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10/21/2010 01:52 AM

implanting STEM CELLS into the brain story

Bettyg
 
Posts: 32225
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she is going for her 6 month check up 1st week in feb!

Date: Friday, August 28, 2009, 5:12 PM

Dear Family and Friends,

I apologize for not updating you sooner. I have been composing this letter in my head for the past week.

We arrived home from our trip to

Monterrey, Mexico on Monday, August 10. It felt hotter here because of the humidity even though Monterrey averaged 105 daily.

I have to preface the story by saying Bill took 2 years of Spanish in high school, William has 5 years of Latin, Michael 3 years of Italian and 1 of Latin, and myself 5 years of French, 1 year of Latin and 1 of German (and I can't talk period!). Get the picture?

On the plus side, you will be happy to know that by the end of our ten days, Bill was proficient in saying “buenas dias” and “gracias” all over, right down to the US Customs agents in Houston and our Russian limo driver from Newark.

In February, the attached publication came out. I saw it on one of the ALS websites.

It was interesting because they actually implant the cells into the brain. The cells are not given by IV or injection.

ALSWorldwide.org, founded by Steve and Barbara Byer, actually went to MTY to investigate.

They found it to be a viable procedure with promising results. It is not a cure.

Rather, it has stopped progression in almost all test subjects.

At best, one could see slight improvement up to 30%.

Steve and Barb lost their 36 year old son to ALS last July. They continue to work tirelessly for the rest of us.

Steve, with my permission, submitted my name to be a participant in the next phase of the study.

Brainstorm, an Israeli company, is scheduled to start similar trials using bone marrow cells (mesenchymal) in 2010.

Neuralstem, a US company whose CEO we met in November, has been forestalled by the FDA (surprise, surprise) and is commencing trials in Taiwan within the next few months using neural stem cells.

Monterrey uses autologous stem cells, derived from your own blood.

We left at 5:30 AM on Friday, July 31, had an hour layover in Houston, and arrived in Monterrey (MTY) at 11 AM local time, which is CST.

MTY is a 3 hour drive (1550 miles) southeast of Laredo, TX, is the third largest city in Mexico and is situated in the Sierra Madre Mountains.

It is heavily industrial but also quite cultural with numerous art museums.

The only thing that MTY lacks is adequate road maps. None of our GPS systems worked there and the AAA map and Hertz did not have really detailed street maps of the city.

So, after stopping for a quick lunch, it took us almost 3 hours to find our hotel, which is 17 miles from the airport.

You will be happy to know that by the time we left on Monday, it only took us 25 minutes to get to the airport from our hotel. Almost natives!

Bill was an expert at “Retorno” by the time we reached the hotel. Needless to say, we had quite a few laughs, some so hard we were crying.

We did ask directions; some people didn't speak English and others didn't know the area our hotel was in. But the hotel was well worth it.

It is in the financial area of the city, in the foothills of the mountains. It was Old World, beautiful and comfortable. The hospital made all arrangements.

Our plan was to sightsee Sat and Sun because I had to check in to the hospital at 8 Mon morning.

We headed east (Ote on street signs, west is Pte, south Sur and north Nte – only took us two days to figure that out) to Horsetail Falls, a national landmark, on Sat. As we drove, we passed Tec de Monterrey, which is the MIT of Mexico.

The Falls had to be reached on foot via a steep cobblestone path. After the boys pulled/carried the wheelchair a brief distance, we noticed horse-drawn buggies carrying people up.

So for 20 pesos each ($1.75), we took a buggy. We all felt sorry for the horse, as his hooves kept slipping on the cobblestone – kind of frightening too.

Sunday we visited the brewery where they make Carta Blanca, Tecate and I think Dos Equis.

The boys went exploring after dinner Sat night. They found a place called The Kold Bar. They paid $15 admission each, were given a parka to put on, and entered the club.

All the furniture was made of ice. Drinks were served in blocks of ice with a hole drilled out to hold the liquid. It really sounded pretty neat.

Our medical schedule was to be admitted to the hospital first thing Monday morning. The Hospital San Jose Tec de Monterrey is affiliated with Baylor and Hopkins.

It also has a medical school and research area. I was fortunate to be accepted into the study.

We were very impressed with the facility itself. Spotless, modern, organized, competent.

***************************************

My hospital room was spacious and had its own bath complete with shower (don't worry, Aunt Corinne and Uncle Frank, Bill took pictures).

My protocol was a shot of Neupogen Mon, Tues and Wed morning;

Mon a respiratory test, EKG, and MRI;

Wed at 5 insert chest catheter;

Thurs 8AM start harvesting the stem cells through the catheter;

Thurs 4PM implant stem cells into front cortex;

Fri noon release from hospital.

