Monday, August 31, 2009

Hip Replacement Alternative

By Amy Price PhD
My husband underwent adult stem cell therapy in hopes of staving off hip replacement. The technique in the USA was in the early stages and his hip degeneration was acute. In the end he underwent bilateral hip resurfacing in the UK. The procedure was successful and gave him his life back. The UK surgeons were most interested in stem cell therapy and they were working on getting stem cells federally funded particularly for revision surgery which happens when the artificial hip wears out after about fifteen years.

It was exciting to learn about six hip patients who underwent a very creative stem cell procedure in Spire Hospital, Southhampton UK. This procedure could prevent thousands of people from needing to have an artificial hip fitted.

Here is a short breakdown on how they are doing this. Surgeons are using the patient’s own stem cells to rejuvenate the affected bone and donor bone to speed the process. The stem cells are extracted from the patient’s pelvis, purified and cultured in an organic mixture that promotes growth. When the cells had multiplied they were mixed with cleaned, ground-up hip bone from other patients who had hips replaced.Surgeon then excised dead tissue from the ball of the hip and filled the cavity with the mixture of stem cells and donated bone.

Professor Richard Oreffo of Southampton University explains that stem cells send out chemical signals to attract blood vessels. "Bone is a living vibrant tissue. These stem cells generate new tissue and drive new blood vessel formation to bring in nutrients," he said.

Dr Dunlop is hopeful that this therapy will fix the hip for life. Early reports look promising with good results in 5 out of 6 study participants. The television footage on this was stunning. One patient who had his procedure a year ago looked like he had never experienced a hip problem.
Scientists and doctors are working together to expand this study and to explore the viability of using artificial bone. This would eliminate the problem of donor generated deficits being passed on although I suspect those already in need of new body parts are happy to take their chances.

This news is hot on the heels of research by scientists in New Jersey USA who have successfully isolated nerve growth factors in mesynchemal stem cells and grown them out as published in the latest issue of the Journal of Neurochemisty. Cell biology and Genetic engineering advances may soon provide real answers for those with untreatable neurodegenerative conditions and even those who have sustained brain injury.
Scientist and doctor teams are now considering how this therapy could be applied to other degenerative conditions.

Saturday, August 22, 2009

Predictive Medicine


By Amy Price PhD

Predictive medicine can change our tomorrows today. Regenerative medicine can replace artificial body parts with lab grown technologies while genetic breakthroughs can save families from generations of genetic disability. It is possible that new knowledge of human genetics and cell biology is likely to transform medical practice. Three likely scenarios could evolve:

•Genetics will lead to the classification of diseases on the basis of the underlying genetics or biochemistry, rather than by symptoms alone leading to preventive rather than crisis orientated treatments.
•Genetic information will identify people who are likely to respond to drugs, or to be harmed by them (pharmacogenetics). This is already possible with certain psychotropic drugs on an experimental level but has not trickled down into mainstream medicine.
•Genetic variation will be a new ‘susceptibility factor’, permitting monitoring and early treatment or, perhaps prevention, of an increasing proportion of common, multifactorial diseases, such as coronary heart disease, hypertension, stroke, cancer, diabetes and Alzheimer's disease. Even stress management can be amplified with knowledge of individual genotypes

It is the genetic variation susceptibility factor which is considered to be the change maker for the advent of predictive medicine. This could lead to regenerative medicine on a cellular (somatic) level or even in vitro gene manipulation (germ line therapy) which could prevent intergenerational transfer of genetic disabilities.
Predictive medicine, when it comes, will be based on a much wider use of genetic testing, at present the gap between what the healthcare system is geared up and trained to deliver and what is scientifically viable is huge. For example there are treatments approved for traumatic brain injury that are effective but most be given within a couple of hours of trauma. This can’t happen now because emergency room personnel are not adequately trained or equipped to diagnose MTBI... As with any new technology applied to health in the context of a complex delivery system, implementation is not going to be simple.

First, of course, there needs to be demand from medical personnel and the general public. Typically wide spread change will only take place after the following criteria are established:

•Demonstration of clinical effectiveness and patient safety – through statistically valid clinical trials
•Cost-effective for general use – through economic analysis of trials and other data;
•Standardization of technology, and quality control – generally through outside regulation of suppliers and laboratories;
•Allocation of resources;
•Recruitment and education and training (or retraining) for health workers – including specialists, MDs, nurses, counselors and technicians. For instance a surgeon who makes a good living performing spinal fusions and cervical repairs will need significant convincing, retraining and motivation to become an early adopter of treatment that makes the previous way of doing business obsolete.

