Every day we get a call from someone seeking help. Some are battling a life-threatening or life-changing disease. Others call on behalf of a friend or loved one. All are looking for the same thing; a treatment, better still a cure, to ease their suffering.

Almost every day we have to tell them the same thing; that the science is advancing but its not there yet. You can almost feel the disappointment, the sense of despair, on the other end of the line.

If its hard for us to share that news, imagine how much harder it is for them to hear it. Usually by the time they call us they have exhausted all the conventional therapies. In some cases they are not just running out of options, they are also running out of time.

Chasing hope

Sometimes people mention that they went to the website of a clinic that was offering treatments for their condition, claiming they had successfully treated people with that disease or disorder. This week I had three people mention the same clinic, here in the US, that was offering them treatments for multiple sclerosis, traumatic brain injury and chronic obstructive pulmonary disease (COPD). Three very different problems, but the same approach was used for each one.

Its easy to see why people would be persuaded that clinics like this could help them. Their websites are slick and well produced. They promise to take excellent care of patients, often helping take care of travel plans and accommodation.

Theres just one problem. They never offer any scientific evidence on their website that the treatments they offer work. They have testimonials, quotes from happy, satisfied patients, but no clinical studies, no results from FDA-approved clinical trials. In fact, if you explore their sites youll usually find an FAQ section that says something to the effect of they are not offering stem cell therapy as a cure for any condition, disease, or injury. No statements or implied treatments on this website have been evaluated or approved by the FDA. This website contains no medical advice.

What a damning but revealing phrase that is.

Now, it may be that the therapies they are offering wont physically endanger patients though without a clinical trial its impossible to know that but they can harm in other ways. Financially it can make a huge dent in someones wallet with many treatments costing $10,000 or more. And there is also the emotional impact of giving someone false hope, knowing that there was little, if any, chance the treatment would work.

Shining a light in shady areas

U.C. Davis stem cell researcher, CIRM grantee, and avid blogger Paul Knoepfler, highlighted this in a recent post for his blog The Niche when he wrote:

Paul Knoepfler

Patients are increasingly being used as guinea pigs in the stem cell for-profit clinic world via what I call stem cell shot-in-the-dark procedures. The clinics have no logical basis for claiming that these treatments work and are safe.

As the number of stem cell clinics continues to grow in the US and morephysicians add on unproven stem cell injections into their practices as a la carte options, far more patients are being subjected to risky, even reckless physician conduct.

As if to prove how real the problem is, within hours of posting that blog Paul posted another one, this time highlighting how the FDA had sent a Warning Letter to the Irvine Stem Cell Treatment Center saying it had serious concerns about the way it operates and the treatments it offers.

Paul has written about these practices many times in the past, sometimes incurring the wrath of the clinic owners (and very pointed letters from their lawyers). Its to his credit that he refuses to be intimidated and keeps highlighting the potential risks that unapproved therapies pose to patients.

Making progress

As stem cell science advances we are now able to tell some patients that yes, there are promising therapies, based on good scientific research, that are being tested in clinical trials.

There are not as many as we would like and none have yet been approved by the FDA for wider use. But those will come in time.

For now we have to continue to work hard to raise awareness about the need for solid scientific evidence before more people risk undergoing an unproven stem cell therapy.

And we have to continue taking calls from people desperate for help, and tell them they have to be patient, just a little longer.

***

If you are considering a stem cell treatment, the International Society for Stem Cell Research had a terrific online resource, A Closer Look at Stem Cells. In particular, check out the Nine Things to Know about Stem Cell Treatments page.

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Stems cells have the ability to ___ and ___ themselves.

divide and renew

remain undifferentiated

specialized

totipotent

pluripotent

multipotent

totipotent

pluripotent

multipotent

isolate, rejection

ethical

pluripotent, grow

leukemia and lymphoma

disease, replace

drug

inner cell mass

all

multiple, stem

not yet determined

ectoderm, mesoderm, endoderm

growth, maintenance, and repair

Both; some wait for signal, others constantly replace cells that are lost through wear and tear

few

blood-related diseases

multiple diseases (since they can become any cell type)

multiple diseases (since they can become any cell type) and won't be rejected since they're from your own cells

a human being is cloned (nucleus from somatic cell replaces nucleus in egg) but then the embryo is destroyed; requires human egg donor