Well, that is the way it had been done for all the nationals and the 5 Americans preceding me.

We met the whole team Mon from the head researcher to the neurosurgeon to the person who would propagate the cells once they were harvested.

Of course, Bill was busy taking pictures of everyone right down to the nurses' aides. The doctor said we could leave the hospital during the day after receiving the shot.

Well, we interpreted that to mean we could come each morning to receive the shot and leave. We were all thrilled that I didn't have to stay overnight.

Tuesday morning we returned to my room only to find the door locked. Busted!!

The doctors came and explained that they meant I could leave during the day but was supposed to sleep at the hospital.

However, since we were enjoying our stay and sightseeing, they decided to change the protocol for everyone.

The new patients would have to do the testing on Mon and go back each morning for the shots.

We wouldn't have to be admitted til 4 on Wed.

So I relaxed by the pool, read, shopped, and just had fun with the guys.

We went up to Chipinque, a national park up in the mountains. The “homes” (mansions) we passed on the way up were all gated and lovely, with awesome views.

We went back to the hospital at 4 on Wed. Like clockwork, I went to have the chest catheter inserted.

The guys left at 11 and were back at 8 on Thurs morning.

I was hooked up to the machine which extracts the cells at 8 and was finished at 10:30.

Dr. Martinez and Dr. Gutierrez did a spinal tap; they use the fluid to suspend the cells which are then implanted in the brain.

They separated the 14,000 cells, froze 10,000 and multiplied the remaining into 10 million, 5 million for each side. At 5 PM, I went down to the OR.

They use a 3D screen to pinpoint where the cells are to be implanted.

That's all I remember seeing. I never had any pain or discomfort. By 8, I was back in my room.

The guys said there is a screen in the waiting room with a bar graph. Each patient has a number and his/her progress in the OR is tracked.

They shaved 2 patches on my head about 2 in by 2 in and then made burr holes. I had the stitches out here.

The boys were relieved that it was over. On Fri, I was back at the hotel by noon.

We went shopping downtown as the boys wanted soccer jerseys. We had a fun dinner with Barb and Steve. I was happy to be in my own bed.

Sat morning, Bill and I had breakfast in the hotel. When we sat down, the pianist (told you it was classy) was playing “My Way”. Bill said my dad was watching.

We went for a ride. The plan was the guys would go to the soccer game at 7 and I would stay with Barb and Steve at the hotel.

That changed when the right side of my face began to swell. We thought it was an allergic reaction to something I ate.

Bill was nervous so we sent the boys off to the game alone. They had a great time except for all the cigarette smoke. Sun morning, at brunch, Barb came over to say hi.

They were having breakfast with the head of the medical school who is also a member of the research team.

She was so upset when she saw my eye (not only was it puffy but now it was red and black) she called the doctor over.

He immediately arranged for us to meet the neurosurgeon, neurologist, and an ophthalmologist in the ER in an hour.

They said it was fine, to stay out of the sun, it was a minor bleed totally normal as the blood seeks the soft optical tissue, and it would be gone in 3 weeks. And it is!!

Bill asked the neuro to swear that he didn't punch me for my mom.

We spent the rest of the day relaxing. We also met the next patient from San Diego.

He is on a bipap, speaks very well, has no use of his arms, and limited leg use. He is my age and has 4 kids 10 and under. We now keep in touch.

On our last night, we went up to Chipinque to look down at the city. It was breathtaking.

All in all, no matter what, it was a great experience and opportunity.

I have no expectations other than hopefully stopping progression. Anything else is a plus. They said we might see some changes in 3 months.

We go back Feb 5 for an MRI and a follow up. Next summer, I get a “booster” with the frozen cells.

Thank you for all your prayers and good wishes.

Much love, Debbie

****************************************

1.18.10

Hi Betty,

Absolutely! I am happy to help people in any way I can. Do whatever you think best; I trust your judgement.

I hope you are keeping warm! As much as I like winter, I hate the cold. Today we are having a heat wave -- 50 degrees.

My tongue is still strong and I have gained 5 lbs. People say I move a little more fluidly; it is hard for me to say as I live with it 24/7. I'm sure you understand that.

We go back to Mexico on Feb 4 for my 6 month check up. I'll keep you posted. Stay well.

Love, Debbie

*************************

so this explains what debbie went thru to date ... hope this helps you all.

bettyg, iowa leader/lyme activist/friend to debbie Smile

Reply

05/13/2011 03:20 PM
Bettyg
 
Posts: 32225
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Discovery of Lung Stem Cells May Herald New Treatments

But the research is preliminary, so human benefits won't come any time soon

Wednesday, May 11, 2011

WEDNESDAY, May 11 (HealthDay News) --

Contrary to current scientific thinking, human lungs do harbor stem cells capable of forming different parts of the lung, including blood vessels, a new study says.

