Stem cells have been in the news recently as the cure all for about every medical illness from Alzheimer's to back pain to heart disease.
The premise is that since these cells can give rise to every kind of cell in the body, then they should be able to replace damaged cells and fix every medical condition.
Although this line of thinking is promising, there is a lot research that is needed to be done before the promise of stem cells becomes a reality.
Stem cells, or embryonic stem cells, are cells that have the ability to become any kind cells the body needs. As such, they are called pluripotent cells because of that ability. Embryonic stems are formed, as the name implies, as a baby is being formed. These cells then change and grow into all the various body parts. That is, these cells change and become heart cells, muscle cells, brain cells etc.
However, as we all grow into adulthood we have less and less of these stems cells, therefore we have less and less ability to repair injuries and the aging process.
The excitement about stem cells rests in the belief that since they have the ability to form any kind of cells we could use them to repair any damaged cells in the body. For example, for patients with damage to the heart muscle, stems theoretically could be injected into the heart to repair the damage and allow the heart to function normally.
The same idea exists for any disease process such as brain disease, spinal cord injury and even arthritis in the knee, hip and shoulder.
Despite this, there are many concerns about stems cells. One of the main concerns is whether these cells could become tumors because of their ability to differentiate into any kinds of cells once reintroduced into the body. One possible solution to this problem is to have the stem cells differentiate to the desired cells type before they are used.
One main unknown about stem cells is how they are triggered to start growing into different cells and what ultimately stops them from growing. We do not know if that by simply injecting the cells into a damaged body part will cause them to grow and to perform repair. It is also not known if the cells need other substances within the body to help them grow and replace the damaged cells.
Currently, the use of stem cells is not FDA-approved for use within the United States in clinical practice unless in a research setting. Therefore, most stem cell treatments being currently advertised on TV or on the internet do not have official FDA sanction unless it being used in an approved research study.
And, even in those approved studies, the FDA has restricted how the stem cells can be used. The cells are approved to removed or harvested from the patient, purified and re-inserted in to the patient. The stems are not allowed to be expanded, that is being grown, before injected back into the patient.
These guidelines by the FDA make it difficult to perform clinical research in the U.S. on the amount of stem cells that will be needed for a given condition. Therefore, no one is certain that even if stems cells can treat a condition how many cells are needed.
Patients who want to use stems cells to treat a medical condition are best served by finding an accredited research project treating their conditions, since it is not always possible some patients who can afford the cost of stem cell treatment are travelling overseas to have their treatment done.
So although stem cells hold great future promise there are many current unknowns that will limit their application in treating diseases.
Dr. Dwight S. Tyndall, FAAOS, is an outpatient spine surgeon practicing in the Region. His column covers a wide range of health and medical issues.
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