Stem cells are already being used to treat heart attacks and severe spinal injuries. However, buyer beware of offers to lose ten years and thirty thousand dollars thanks to these cells

Galina Kostina

Even housewives today are talking about stem cells: articles about injections of miraculous cells capable of erasing ten years have begun to appear more and more frequently not only in specialized journals and online, but also in popular glossy magazines. Announcements of potential rejuvenation are growing in number. These rejuvenation services cost $10,000-15,000 and are being offered in Moscow and Russia’s provinces. They promise miracles not only for fading beauties and balding men, but also to patients traditional medicine is currently unable to cure. Advertisements also promise for the same $10,000-15,000 to treat impotency, Parkinson disease, cancer, diabetes, and cirrhosis.

Instead of drugs

Is there at least a grain of truth in these claims? This is the criterion proposed by Russian scientist Alexander Maximov back in 1908. Stem cells are undifferentiated cells capable of self-rejuvenation and further differentiation into specialized cells in the body. They are also known as cell precursors. In the early 20th century, scientists believed that many tissues have cells conducive to tissue regeneration and the activate division of ordinary cells. In the mid-1970s, Soviet scientists Alexander Fridenshtein and Iosif Chertkov laid the foundation for the study of bone marrow stem cells. They proved that the bone marrow is a sort of depot for these magical cells. It later became known that some stem cells migrate in the blood, and they are also present in a number of tissues such as skin and fat tissues. Then they were discovered in the walls of the ventricles of the brain and in the olfactory area of nasal cavity. The reserve of stem cells helps in the event of an “emergency” in the body. When they receive the alarm, they rush to the affected zone. Not only do they start dividing to replace the dead cells in a tissue, but they also begin to produce factors affecting the rate of division of both local stem cells in tissues and specialized healthy cells.
It’s not quite clear to scientists, though, why blood or skin cells are renewed practically on a constant basis, whereas, for example, teeth are not. With age, the regeneration process becomes weaker and weaker. A child’s body takes much less time to heal a scratch or a broken bone than an old man’s. It may even be the case that the body is no longer able to knit bones at all. Is it possible to help a body with fewer and fewer stem cells when tissues are unable to heal fully? The real explosion in stem cells research began quite recently, in 1998, when American scientists James Tomson and John Becker succeeded in isolating human embryonic stem cells and obtained the first cell lines.
Embryonic stem cells’ capacity to differentiate is much higher than that of adult stem cells. A human body evolves just from one cell (the zygote) that emerges as the result of the fusion of male and female cells. During first few days of this cell’s division, a small ball made up of absolutely identical non-specialized cells forms. Embryonic stem cells (ESCs) generate all the rest of the cells in the body. This is why ESCs are called totipotent. For scientists, investigations into ESC are, first of all, a unique opportunity to study cell processes taking place in the body.
However, the usage of these cells is currently prohibited in many countries for ethical reasons, since even a zygote created in a test tube can be considered a future living organism. Nevertheless, many researchers believe that as the treatment of millions of the fatally ill using cells from legal abortions or laboratory fertilization is at stake, these problems will be ultimately overcome.
Research on both embryonic and adult stem cells is being conducted quite actively, and news of scientists’ achievements appears in the world scientific press practically every day. Some researchers have succeeded in obtaining neurons from stem cells. Others have succeeded in obtaining skin or cartilage tissue, while others have succeeded in growing blood vessels, bones, or even an entire jaw. However, despite the fact that researchers have made major progress in some areas and clinical trials number in the tens of thousands, treatment remains at the stage of trials and scientific research and has yet to become widely used medical practice.
Many specialists see problems associated with the practical application of stem cells, which not only involve ethical issues but also the insufficient analysis of the results of ESC transplantation. Most researchers prefer to work either with stem cells obtained from umbilical cord blood or with adult stem cells. Although there are very few stem cells in an adult body and they have limited potency, scientists have already discovered how to isolate, cultivate, maintain, and cause them to differentiate. But most interestingly, a number of studies indicate that it may be possible to bring adult stem cells back to their previous state, meaning to increase their potency and, hence, the number of types of cells into which they can differentiate. This is why many observers are talking about the possibility that in the next decade methods using stem cells isolated from umbilical cord blood or bone marrow and tissues of the adult body could largely replace drug therapy.

