Basic Information on Stem Cell Therapy

What is a Stem Cell?

A stem cell is a special kind of cell that has a unique capacity to renew itself and to give rise to specialized cell types. Although most cells of the body, such as heart cells or skin cells, are committed to conduct a specific function, a stem cell is uncommitted and remains uncommitted, until it receives a signal to develop into a specialized cell. Their proliferative capacity or ability to multiply combined with the ability to become specialized makes stem cells unique.

There are different sources of stem cells. During the past decade, scientists discovered that a certain class of stem cells - adult stem cells, could be used in different clinical scenarios. An adult stem cell is an undifferentiated cell that is found in a differentiated (specialized) tissue in a person, such as blood, bone marrow, and other organs such as the brain, liver, heart, etc. It can yield the specialized cell types of the tissue from which it originated, and appear to be capable to developing into cell types that are characteristic of developing into cell types that are characteristics of other tissues. In the body, it too, can renew itself.

At The Medical City, we only use adult stem cells from the bone marrow, peripheral blood, and umbilical cord for stem cell therapy.

Most organ systems of the body have a resident pool of tissue-specific stem cells (endogenous stem cells or stem cell originating from our own body). In many cases of traumatic injury or disease, the quantity and potency of these endogenous stem cell populations are insufficient to regenerate damaged tissues. In these cases, exogenous (those derived externally from an outside source) or non-tissue-specific stem cell sources can be used for tissue repair and regeneration. Numerous studies have demonstrated that mobilization of endogenous stem cells or exogenous administration of a number of stem cell populations to injured tissues has resulted in structural regeneration of tissue as well as functional improvement.

When is Stem Cell Therapy used?

Adult stem cells present a promising tool for cell therapy. They have been extensively tested and proven effective in many animal and human preclinical studies. Currently, there are investigations being done on the use of stem cells for different disorders such as myocardial infarction (heart attack), cardiomyopathy (disease of the heart muscle), stroke, neurodegenerative diseases (conditions resulting in wasting and deterioration of brain function in particular for those that are fatal and difficult to treat, such as Huntington's disease and amyotrophic lateral sclerosis), graft-versus-host disease (a complication following organ transplantation where the immune cells from the donor attacks the host's body cells), diabetes and it's sequelae, autoimmune diseases (conditions where the immune system attacks its own host such as rheumatoid arthritis, Crohn's disease, inflammatory bowel disease, systemic lupus erythematosus), among others.

For some diseases such as blood malignancies (e.g. leukemia, lymphoma) and primary immunodeficiency diseases, stem cell therapy is part of the standard of care. However, newer therapies using stem cells are considered innovative or even experimental. For these diseases, more investigations are continuously being done to determine which cells will work best to repair a particular damaged or diseases tissue. Therefore, it is important to understand that even when a patient is receiving stem cell therapy, they should continue the other medical interventions that they are currently using or undergoing (e.g. medications/pharmacotherapy, physical therapy, dietary modifications, etc.).

What are the Risks of using Stem Cell Therapy?

All the side effects, especially long-term side effects from this form of therapy have yet to be characterized and determined. Therefore, careful monitoring and follow-up of patients who receive stem cell treatments is extremely important. No medical treatment can ever be described as completely safe. There are risks involved with all medical treatment: some minimal, others more serious. With the use of autologous (patient's own), or in some instances appropriately matched adult stem cells, the risks of side effects appear to be small. There are numerous reports in the literature regarding the safety of using adult stem cells for stem cell therapy.

Risks involved in stem cell therapy depend on the kinds of stem cells used and the procedures involved in giving the cells. It is very important to discuss with your doctors what risks the therapy will involve in your individual case.

How is Stem Cell Therapy done?

At The Medical City, we only use adult stem cells which can be harvested from the bone marrow (bone marrow aspiration) or the peripheral blood. We can also use stem cells from the umbilical cord blood and materials. The Medical City has an Umbilical Cord Bank. In our laboratory, the cells are then isolated, cultured and expanded, engineered and processed. The kind of cells that will be eventually used is dependent on the individual patient's needs and disease processes.

