Stem Cell Clinic

Daughter leads full life thanks to stem cell therapy – Independent Online

By adminAugust 8, 2017Uncategorized

Erna West and daughter Gizelle, who was diagnosed with Fanconi anaemia aged 9. Her life was saved by a blood marrow transplant from her mother. Picture: SUPPLIED

The one thing I still remember is us driving in our car and my daughter asking me, Mommy, am I going to die? West recounted.

Now an ardent advocate for stem cell therapy and storage, West, a product specialist for CryoSave, credits stem cells with saving her daughters life.

Her daughter needed a bone marrow transplant, which involved the transplanting of stem cells.

She found she was an exact donor match for her daughters bone marrow transplant - a one-in-a-million occurrence.

When youre faced with a situation such as that as a parent, you want and are willing to do anything to save your childs life I just want parents to understand what stem cells can do.

Fast forward 21 years and stem cells are revolutionising health care and through modern technology, parents can store their newborn babys umbilical cord stem cells in case of any future illnesses or health care needs.

Stem cells are present in the human body throughout life, constantly repairing tissue damaged by normal activity, the environment and other extraneous factors. They can replicate or regenerate themselves and have the ability to differentiate into any kind of specialised cell in the body.

Africa is the only continent without a public stem cell bank - private stem cell storage banks are in increasing demand as research and medical innovation has shown that many blood cancers, blood disorders, autoimmune diseases and immunodeficiencies are treatable with cord blood.

Umbilical cord blood and stem cell banking is still a relatively novel concept in South Africa.

However, new parents are increasingly opting to have their newborn babies stem cells extracted from their umbilical cords.

According to CryoSave - which stores 7 800 client stem cell samples - the process is simpler and quicker than one might expect.

Once the baby is born, the umbilical cord is clamped and cut as per normal in any birth. It is only after this that the blood and tissue are collected from the cord - which is usually discarded as medical waste after the birth.

A babys umbilical cord stem cells are a 100% perfect match and biological parents stem cells will be at least a half-match.

There is a 25% probability of matching siblings and, unlike bone marrow transplants, one doesnt have to have a perfect match in transplants when making use of cord blood stem cells.

Today, umbilical cord blood stem cells are used in more than one-third of all blood stem cell transplants in the world.

Explaining the process behind the storage of umbilical cord cells at their labs, Christiene Botha, a lab quality manager said: The blood we receive goes through a rigorous sterilising, processing and freezing process.

The samples are then stored in liquid nitrogen tanks at a temperature of -196C.

But time is of the essence in this process.

The umbilical cord blood sample needs to reach the lab within 48 hours - and the cut off is at 64 hours - as blood cells start dying after 72 hours.

Depending on what product one uses to store the cells, storage rates can be from R250 to R300 a month.

The fact that we dont have a public national bank puts us at a disadvantage because it is the ideal. So there arent many choices for parents out there - but families can look after themselves through this type of storage.

"My daughter is 30-years-old, is married and lives a full life because of stem cells, West concluded.

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Daughter leads full life thanks to stem cell therapy - Independent Online

A Chip That Reprograms Cells Helps Healing, At Least In Mice – NPR

By adminAugust 8, 2017Uncategorized

The chip has not been tested in humans, but it has been used to heal wounds in mice. Wexner Medical Center/The Ohio State University hide caption

The chip has not been tested in humans, but it has been used to heal wounds in mice.

Scientists have created an electronic wafer that reprogrammed damaged skin cells on a mouse's leg to grow new blood vessels and help a wound heal.

One day, creator Chandan Sen hopes, it could be used to be used to treat wounds on humans. But that day is a long way off as are many other regeneration technologies in the works. Like Sen, some scientists have begun trying to directly reprogram one cell type into another for healing, while others are attempting to build organs or tissues from stem cells and organ-shaped scaffolding.

But other scientists have greeted Sen's mouse experiment, published in Nature Nanotechnology on Monday, with extreme skepticism. "My impression is that there's a lot of hyperbole here," says Sean Morrison, a stem cell researcher at the University of Texas Southwestern Medical Center. "The idea you can [reprogram] a limited number of cells in the skin and improve blood flow to an entire limb I think it's a pretty fantastic claim. I find it hard to believe."

When the device is placed on live skin and activated, it sends a small electrical pulse onto the skin cells' membrane, which opens a tiny window on the cell surface. "It's about 2 percent of the cell membrane," says Sen, who is a researcher in regenerative medicine at Ohio State University. Then, using a microscopic chute, the chip shoots new genetic code through that window and into the cell where it can begin reprogramming the cell for a new fate.

Sen says the whole process takes less than 0.1 seconds and can reprogram the cells resting underneath the device, which is about the size of a big toenail. The best part is that it's able to successfully deliver its genetic payload almost 100 percent of the time, he says. "No other gene delivery technique can deliver over 98 percent efficiency. That is our triumph."

Chandan Sen, a researcher at Ohio State University, holds a chip his lab created that has reprogrammed cells in mice. Wexner Medical Center/The Ohio State University hide caption

Chandan Sen, a researcher at Ohio State University, holds a chip his lab created that has reprogrammed cells in mice.

