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ScienceDaily (July 30, 2012) Stem cells can actually replace dead heart tissue after a heart attack very early in life -- but those same cells lose that regenerative ability in adults, according to researchers at Cornell University and the University of Bonn.

The study, using mice as subjects, found that undifferentiated precursor cells grow new heart cells in a two-day-old mouse, but not in adult mice, settling a decades-old controversy about whether stem cells can play a role in the recovery of the adult mammalian heart following infarction -- where heart tissue dies due to artery blockage.

"While the existence of these cells in adults is controversial, if one did have fully capable stem cells in adults, why are there no new heart cells after an infarct? Whether this is due to a lack of stem cells or to something special about the infarct that inhibits stem cells from forming new heart cells is the question we addressed, taking advantage of the fact that the newborn mouse has these cells," said Michael Kotlikoff, dean of Cornell's College of Veterinary Medicine and senior author of the paper. The paper will appear Aug. 29 in the Proceedings of the National Academy of Sciences.

Kotlikoff and his fellow researchers found that two-day-old mice grew new heart cells and almost completely recovered from infarction, proving that the injury did not inhibit stem cells from growing new heart cells. The same procedure was carried out on adult mice and no new heart cells formed, confirming that adults do not have the requisite stem cells to create new heart cells, called myocytes, though new blood vessel cells were created.

The stem cells found in the adult heart "have lost the ability to become heart cells, and are only capable of forming new vessels," Kotlikoff said. Single stem cells differentiate into all tissues at the start of life, but over time these cells become "developmentally restricted" or specialized to form only certain tissues.

Sophie Jesty, Michele Steffey, and Frank Lee are the paper's lead authors and the work is part of a long-term collaboration with Professor Bernd Fleischmann's team at the University of Bonn.

The study was funded by the National Institutes of Health, New York State Stem Cell Science and the European Union Seventh Framework Programme.

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Stem cells repair hearts early in life, but not in adults

ITHACA, N.Y., July 31 (UPI) -- Stem cells can replace dead heart tissue after a heart attack very early in life, but they lose that ability in adults, U.S. and German researchers say.

Senior author Michael Kotlikoff, dean of Cornell's College of Veterinary Medicine, and colleagues at the University of Bonn said the study involving mice found undifferentiated precursor cells grow new heart cells in a 2-day-old mouse, but not in adult mice.

Kotlikoff said the finding settles a decades-old controversy about whether stem cells can play a role in the recovery of the adult mammalian heart following infarction -- in which heart tissue dies due to artery blockage.

"While the existence of these cells in adults is controversial, if one did have fully capable stem cells in adults, why are there no new heart cells after an infarct? Whether this is due to a lack of stem cells or to something special about the infarct that inhibits stem cells from forming new heart cells is the question we addressed, taking advantage of the fact that the newborn mouse has these cells," Kotlikoff said in a statement.

The study, scheduled to be published in the August issue of the Proceedings of the National Academy of Sciences, found that 2-day-old mice grew new heart cells and almost completely recovered from infarction, proving that the injury did not inhibit stem cells from growing new heart cells.

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Stem cells repair heart only early in life

A US federal court rules that procedures in which a patients own stem cells are extracted, manipulated, and reinjected should be regulated by the FDA.

By Bob Grant | July 30, 2012

Leonardini | stock.xchng

After years of legal wrangling, the US District Court in Washington, DC, last week upheld the Food and Drug Administrations power to regulate adult stem cell treatments in which the cells are more than minimally manipulated before being injected back into the patient. The court ruled that the FDA was operating within its legal mandate when it filed suit against Colorado-based stem cell treatment clinic Regenerative Sciences in 2010 to stop them from extracting, processing, and then reinjecting patients own bone marrow stem cells to treat bone and joint disorders.

The FDA argued that the treatment fell under its purview and was subject to approval like any new drug because the extracted cells were significantly modified using reagents that cross state lines. Regenerative Sciences disagreed, characterizing the treatment as a simple medical procedure, which dont require FDA approval. The court sided with the FDA, making similar stem cell clinics popping up in the United States take notice. University of Minnesota bioethicist Leigh Turner told Nature that the ruling was spot on. It is much too simplistic to think that stem cells are removed from the body and then returned to the body without a manufacturing process that includes risk of transmission of communicable diseases, he said. Maintaining the FDAs role as watchdog and regulatory authority is imperative.