Once the stem cells are completely prepared, they are either injected intradermally or through the skin (e.g. in case of cancer vaccines), infused intravenously (through the veins) or locally injected (e.g. intraspinal injection or injected into joints). This is done in the hospital under careful monitoring. The duration of the treatment will depend again on the individual patient's disease and response.

Stem cell therapy is not a one-size-fits-all therapy. Each person is different. The response of each person to the therapy is likewise different, even if they have similar disease. So it is important to discuss with your doctors the kind and extent of cellular therapy you will need depending on your disease, lifestyle, genetic make-up and personal circumstances.

What happens after Stem Cell Therapy?

At The Medical City, all patients are closely monitored and followed-up while receiving stem cell therapy. We monitor clinical outcomes and collect data that are important for the disease being treated and also for any adverse reactions from the therapy itself. We also communicate with the other physicians involved in the patient's care for better monitoring and continuity of care.

How can The Medical City help you?

At The Medical City, we have a complete roster of competent doctors who can assess and treat patients needing stem cell therapy. For more information, you may also contact the Institute for Personalized Molecular Medicine at (632) 988-1000 / (632) 988-7000 ext. 6307/6551.

As a patient, you have the right to know all the information regarding this option for therapy to make an informed decision. We will certainly explain your options for treatment as well as the risks, your rights and your responsibilities. You are encouraged to ask a lot of questions about the treatment being offered and even to seek second opinion from independent qualified doctors.

For inquiries, please call:

INSTITUTE FOR PERSONALIZED MOLECULAR MEDICINE   

12th Floor Nursing Tower 2, The Medical City

Ortigas Ave., Pasig City

Tel. no.: (632) 988-1000 / (632) 988-7000 ext. 6307/6551

REFERENCES:

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Le Blanc K, Frassoni F, Ball L, et al. Mesenchymal stem cells for treatment of steroid-resistant, severe, acute graft-versus-host disease: a Phase II study. Lancet 2008;371 (9624):1579-1586.

Augelio A, Tasso R, Negrini SM, Cancedda R, Pennesi G. Cell therapy using allogeneic bone marrow mesenchymal stem cells prevents tissue damage in collagen-induced arthritis. Arthritis Rheum2007;56(4):1175-1186.

Gonzalez-Rey E, Gonzalez MA, Varel N, et al. Human adipose-derived mesenchymal stem cells reduce inflammatory and T cell responses and induce regulatory T cells in vitro in rheumatoid arthritis.Ann.Rheum.Dis.2009.

Haller MJ, Viener HL, Wasserfall C, Brusko T, Atkinson MA, Schatz DA. Autologous umbilical cord blood infusion for type 1 diabetes. Exp. Hematol 2008;36(6):710-715.

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Lu P, Jones LL, Snyder EY Tuszynski MH. Neural stem cells constitutively secrete neurotrophic factors and promote extensive host axonal growth after spinal cord injury. Exp. Neurol 2003;181(2):115-129.

Takahashi M, Li TS, Suzuki R, et al. Cytokines produced by bone marrow cells can contribute to functional improvement of the infarcted heart by protecting cardiomyocytes from ischemic injury. Am.J.Physiol.Heart Circ.Physiol 2006;291.

Kubal C, Sheth K, Nadal-Ginard B, Galinanes M. Bone marrow cells have a potent anti-ischemic effect against myocardial cell death in humans. J. Thorac.Cardiovasc.Surg 2006l132(5):1112-1118.

Lin CD, Allori AC, Macklin JE, et al. Topical lineage-negative progenitor-cell therapy for diabetic wounds. Plast. Reconstr. Surg 2008;122(5):1341-1351.

Jun Liang, Huayong Zhang et al. Allogenic mesenchymal stem cells transplantation in refractory systemic lupus erythematosus: a pilot clinical study.Ann Rheum Dis 2010;69:1423-1429

Bruno Solano de Freitas Souza, Renata Campos Nogueira, et al. Current Status of Stem Cell Therapy for Liver Diseases. Cell Transplantation, Vol. 18, pp. 1261-1279, 2009.

Note:   This information is not intended to be used as a substitute for professional medical advice, diagnosis or treatment.   If you or someone you know have any of the symptoms mentioned above, it is advisable to seek professional help.