Example:

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Stem Cells flashcards | Quizlet

HOME UNDERSTANDING PARKINSON'S Living with Parkinson's

Stem cells are a renewable source of tissue that can be coaxed to become different cell types of the body. The best-known examples are the embryonic stem (ES) cells found within an early-stage embryo. These cells can generate all the major cell types of the body (they are pluripotent). Stem cells have also been isolated from various other tissues, including bone marrow, muscle, heart, gut and even the brain. These adult stem cells help with maintenance and repair by becoming specialized cells types of the tissue or organ where they originate. For example, special stem cells in the bone marrow give rise to all the various types of blood cells (similar blood cell-forming stem cells have also been isolated from umbilical cord blood).

Because adult stem cells become more committed to a particular tissue type during development, unlike embryonic stem cells, they appear to only develop into a limited number of cell types (they are multipotent).

In addition to ES cells, induced pluripotent stem (iPS) cells, discovered in 2007, represent an important development in stem cell research to treat diseases like Parkinsons disease. Essentially, iPS cells are man-made stem cells that share ES cells' ability to become other cell types. IPS cells are created when scientists convert or "reprogram" a mature cell, such as a skin cell, into an embryonic-like state. These cells may have potential both for cell replacement treatment approaches in patients and as disease models that scientists could use in screening new drugs.

IPS cell technology is somewhat related to a previous method called somatic cell nuclear transfer (SCNT) or therapeutic cloning (the technology that gave us Dolly the Sheep). Unlike the iPS cell approach, which converts adult cells directly into stem cells, SCNT involves transferring the genetic material of an adult cell into an unfertilized human egg cell, allowing the egg cell to form an early-stage embryo and then collecting its ES cells (which are now genetic clones of the person who donated the adult cell). To date, however, this has not been successfully demonstrated with human cells and iPS cell methods may be replacing SCNT as a more viable option.

A potentially exciting use for iPS cells is the development of cell models of Parkinsons disease. In theory, scientists could use cells from people living with Parkinsons disease to create iPS cell models of the disease that have the same intrinsic cellular machinery of a Parkinsons patient. Researchers could use these cell models to evaluate genetic and environmental factors implicated in Parkinsons disease.

Stem cell research has the potential to significantly impact the development of disease-modifying treatments for Parkinson's disease, and considerable progress has been made in creating dopamine-producing cells from stem cells. The development of new cell models of Parkinsons disease is a particularly promising area of stem cell research, as the current lack of progressive, predictive models of Parkinsons disease remains a major barrier to drug development. Cell models of Parkinsons disease generated from stem cells could help researchers screen drugs more efficiently than in currently available animal models, and study the underlying biological mechanisms associated with Parkinsons disease in cells taken from people living with the disease.

However, there are many challenges that need to be overcome before stem cell-based cell replacement therapies for Parkinsons disease are a reality. Work is still needed to generate robust cells, in both quality and quantity, that can also survive and function appropriately in a host brain. Although ES (and now iPS) cells hold great potential, we do not yet know which stem cell type ultimately holds the greatest promise. Thus, researchers require scientific freedom to pursue research on all types including ES, adult and IPS cells in order to yield results for patients.

The Michael J. Fox Foundation played an early role in supporting work in stem cell research for Parkinsons disease, including funding the original proof of principle demonstrating that ES cells could provide a robust source of dopamine neurons. Since that time, significant other funding resources at both the state and federal levels have been unleashed to support the whole field, allowing the Foundation to continue to target strategic funding in other critical areas of developing therapies for Parkinsons disease. The Foundation will continue to monitor Parkinsons disease specific stem cell developments for opportunities where the Foundation can help in advancing this research.

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Stem Cells and Parkinson's Disease | Parkinson's Disease ...

Cells in animals and in plants that are capable of becoming any other type of cell in that organism and then reproducing more of those cells. Despite the fact that stem cell research is in its infancy, many cosmetics companies claim they are successfully using plant-based or human-derived stem cells in their anti-aging products. The claims run the gamut, from reducing wrinkles to repairing elastin to regenerating cells, so the temptation for consumers to try these products is intense.