But Chris Centeno, Regenerative Sciences medical director told Nature that the clinic plans to continue offering patients 3 of its 4 stem cell treatments, in which cells are only processed for 2 days before reinjection. He added that the company will continue to treat patients using the process now prohibited by the FDA in a clinic located in the Cayman Islands and that Regenerative Sciences plans to appeal the courts ruling.

By Edyta Zielinska

The National Institutes of Health will fund 17 projects developing lab-on-a-chip applications to improve drug screening.

By Cristina Luiggi

After treating terminally ill patients with an unauthorized experimental probiotic procedure, two California doctors can no longer participate in human research.

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Stem Cell Treatment = Drug

July 30, 2012

Stem cells create new heart cells in baby mice, but not in adults, study shows

Kotlikoff Lab

In a two-day-old mouse, a heart attack causes active stem cells to grow new heart cells; a few months later, the heart is mostly repaired. But in an adult mouse, recovery from such an attack leads to classic after-effects: scar tissue, permanent loss of function and life-threatening arrhythmias.

A new study by Cornell and University of Bonn researchers found that stem cells did not create new heart cells in adult mice after a heart attack, settling a decades-old controversy about whether stem cells play a role in the recovery of the adult mammalian heart following infarction -- the leading cause of sudden death in the developed world -- where heart tissue dies due to artery blockage.

"If you did have fully capable stem cells in adults, why are there no new heart cells after an infarct? And is this due to the lack of stem cells or due to something special about the infarct that inhibits stem cells from forming new heart cells?" asked Michael Kotlikoff, the Austin O. Hooey Dean of Cornell's College of Veterinary Medicine, and senior author of the paper appearing Aug. 29 in the Proceedings of the National Academy of Sciences.

Beating heart cells

This movie shows beating heart cells in culture that originated as stem cells (look closely around the center of the frame). The researchers used a mouse model where heart cells fluoresced red and undifferentiated stem cells fluoresced green. All of the cells shown in the movie were green at the time of culture and they turn red after they become heart cells. There were no red cells to start, indicating that the origin of the beating red cells was green stem cells. Watch video

Co-author Michelle Steffey, a small-animal surgeon in Cornell's veterinary college, developed a procedure to infarct a neonatal mouse heart that is only one-tenth-of-an-inch wide. "It was a tour-de-force technically to infarct and recover those baby mice," said Kotlikoff.

The baby mice grew new heart cells and almost completely recovered from infarction, proving that the infarction did not inhibit stem cells from growing new heart cells. The same procedure was carried out on adult mice and no new heart cells formed, confirming that adults do not have the requisite stem cells to create new heart cells, called myocytes, though new blood vessel cells were created.

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Stem cells create new heart cells in baby mice, but not in adults, study shows

July 27, 2012

Lee Rannals for redOrbit.com Your Universe Online

Findings presented at the American Heart Associations Basic Cardiovascular Sciences 2012 Scientific Sessions show that adult stem cells extracted during liposuction can be used to grow small-diameter blood vessels that could be used in heart bypass surgery.

Matthias Nollert, the lead author of the study, said these liposuction-derived vessels could help solve major problems associated with grafting blood vessels from other places in the body, or form using artificial blood vessels that are not living tissue.

Current small-diameter vessel grafts carry an inherent risk of clotting, being rejected or otherwise failing to function normally, Nollert said in a press release. Our engineered blood vessels have good mechanical properties and we believe they will contract normally when exposed to hormones. They also appear to prevent the accumulation of blood platelets a component in blood that causes arteries to narrow.

Adult stem cells derived from fat are turned into smooth muscle cells in the laboratory, and then are seeded into a thin collagen membrane. As the cells multiply, the researchers rolled them into tubes matching the diameter of small blood vessels.

Within three to four weeks, the cells brew into healthy, usable small-diameter blood vessels. Millions of people with heart disease need small blood vessel replacements or grafts to restore function to damaged arteries.