To test the device's healing capabilities, Sen and his colleagues took a few mice with damaged leg arteries and placed the chip on the skin near the damaged artery. That reprogrammed a centimeter or two of skin to turn into blood vessel cells. Sen says the cells that received the reprogramming genes actually started replicating the reprogramming code that the researchers originally inserted in the chip, repackaging it and sending it out to other nearby cells. And that initiated the growth of a new network of blood vessels in the leg that replaced the function of the original, damaged artery, the researchers say. "Not only did we make new cells, but those cells reorganized to make functional blood vessels that plumb with the existing vasculature and carry blood," Sen says. That was enough for the leg to fully recover. Injured mice that didn't get the chip never healed.

When the researchers used the chip on healthy legs, no new blood vessels formed. Sen says because injured mouse legs were was able to incorporate the chip's reprogramming code into the ongoing attempt to heal.

That idea hasn't quite been accepted by other researchers, however. "It's just a hand waving argument," Morrison says. "It could be true, but there's no evidence that reprogramming works differently in an injured tissue versus a non-injured tissue."

What's more, the role of exosomes, the vesicles that supposedly transmit the reprogramming command to other cells, has been contentious in medical science. "There are all manners of claims of these vesicles. It's not clear what these things are, and if it's a real biological process or if it's debris," Morrison says. "In my lab, we would want to do a lot more characterization of these exosomes before we make any claims like this."

Sen says that the theory that introduced reprogramming code from the chip or any other gene delivery method does need more work, but he isn't deterred by the criticism. "This clearly is a new conceptual development, and skepticism is understandable," he says. But he is steadfast in his confidence about the role of reprogrammed exosomes. When the researchers extracted the vesicles and injected them into skin cells in the lab, Sen says those cells converted into blood vessel cells in the petri dish. "I believe this is definitive evidence supporting that [these exosomes] may induce cell conversion."

Even if the device works as well as Sen and his colleagues hope it does, they only tested it on mice. Repairing deeper injuries, like vital organ damage, would also require inserting the chip into the body to reach the wound site. It has a long way to go before it can ever be considered for use on humans. Right now, scientists can only directly reprogram adult cells into a limited selection of other cell types like muscle, neurons and blood vessel cells. It'll be many years before scientists understand how to reprogram one cell type to become part of any of our other, many tissues.

Still, Morrison says the chip is an interesting bit of technology. "It's a cool idea, being able to release [genetic code] through nano channels," he says. "There may be applications where that's advantageous in some way in the future."

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A Chip That Reprograms Cells Helps Healing, At Least In Mice - NPR

Texas Heart Institute Awarded Grant to Study Sex Differences in Cardiac Repair – Texas Medical Center (press release)

By adminAugust 8, 2017Uncategorized

Earlier this year, Texas Heart Institute received Alpha Phi Foundations 2017 Heart to Heart Grant. The $100,000 grant will fund research led by Doris Taylor, Ph.D., director of the Regenerative Medicine Research and the Center for Cell and Organ Biotechnology at the Texas Heart Institute, to study cardiac repair in women at the cellular level.

Were just really passionate about these projects that have long-term clinical relevancy, as a women-driven organization and being committed to womens heart health, said Colleen Sirhal, vice chair of the Alpha Phi Foundation.

The study will explore sex differences in blood, bone marrow and stem cells of patients enrolled in cell therapy clinical trials.

While bone marrow cell therapy has been used to treat cardiovascular disease in clinical trials, very few studies have been conducted to assess the sex differences in efficacy and outcomes. By performing a proteomic analysis of the samples and evaluating the proteins that cells produce and secrete, the results could shed light on unanswered questions related to critical sex-specific differences in cardiovascular disease, potentially leading to improved cell therapies.

Its about time that were paying attention to sex differences, Taylor said. Were not just small men. The biology is different.

Heart disease remains the No. 1 cause of death in both men and women in the United States, yet theres a limited understanding in the scientific community as to why it affects men and women differently. For example, women 45 years old and younger have a higher likelihood than men of dying within a year of their initial heart attack.

In addition, women have a higher risk of developing small vessel disease, in which the walls of tiny vessels within the heart muscle become blocked rather than larger arteries, causing heart-related chest pain. Because the major coronary arteries may look normal, women with small vessel disease can have a heart attack go undiagnosed and untreated.

We know heart disease happens differently in men and women, Taylor said. More young women than men die of heart disease. Why is that? Is there something that happens early? If we only look at these women who are older, are we missing something major? By looking at healthy, normal younger women, were going to be able to do comparisons across time, comparisons by disease, and comparisons by sex. I think thats really exciting.

Historically, women and minorities have largely been underrepresented in research and clinical trials, especially pertaining to cardiovascular disease.

Dr. Taylors colleague at the Texas Heart Institute, Stephanie Coulter, M.D., a cardiologist and the director of the Center for Womens Heart and Vascular Health at Texas Heart Institute and a recipient of the 2013 Heart to Heart Grant, is actively recruiting younger women to participate in her research registry.