The truth is that stem cells in skincare products do not work as claimed; they simply cannot deliver the promised results. In fact, they likely have no effect at all because stem cells must be alive to function as stem cells, and by the time these delicate cells are added to skincare products, they are long since dead and, therefore, useless. Actually, its a good thing that stem cells in skincare products cant work as claimed, given that studies have revealed that they pose a potential risk of cancer.

Plant stem cells, such as those derived from apples, melons, and rice, cannot stimulate stem cells in human skin; however, because they are derived from plants they likely have antioxidant properties. Thats good, but its not worth the extra cost that often accompanies products that contain plant stem cells. Its also a plus that plant stem cells cant work as stem cells in skincare products; after all, you dont want your skin to absorb cells that can grow into apples or watermelons!

There are also claims that because a plants stem cells allow a plant to repair itself or to survive in harsh climates, these benefits can be passed on to human skin. How a plant functions in nature is completely unrelated to how human skin functions, and these claims are completely without substantiation. It doesnt matter how well the plant survives in the desert, no matter how you slather such products on your skin, you still wont survive long without ample water, shade, clothing, and other skin-protective elements.

Another twist on the stem cell issue is that cosmetics companies are claiming they have taken components (such as peptides) out of the plant stem cells and made them stable so they will work as stem cells would or that they will influence the adult stem cells naturally present in skin. In terms of these modified ingredients working like stem cells, this theory doesnt make any sense because stem cells must be complete and intact to function normally. Using peptides or other ingredients to influence adult stem cells in skin is something thats being explored, but to date scientists are still trying to determine how that would work and how it could be done safely. For now, companies claiming theyve isolated substances or extracts from stem cells and made them stable are most likely not telling the whole story. Currently, theres no published, peer-reviewed research showing these stem cell extracts can affect stem cells in human skin.

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Dr. Marc Darrow Stem Cell Therapy

In this article Marc Darrow, M.D., explains Stem Cell Therapy for Bone on Bone Knee

In recent research, doctors followed patients for five years and found that five years after treatment stem cell treated knees were still better than before treatment.1 In a second study doctors in China announced that in their animal studies,stem cells injected into the site of a bone fracture, promoted rapid and accelerated bone healing.

The implications of the above researchcan help revolutionize the way standardized medicine addresses problems of bone degeneration and necrosis (bone death). When the doctor says you have bone-on-bone, it can be used as an umbrella term to describe various levels of knee degeneration. In the knee joint, cartilage protects the shinbone, the thighbone, and the back of the knee cap the patella. In addition to this cushion is the thick meniscus the padding between the bones. A healthy knee has all its surfaces glide smoothly atop these cartilages for pain free, efficient, and in the case of athletics explosive movement.

Bone-on-bone means one, some, or all the cartilage and/or the meniscus has defects or holes in them.

Frequentlythese holes go all the way down to the bone and thus painful, debilitating bone-on-bone osteoarthritis develops.

Many times a patient will assume that bone-on-bone means extreme or advanced deterioration, many times that is not the case at all.

When a patient asks us this question we respond by saying that following a physical examination we discuss our non-surgical treatment methods including Prolotherapy, Platelet Rich Plasma Therapy, and Stem Cell Therapy. In minor deterioration, sometimes we start with simple dextrose. In advanced deterioration we may employ both PRP and stem cells.

When stem cells are recommended, we draw stem cells from you. Stem cells have the ability to morph into a variety of cell types including: osteoblasts (bone cells) and chondrocytes (cartilage cells). So it is understandable why so much research and effort are being put into this alternative to knee surgery.

Rebuilding cartilage in severe osteoarthritis is considered one of the great challenges in orthropedic medicine. A recent medical paper sums it up:

Drug interventions and surgical treatments have been widely attempted for cartilage regeneration in osteoarthritis. However, the results were largely unsatisfactory. Autologous chondrocyte implantation (ACI) or matrix-induced autologous chondrocyte implantation (MACI) offers potential for the regeneration of cartilage over the long-term.

However, due to the limitations and disadvantages of ACI, alternative therapies for cartilage regeneration are in need.

