Adult Stem Cell "Failure" — A Closer Look
By James P. Kelly
A recent article in Joongang Daily reports the sad medical condition of Hwang Mi-sun, a courageous woman who after nineteen years of paralysis reached for her dream — and for a brief time almost found it. Doctors connected to Chosun University Medical School injected umbilical cord stem cells into Hwang Mi-sun's damaged spinal cord. Within weeks Mi-sun began voluntarily moving muscles in her legs for the first time in almost two decades.Sadly, her condition stabilized, then began to regress, leading Mi-sun to attempt a second treatment. She developed a spinal infection from this and now sits in bed, in pain, having again lost the ability to move her legs. However, initially her improvements were hailed by many as a miracle. Indeed they were.In my previous article in The Seoul Times, "Cloning, Stem Cells, and Bioethics: Another Look," I pointed to Mi-sun's treatment as a justifiable cause for Korean pride. I stand by that statement. I also mentioned that embryonic stem cell researcher Ron McKay told the Washington Post that "People need a fairy tale to believe in. Maybe that's unfair, but they need a story line that's relatively simple to understand." This statement deserves a closer look.On the surface I strongly disagree that people with disability or disease "need" fairy tales. I believe we need solid reasons for practical hope. I especially question scientists and industries who "sell" fairy tales that support their lucrative goals. However, many patients may not fully understand complex issues involved in curing their medical conditions. In fact, those who look to science with hope are far more interested in "being" cured, than in "how" they are cured If the cure appears through a miraculous "stem cell" treatment, scientists can keep the details — just give us the cure.Which brings us to Hwang Mi-sun.For 19 years Mi-sun's legs remained paralyzed. Suddenly, within weeks of being treated with cord blood stem cells she could move them again — not normally, of course, but they could move under her control. What did this mean?Experts believe that nerves of the spinal cord grow at one millimeter per day. It is therefore inconceivable that broken nerves in Mi-sun's spinal cord had remade lost connections. Her doctors admitted this. It is also unlikely that her improvements occurred due to myelination — the coating of bare nerve connections with a fatty insulation. Stem cells injected into Mi-sun would have needed to first mature into myelinating cells before this could occur. Also, no published scientific studies have shown that myelination alone can cause "any" functional improvements in animal models of chronic SCI. The most likely explanation for Mi-sun's improvement is that something about her treatment allowed impaired nerves in Mi-sun's spinal cord to begin functioning again — after 19 years! Is this possible? Is there any evidence in science that such a thing may occur? There is. It was long considered that many crucial nerve cells, called neurons, are lost throughout the spinal cord in chronic SCI. Professor Jerry Silver, who redirected the course of Neuroscience by identifying potent molecular obstacles to nerve re-growth, once told me that to replace these neurons, then cause them to grow in "two" directions — reconnecting with the brain and body — would be a "colossal" medical task. Fortunately, Canadian researcher Dr. John Steeves says that many neurons away from the injury site are not dead, that "neuronal death has probably been overestimated."Multiple studies report that neurons thought to have died actually shrink — atrophy — and metabolically shut down. These studies also report these neurons might be revived if given specific chemicals, called growth factors."If SCI-induced atrophy is common among CNS neurons," Steeves says, "it may mean that rather than attempting to replace neurons through transplantation of embryonic tissue or multipotent cells, therapies directed at 'reviving' these 'hibernating' neurons may be more appropriate."The studies that Steeves point to used a growth factor called Brain-Derived Neurotropic Factor (BDNF) to restore atrophied neurons to a "normal" state. Meanwhile, Drs. Michael Chopp and Paul Sanberg report that intravenous injections of cord blood stem cells secrete this very substance, BDNF, which enters the brain and rescues endangered neurons in animal models of Traumatic Brain Injury and Stroke. "Cord blood is readily available, non-controversial and produces therapeutic benefit by stimulating endogenous (existing) restorative responses in the injured brain," says Chopp.Is this the secret behind Mi-sun's "miraculous" initial improvements? We don't know. But her improvements give striking evidence that impaired neural connections may still exist long after injury — and "might" be reclaimed. Rather than having to wait decades for science to "possibly" discover how to remake the spinal cord, through Mi-sun's courage we have a practical reason for hope. Those with SCI can only