Since women are typically affected by heart disease a decade or more later than men, age may also have played a role in this underrepresentation, Coulter said. Our Womens Center research is focusing on women age 18 and older to address this very issue.

Coulter added that trials focusing on prevention in women, such as the Womens Health Initiative and Womens Health Study, have, in fact, had clinical impact. However, the percentage of women enrolling in clinical trials continues to be disproportionate to the prevalence of cardiovascular disease in women, but we are seeing improvements thanks to multiple initiatives in the U.S. that continue to address the issue of women in clinical trials.

Its easy for people to assume that if you study men, itll apply to women, but it seems anathema to people to assume that if you study women it might benefit men, Taylor said. At the end of the day, when it comes time to look at the data and ask, How does this treatment work in women? How does this treatment work in men?, oftentimes there arent enough women enrolled in the trials to split that out. Statistically, youd be doing yourself a disservice.

Taylor has spent nearly two decades studying key contributors to cardiac repair at the cellular level, specifically looking at proteins cells produce and secrete based on gender as a new frontier in cell therapy.

Early on in Taylors career, she studied how bone marrow cells behaved based on gender. She extracted cells from male mice and administered them to female mice and vice versa, allowing her to track the Y chromosome. The results showed that only the males treated with female cells improved. This phenomenon raised the question of whether or not the bone marrow cells were the same.

After measuring the bone marrow cells that were present in males and females, Taylor discovered that the cells were inherently different: In the male mice, there were more inflammatory cells, fewer progenitor and stem cells and a different number of immune cells than in the female mice. In addition, when the bone marrow cells were placed in a petri dish, the female cells produced more growth factors responsible for recruiting repair cells after an injury.

Taylor conducted follow-up experiments in which she gave female and male cells to both female and male mice. The results confirmed her hunch: The only cells that were reparative were the female cells.

It made me realize a critical detail for the first time:Every time we take bone marrow from a different person with the intention of delivering it back to them as a therapy, if we look at the cells present in the marrow, theyd be different, Taylor said. Which means, every time were doing an autologous cell therapytrial, in which you take bone marrow and deliver it back to an individual, you are giving each person a completely different or unique drug in that trial.

Through the Heart to Heart grant, the data from Taylors research will allow her to build upon her early research on sex differences and, hopefully, identify a way to optimize cell therapy.

Already cells are as good as some drugs. If we optimize them and choose the right cells for the right patient at the right time, maybe well hit the home run, Taylor said.

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Texas Heart Institute Awarded Grant to Study Sex Differences in Cardiac Repair - Texas Medical Center (press release)

Prostate Cancer Cells Become ‘Shapeshifters’ to Spread to Distant Organs – Laboratory Equipment

By adminAugust 8, 2017Uncategorized

Johns Hopkins Kimmel Cancer Center scientists report they have discovered a biochemical process that gives prostate cancer cells the almost unnatural ability to change their shape, squeeze into other organs and take root in other parts of the body. The scientists say their cell culture and mouse studies of the process, which involves a cancer-related protein called AIM1, suggest potential ways to intercept or reverse the ability of cancers to metastasize, or spread.

Results of the research are described in the July 26 issue of Nature Communications.

For the study, the Johns Hopkins scientists mined publically available research data on the genetics and chemistry of hundreds of primary and metastatic cancers included in five studies of men with prostate cancer. They found that a gene called AIM1 (aka absent in melanoma 1), which makes proteins also called AIM1, is deleted in approximately 20 to 30 percent of prostate cancers confined to the gland and about 40 percent of metastatic prostate cancers. In addition, the scientists found, on average, two- to fourfold less amounts of AIM1 expression in metastatic prostate cancers compared with normal prostate cells or those from men with prostate cancers confined to the prostate, suggesting that reduction of AIM1 proteins is somehow linked to tumor spread.

Aside from its link to the development of melanoma, a deadly skin cancer, scientists knew little about the function of AIM1.

Our experiments show that loss of AIM1 proteins gives prostate cancer cells the ability to change shape, migrate and invade. These abilities could allow prostate cancer cells to spread to different tissues in an animal and presumably a person, said Michael Haffner, M.D., Ph.D., a pathology resident and former postdoctoral fellow at the Johns Hopkins Kimmel Cancer Center who is involved in the research. Its not the whole story of what is going on in the spread of prostate cancer, but it appears to be a significant part of it in some cases.

Looking more closely at the AIM1 gene and its protein levels in prostate cancer tissues, the Johns Hopkins scientists found that many times, even when the gene isnt completely deleted and its protein production is reduced, its location in the prostate cancer cell is highly abnormal compared with normal prostate cells. This occurs even in primary prostate cancer cells, which have invaded the local structures to form invasive cancer within the prostate gland, say the scientists.

The research team used dyes to track the location of AIM1 proteins in human cells grown in the lab and followed where they appear in normal and cancerous prostate tissues. In normal prostate cells, AIM1 was located along the outside border of each cell and paired up with a protein called beta-actin that helps form the cells cytoskeleton, or scaffolding. However, in prostate cancer cells, the protein spread away from the outer border of the cells and no longer paired up with beta-actin.