The availability of large quantities of mesenchymal stem cells (MSCs) and the multilineage differentiation (the morphing ability), especially their chondrogenic (for cartilage) differentiation property, have made MSCs the most promising cell source for cartilage regeneration. 2

MSCs can modulate the immune response of individuals and positively influence the microenvironment of the stem cells already present in the diseased tissue. 3

In other words, spark a new healing cascade for advanced osteoarthric cases.

Researchers are looking at the osteoblasts, specialized mesenchyme-derived (stem) cellsaccountable for bone synthesis, remodelling and healing. What they are finding is that these cells rebuild bones through various mechanisms including cell homing or cell signalling. This is where stem cells communicate with the surrounding tissue to help them navigate to the site of the wound and differentiate themselves into the material to build bone.4Other research suggests positive results even in cases ofAvascular necrosis. 5 Researchers in China announced that in their animal studies, stem cell injections accelerated bone healing and the further research should investigate stem cell injections for fractures of the bone.6

Should you consider stem cell therapy for your bone-on-bone?The Darrow Wellness Institute has long been recognized for utilizing advanced, non-surgical options for degenerative joint disease including Stem Cell Therapy. Stem Cell Therapy, like Prolotherapy and Platelet Rich Plasma Therapy are designed to stimulate the immune system to heal and rebuild damaged joints without the significant risks that surgeries, joint replacement, or other invasive procedures come with.

1. Davatchi F, Sadeghi Abdollahi B, Mohyeddin M, Nikbin B. Mesenchymal stem cell therapy for knee osteoarthritis: 5 years follow-up of three patients. Int J Rheum Dis. 2015 May 20. doi: 10.1111/1756-185X.12670. [Epub ahead of print]

2. Qi Y, Yan W. Mesenchymal stem cell sheet encapsulated cartilage debris provides great potential for cartilage defects repair in osteoarthritis. Med Hypotheses. 2012 Sep;79(3):420-1. Epub 2012 Jun 1.

3. Qi Y, Feng G, Yan W. Mesenchymal stem cell-based treatment for cartilage defects in osteoarthritis. Mol Biol Rep. 2012 May;39(5):5683-9. Epub 2011 Dec 20.

4. Titorencu I, Pruna V, Jinga VV, Simionescu M. Osteoblast ontogeny and implications for bone pathology: an overview. Cell Tissue Res. 2014 Jan;355(1):23-33. doi: 10.1007/s00441-013-1750-3. Epub 2013 Nov 29.

5.Calori GM, Mazza E, Colombo M, Mazzola S, Mineo GV, Giannoudis PV. Treatment of AVN using the induction chamber technique and a biological-based approach: Indications and clinical results. Injury. 2013 Sep 19. pii: S0020-1383(13)00423-3. doi: 10.1016/j.injury.2013.09.014. [Epub ahead of print

6.Huang S, Xu L, Zhang Y, Sun Y, Li G. Systemic and local administration of allogeneic bone marrow derived mesenchymal stem cells promotes fracture healing in rats. Cell Transplant. 2015 Feb 2. [Epub ahead of print]

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Stem Cell Therapy - Prolotherapy Institute Los Angeles

Stem cells: Cells that are able to (1) self-renew (can create more stem cells indefinitely) and (2) differentiate into (become) specialized, mature cell types.

Embryonic stem cells: Stem cells that are harvested from a blastocyst. These cells are pluripotent, meaning they can differentiate into cells from all three germ layers.

Embryonic stem cells are isolated from cells in a blastocyst, a very early stage embryo. Once isolated from the blastocyst, these cells form colonies in culture (closely packed groups of cells) and can become cells of the three germ layers, which later make up the adult body.

Adult stem cells (or Somatic Stem Cell): Stem cells that are harvested from tissues in an adult body. These cells are usually multipotent, meaning they can differentiate into cells from some, but not all, of the three germ layers. They are thought to act to repair and regenerate the tissue in which they are found in, but usually they can differentiate into cells of completely different tissue types.

Adult stem cells can be found in a wide variety of tissues throughout the body; shown here are only a few examples.

The Three Germ Layers: These are three different tissue types that exist during development in the embryo and that, together, will later make up the body. These layers include the mesoderm, endoderm, and ectoderm.