The findings, reported May 12 in the New England Journal of Medicine, may open the door to eventual bioengineered lung tissue repair and replacement.

"These cells are very smart. They know what to do," said study senior author Dr. Piero Anversa. "The clinical implications are significant."

The findings could potentially offer a new avenue of treatment for patients suffering from respiratory conditions, such as emphysema, chronic obstructive pulmonary disease or pulmonary hypertension, that currently have only limited treatment options.

"Now that we have identified these cells and have the potential of growing them, we know it's not science fiction," said Dr. Andrew Pecora, vice president of cancer services and a stem cell expert with Hackensack University Medical Center in New Jersey.

"A single cell placed in the right environment allows for the development of adult cells that can live for 80 years. The implications are potentially limitless."

Stem cells are those that first exist without organ-specific features but are capable of dividing and morphing into every other type of cell in the human body.

Stem cells are scattered throughout the body, and a growing cadre of scientists is attempting to harness their innate abilities to regenerate and repair parts of the human body, such as the heart.

The new findings challenge conventional knowledge about lung cells.

According to an accompanying journal editorial, scientists had been holding on to the belief that no single cell in the lung could differentiate into multiple different types of cells, even though some cells do grow into specific cells, such as endothelial cells and the cells of the upper and lower airways.

For this trial, researchers were able to identify stem cells from 21 samples of normal human lungs, then expand them in a test tube.

The researchers coaxed the cells into developing into different types of lung cells, such as epithelial or vascular cells.

They next injected undifferentiated cells into mice whose lungs had been damaged.

"Over a period of about two weeks, we were able to regenerate a significant portion [of the lung] and essentially recreate various tissues," said Anversa, director of the Center for Regenerative Medicine at Brigham & Women's Hospital and Harvard Medical School in Boston.

"The human structure was perfectly integrated with the structure of the mouse lung," he noted.

"The cells have the fundamental properties of stem cells," Anversa added.

That means they could divide into new cells, form into many other types of cells and function when introduced into other environments.

But there's still a lot of work to be done before these cells actually have any implications for humans, the editorial cautioned.

Anversa will study the cells in larger animals before initiating a phase I clinical trial.

"We're talking a few years from now," he said. "We're not talking about tomorrow morning."

SOURCES:

Piero Anversa, M.D., director, Center for Regenerative Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston;

Andrew Pecora, M.D., vice president of cancer services and stem cell expert, Hackensack University Medical Center, N.J.;

May 12, 2011, New England Journal of Medicine

HealthDay

Copyright (c) 2011 HealthDay. All rights reserved.

http://www.nlm.nih.gov/medlineplus/news/ fullstory_111957.html


07/15/2011 01:30 AM
Bettyg
 
Posts: 32225
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Induced Pluripotent Stem Cells Give Investigators a New Window into Neurological Disease

Friday, June 24, 2011

This cluster of human iPS cells has been induced to differentiate and express proteins found in dopamine-producing neurons.

The proteins are visible with colorful fluorescent antibodies.

Courtesy of Dr. Ole Isacson, McLean Hospital and Harvard Medical School.

Since the discovery of human embryonic stem cells in the late 1990s, scientists have been racing to bring stem cell therapy into the clinic.

The therapy would involve transforming stem cells into specific cell types, and using them to replace tissues that have been damaged by disease.

Such transplants are being put to the test in clinical trials for spinal cord injury and age-related macular degeneration.

Stem cell research is advancing on other fronts, too.

It is now possible to take a sample of skin cells or other body cells, and reprogram them to behave like embryonic stem cells.

These reprogrammed cells are called induced pluripotent stem (iPS) cells, and in theory, they could be derived from a patient afflicted with a disease, corrected for defects and transplanted back into the patient's body.

Scientists are also using patient-derived iPS cells to study disease mechanisms and test potential therapeutic drugs – all in a test tube.

In 2009, the National Institute of Neurological Disorders and Stroke (NINDS) funded three consortia to develop iPS cell lines from individuals with Parkinson's disease, amyotrophic lateral sclerosis (ALS), and Huntington's disease.

By coaxing these cells to become specialized types of neurons, researchers can examine how these neurons die in each disease and test drugs that may be able to slow or prevent neuronal death.

iPS Cells as Models of Disease

Embryonic stem cells are responsible for generating all of the body's cell types.

During early development, they are poised in a state of indecision, ready to become muscle, bone, nerve or other cell types as needed.

This is called pluripotency, and researchers have discovered that it depends on a unique genetic program.