Nolbert said that creating blood vessels through this technique has potential for off-the-shelf replacement vessels that can be used in graft procedures.

The researchers hope that within six months, they will have a working prototype to start testing in animals.

Although it is still just a preliminary study, further successful results in deeper studies could eventually lead to the stem cell derived small blood vessels being used during heart bypass surgery and other procedures when blood needs to be re-routed.

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Stem Cells Extracted During Liposuction Help Create Blood Vessels

NEW ORLEANS, July 28 (UPI) -- Adult stem cells extracted during liposuction can be used to grow new, small-diameter blood vessels for use in heart bypass surgery, U.S. researchers say.

Lead author Matthias Nollert -- an associate professor at the University of Oklahoma School of Chemical, Biological and Materials Engineering, in Norman, Okla. -- said the liposuction-derived vessels, grown in a laboratory, could help solve major problems associated with grafting blood vessels from elsewhere in the body or from using artificial blood vessels that are not living tissue.

In the study, adult stem cells derived from fat were turned into smooth muscle cells in the laboratory, and then "seeded" onto a very thin collagen membrane.

As the stem cells multiplied, the researchers rolled them into tubes matching the diameter of small blood vessels. In three to four weeks, they grew into usable blood vessels, Nollert said.

"Current small-diameter vessel grafts carry an inherent risk of clotting, being rejected or otherwise failing to function normally," Nollert said in a statement. "Our engineered blood vessels have good mechanical properties and we believe they will contract normally when exposed to hormones. They also appear to prevent the accumulation of blood platelets -- a component in blood that causes arteries to narrow."

The findings were presented at the American Heart Association's Basic Cardiovascular Sciences scientific sessions in New Orleans.

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Blood vessels from liposuction stem cells

A court decision on 23 July could help to tame the largely unregulated field of adult stem-cell treatments. The US District Court in Washington DC affirmed the right of the Food and Drug Administration (FDA) to regulate therapies made from a patients own processed stem cells. The case hinged on whether the court agreed with the FDA that such stem cells are drugs.

The judge concurred, upholding an injunction brought by the FDA against Regenerative Sciences, based in Broomfield, Colorado. Under the treatment sold by the firm, stem cells are isolated from patients bone marrow, processed, and the resulting cells injected back into the patients to treat joint pain. The FDA calls this procedure the manufacturing, holding for sale, and distribution of an unapproved biological drug product, and in August 2010, ordered Regenerative Sciences to stop offering the treatment (see Nature 466, 909; 2010).

During investigations leading up to the injunction, the FDA also found that, because of flaws in its cell processing, the company was violating regulations on adulteration that are meant to ensure patients safety.

Jeanne Loring, a regenerative-medicine scientist at the Scripps Research Institute in La Jolla, California, says that the decision will send a warning to other entrepreneurs offering unapproved stem-cell treatments. So many people want to start these companies. They say, FDA? What FDA?.

Chris Centeno, the medical director of Regenerative Sciences and one of two majority shareholders, told Nature that he plans to appeal against the ruling. During the case, the company claimed that the cells in its Regenexx procedure are not significantly modified before they are reinjected, so the procedure should be considered routine medical practice. The company also argued that because all the processing work is done in Colorado, the procedure should be subject to state law, rather than to regulation by the FDA.

The court disagreed on both counts, noting that the biological characteristics of the cells change during the process, and that this, together with other factors, means the cells are more than minimally manipulated.

Maintaining the FDAs role as watchdog and regulatory authority is imperative.

Leigh Turner, a bioethicist at the University of Minnesota in Minneapolis, agrees. It is much too simplistic to think that stem cells are removed from the body and then returned to the body without a manufacturing process that includes risk of transmission of communicable diseases, he says. Maintaining the FDAs role as watchdog and regulatory authority is imperative.

Centeno says that the FDA injunction applies to only one of his companys four stem-cell products one that requires 46weeks of processing. The procedure will still be available: after the 2010 injunction, the company moved its treatment location to an affiliated Cayman Island clinic.