Predictive, regenerative medicine may be the wave of the future. History teaches us that the way to greatness is to find a way to serve many. My dream is to witness a generation of scientists and medical professionals join in unity with a foundation of integrity to build a tomorrow for the patients and public who have make their careers possible.

References:

Materials adapted from Open University Course Materials (accessed july,2009)

Tuesday, August 18, 2009

I Need Stem Cells!


By Amy Price PhD

Adult stem cell viability is on many minds. I have had queries from UN ambassadors to children of only nine asking me about stem cells. The curiousity is international but the questions are the same. People are not sure who to trust and they need stem cells now. Many can not travel to other countries because they are too ill and others lack funding for private stem cell clinics. Some of these feel the FDA or the NHS is unreasonable in thier demands for testing while others feel patient testimonials should be outlawed. My own training is in mental health/psychology so patient to patient information is all I can offer.

I personally like patient testimonials especially when they are accompanied by forums where people discuss how and if the treatment worked and what the hurdles were in getting treatment. I have often learned more from groups of patients with an experience than from professionals with just a theory. Forums are not meant to be professional research, they are peer to peer information only. Google stem cell or regenerative medicine forums and you will get many choices.

I agree clinical trials and time are important to assess treatments but realistically it will be 15 or 20 years before long term results are on the table for clinical trials. There are some companies that have obtained FDA approval for trials, others are listed at clinicaltrials.gov It may be useful to look at this Doctor's description of FDA off label drug use for drugs to understand how the rules were set up and to get an inkling of how this could all translate to cell biology.

My concerns are that engineering any living object is not a simple process and what looks simple from the outside in a needle in/needle out sort of process is very complex from a laboratory perspective and all the answers may not be in. Some clinics are reputable, give good patient care and patients are reporting good long-term results. Some patients are fortunate enough to get into a university sponsored trial that is tied to a major research hospital. Other clinics are still using methods that were proven ineffective many years ago. Patients are vulnerable and need protection sometimes even from themselves. I can no longer count the number of friends I have lost to questionable therapies after spending family fortunes in a quest for a cure. There are no easy answers...

Having said this and knowing from personal experience the agony of chronic unrelenting pain and the sadness of life lost because of disability I would not likely wait until the votes were in but would join in the age old clamor of patients trapped by pain "Just fix me!" The International Society for Stem Cell Research has released guidelines which are helpful to use when considering any new therapy. The PDF is available here

Instant stem cells...Freeze Dried Anyone?


By Amy Price PhD

I recently shared some posts on umbilical cord banking information. Dr Fran Verter of the Parent’s Guide to Cord Blood Foundation shared with us how this works. It seems storage and transport can introduce complications so I wondered what would happen if we eliminated those high tech freezers and freeze dried the stem cells instead. Could they be reconstituted and retain the integrity needed to reproduce?

I located a journal article on Plos One along with others who are using these techniques. Apparently the first generation reproduced DNA accurately which is no surprise as this is a forensics basics but the other portions of the cell needed for healthy growth didn't survive. They are now getting success rates in the 90% range for cells they have reconstituted and then reproduced. The University of Rochester, Image above, is showing some interesting research on using freeze dried cells for bone repair and tissue engineering

This solves a lot of storage problems, should reduce costs and cells could last for years. The ones used in the studies were three years old and over. It is anyone's guess how long this could take to become a viable option for human adult stemcell storage but what a great concept...Stemcells To Go

Tuesday, August 11, 2009

The Spinal Injury Blues!


By Amy Price PhD

With spinal injuries and head injuries it is often the secondary damage to the neurons that causes big problems especially when that swelling and inflammation is in the spinal cord or the brain. The worst damage shows up several hours to many days later. Now, scientists in Rochester, New York, have discovered a simple way to stop a lot of this secondary damage in its tracks...at least in mice by using that old familiar blue food dye that gives M&Ms, blue bubble gum and blue raspberry popsicles their color. Patients with spinal injuries could escape with vastly reduced loss of function if this works in people but they'll turn bright blue in the process.