By 2008, several research labs found that by adding just a few genes into adult human skin cells, they could turn back the cells' developmental clock and revert them to a pluripotent state, much like embryonic stem cells.

Scientists quickly realized the potential of these human iPS cells to serve as models of disease.

"For neurodegenerative diseases in general, most of the existing cellular and animal models we have do not perfectly replicate the human condition," said Margaret Sutherland, Ph.D., a program director at NINDS.

"We thought that iPS cells derived from patients would provide an additional tool to augment drug discovery and provide further insights into the cell biology behind neurodegenerative diseases."

"The passage of the American Recovery and Reinvestment Act (ARRA) in 2009 created an opportunity for a large, concerted effort to develop iPS cell models of neurological disease," Dr. Sutherland said.

After a call for applications, each of the three iPS cell consortia was funded with a $1.9 million ARRA grant from NINDS, with additional support from the Michael J. Fox Foundation, the ALS Association, and CHDI Foundation, which supports research on Huntington's disease.

In December 2010, the consortia researchers met at a workshop near the NIH campus in Bethesda, Maryland to discuss ongoing progress and challenges.

They have generated and characterized dozens of iPS cell lines from patients and healthy individuals, and have begun using the cells to probe disease mechanisms.

As new iPS cell lines are generated, they are deposited into the NINDS human cell line repository at the Coriell Institute for sharing with the broader research community.

Parkinson's Disease Consortium - Led by Ole Isacson, M.D. Ph.D., McLean Hospital and Harvard Medical School, Boston.

Parkinson's disease affects a part of the brain called the substantia nigra, destroying neurons there that produce the chemical dopamine.

Consortium researchers have successfully generated iPS cells from individuals with the disease, and in turn have used those cells to generate dopamine-producing neurons.

Most cases of Parkinson's disease are sporadic, meaning that the cause is unknown.

But there are about a dozen genes associated with the risk of developing Parkinson's, and in some individuals, the disease is caused by a mutation in just one such gene.

Consortium researchers are deriving iPS cells from individuals with sporadic Parkinson's, as well as from individuals with mutations in the genes most strongly linked to Parkinson's, including alpha-synuclein, LRRK2, parkin and PINK1.

Already, an NINDS-funded team has used iPS cells to investigate the functions of PINK1.1

Previous research suggested that PINK1 maintains cellular health by disposing of old or damaged mitochondria, which are cellular energy factories. But those studies were done in animal models and non-neuronal cells.

In a new study, Dimitri Krainc, M.D., Ph.D., an investigator at Massachusetts General Hospital in Boston, examined iPS-derived neurons from people with PINK1 mutations.

He found that the cells accumulate abnormal mitochondria, and that this could be reversed with delivery of normal PINK1.

ALS Consortium - Led by Jeffrey Rothstein, M.D., Ph.D., The Johns Hopkins University, Baltimore.

ALS attacks muscle-controlling nerve cells called motor neurons, leading to weakness and muscle wasting.

Like Parkinson's disease, ALS is usually sporadic but about 10 percent of cases are genetic.

Consortium researchers have derived iPS cells from individuals with the most common mutations that cause ALS (in the genes SOD1 and FUS) and from individuals with sporadic ALS. They have successfully converted these iPS cells into motor neurons.

Motor neurons derived from iPS cells.

Courtesy of Mackenzie W. Amoroso, Project ALS/Jenifer Estess Laboratory for Stem Cell Research, Columbia University.

The hope is that a common picture of ALS will emerge by studying iPS cells from different patients.

However, not all iPS cell lines are equal.

Some lines appear to have a low efficiency for generating certain cell types, including motor neurons.

Researchers worry that such differences between cell lines will obscure any differences related to ALS.

Kevin Eggan, Ph.D., and colleagues at the Harvard Stem Cell Institute recently analyzed 16 iPS cell lines from ALS patients and healthy individuals.2

All 16 lines were able to become – or differentiate into – motor neurons, but with different efficiencies that depended on the unique genetic makeup of each donor.

It will be important to factor in this donor-related variability as the consortia move forward, the researchers said.

The good news is that the iPS cells' ability to differentiate was not affected by different lab protocols or handling in independent labs.

In a related effort, Dr. Eggan worked with Alexander Meissner, Ph.D., at Harvard to develop a "scorecard" of genetic markers that can be used to predict the differentiation capacity of new iPS cell lines.3

Huntington's Disease Consortium - Led by Leslie Thompson, Ph.D., University of California, Irvine

Huntington's disease attacks neurons in the striatum, a brain region that controls movement. The disease is caused by mutations in the huntingtin gene.

In the language of DNA, these mutations consist of the repeating three-letter phrase CAG.