The three germ layers form during the gastrula stage of development. The layers are determined by their physical position in the gastrula. This stage follows the zygote and blastocyst stages; the gastrula forms when the embryo is approximately 14-16 days old in humans.

Endoderm: One of the three germ layers. Specifically, this is the inner layer of cells in the embryo and it will develop into lungs, digestive organs, the liver, the pancreas, and other organs.

Mesoderm: One of the three germ layers. Specifically, this is the middle layer of cells in the embryo and it will develop into muscle, bone, blood, kidneys, connective tissue, and related structures.

Ectoderm: One of the three germ layers. Specifically, this is the outer layer of cells in the embryo and it will develop into skin, the nervous system, sensory organs, tooth enamel, eye lens, and other structures.

Differentiation, Differentiated: The process by which a stem cell turns into a different, mature cell. When a stem cell has become the mature cell type, it is called differentiated and has lost the ability to turn into multiple different cell types; it is also no longer undifferentiated.

Directed differentiation: To tightly control a stem cell to become a specific mature cell type. This can be done by regulating the conditions the cell is exposed to (i.e. specific media supplemented with different factors can be used).

The differentiation of stem cells can be controlled by exposing the cells to specific conditions. This regulation can cause the cells to become a specific, desired mature cell type, such as neurons in this example.

Undifferentiated: A stem cell that has not become a specific mature cell type. The stem cell holds the potential to differentiate, to become different cell types.

Potential, potency: The number of different kinds of mature cells a given stem cell can become, or differentiate into.

Totipotent: The ability to turn into all the mature cell types of the body as well as embryonic components that are required for development but do not become tissues of the adult body (i.e. the placenta).

A totipotent cell has the ability to become all the cells in the adult body; such cells could theoretically create a complete embryo, such as is shown here in the early stages.

Pluripotent: The ability to turn into all the mature cell types of the body. This is shown by differentiating these stem cells into cell types of the three different germ layers.

Embryonic stem cells are pluripotent cells isolated from an early stage embryo, called the blastocyst. These isolated cells can turn into cells representative of the three germ layers, all the mature cell types of the body.

Multipotent: The ability to turn into more than one mature cell type of the body, usually a restricted and related group of different cell types.

Mesenchymal stem cells are an example of multipotent stem cells; these stem cells can become a wide variety, but related group, of mature cell types (bone, cartilage, connective tissue, adipose tissue, and others).

Unipotent: The ability to give rise to a single mature cell type of the body.

Tissue Type: A group of cells that are similar in morphology and function, and function together as a unit.

Mesenchyme Tissue: Connective tissue from all three germ layers in the embryo. This tissue can become cells that make up connective tissue, cartilage, adipose tissue, the lymphatic system, and bone in the adult body.

Mesenchyme tissue can come from all three of the germ layers (ectoderm, mesoderm, and endoderm) in the developing embryo, shown here at the gastrula stage. The mesenchyme can become bone, cartilage, connective tissue, adipose tissue, and other components of the adult body.

Hematopoietic Stem Cells: Stem cells that can create all the blood cells (red blood cells, white blood cells, and platelets). These stem cells reside within bone marrow in adults and different organs in the fetus.

Hematopoietic stem cells can become, or differentiate into, all the different blood cell types. This process is referred to as hematopoiesis.

Bone marrow: Tissue within the hollow inside of bones that contains hematopoietic stem cells and mesenchymal stem cells.

Development: The process by which a fertilized egg (from the union of a sperm and egg) becomes an adult organism.

Zygote: The single cell that results from a sperm and egg uniting during fertilization. The zygote undergoes several rounds of cell division before it becomes an embryo (after about four days in humans).

When an egg is fertilized by a sperm, the resultant single cell is referred to as a zygote.

Blastocyst: A very early embryo (containing approximately 150 cells) that has not yet implanted into the uterus. The blastocyst is a fluid-filled sphere that contains a group of cells inside it (called the inner cell mass) and is surrounded by an outer layer of cells (the trophoblast, which forms the placenta).

The blastocyst contains three primary components: the inner cell mass, which can become the adult organism, the trophoblast, which becomes the placenta, and the blastocoele, which is a fluid-filled space. The blastocyst develops into the gastrula, a later stage embryo.