The scientists found this pattern among a set of human prostate tissue samples including 81 normal prostates, 87 localized prostate cancers and 52 prostate cancers that had spread to the lymph nodes.

It appears that when AIM1 protein levels drop, or when its abnormally spread throughout the cell instead of confined to the outer border, the prostate cancer cells scaffolding becomes more malleable and capable of invading other tissues, said Vasan Yegnasubramanian, M.D., Ph.D., associate professor at the Kimmel Cancer Center and a member of the research team. With AIM1, the scaffold, Yegnasubramanian says, keeps normal cells in a rigid, orderly structure. Without AIM1, cells become more malleable, shapeshifting nomads that can migrate to other parts of the body, he said.

To track how these shapeshifting cancer cells move, the Johns Hopkins scientists, with Steven An, Ph.D., an expert in cellular mechanics and an associate professor at the Johns Hopkins Bloomberg School of Public Health, took a close-up look at AIM1-lacking prostate cancer cells, using sophisticated and quantitative single-cell analyses designed to probe the material and physical properties of the living cell and its cytoskeleton.

They found that cells lacking AIM1 remodeled their scaffolding more than twice as much as cells that had normal levels of AIM1, and that they exert three- to fourfold more force on their surroundings than cells with normal levels of the protein. Such cellular properties are reminiscent of cells with high potential to invade and migrate, An noted.

In addition, the scientists found that AIM1-lacking prostate cells were capable of migrating to unoccupied spaces on a culture dish or invading through connective tissue-like materials at rates fourfold higher than cells with normal levels of AIM1.

Next, the scientific team implanted human prostate cancer cells engineered without AIM1 in five mice and found that the cells spread to other tissues at levels 10 to 100 times more than cells with normal levels of AIM1 that were implanted in five similar mice. However, the AIM1-lacking cells were not able to establish full colonies and tumors at those other tissues, suggesting that AIM1 depletion is not the whole story in the spread and growth of metastatic prostate cancer.

AIM1 may help prostate cancer cells disseminate throughout the body, but something else may be helping them form full-blown metastatic tumors when they get there, said Yegnasubramanian.

VistaGen Therapeutics (VTGN) Receives Notice of Allowance For Methods for Producing Blood Cells, Platelets and … – StreetInsider.com

By adminAugust 8, 2017Uncategorized

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VistaGen Therapeutics Inc. (NASDAQ: VTGN), a clinical-stage biopharmaceutical company focused on developing new generation medicines for depression and other central nervous system (CNS) disorders, announced today that the Company has received a Notice of Allowance from the U.S. Patent and Trademark Office (USPTO) for U.S. Patent Application No. 14/359,517 regarding proprietary methods for producing hematopoietic precursor stem cells, which are stem cells that give rise to all of the blood cells and most of the bone marrow cells in the body, with potential to impact both direct and supportive therapy for autoimmune disorders and cancer.

The breakthrough technology covered by the allowed U.S. patent was discovered and developed by distinguished stem cell researcher, Dr. Gordon Keller, Director of the UHN's McEwen Centre for Regenerative Medicine in Toronto, one of the world's leading centers for stem cell and regenerative medicine research and part of the University Health Network (UHN), Canada's largest research hospital. Dr. Keller is a co-founder of VistaGen and a member of the Company's Scientific Advisory Board. VistaGen holds an exclusive worldwide license from UHN to the stem cell technology covered by the allowed U.S. patent.

"We are pleased to report that the USPTO has allowed another important U.S. patent relating to our stem cell technology platform, stated Shawn Singh, Chief Executive Officer of VistaGen. "Because the technology under this allowed patent involves the stem cells from which all blood cells are derived, it has the potential to reach the lives of millions battling a broad range of life-threatening medical conditions, including cancer, with CAR-T cell applications and foundational technology we believe ultimately will provide approaches for producing bone marrow stem cells for bone marrow transfusions. As we continue to expand the patent portfolio of VistaStem Therapeutics, our stem cell technology-focused subsidiary, we enhance our potential opportunities for additional regenerative medicine transactions similar to our December 2016 sublicense of cardiac stem cell technology to BlueRock Therapeutics, while focusing VistaStem's internal efforts on using stem cell technology for cost-efficient small molecule drug rescue to expand our drug development pipeline."

Stem cell treatment may harm heart disease patients – ISRAEL21c

By adminAugust 8, 2017Stem Cell Treatment

For patients with severe and end-stage heart failure there are few treatment options left apart from transplants and stem-cell therapy. But a new Israeli study finds that stem-cell therapy may harm heart-disease patients.

The research, led by Prof. Jonathan Leor of Tel Aviv Universitys Sackler Faculty of Medicineand Sheba Medical Center and conducted by TAUs Dr. Nili Naftali-Shani, explores the current practice of using cells from the host patient to repair tissue and contends that this can prove toxic for patients.

We found that, contrary to popular belief, tissue stem cells derived from sick hearts do not contribute to heart healing after injury, said Leor. Furthermore, we found that these cells are affected by the inflammatory environment and develop inflammatory properties. The affected stem cells may even exacerbate damage to the already diseased heart muscle.