The risk of Huntington's varies with the number of these CAG repeats, which can be counted through genetic testing.

Most people have fewer than 27 repeats and are not at risk for Huntington's.

Individuals with 36 or more repeats are likely to develop Huntington's.

Higher repeat lengths are associated with earlier onset and more rapid disease progression.

The consortium researchers have derived iPS cell lines from individuals with and without Huntington's disease, harboring a range of 20-180 repeats.

They have found that they can convert these cells into striatal neurons, and are investigating how CAG repeat length affects the health and survival of iPS-derived neurons.

Looking Ahead

In April 2011, NINDS announced the availability of two years of additional funding for the consortia, and asked the investigators to submit proposals for the continued development, study and sharing of iPS cells.

This work would include expanding the number of iPS cell lines and the number of disease-related mutations represented, as well as characterizing each line's pluripotency.

Importantly, much work remains to be done to establish that patient-derived iPS cells can serve as useful models of disease and as tools for drug discovery.

Investigators hope to confirm that, like the neurons living inside patients, neurons derived from patient iPS cells show evidence of distress, degeneration, or vulnerability.

Once such defects are identified and carefully accounted, potential drugs could be tested for the ability to correct them.

Dr. Krainc's study on PINK1-deficient neurons is one example of progress on this front. Yet, neurons are not the only cells of interest.

The consortia are also looking for signs of disease in patient-derived glia. These support cells in the nervous system outnumber neurons and play influential roles in many neurological diseases.

Meanwhile, NINDS is working with the consortia to establish standard protocols, and to ensure the quality of iPS cell lines within the NINDS-Coriell repository.

For example, Dr. Eggan's scorecard for measuring differentiation capacity will be used to evaluate all cell lines submitted to the repository.

Dr. Sutherland said she hopes that the standards used by the consortia will make it easier for all researchers to work with iPS cells and use them in broader therapeutic efforts.

"If the iPS cell repository proves to be a sustainable, useful resource, it will give us a strong case for using the same approach to tackle other diseases," she said.

- By Daniel Stimson, Ph.D.

1Seibler P et al. "Mitochondrial Parkin Recruitment is Impaired in Neurons Derived from Mutant PINK1 Induced Pluripotent Stem Cells." Journal of Neuroscience, April 20, 2011, Vol. 31(16), pp. 5970-5976.

2Boulting GL et al. "A Functionally Characterized Test Set of Human Induced Pluripotent Stem Cells." Nature Biotechnology, March 2011, Vol. 29(3), pp. 279-286.

3Bock C et al. "Reference Maps of Human ES and iPS Cell Variation Enable High-Throughput Characterization of Pluripotent Cell Lines." Cell, February 4, 2011, Vol. 144, pp. 439-452.

Date Last Modified: Friday, June 24, 2011

National Institute of Neurological Disorders and Stroke

http://www.ninds.nih.gov/news_and_events/news_articles/ NINDS_iPSC_consortia_2011.htm

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07/16/2011 01:48 AM
Bettyg
 
Posts: 32225
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Neural Stem Cells Block Brain RT Memory Effects

By Charles Bankhead, Staff Writer, MedPage Today

Published: July 14, 2011

Cognitive function improved significantly after human neural stem cell transplantation in a preclinical model of radiation-induced cognitive impairment, researchers reported.

One month after stem-cell implantation, irradiated rats' performance on standardized tasks was similar to that of control animals not exposed to cranial irradiation.

In contrast, irradiated animals that did not receive neural stem cells performed significantly worse than either treated animals or the control group.

Four months after engraftment, the treated irradiated animals continued to perform significantly better than the untreated irradiated animals, as reported July 15 in Cancer Research.

The improved performance by treated animals was associated with engraftment-cell survival and migration.

"Engrafted cells migrated extensively, differentiated along glial and neuronal lineages, and expressed the activity-regulated cytoskeleton-associated protein (Arc), suggesting their capability to functionally integrate into the hippocampus," Munjal M. Acharya, PhD, of the University of California Irvine, and co-authors wrote in conclusion.

"These data show that human neural stem cells afford a promising strategy for functionally restoring cognition in irradiated animals."

Cranial radiotherapy for brain malignancies can cause progressive, debilitating cognitive impairment.

Although the mechanisms of the impairment are unclear, loss of neural stem cells in the hippocampus is one plausible explanation, the authors noted in their introduction.

Neural stem cells that survive irradiation exhibit a stress response that leads to altered proliferation, metabolism, survival, and differentiation, as well as altered expression of certain genes, such as Arc.

To determine the potential of neural stem cell transplantation to reverse radiation-induced cognitive impairment, the authors conducted a study involving three groups of laboratory rats.

