC are adult cells such as skin cells that have been genetically reprogrammed to an embryonic stem cell-like state. Neurons are a basic building block of the nervous system, which is affected by ALS. After injection, the stem cells migrated to the spinal cord of the mice, matured and multiplied.

The study found that stem cell transplantation significantly extended the lifespan of the mice by 20 days and improved their neuromuscular function by 15 percent.

"Our study shows promise for testing stem cell transplantation in human clinical trials," said Corti.

The study was supported by AriSLA - The Italian Foundation for Research on Amyotrophic Lateral Sclerosis (ALS).

Learn more about ALS at http://www.aan.com/patients.

The American Academy of Neurology, an association of more than 25,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer's disease, stroke, migraine, multiple sclerosis, brain injury, Parkinson's disease and epilepsy.

For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, Google+ and YouTube.

SOURCE American Academy of Neurology

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Stem Cells May Hold Promise for Lou Gehrig's Disease (ALS)