Tissue or adult stem cells blank cells that can act as a repair kit for the body by replacing damaged tissue encourage the regeneration of blood vessel cells and new heart muscle tissue. Faced with a worse survival rate than many cancers, many heart-failure patients have turned to stem-cell therapy as a last resort.

But our findings suggest that stem cells, like any drug, can have adverse effects, said Leor. We concluded that stem cells used in cardiac therapy should be drawn from healthy donors or be better genetically engineered for the patient.

The researchers, who published their study in the journal Circulation, also discovered the molecular pathway involved in the negative interaction between stem cells and the immune system as they isolated stem cells in mouse models of heart disease. Afterward, they focused on cardiac stem cells in patients with heart disease.

The results could help improve the use of autologous stem cells those drawn from the patients themselves in cardiac therapy, Leor said.

We showed that the deletion of the gene responsible for this pathway can restore the original therapeutic function of the cells, said Leor. Our findings determine the potential negative effects of inflammation on stem-cell function as theyre currently used. The use of autologous stem cells from patients with heart disease should be modified. Only stem cells from healthy donors or genetically engineered cells should be used in treating cardiac conditions.

The researchers are currently testing a gene editing technique (CRISPER) to inhibit the gene responsible for the negative inflammatory properties of the cardiac stem cells of heart disease patients. We hope our engineered stem cells will be resistant to the negative effects of the immune system, said Leor.

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Stem cell treatment may harm heart disease patients - ISRAEL21c

Dramatic Burn-Healing Through Stem Cell Treatment – Fox Weekly

By adminAugust 8, 2017Stem Cell Treatment

A med-tech startup has developed a fast and easy way to treat certain burn wounds with stem cells. This technology is developed by German researcher Dr. Jrg Gerlach. He is the worlds first ever person who use a patients stem cells to directly heal the skin. The technique is meant to reduce the healing time and minimize complications, with aesthetically and functionally satisfying outcomes. There are no scars, no residual pain and its like there wasnt any burn to start with. Its not less than a miracle.

The medical technology startup has now transformed the proof-of-concept device from a complicated prototype into a user-friendly product called a SkinGun, which it hopes doctors will be able to use outside of an experimental setting. RenovaCare CEO Thomas Bold believes, the SkinGun can compete with, or even replace, todays standard of care. The sprayer allows us to have a generous distribution of cells on the wound, explained Roger Esteban-Vives, director of cell sciences at RenovaCare.

RenovaCares SkinGun sprays a liquid suspension of a patients stem cells onto a burn or wound in order to re-grow the skin without scars. Stem-cell methods helped cut this risk by quickening healing and providing a source of new skin from a very small area. Cell Mist method gets a greater yield from its harvest than mesh grafting, a more common way to treat burns. At a maximum, grafting can treat six times the size of its harvest area. Cell Mist can cover 100 times its harvest area.

When dispensing cells over a wound, its important that they make the transition without any damage. Damaged cells reduce the effectiveness of the treatment.

High cell viability also contributes to faster healing. When a wound heals naturally, cells migrate to it to build up the skin. That process can take weeks.

Stem cells have tremendous promise to help us understand and treat a range of diseases, injuries and other health-related conditions.

There is still a lot to learn about stem cells, however, and their current applications as treatments are sometimes exaggerated by the media and other parties who do not fully understand the science and current limitations

Beyond regulatory matters, there are also limitations to the technology that make it unsuitable for competing with treatments of third-degree burns, which involve damage to muscle and other tissue below the skin.

When burn victims need a skin graft they typically have to grow skin on other parts of their bodies. This is a process that can take weeks. A new technique uses stem cells derived from the umbilical cord to generate new skin much more quickly.The umbilical cord consists of a gelatinous tissue that contains uncommitted mesenchymal stemcells (MSC)

Research is underway to develop various sources for stem cells, and to apply stem-cell treatments for neurodegenertive diseasesand conditions such as diabetes, heart disease, and other conditions.

Tens of thousands of grafts are performed each year for burn victims, cosmetic surgery patients, and for people with large wounds having difficulty healing. Traditionally, this involves taking a large patch of skin (typically from the thigh) and removing the dermis and epidermis to transplant elsewhere on the body. Burns victims are making incredible recoveries thanks to a revolutionary gun that sprays stem cells on to their wounds, enabling them to rapidly grow new skin. Patients who have benefited say their new skin is virtually indistinguishable from that on the rest of the body.

Thomas Bold, chief executive of RenovaCare, the company behind SkinGun, said: The procedure is gentler and the skin that regrows looks, feels and functions like the original skin.

If you are planning to have stem cell treatments dont forget to remember these points

Stem cell researchers are making great advances in understanding normal development. They are trying to figure out what goes wrong in disease and developing and testing potential treatments to help patients. They still have much to learn. However, about how stem cells work in the body and their capacity for healing. Safe and effective treatments for most diseases, conditions and injuries are in the future.

