Stem cells are the new focus of the rich and famous, with Hollywood stars reportedly spending tens of thousands of pounds a year on expensive therapies offered by private longevity clinics that promise to regenerate the aging body.
The latest taker is 84-year-old John Cleese, who revealed in an interview earlier this week that he pays £17,000 every 12 to 18 months for private stem cell therapy in the hope of buying “a few extra years”.
But while stem cells have long been considered one of regenerative medicine’s greatest hopes, with long-standing applications in leukemia and ongoing clinical trials in a range of diseases from age-related macular degeneration to multiple sclerosis and motor neuron diseases, they are also highly misunderstood. understood.
Because while there are very few evidence-based stem cell therapies that have been officially approved by government agencies, there are countless private clinics in countries such as Switzerland, China, Mexico, India and the United States, operating in what experts describe as “a regulatory gray zone” .
“These clinics may be operating outside of regulatory oversight and scientific collaboration, and not publishing the protocols or results of what they do with patients who pay for their services,” said Dr. Anna Couturier, head of research, development and strategy at an academic non-profit consortium providing information on gene and cell therapies, called EuroGCT.
It is not difficult to find evidence of the potential dangers. Last year, reports emerged that patients in the US lost their sight after receiving stem cell treatment for a degenerative eye condition at a private clinic in Florida. And while some clinics claim to offer injectable stem cell therapies that boost collagen and give the face a more youthful appearance, scientists say there is little published evidence that this is safe or effective.
“There is no approved use of stem cells in the cosmetic industry, so all suppliers offering these direct-to-consumer interventions are exploiting a gray zone,” says Darius Widera, professor of stem cell biology and regenerative medicine. at the University of Reading.
What can stem cells actually do, and what are the common misconceptions?
There is no one ‘stem cell treatment’
Just as cancer and dementia are collections of hundreds of different diseases, rather than separate entities, there are many different types of stem cells, and as such the potential applications vary greatly.
Stem cell medicine is most advanced when it comes to adult stem cells, which can only be used to generate fresh cells in their own specific location. For example, stem cells found in the brain can only be used to produce new brain cells.
Professor Jon Frampton, a stem cell biologist at the University of Birmingham, describes the longest-standing use of adult stem cells in leukemia patients, often involving a stem cell transplant to replace the diseased cells in the bone marrow with those from a matched donor.
“You want to get rid of the disease and then replace the blood system with some fresh stem cells,” he says. “It has been tried and proven to work.”
Over the past twenty years, much excitement and controversy has arisen over so-called pluripotent stem cells, which can either be extracted from human embryos or generated by clever manipulation in the laboratory. These stem cells can develop into any cell type in the body. Although they are often hyped as potential miracle cures, their safety and efficacy are tested in early-stage clinical trials and remain largely unproven.
You don’t want them injected into your body
In an interview with Saga magazine, Cleese described receiving treatment that he seemed to describe as a form of ongoing anti-aging maintenance.
“These cells travel through the body and when they spot a spot that needs repairing, they turn into the cells you want repaired so they can become cartilage cells or liver cells,” he says.
It is not clear what type of stem cell treatment Cleese will receive, but Prof Frampton says anyone receiving pluripotent stem cell injections is likely to be at risk.
“When stem cells are put in the wrong context without the right cues and signals, they do what they are capable of doing, but in a very random way,” he says. “You can get a tumor called a teratoma because the stem cells grow a lot and form a lump. A teratoma is a terrible mass of many different tissue types, all together in a tumor.”
They can be used to address muscle degeneration and fragility
Stem cell therapies have extended the careers of countless athletes, from Rafael Nadal to Cristiano Ronaldo. Experts say there are several potential stem cell treatments that could be applicable to athletes and could one day be used to address certain aspects of the aging process.
These treatments use adult stem cells, known as mesenchymal stem cells, which make parts of the skeleton, such as knee cartilage or the intervertebral discs in the back. Prof Frampton describes the therapy as a complex multi-stage process in which surgeons extract the patient’s own mesenchymal stem cells before using them to generate new ligament or cartilage cells in a petri dish in the laboratory.
“You would need a biomaterial or a structure that makes those cells work and come together to form new cartilage, for example, and have the right properties,” explains Prof. Frampton. “And then you would transplant that back into the patient.”
Several clinical trials are now taking place in the UK testing the same approach as a possible treatment for degenerative conditions such as osteoarthritis. Other studies are investigating whether new drug therapies can help combat conditions such as age-related muscle wasting by stimulating muscle stem cells and making them more active.
“As we get older, our adult stem cells become less able to do what they need to do,” continues Prof. Frampton. “So there are medications that may be able to reverse some of these deficiencies so that they can continue to do what they are intended to do for a few more years.”
They could replace tissue
Some of the most dramatic applications could be achieved by using pluripotent stem cells to replace lost tissue, for example in age-related macular degeneration (AMD), in which patients slowly lose their central vision. This happens due to the deterioration of a thin layer of tissue at the back of the eye, the macula.
Prof Frampton adds that some researchers are investigating whether pluripotent stem cells can be used to generate a new macula in the laboratory, which can then be transplanted into patients with AMD. “It’s being trialled and I’m hopeful that this will be a cure for at least some patients with that disease,” he says.
But in the meantime, researchers recommend steering clear of private clinics that claim to offer yet unproven therapies. In addition to the cancer risk, there are numerous cases of patients receiving unregulated stem cell treatments developing brain infections, life-threatening blood clots and infections, some even dying.
“If the product is not sterile, it can lead to inflammation and, in the worst case, to septic shock,” says Prof. Widera. “Many patients have been harmed by these gray zone clinics.”
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