Two groups of animals underwent cranial irradiation, followed by human neural stem cell transplantation into the hippocampus or a sham transplant procedure. A control group consisted of animals that were not irradiated but underwent sham transplantation.

One and four months after transplantation, investigators assessed stem-cell survival and phenotypic fate, as well as the rats' cognitive function.

The authors found that 23% of the transplanted

cells survived at one month and 12% at four months.

The patterns of proliferation, migration, and differentiation, as well as Arc expression, suggested the transplanted cells had the potential to integrate into the hippocampus.

Assessment of cognitive function, primarily by tasks involving memory and retention, showed that irradiated animals engrafted with human neural stem cells were indistinguishable from the control animals but performed significantly better than the irradiated animals that had sham transplants (P<0.001 to P<0.0001).

"Our current studies have now clearly shown the benefits of engrafted stem cells for reversing cognitive impairment following cranial irradiation," the authors wrote.

"The capability to minimize the adverse cognitive sequelae associated with cranial radiotherapy is encouraging and points to the promise of using stem-cell-based strategies or minimizing normal tissue damage," they added.

The study was supported by the California Institute for Regenerative Medicine, NIH, and the Department of Energy.

The authors had no relevant disclosures.

Primary source: Cancer Research

Source reference:

Acharya MM et al. "Human neural stem cell transplantation ameliorates radiation-induced cognitive dysfunction" Cancer Res 2011; 71: 4834-4845.

http://www.medpagetoday.com/HematologyOncology/OtherCancers/ 27533?utm_content=&utm_medium=email& utm_campaign=DailyHeadlines&utm_source=

© 2011 Everyday Health, Inc. All rights reserved.


08/06/2011 11:14 PM
Bettyg
 
Posts: 32225
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Gov. Rick Perry's STEM CELL Controversial Surgery Sparks Debate

By Emily P. Walker, Washington Correspondent, MedPage Today

Published: August 05, 2011

Texas Gov. Rick Perry received an injection of his own stem cells during spinal fusion surgery last month and wants his state to be a leader in the use of adult stem cells in medical treatment.

But using a concentrated mixture of adult stem cells to fuse bone hasn't been tested in any major U.S. trials, raising questions of whether a governor (and reportedly a potential Republican presidential candidate) should be advocating an unproven medical procedure.

Perry and a state representative who has multiple sclerosis championed a healthcare bill that created an adult stem cell bank in Texas.

A month after Perry signed that bill into law, his friend, Stanley Jones, MD, a Houston-based orthopedist, performed spinal fusion surgery on the governor using Perry's own stem cells to treat a recurring spinal injury, according to an article in the Texas Tribune.

The Tribune also said that Jones is a major advocate for adult stem cell therapy: Jones says he was cured of his debilitating arthritis after receiving injections of his own stem cells in Japan.

Experts contacted by ABC News/MedPage Today, who weren't familiar with the specifics of Perry's surgery, guessed that the governor had mesenchymal stem cells cultured from a biopsy of his own marrow or fat, that those cells were concentrated in a lab, and then were reinjected onto a scaffold-like device implanted in the spine.

Following the surgery, according to the Texas Tribune, Perry and Jones reportedly urged the Texas Medical Board to hold a meeting to explore ways to regulate the procedure in Texas.

The procedure is similar to spinal fusion surgery using a piece of bone harvested from the patient's own iliac crest to fuse two or more vertebrae.

However, mesenchymal stem cells have a higher stem cell concentration than what is found in the iliac crest, and after the cells are spun in a centrifuge, the stem cells become even more concentrated.

Mesenchymal stem cells differ from iliac bone cells because they are multipotent, meaning they can turn into bone, fat, cartilage, muscle, and skin.

There have not been any phase III clinical trials that tested the utility and safety of stem cell spinal fusion procedures, nor have there been any published trials of the procedure in the U.S.

A Chinese study randomized 56 patients with degenerative disc disorder, lumbar instability, or spinal stenosis to receive either their own iliac crest bone, or enriched mesenchymal stem cells from bone marrow.

The mesenchymal stem cells were enriched and spun, which researchers found greatly increased the concentration of stem cells.

They concluded the enriched mesenchymal stem cells are "a good bone substitute in posterior spinal fusion."

Nick Shamie, MD, president of the American College of Spine Surgery and an associate professor at UCLA, said he used a similar method in patients and has had "numerous" examples of success.

In one case, Shamie treated a young woman who was suffering from painful vertebra slippage for 12 years.

He used her own stem cells to fuse her spine, and two-and-a-half months after surgery she is pain-free, he told MedPage Today.

However, there is some concern about what happens to cells when they are concentrated.