Should You Think Twice About Cortisone? – HuffPost

By adminAugust 8, 2017Platelet Rich Plasma Injections

Corticosteroid - or more commonly called cortisone - injections are routinely performed in medical offices throughout the world. Injections for the knee have been described as far back as 1897, but it really wasnt until the 1960s that knee injections of steroids became widely available. Over the last 50 yeas, thousands of papers have been dedicated to corticosteroid injections of the knees but not many of them can stand up to rigorous scientific analysis. Furthermore, the use of steroid injections have been extrapolated to other joints and tendons in the body, but the truth is, the value and effect of injections in these areas may be even less understood and scientifically proven.

If we were to zoom down into cells we would see complex shaped protein molecules that acct as landing sites, or receptors for steroids. When a steroid chemical binds to one of these receptors they can affect hormone or gene expression. As scientists, we know that corticosteroids have both anti-inflammatory and immunologic effects, but their mechanism of action are complex and not completely understood. There are a handful of studies of cortisone injections in the knee for arthritis which show fleeting effects of pain relief, but its unclear exactly how or why this commonly used medication actually helps.

Typical arthritis is a gradual loss of cartilage from the ends of the bones. You can see the pearly white cartilage if you ever pick up a chicken bone and look at its end. This cartilage helps to absorb and distribute pressure within our joints. Over the years from injuries or wear and tear, and also likely from genetics, cartilage in the knee can become thinner and thinner until the bones of the knee are touching each other. This increase stress on the cartilage-less bone can cause pain and some inflammation, but arthritis really isnt an inflammatory condition, so it doesnt make complete sense why a corticosteroid can help. There is no doubt that it can provide some relief, usually just a few weeks, but if you ask doctors, patient responses are variable. Some patients swear by their annual or semi-annual injection cortisone injections while others will tell you they maybe only had one or two days of relief and then the pain came back. Unfortunately, this unpredictable response is even less predictable when it comes to treating non-arthritis conditions of the knee such as tears of the ligaments, tendons, or other structures.

When it comes to corticosteroid injections, especially in the world of orthopedics, you will find surgeons who inject everyone, only older patients or specific diagnoses, or sometimes nobody at all. Those surgeons who inject everyone have several beliefs among which include that cortisone is rather harmless, it is effective, and if it doesnt work then there is always surgery. Those who avoid it altogether point to the potential risks and instead lead patients towards less-studied, but possibly superior alternatives such as Platelet-Rich-Plasma (PRP) or stem cells. These are promising options, but the verdict is still out on their long-term efficacy and unlike cortisone, they are not covered by insurance and run anywhere from 500 to 2,000 dollars an injection. In addition, injections that mimic the lubrication fluid of the knee have been shown to be more effective and longer lasting than cortisone, but due to some conflicting earlier studies, many national medical specialty groups cannot fully recommend them and insurances are starting to approve them less often for the knee, and wont even consider it for other joints in the body. Some doctors adopt the belief that there may be a risk to the cartilage with cortisone and therefore will limit their injections only to those who already have evidence of arthritis with the belief that the die has already been cast when it comes to the status of the cartilage in the knee.

Geography of patient demand may also play a role. For example, a surgeon in the Midwest may see a farmer who only wants to come to the doctor for a knee injection once or twice a year and has no interest in traveling to get an MRI or weekly Physical Therapy visits. Or in Southern California, a 49 year-old semi-professional volleyball player may want an injection before an upcoming tournament since that is what he or she has been doing for years and is convinced their performance is not limited by pain because of the effects of the injection. Injection patterns also vary from the private practice to the academic setting where financial considerations and reimbursements differ. In private practice, increased overhead and decreased reimbursement from insurance companies may force physicians to rely on cortisone injections as a significant source of revenue, which is further bolstered with the use of ultrasound that helps the surgeon locate more specifically where the injection is going.

When we look at the basic science studies of corticosteroids in the laboratory, we know that cortisone injections have an effect on the health of cartilage. There is a time- and dose-dependent effect of corticosteroids. Beneficial effects of corticosteroids occur at low doses and short exposure times where there may actually be increased cell growth and recovery from damage. However, at higher doses and longer exposure times, corticosteroids can be associated with cartilage damage. The scientific evidence in treating other conditions of the body which are commonly injected is even less convincing. Perhaps the two most injected areas of the body that have the least supporting evidence are the rotator cuff of the shoulder and the tendons of the elbow. Just to clarify, as muscles insert into bones, they become thick tendons as opposed to the meaty substance of the muscles so they can make bone and joints move. This is in contrast to ligaments which are thick bands that simply connect one bone to another without moving anything.

The rotator cuff is a group of tendons that help rotate you shoulder internally and externally and also help you to start raising your arm out at the side. When these tendons become injured or over-used they can become inflamed and the covering over them called the bursa can also get inflamed leading to a condition called bursitis or inflammation aka itis of the bursa. In order to reduce this inflammation, doctors often inject cortisone into the bursa of the shoulder. Unfortunately, the overall effects of injection in the tendons arent fully understood and recent studies of the effects of cortisone on rotator cuff tendons in rats have shown decreases in tendon strength after only a single injection. Repeated corticosteroid injections are especially worse.