Much secondary damage is caused by adenosine triphosphate, or ATP. This chemical can go into overkill with trauma and cause neurons to fire until they burn out and die leaving inflammation and sludge to trip up the neurons behind them causing an unhealthy destructive cycle. With spinal trauma, the area around the injury is flooded with ATP, which causes otherwise healthy neurons to fire out of control until they die of exhaustion. It also increases the swelling around the wound. Swelling around an injury site is a positive healing factor in many parts of the body, but because the spinal cord is encased in a narrow column blood supply gets cut off and cells die. But a study published in July 28's Proceedings of the National Academy of Sciences (PNAS) seems to show that it's possible to block the actions of ATP and greatly reduce the severity and permanence of spinal injuries - using the same type of food dye that gives blue M&Ms their color, a food dye called Brilliant Blue G, or BBG.

BBG can be administered intravenously with no need to inject directly into the injury site. It has the ability to cross the blood-brain barrier, which then gives it access to the spinal cord. BBG binds to the same neuroreceptor (P2X7) as the ATP binds to but it has a stronger affinity for the receptor than ATP has and gets there first so it effectively blocks the action of the ATP at the injury site.
Only one problem....patients turn blue ! It is temporary and is sure better than having a serious injury. You wear the injury but the blue die wears off.....All I can say is color me blue for spinal injury.

See the full method of the experiments here (PDF). BBG has been a food dye approved by the FDA since the 1920s but would this be considered off label use like the cholesterol lowering of Cheerios cereal. While all the rats were severely injured, the BBG-injected rats showed a greatly improved ability to support their bodyweight on their hind legs, control their bladders, and even walk in some cases. The blue skin coloring eventually faded as well, and no side effects were noted.

Human testing would be required before BBG can be moved forward into clinical use. It would be a terrific tool for ambulance drivers and paramedics. They could begin treatment right at the site of the incident, It is cheap and easy, even hospitals can use the blue stuff as soon as they get the patient hooked up and ready to go.

The kids must have known best when they told me blue ice cream was good for me ...As for me...I will stock up on blue Gatorade and drink it down just in case it could make a difference!

Friday, August 7, 2009

Scar Care Hints and Tips



By Amy Price PhD

Scar care can make a difference in how you heal. In Europe and Canada scar aftercare is taught following an injury or surgery. It is important that the scar is allowed to heal shut before any attempt is made to cover it with silicone or massage it.

Your doctor is the best one to advise you about the best time to start. If the scar becomes hot, oozes, or bleeds a lot get medical attention. If the area turns black, is extremely painful or very dark, smells,or has dark lines leading way from the wound get it checked by a doctor. Remember some emergency rooms have as high as a 30%return visit ratio so being seen in emergency does not necessarily mean all is well.

If dissolving stitches were used to repair the wound follow your doctors advice for care. The surgeon who repaired my hand and wrist suggested using antibiotic ointment with Zinc oxide until the wound healed and using hand sanitizer for the areas that contained pins. I was urged not to get it wet because the pins go into the bone and infection can become systemic if bacteria is allowed to enter.

Once the wound has healed gentle massage using cream, vitamin E, olive oil, evening primrose oil will keep the area lubricated and help soften it. I was advised to use small circular motions in both directions to break up adhesions and to promote circulation. Gentle but firm consistent pressure is needed. Getting over enthusiastic can re-injure tissue and cause inflammation.

Silicone pads cut to the wound size are very effective in taking away redness,and to reduce raised scars. It does take a few weeks to show results so be patient. The silicone pads can be bought as washable reusable patches that last about a month or as disposable patches that you use and throw away.Best results come from leaving the patches on about 12 hours at a time. They should not be used on open wounds because of the risk of infection. First aid tape can be used to keep the scar sheet in place. Avoid getting it wet. If you are allergic to silicone there are polymer patches that work the same way.

Silicone gel is good to use on areas like knuckles, elbows or the face. It is very important to protect the scarred area from sun exposure for at least two years to avoid damage to skin.

If you are unfortunate enough to experience a road rash scar keep it covered and moist until the skin underneath heals. Burn dressings available at a pharmacy work quite well. Keep it clean with saline and antibiotic ointment rather than using hydrogen peroxide or other harsh disinfectants that will burn and damage the skin underneath. If it is a large area using a cut up tube sock over the dressing can protect it. Remember to keep the dressing and the area clean to promote healing.

Diet makes a difference this is a good time to eat fruits and vegetables plus sufficient protein. Fish oil, vitamin C and antioxidants will help to promote healing.

This Post is for educational patient to patient purposes only and is not meant to treat, diagnose or take the place of medical care or advice.