Bryon Petersen, PhD, a stem cell researcher at Wake Forest Baptist Medical Center, in Winston-Salem, N.C., said that culturing cells in a lab for a long period of time could potentially have a "deleterious" effect on the cells and transform them into potentially cancer-causing cells.

Those cells must be carefully weeded out before being injected into a patient, he said in an email to MedPage Today and ABC News.

However, he added that the idea of using one's own stem cells to cure an ailment -- "self healing self" as he phrased it -- is a "very real possibility" and a "technology that the United States should actively be pursuing."

While Shamie and Peterson expressed excitement about stem cell spinal fusion, other experts contacted by ABC News/MedPage Today said the procedure is untested and not ready to be marketed to the American public.

George Daley, MD, PhD, a professor of biological chemistry and molecular pharmacology at Harvard Medical School, pointed to the dearth of evidence on the value of injecting mesenchymal stem cells, and said he worries that the procedure is being done based on anecdotes or observational trials.

"I suspect that what is going on here is part of the world-wide rush to commercialize stem cells prematurely, to capitalize on the hype and [make] a buck, long before the treatments have been proven safe and effective," Daley said in an email.

Richard Fessler, MD, professor of neurological surgery at Northwestern University's Feinberg School of Medicine, echoed Daley's sentiments.

"Although this is a promising technology for the future, at this point there is minimal evidence that it is effective in humans," he said in an email.

Jonathan Moreno, MD, professor of biomedical ethics at the University of Pennsylvania, was harsher in his assessment:

"The medical claims being made for this 'treatment' are nonsense," he said, also in an email.

Moreno dismissed the science of the procedure, but said the political ramifications of the Perry situation are especially interesting:

"Namely, how talk of a stem cell industry in Texas would cause anxiety among cultural conservatives that such an effort could involve more controversial forms of research, like embryonic stem cells," he said.

Adult stem cells are not the same as embryonic stem cells.

Perry -- and many conservatives -- oppose using cells from human embryos for research.

Daley pointed to another political issue: A governor using his power to promote a procedure that hasn't been proven.

"It's sad when someone in such a powerful position like the governor of a major state can act without the benefit of evidence-based medicine," he said.

Still, others like Peterson are waiting to see how the new technology evolves.

"It will be interesting to see just what happens in this case and hopefully many more cases to come," he said.

This article was developed in collaboration with ABC News.

View Comments By: Healthcare Professionals All

J Harris, RN, BS - Aug 06, 2011

While stem cell therapy appears to hold promise as a treatment option for many diseases, the third to last paragraph expresses the sentiment of many.

Politics aside, Governer Perry's wisdom regarding this decision is questionable.

***********************

Jim - Aug 06, 2011

I'm glad that the governor has brought this into the spotlight. I know firsthand the miracle of autologous stem cells.

While there are plenty of naysayers around, claiming that this type of treatment is unproven, blah, blah, etc., blah, how do they answer the patient who has exhausted all other available options?

The patient who has nothing to lose, but much to gain?

The patient who has made an educated and calculated decision?

The USA -- you know, the country with the best medical care in the world -- is lagging seriously behind here.

And much of that has to do with our misplaced focus on embryonic stem cells.

We are spending our research dollars in the wrong place.

We should be concentrating on adult stem cells which are now being regularly used on a daily basis to heal real, live people. But just not here.

I applaud the governor's courage in making his treatment public, and for trying to bring this country's medical arsenal up to date.

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david riding - Aug 06, 2011

Was Perry's procedure covered by his insurance?

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jeanne barrett - Aug 06, 2011

Moreno missed the point. ADULT stem cells were used, not embryonic.

No human beings were killed using this procedure.

It seems that ABC has an agenda of its own: to confuse people. Its bias is really getting annoying.

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drsanity - Aug 06, 2011

Interesting how the Drs. who made a fortune on their devices are the first to express outrage at a new technique that may compete with their product.

A patient, governor or not, has the right to try whatever he wants as long as it's not illegal.

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carmen b.s.g. montaner - Aug 06, 2011

I have no direct experience with stem cell treatment, but I am seeing more and more anecdotal reports on their almost miraculous results. True or exageration?

My concern with this technique is that if the patient should be harboring cancer cells or cells that may cause congenital problems in a fetus whose mother may have had cell therapy, etc. - is there a way to predict or prevent a catastrophe ?*******************************

richard scott - Aug 06, 2011

orthopedic surgeons have been using autogenous iliac bone marrow to supplement local bone in spine fusion and delayed union of fractures.

These are used almost always at the same time as the bone or spine surgery.

Granted these contain marrow elements, but the most important is the osteoblast which forms bone.

The osteoblast is like most mesenchymal cells pluripotential and can differentiate in vivo.