When it comes to cortisone injections for inflammation of the tendons on the outside of the elbow, a condition commonly referred to as tennis elbow, the results are also mixed. There is no doubt that patients can experience relief with corticosteroid injections, but some controversy has been raised due to the fact that some studies have shown that patients who received cortisone shots had a much lower rate of full recovery than those who did nothing or who underwent physical therapy. They also had a higher risk of relapse than people who adopted a more conservative approach. That being said, many patients are too busy and active to adopt a more complacent wait-and-see approach and are seeking a more immediate solution to their pain by visiting their doctor. To them, simply being told to wait it out after making an appointment and paying a copay seems like a waste of time.

To complicate matters, many studies show that the pain affecting these tendons or bursa, i.e. the "itis", may not actuallybe inflammation. Tennis elbow for example actually shows less evidence of inflammation and more evidence of blood vessel invasion and tissue degeneration and disarray. So the question then becomes why do these injections work? Some scientists think there is an effect on the nerve receptors involved in creating the pain in the sore tendons. They act to change the biology of pain in the short term. This why corticosteroid injections may be actually helpful for the acute inflammatory-type pain but don't actually do anything to cure the disease. In some cases like rotator cuff bursitis where the tendons are pinched under the top of a forward leaning shoulder blade, physical therapy to re-train the shoulder blade to get it out of the way as the arm is raised is really the long-term solution to the problem and the role of the injection may be to help the patient find short-term pain relief to be able to do the therapy.

As a profession, orthopedics and other medical specialties are continuing to reappraise what we have been doing for decades to see if the evidence actually shows what we are doing is helping the patient, or if what we are doing is only useful in the short-term with other therapies perhaps better in the long-term. That is why there is a quest underway for better and longer-lasting therapies but as medical professionals and scientists, we must be careful to continue to self-reflect and see what the evidence of efficacy actually tells us.

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Should You Think Twice About Cortisone? - HuffPost

Stem cells: science prepares to take the first sip from the real fountain of youth – Catholic Online

By adminAugust 8, 2017Stem Cell Doctors

Theoretically, eternal youth is now within our grasp.

Doctors are close to discovering a real life fountain of youth that could theoretically enable patients to live forever. Advances in stem cell treatments and now, tissue nanotransfection (TNT), which is a new technique, can theoretically provide patients with the benefits of youth for life.

The fountain of youth is within the grasp of science, but so far, only for mice. Human trials come next year.

LOS ANGELES, CA (California Network) -- The quest for eternal life is ancient. It is mentioned in the first and oldest story we have, the Epic of Gilgamesh. In that ancient Sumerian tale, only Utnapishtim, a man who built and ark and survived a great flood in a story that is almost identical to the story of Noah's ark, knows the secret to eternal life, which ultimately proves elusive. In the centuries that followed, people have tried every remedy imaginable to prolong life. They searched for the fabled fountain of youth, and according to some legends, bathed in the blood of virgins and children.

Today, we know none of these endeavors would work because ageing is carried on in the genes. The only way to reverse ageing is to manipulate the genes. And this is precisely what doctors are looking to do in order to produce new cells, and even whole organs.

Researchers now know the primary difference between a young person and an old person is the number of stem cells in their body. Young people have many times more stem cells. This is the basic, underlying reason why young people are so youthful. A young body can repair itself more rapidly and thoroughly than an older one because of the number of stem cells. But if stem cells could be injected into an older body, in quantities similar to those enjoyed by a young person, what would happen then?

Nobody knows for certain because the experiment hasn't been conducted, but the hypothesis is that the older person would become more youthful, healthier, and longer lived.

As stem cells enter the medical mainstream, and may become a standard part of medical treatment in the near future, there is another development that could make stem cells irrelevant. Nanotransfection, abbreviated as TNT, is a new method whereby skin cells can be turned into any other cell in the body using a special microchip and electricity.

The device, called a nanochip, is loaded with genetic material essential to turning cells into other kinds of cells. The electrical current enables the device to inject the genetic material into the skin where it ends up inside the cells. These cells can then travel though the body and take on the properties of healthy cells around damaged tissue, facilitating repair. On other words, a damaged liver or heart can be repaired with this tiny device. The advantage of this method is that stem cells are not required. Your skin cells simply become whether other kind of cells they are told to become by the injected genetic material.

A study affirming the effectiveness of this approach was published in the journal, Nature Nanotechnology. It has been tested on mice and was successful in restoring function to non-functioning limbs. It will be tested on humans within the next year.

Scientists have known they can reprogram cells into other kinds of cells for a long time now, but only recently have they developed the method to do so cheaply and efficiently. The actual procedure requires a chip that is as small as a penny, and takes only a second to work.

If the procedure works on humans, then doctors may have a cheap and efficient way to repair and even replace organs. The discovery is so dramatic is it difficult to believe. More testing is required, but it shows just how far we have come in our ability to edit genes and reprogram cells to grow specific forms of tissue within the body.

In a generation or less, it is reasonable that we will have unlocked the secret to reversing ageing. Of course, this discovery opens a whole host of ethical and philosophical questions, but that's for the ethicists and politicians to work out. For now, science is about to take the first sip from the fountain of youth, and we await the result.