Inner Cell Mass: A small group of cells that are attached inside the blastocyst. Human embryonic stem cells are created from these cells in blastocysts that are four or five days post-fertilization. The cells from the inner cell mass have the potential to develop into an embryo, then later the fetus, and eventually the entire body of the adult organism.

Cells taken from the inner cell mass of the blastocyst (a very early stage embryo) can become embryonic stem cells.

Embryo: The developing organism from the end of the zygote stage (after about four days in humans) until it becomes a fetus (until 7 to 8 weeks after conception in humans).

Models: A biological system that is easy to study and similar enough to another, more complex system of interest so that knowledge of the model system can be used to better understand the more complex system. Such systems can include cells and whole organisms.

Model organism: An organism that is easy to study and manipulate and is similar enough to another organism of interest so that by understanding the model organism, a greater understanding of the other organism may be gained. For example, rats and mice can be used as model organisms to better understand humans.

Shown are several different model organisms frequently used in laboratory studies.

Severe Combined Immune-Deficient (SCID) mouse: A mouse lacking a functional immune system, specifically lacking or abnormal T and B lymphocytes. This is due to inbreeding or genetic engineering. They are extensively used for tissue transplants, because they lack an immune system to reject foreign substances, and for studying an immunocompromised system.

Cellular models: A cell system that can be used to understand normal, or diseased, functions that the cell has within the body. By taking cells from the body and studying them outside of the body, in culture, different conditions can be manipulated and the results studied, whereas this can be much more difficult, or impossible, to do within the body.

Stem cells obtained from different tissues of the body can be used as models to study normal, or diseased, cells in these tissues.

Cell Types:

Somatic Cell: Any cell in the body, developing or adult, other than the germline cells (the gametes, or sperm and eggs).

Gametes: The cells in the body that carry the genetic information that will be passed to the offspring. In other words, these are the germline cells: an egg (for females) or sperm (for males) cell.

Other terms:

Regenerative Medicine: A field of research that investigates how to repair or replace damaged tissues, usually by using stem cells. In this manner, stem cells may be differentiated into, or made to become, the type of cell that is damaged and then used in transplants. Also see clinical trials.

Clinical trials: A controlled test of a new drug or treatment on human subjects, normally performed after successful trials with model organisms. ClinicalTrials.gov lists many stem cell clinical trials.

Stem cells have great potential to treat a wide variety of human diseases and medical conditions.

Cell Surface Marker proteins, or simply Cell Markers: A protein on the surface of a cell that identifies the cell as a certain cell type.

Somatic Cell Nuclear Transfer (SCNT): A technique that uses an egg and a somatic cell (a non-germline cell). The nucleus, which contains the genetic material, is removed from the egg and the nucleus from the somatic cell is removed and combined with the egg. The resultant cell contains the genetic material of the nucleus donor, and is turned into a totipotent state by the egg. This cell has the potential to develop into an organism, a clone of the nucleus donor.

Dolly the sheep was cloned through somatic cell nuclear transfer (SCNT). An adult cell from the mammary gland of a Finn-Dorset ewe acted as the nuclear donor; it was fused with an enucleated egg from a Scottish Blackface ewe, which acted as the cytoplasmic (or egg) donor. An electrical pulse acted to fuse the cells and activate the oocyte after injection into the surrogate mother ewe. A successfully implanted oocyte developed into the lamb Dolly, a clone of the nuclear donor, the Finn-Dorset ewe.

Clone: A genetic, identical copy of an individual organism through asexual methods. A clone can be created through somatic cell nuclear transfer.

Other stem cell glossaries:

Image credits Images of Endoderm, Mesoderm, Ectoderm, Bone Marrow, Neurons, Cartilage, Hand Skeleton, Connective and Adipose Tissue, Gastrula, Clinical Trials, Mouse, Rat, Drosophila, C. Elegans, Arabidopsis, Sea Urchin, Xenopus, Somatic Cell Nuclear Transfer to Create Dolly and other images were taken from the Wikimedia Commons and redistributed and altered freely as they are all in the public domain. The image of Hematopoiesis was also taken from the Wikimedia Commons and redistributed according to the GNU Free Documentation License.

2009. Teisha Rowland. All rights reserved.

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