While there are multiple kinds of bone available, commercially, for transplant in bone healing, most are marketed to be as free of cells with potential transformation into other cells.

That research into the use of marrow stem cells may be productive in the future for either making lots of osteoblasts for help in bone healing or for making cells too make bone morphogenic protein which may have the potential for stimulating the patient to make bone.

The researchers quoted are correct. But we are talking of apples and oranges.

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elizabeth mangieri-omps, fnp-c - Aug 06, 2011

Interesting that Perry would offer himself up in this way. Makes one suspect that he's in a LOT of pain and willing to try something untested and with such risk?

However, it just goes to PROVE that with money and power - you can buy ANYTHING!

Are his surgeons going to be censured? I doubt it.

Research for new technologies is too slow. If informed consent is given and risks accepted: why NOT?

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alice carroll - Aug 06, 2011

I'd be willing to bet that Governor Perry or his friends have some sort of financial interest in a company that banks stem cells.

The Texas Enterprise Fund, started by Perry, funnels taxpayer money to businesses to bring their companies to Texas.

It is never disclosed who gets these funds.

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elizabeth mangieri-omps, fnp-c - Aug 06, 2011

I agree with Montaner.

When my children were born in the late 90s umbilical cord blood banking was new. I considered it - given every mother's desire to prevent any catastrophe which might befall her child.

The technology was not so good, the costs were astronomical and insurance considered it 'experiment', hence storage and maintenance fees were not covered. I declined the offer.

I recall hearing about the possibility that, in the event of leukemia or other dz process, that the stem cells might very well contain that same pathway. What's a mother to do?

The ubiquitous question in medical advances comes down to the same old risk:benefit ratio.

We cannot choose for others but the choice SHOULD be available for those willing to take the risk.

This is what HIV activists did for themselves in the early days of the dz when it was wiping out entire populations of gay men.

They DEMANDED and GOT experimental therapies which extended life.

Look at how far THAT dz has come in a short 3 decades!

*******************************

Dr. Jacob R. Raitt - Aug 06, 2011

To see a Republican governor, especially from Texas, a state where teachers are punished for excellence and degree of experience, propose medical research, is simply startling.

Is this the same man who decried the rationality of evolution?

Or might he simply be trying to get something from which great monetary profit could result? If it doesn't work, it doesn't work. And, should it do nothing he has lost nothing.

But, should it be effective monetary gain could be monumental, for you know he would not offer this to the public as a successful research project.

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LMyers - Aug 06, 2011

Every single healing process stimulates a person's stem cells. Is it "proven" that by adding a persons own stem cells to an injured area will help healing?

Probably not, but there is no reason that if the persons is willing, it should be allowed.

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Darryl Etcher - Aug 06, 2011

It is no secret stem cells play an integral role in regenerative medicine.

China is heavily invested in regenerative medicine.

China does not have the same 'safety' restrictions as the U.S.

I see similarities between regenerative medicine and the space race of the '50s and '60s.

If we're not careful, China will reap the benefits (financial via patents, etc.) of winning this race while we argue over the minutiae of stem cell legislation.

I, for one, applaud Governor Perry's actions in this matter. Audentes fortuna juvat

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Joyce A. Cocke RN, BSN - Aug 06, 2011

I have to agree with Elizabeth.

As long as the person is given all the pros and cons of the proceedure, knows it has unknown risks, and is willing to accept the finacial burden, he or she should have the right to have it done.

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michael scott harris - Aug 06, 2011

Strict adherence to evidence based medical practice will herald a new medical dark age in the USA.

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TKeller - Aug 06, 2011

Ms. Carroll asserts regarding the Texas Enterprise Fund that :It is never disclosed who gets these funds."

This is not correct. The list can be found at

http://governor.state.tx.us/files/ecodev/TEF_listing.pdf .

Included by month and year of the grant are the names of the organizations and the amount of funds provided to each organization.

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lou - Aug 06, 2011

this is experimental at best. was this under an experimental protocol.

i know the surgeon can do this as a one off, but if this is his usual way, then the fda needs to investigate.

i do not like the governor promoting an unproven therapy. evidence based medicine is what we need.

what does the tx board of medicine say about the use of stem cells for this indication.

there are many questions that this article leads to. all these questions are worthy of answer.

i look forward to seing a review of the medical issues, payment, political and ethical issues. someone needs to investigate this.

http://www.medpagetoday.com/PublicHealthPolicy/ StemCellResearch/27926?utm_content=&utm_medium=email& utm_campaign=DailyHeadlines&utm_source=

© 2011 Everyday Health, Inc. All rights reserved.

Post edited by: Bettyg, at: 08/06/2011 11:22 PM

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