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Pope Francis Prayer Intentions for JULY 2017 Lapsed Christians. That our brothers and sisters who have strayed from the faith, through our prayer and witness to the Gospel, may rediscover the merciful closeness of the Lord and the beauty of the Christian life.

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Stem cells: science prepares to take the first sip from the real fountain of youth - Catholic Online

Odessa physician offering stem cell therapy – Odessa American

By adminAugust 8, 2017Stem Cell Doctors

An Odessa physician who specializes in pain management has begun offering stem cell therapy for inflammation from a variety of arthritis.

Dr. Mandeep Othee of ProCare Interventional Pain Medicine, said stem cell therapy has been around since as early as 1938. It has recently been used to stem inflammation, wound care and post-surgical use to help in healing.

The purpose for me is going to be for inflammation for knee arthritis, shoulder arthritis any sort of arthritic process in the neck, the back; any part of the body, Othee said.

Othee said hes always interested in cutting-edge treatments. As associate medical director of In-Patient Rehabilitation at Medical Center Hospital, Othee oversees care for patients with a variety of orthopedic needs, ranging from stroke patients to those recovering from joint replacement surgery, the hospital website said.

He also specializes in diagnosing and treating neck and low-back pain.

The source of the amniotic stem cells is healthy women who have had C-sections who donate their amniotic fluid to a tissue bank. Othee said it is fully regulated by the U.S. Food and Drug Administration and the cells are purified and frozen to preserve them.

The cells provide cushioning, support and lubrication to a developing fetus in the womb.

Its a similar process in the body, so for example, if we take that same stem cell and inject it into the patients knee, or shoulder, or back, or neck it provides the same cushioning, support, lubrication and inflammation reduction that it does in the developing fetus, Othee said.

He added that there are 226 growth factors in the fluid itself, which includes proteins, lipids electrolytes and the magic element of hyaluronic acid.

Thats the typical injection a patient receives in an orthopedic surgeons office. It basically heals the area, provides collagen synthesis and helps with the re-growth of that lost cartilage , Othee said.

Cartilage wears down over time in the joints and injecting the stem cells greatly increases the patients own healing response. Othee said it works 100,000 times better than Platelet Rich Plasma, which is taking a patients own platelets, spinning it down, putting it into a concentrated format and injecting into the patients knee, shoulder, neck or back, Othee said.

Typically, Othee said hes read studies have shown 30, 90 and 100-day responses that are better than steroid shots or hyaluronic acid injections.

It can help patients avoid or delay joint replacement surgeries.

The product he chose is OrthoFlo made by MiMedx.

I chose them because theyre the biggest and the best, Othee said. Their company specializes in different products. One is OrthoFlo. It contains pro-growth factors (and) no tissue fragments or dead cells. It is highly purified human amniotic fluid.

He noted that thousands of injections have been administered over the last five to 15 years and no reactions, side effects or infections have been reported that hes read about.

Currently, no insurance companies pay for the stem cell therapy, but athletes have been getting these for years in other countries, such as Germany and England, and larger cities such as Houston and Dallas. The cost is $2,200 per injection from Othee.

The patient may be sore for a day or two after the stem cell injection and they are able to walk out of the office without a problem. For any sort of knee injections, Othee said a patient may want to wait a week to start running or doing other activities.

Othee said he usually asks patients to stop taking anti-inflammatory medicine for at least seven days before and after the treatment.

He added that there is no age limit on people who could receive stem cell therapy.

Othee said patients may have tried steroid shots, hyaluronic acid, or platelet rich plasma before stem cell therapy. However, they could skip right to stem cell therapy, he added.

Othee said he has spoken to other doctors with patients who have gone straight to stem cell therapy and it works.

Orthopedic surgeon Dr. Vijay Borra doesnt do stem cell injections. He said he thinks research into stem cells just as an injection for osteoarthritis is still in its infancy.

I think a lot of research now is going into using stem cells to generate chondrocytes, which are cartilage to see if we can plug in focal cartilage deficits. Thats where all the research is now. As far as just injecting stem cells into the joint, were still at the very early stages and theres still very little data as to whether it actually works or not, Borra said.

Borra added that there is a lot of good data using that to generate cartilage.

Theres some data there can be used to plug defects. Its an option for people who have done everything like a steroid or hyaluronic gel injections. Theyve done all that and they dont want a knee replacement, or they have too many medical issues and theyre not a candidate. Then it is an option. If theres nothing else, then stem cell is an option, Borra said.

He added that stem cell therapy is not covered by most insurance plans and the out-of-pocket pay is very high.

Its really like an end-stage resort for someone who doesnt want surgery. Theres really no down side. Its not going to do any damage, so you can always try to see if it helps, Borra said.

When patients come to see him, Borra said he first gives them an x-ray to see what the problem is. Most of the time, its osteoarthritis.

By the time they come to Borra, he said the patient has tried anti-inflammatories, weight loss and therapy.

Theyve already done all that, so I start off with a steroid injection. If it works five, six months some people choose to do two or three a year. If it doesnt work, the next option is gel injections, hyaluronic acid, which is like artificial joint fluid, Borra said.

He said Othee also offers nerve blocks.

Link:
Odessa physician offering stem cell therapy - Odessa American