hope that science follows this clue. However, this presents a serious cause of alarm for any opposed to medical progress. The Spinal Cord Society is an international non-profit research foundation directed by paraplegic Charles Carson, Ph.D. The SCS research team tests potential regenerative treatments in animal models of SCI. Carson takes no sides in "stem cells and cloning" debates. For practical reasons the SCS primarily works with adult stem cells and tissues. However, in this month's SCS newsletter Carson shares candid thoughts regarding "massive opposition" to medical progress:"It's not from open opponents worried about religion," says Carson, "but from the silent inertia of the huge status quo that is the traditional medical community, the drug and health insurance industries, the hospital industry, and bureaucracy." I couldn't agree more. I'd only add the basic research industry to Carson's list. Many basic researchers work hand-in-hand with the biotech and pharmaceutical industries — selling, leasing, and developing publicly-funded research for profits, royalties, and licensing fees. This relationship makes money for universities, institutes, and researchers, while providing industry with a "patented" leash on medical progress.Cord blood stem cells are already used in humans to effectively treat seventy forms of blood and bone marrow cancers. Peer-reviewed science reports their positive effects in animal models of Stroke, Parkinson's Disease, Alzheimer's Disease, Huntington's Disease, Motor Neuron Disease (ALS), Heart Disease, radiation sickness, Diabetes I & II, Traumatic Brain Injury, Spinal Cord Injury, and Lupus. Dr. Joanne Kurtzberg at Duke University reports the apparent "curing" of children with two fatal neurological diseases, Krabbe's Disease and Hurler's Syndrome, provided that cord blood stem cells are administered before too much damage occurs. After using cord blood stem cells to remove the cause of disease in a boy with Adrenoleukodystrophy (ALD), the degenerative brain disease featured in the movie "Lorenzo's Oil," Kurtzberg and the boy's parents were amazed when previous damage to the boy's brain reversed. Today he is a normal six year old.Yet the same article that reports Mi-sun's present condition claims that "there is no proof of the effectiveness of adult stem cell therapy for any disease or condition."Not only is this statement totally false, it's dangerously irresponsible. JoongAng Ilbo surveyed 73 additional adult stem cell treatments, reporting that 80 percent of patients suffered side effects and 12 have died. However, JoongAng Ilbo fails to report the medical condition of patients at the time of treatment, the disease or injuries being treated, the types of side effects, or causes of death. If these patients suffered from a fatal disease such as ALS these numbers could reflect a dramatic "success."The JoongAng Ilbo report may indicate a need for refined treatment protocols, or for more stringent clinical care, or a return to animal studies – or it may be nothing more than a pretext for attacking adult stem cell and cord blood medical advances, which especially threaten the biotech cloning agenda in the aftermath of Hwang-gate.Existing treatments and clinical trials involving cord blood stem cells or adult stem cells only skim the surface of their medical worth. They may also offer unique clinical research tools. Numerous reports exist of adult bone marrow stem cells having protective and reparative effects in multiple tissues, including the heart, liver, and brain. Cord blood stem cells reportedly have similar effects in the brains, livers, spinal cords, and hearts of animals. Transfusions of whole, untreated umbilical cord blood allegedly led to functional improvements in 17 out of 46 patients with ALS, a fatal motor neuron disease with no known cause in roughly 95% of cases. ( For more on this point visit www.cures1st.blogspot.com )If science could learn how cord blood and adult stem cells have these effects, especially in humans with diseases that have no known cause, science might discover the causes of these diseases and how to cure them. Therefore it isn't hard to understand why research-related industries might wish to discredit adult stem cells and cord blood, while promoting long range embryonic stem cell and cloning research. The hard part is believing they would do it."How nice it would be," says Carson, regarding those who wish to keep the medical status quo, "if stem cell progress would just go away. Then business could continue as usual. Everyone but the victims would be happy."
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James P. Kelly, who serves as biotech writer for The Seoul Times, is the director of the Cures 1st Foundation, Inc. in the US. As a paralyzed American research advocate, Director Kelly promotes practical research for the sake of treatments and cures. Mr. Kelly has testified on cloning before committees in America's Congress, in debate with actor Christopher Reeve, and most recently on CNN International.