Centeno plans to continue providing the other three procedures, also used for joint pain, in the United States. In those treatments, the cells are reinjected within two days. Centeno claims that those cells are minimally manipulated, and that the FDA sees them as the practice of medicine and has no issues with them. Indeed, until 25July, a graphic on the Regenerative Sciences website claimed that these three procedures were FDA approved.

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FDA’s claims over stem cells upheld

Stem cell injections in dogs will become routine in the next two years and will probably cost less than $1000.

The first data, collated last week, into the use of the procedure where cultured cells are injected into the joints of dogs with hip dysplasia or canine osteoarthritis has shown a success rate of 96 per cent.

The procedure will be made available to veterinary clinics, promoted at dog shows and possibly in a television campaign.

It has been transformed in little more than a year with stem cells from one animal used to treat other dogs.

Previously, an invasive procedure was necessary, with incisions to remove subcutaneous or fatty tissue from the affected dog and stem cells isolated in a laboratory before being injected back into the dog.

The procedure resulted in a culture containing only about 10 per cent to 15 per cent stem cells, while the culture from a donor in a breed with a genetic line clear of arthritis can been screened to provide a culture containing 100 per cent stem cells.

The figures were collected from vets by Australian Veterinary Stem Cells, which supplies stem cell treatments and has a partnership with the immunology and stem cell research department at Monash University in Melbourne.

The sample size for the study was small at 150 but only about 1000 animals have had the treatment.

The results found that with an injection into the affected joint, 60 per cent of dogs had a ''significant improvement'' while 96 per cent of dogs showed ''improvement''.

For dogs given an intravenous injection - usually older animals not suitable for a general anaesthetic - vets reported 79 per cent improved.

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Lame dogs brought to heal with stem cells

Imagine a man with a recent severe heart attack who has the muscle repaired with stem cells or a child with a severe bladder defect repaired with stem cells grown on a biodegradable scaffold. Sounds like science fiction but these are actual clinical studies in progress today. Stem cell therapies promise to be one of those scientific breakthroughs that will have an enormous impact on health care in the future. Stem cells will bring us closer to the goal of personalized medicine, just as genomics is doing. The course of a disease will change once we have the technology to develop and then insert stem cells into the human body to actually create a tissue. For example, a person with a heart attack will not go on to live the rest of his or her life with damaged heart muscle and resultant heart failure. Instead, stem cells will repopulate the heart muscle and make it whole again. Similarly, a person with Parkinsons disease will recover full faculties thanks to the ability of stem cells to regenerate the damaged area of the brain. The person with type I diabetes will be free of the disease because of the formation of new pancreatic islet cells. The athlete will play again because new cartilage will be created for the worn knee. This is the promise of regenerative medicine. I have written the above as though each will definitely happen, a promise that will be kept. They probably will, but it may be a long time before the science of stem cells is sufficiently developed that these types of incredible results will be commonplace. Adult stem cells are being used today for treatment of a few diseases and there are studies ongoing and planned for many additional possibilities. Lets consider a few of them. Each of our tissues has a population of cells that can divide as needed to keep the organ or tissue functional as cells die or are injured. We see this with our skin as it constantly lays down new cells which make their way to the surface as the dead cells on the surface are rubbed off in the shower. We also see it when we cut ourselves and yet in a few days the wound is completely healed that was stem cells at work. It appears that essentially every organ has its own pool of such cells. There are cells in the bone marrow that can become stem cells for many different tissues. These cells circulate in the blood and can be called to assist a tissue or organ to rebuild itself after injury or damage. So for example, if a surgeon takes one half of a fathers liver for transplantation into his son, we know that the fathers liver will grow back to normal size within about 6 to 8 weeks. Some of the stem cells will have been those already in the liver but some will have come from the blood stream to assist. Of course, the liver is the exception to the rule that if a portion of an organ is removed by trauma or surgery, it will not grow back. Cut off your finger and stem cells will help it to heal but not to grow back to its original state. Adult stem cells are the ones used for treating leukemia, myeloma and other cancers and for correcting certain childhood immune deficiencies. Most often is the use of allogeneic hematopoietic stem cell transplantation, meaning the use of stem cells obtained from a closely matched individual. An identical twin is ideal but few have such a potential donor. Only 25% of siblings will likely match completely. This leaves the use of the National Marrow Donor Registry to find as close a match as possible from unrelated individuals. The Registry has markedly improved the chances for a close match and thus for successful transplantation outcomes. Many parents are now having umbilical cord blood saved and frozen to have available in the unlikely event that their child requires a transplant many years later. Although these cells are identical they usually are not sufficient in numbers to lead to engraftment and often the white blood cells (neutrophils) recover only very slowly leaving a prolonged period of infection risk. Perhaps a technique will be found to get the umbilical stem cells to multiply in the laboratory so that a larger number would be available. Adult stem cells are being used in studies of myocardial infarction and heart failure. Current guidelines of immediate angioplasty and stent insertion as appropriate help protect the heart from permanent damage after an infarct. Still, about 400,000 new cases of heart failure are developing in the USA each year. Long term survival is limited once overt failure develops. Could the damaged heart muscle be fixed? The concept is to use stem cells to repopulate the muscle fibers and to have those cells divide over and over and differentiate into new muscle fibers or perhaps also the small vessels that carry blood to the muscle cells. So far there are some exciting animal studies and even some trials in patients that are encouraging enough to warrant further evaluations. For example, one study uses adult mesenchymal stem cells derived from the bone marrow and infused intravenously within 7 days after a heart attack. 42 centers are collaborating in this double blind, randomized trail in conjunction with Osiris Therapeutics. 220 patients will receive either the stem cells or a placebo and then be monitored with various imaging and functional studies. So, stay tuned. Another common albeit less lethal problem is loss of bladder control leading to incontinence. There are studies in progress to determine if stem cells placed into the bladders sphincter muscle will help it regain control. The adult stem cells are obtained from a leg muscle biopsy. Stem cells are isolated and allowed to grow in tissue culture. These are then injected into the weakened bladder sphincter muscle. Once again, these are studies just beginning but with intriguing early results. Here is another bladder repair concept. When the bladder muscle is weak or largely missing in children it may be possible to literally rebuild the bladder by tissue engineering. A biopsy of the bladder yields cells that can be grown in the laboratory to large numbers. They can then be placed on a biodegradable scaffold and grown further. In time they seem to create a new bladder muscle wall complete with blood vessels. This layer of cells can be implanted in the bladder of children with a defect. Once more I need to note that it is still early days in these studies but they do raise exciting possibilities. The message here is that adult stem cells are being used today for life threatening and life impairing diseases with excellent success and are being studied in other diseases with exciting prospects for the future.

