Thursday, October 31, 2013

A New Hope….The “Wow” Of Stem Cell Treatments

A New Hope….The “Wow” Of Stem Cell Treatments

Stem Cells under High Magnification

 There I was sitting in the audience of the darkened convention center staring at the slides running on the screen feeling a slight tinge of envy and an odd sense of disappointment thinking that it could have been me there presenting these results, if only. Ah, that "if only" plays a major part of all our lives doesn’t it?

Anyway to start from the beginning I had spent the last three days at a specialty national conference as part of my commitment for annual medical education to learn what’s new in the field of regeneration. Too many times we get caught up in the everyday worries of clinical practice and forget that there is a whole lot of innovation taking place out there in science some of which may be a game changer to how we practice medicine in the near future.

Take for example stem cells. Those who follow this blog regularly know that i have in the past been dismissive of what I have thought was the highly inflated claims of the stem cell propagandists in touting it as a cure for all diseases (read here and here). Well I am happy to confess that i have now changed my mind. I too believe in stem cells now. I believe that soon, very soon we might have actually workable stem cell therapies at hand- something which i would have argued against a few months ago.

There is a thin line separating skepticism and cynicism- what with all the false stuff floating around in the name of miracle cures - science needs us to be ever vigilant and skeptic and believe any claim only if it is proved or disproved with reliable evidence. But to reject the hypothesis without examining the evidence at all is a sign of a closed mind and cynical in the extreme. Thankfully I am not a cynic and if you show me the evidence and it stands rigorous examination then I am happy to change my mind and jump onto the bandwagon too. That’s the advantage of having an open mind.

As I said earlier, I sat there (for three days) in the darkened auditorium staring rapt in attention watching slide after slide of before and after treatment photographs and micro-photographs (histological slides under high magnification) of various diseases where stem cells had been used and I came away impressed. I could see jaws which had been amputated halfway- hemi-mandibulectomy done- grow back into normal jaws with stem cells. And i saw unhealed diabetic ulcers and amputation wounds close down normally with no sweat at all and I couldn’t help thinking that this stem cell therapy thing is definitely a breakthrough in medicine.

Best of all these were all mesenchymal stem cells harvested from routine menstrual blood and not embryonic stem cells with all its hassles (complicated procedures) of cord blood collection and storing even as the child is being born. That old adage of women being life givers is once again being reinforced with even their menstrual blood which is usually discarded as unsanitary -being put to life giving use. And it made me think of that quaint old Indian habit of women being considered as untouchables during their three days of menses and often set apart from the pooja rooms and other religious ceremonies. Science is now providing a fitting reply to religious obscurantism isn’t it?

If you think I am painting too rosy a picture i would be the first to agree that there are still a lot of steps to go through- there are unresolved issues in collecting the stem cells, culturing them (growing them) in the lab and making use of them in the proper way for the proper disease to get the proper result - for the cure should not be worse than the disease, right? There are also worries about stem cells helping cancer cells to grow faster along with normal cells and their cessation of growth by contact inhibition is yet to be elucidated- that is how does the stem cell know that your kidney is only this big and it stops growing further once your size is reached? What if it decides to keep on growing in size till you have the mother of all kidneys? What stops it actually? Food for thought right?

But anyway all these are technical issues and once the proof-of-concept is validated then these can be tackled by multiple people working simultaneously everywhere. Its like somebody inventing the first car and showing that it can indeed run on the road and then people everywhere get in to solve the practical issues- like one person inventing the accelerator, someone else somewhere inventing the brake and someone else inventing the gear box- none of which was possible till people believed that a car could actually run as said.

And as the researchers stressed again and again they were still only dipping their toes in using stem cells  for treatment, exploring the possibilities of its application in a blind "let’s try this and see what does happen" way and it was still in the experimental stage with no long term results available YET. But if the initial results are anything to go by then we are just that nearer to growing back lost or damaged organs- like a kidney, liver or even an amputated limb. We can hopefully cure diabetes, restore lost memory in dementia cases and even make sure that those with spinal cord injuries and paralyzed in bed can take up their beddings and walk again- as the bible says

It might take us another ten years or fifteen for the treatment to go through all the approved regulatory agencies and for all the working mechanisms involved to be studied fully - for we still don’t know much about how/why it works - just that it works but eventually we are going to be able to get commercially mass produced stem cells which can be injected in a wound site and the damaged part is going to heal over nicely without any sign of the original injury or scar.

I even got offers from one or two companies which are early pioneers in this business (start-ups) offering to supply me with stem cells for competitive rates at RS------for a million cells- the total dosage to be determined by the wound size and disease. Of course if I did buy them and use them on my patients it would have to be an experimental trial (clinical study) only and i would have to go through all the prescribed procedures for conducting such a trial prior to doing the treatment. Or I could wait till it becomes mainstream in a few more years and then start using it on my patients along with every other doctor.

As I said right at the beginning of this post, over the three days I was there at the conference I did feel slightly (well, a lot) envious of all the cutting edge advances taking place, more so from the fact that i too could have been one of those up on the podium getting the applause from the audience if only i had not been chased away from all research by the memory of my bitter experiences during college days.

For those readers who have been with this blog for some time I have in some of my past posts mentioned how when I was a promising young researcher working on my thesis some of my results were stolen in the pre-publication stage by a trusted mentor and I had to practice a scorched earth policy in making sure that no one, including me, could ever use that research anywhere. Not the wisest of options I guess- wasting two years of my hard work in the bargain but I simply wasn’t willing to sit back and allow myself to be cheated without fighting it to the bitter end.

Come to think of it now when i have a far more mature head on my shoulders I feel that I overreacted and let the shock of betrayal lead me to burn down the entire house to deal with a backstabbing rat but for good or bad I swore off research forever and decided to stick to clinical practice (and making money) for the rest of my life. So for years and years i have been happily practicing my cutting and sewing working with real patients instead of petri dishes and microscopes and making me a comfortable living in the bargain- but there is always a tiny bit of regret buried somewhere in my heart that i did not follow through with my research ambitions, especially when i attend conferences like these and see such cutting edge scientific advances.

I know it’s just presumptuous to assume that I might have been a success as a researcher but who knows? The future is a closed book to us and if destiny guides me to a path of research again I might even chuck my scalpel away and start ogling at microscopes. Even if I have to sacrifice some/lot of my current income and get accustomed to a lower standard of living just so future generations can benefit from my research findings. Besides there is a hidden thrill in research - that moment when you see the first evidence of your hunch being proven right- a sense of winning against your own doubts which is almost an orgiastic experience and it pays off for all the sacrifices you made till then.

So that’s all about the stem cell therapies i learned about recently which might provide a far more brighter and enriching life (disease-free) to future generations of humanity- so much so that I am tempted to label it "A New Hope" - a phrase familiar to all Star Wars fans. The future, ladies and gentlemen, looks far, far bright than the present. God bless us all.

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