Ready for the world?

It is quite natural that these achievements have sparked attempts to introduce these approaches to practical medicine as soon as possible. An army of patients suffering from currently incurable illnesses and the market expanding exponentially with every new discovery encourage this, too. Yet, scientists and health care specialists remain cautious. World practice only allows scientists to conduct experimental clinical tests. Are these methods ready for the world? Scientists have yet to give a clear answer. “If tens of thousands of operations have already been conducted worldwide, should we consider them mere trials?” asks Professor Andrei Bryukhovetsky, General Director of NeiroVita Clinic. “For example, we have already expended a lot of years and effort developing our technologies. We have already accumulated experience. Hundreds of people suffering from severe injuries and traumas in Chechnya have undergone stem cell treatment.”
Although patients with various spinal traumas and brain injuries cured by stem cells number in the dozens, Bryukhovetsky thinks that approach still needs to be perfected and further clinical trials conducted. Stem cell treatment is very delicate matter, and extensive experience is required to enable specialists at other clinics to use it. On the other hand, specialists dealing with the bone marrow hemopoietic cells used in cardiology believe that they have already the requisite experience. “We’ve learned how to grow cardiomyoblasts from bone marrow stem cells that are used in the treatment of heart attacks, coronary bypass grafting, and heart transplants, which our Director, Academician Valery Shmakov, has successfully conducted,” relates Nina Onishchenko, head of the Stem Cell Biotechnology Laboratory at the Institute of Transplants and Artificial Organs. She believes that cardiomyoblast transplantation technology is ready to be used as a full-fledged treatment method, not just as an experiment. The famous cardiac surgeon Leo Bokeria, a member of the Russian Academy of Medical Sciences and the head of the Bakulev Research Center for Cardiovascular Surgery, holds the same opinion.

Outlaw cells

Serious researchers realize that new methods designed for medicine must undergo a procedure similar to those in pharmacology: before a new drug hits the shelves, it has to pass appropriate tests and be registered. The lack of clearly defined legislation governing stem cells and the need for a law on cells were on the agenda of 13th Session of the General Meeting of the Russian Academy of Medical Sciences held last February. The legal basis is in the process of formation. Cellular technologies have been included in the category of activities subject to government licensing. Last year, the Ministry of Health issued the order “On Cellular Technology Development.” A program of the same name has been drafted, and a Council of Experts made up of famous scientists and specialists in cellular technologies founded. For the time being, scientific achievements and new projects are discussed at the Council’s meetings, and the Council gives permission to use these technologies in various clinical trials.
What do members of the Council think about the new technologies’ readiness for practical application? Vladimir Yarygin, Rector of the Russian State Medical University, names only technologies of using hemopoietic cells to cure cardiovascular diseases as sufficiently established. In this area, scientists at the Cardio Center, the Institute of Transplants and the Bakulev Institute have accumulated extensive positive results. As for other methods, the Council of Experts carefully monitors accumulated results and give its appraisal, whether or not they can be recommended for clinical trials. In particular, NeiroVita Clinic has been granted permission to conduct further research.
Regarding the rejuvenation methods mentioned at the very beginning of this article, the Council of Experts is not able to pass judgment, since it doesn’t have information on how these cells were obtained, cultivated, certified, and tested for safety. It seems that practitioners of rejuvenation themselves are not interested in such details. Specialists don’t deny that rejuvenation or revitalization technologies may be quite effective. But today, none of experts in the field of cellular technologies can give a 100-percent guarantee that patients can get safe and high-quality treatment for their $10,000 or $30,000.

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