Stephen C Schimpff, MD is an internist, professor of medicine and public policy, former CEO of the University of Maryland Medical Center and is chair of the advisory committee for Sanovas, Inc. and senior advisor to Sage Growth Partners. He is the author of The Future of Medicine Megatrends in Healthcare and The Future of Health Care Delivery- Why It Must Change and How It Will Affect You from which this post is partially adapted. Updates are available at http://medicalmegatrends.blogspot.com

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Medical Megatrends – Stem Cells – Part II of III

MIAMI (WTVJ/NBC) - It is widely known that stem cells can be used in life-saving treatments for deadly diseases.

Now they are being used in the fight against wrinkles.

Donna Pritchit recently had a "stem cell" makeover.

The 64-year-old headed into the operating room wanting to turn back the hands of time without it being totally obvious.

"I don't want someone to stop and go by and say Oh, she had a facelift.' I want to have someone say Donna went on vacation she must be having a great life,'" she said before the $5,000 procedure began.

Dr. Sharon McQuillan at the Ageless Institute in Aventura, FL marked the areas where she would take fat out of Pritchit's belly - and place it back into her face.

The retired teacher also hoped it would be her last step in getting rid of embarrassing acne scars.

The outpatient procedure began with traditional liposuction, and then McQuillan and her team processed that fat and concentrated the stem cells so they could be injected into Pritchit's wrinkles and in places where she has lost fullness.

"Stem cells in general are the cells in your body that regenerate tissue and heal tissue, and they make the skin look beautiful and younger," McQuillan explained.

While there are not many long-term studies on the procedure, McQuillan said the results are permanent.

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Stem cell 'makeovers' provide a way to get rid of wrinkles