If you were to read many of the adverts for stem cell therapy that you can find online, you would be forgiven for believing that stem cell therapy is nothing short of a panacea. It is, according to those ads, able to improve all sorts of conditions, from knee pain and osteoarthritis, hair loss to heart disease, diabetes and even autism.

Theres just one problem theres little science behind many of the claims.

Stem cells are only approved for use in treating certain cancers and blood disorders, yet a search for the term on Facebook or Google will return details of a large number of clinics offering treatments for many other conditions.

The harsh reality is that while there is a lot of promising research being undertaken in this area, nobody should be parting with large sums of money for what may be currently no more than snake oil treatments, according to Noel Caplice, who is professor of cardiovascular sciences in the department of medicine at University College Cork and a consultant cardiologist.

Caplice, who has more than 20 years experience monitoring stem cell research as part of his studies into heart disease, told The Irish Times that we should all be suspicious about the range of different ailments clinics are willing to treat with stem cells.

There should be red lights flashing and alarm bells ringing. No therapy treats everything from Parkinsons disease to multiple sclerosis to heart disease to knee pain thats idiotic. Medicine just doesnt work like that.

True stem cell therapy is extremely complex because you have to refine the type of cell youre going to give to the organ it will be used in, and there are different challenges in different organs. Legitimate scientists are working on these things, but they are not there yet. Its an incredibly difficult area of research.

Stem cells have long been considered a great hope of medicine. They are the bodys building blocks, the cells from which other types of cells develop. Under the right conditions they can be encouraged to become any other type of cell found in the body, such as blood cells, brain cells, heart muscle cells and so on.

At its simplest, stem cell therapy involves cultivating stem cells in the lab, guiding them to grow into specific types of other cells, and then injecting those healthy cells into diseased parts of the body where in certain circumstances they have been shown to help the bodys own cells to fight disease.

This effect was first shown around 30 years ago in experiments on mice. However, things have not been all plain sailing since then.

The initial promise of stem cells has not been fulfilled, and whats happened in the meantime is that commercial clinics offering treatments have gotten ahead of the science, said Caplice.

The first trials in mice showed incredible regeneration, but their progress turned out not to be so straightforward. When the initial trials were replicated, the researchers couldnt reproduce the same early data.

While research is ongoing and there have been a few significant breakthroughs using stem cells, notably in the case of combined stem cell and gene therapy for thalassemia and leukaemia, that has not stopped unscrupulous clinics from marketing all sorts of treatments under the banner of stem cell therapy.

In the private world anything goes. There are people spinning this therapy for multiple sclerosis, Parkinsons, solid organ deterioration a whole range of problems. Ten years ago there was even a boat operating off the west Cork coast that was treating people for multiple sclerosis using stem cells. This has been going on for decades in this parallel world, and its mostly driven by money, Caplice said.

According to Frank Barry, professor of cellular therapy at the regenerative medicine institute with NUI Galway, a negative side effect of the off-label use of stem cells is that it makes it harder for researchers to raise money for research.

It damages our reputation to have people doing this. We all get painted with the same brush, and it makes it much harder to raise money. When these maverick clinics are exposed for their bad practices, there is a blow-back effect on us even though were completely unconnected, he said.

The sad thing is that there are genuinely quite exciting applications of stem cell therapy that will be possible in the future. All of these are undergoing scientifically-designed clinical trials that are carefully done, carefully managed, are placebo-controlled, double blind the works. Some of these trials are going quite well and suggest that the outcome will be good.

The biopharmaceutical company Takeda Ireland, for example, is currently developing a treatment for inflammatory bowel disease using the results of a trial that was conducted into stem cells.

Thats a dreadful condition that blights peoples lives. This is a new treatment so thats very exciting. That project achieved market authorisation because of careful work done over many years in high quality clinical trials, said Barry.

My own work is in the treatment of arthritis with stem cell therapy, and thats also going well. Were in the middle of a big trial thats been running in a number of clinical sites around Europe, and we think that when its finished itll be positive.

Running trials like these takes a lot of time and a lot of money. In the meantime bad actors are stepping into the gap that exists between promising early results and actual rigorous and robust science.

The harsh reality is that you cant recommend that a patient has stem cell therapy for anything that isnt directly authorised. If someone does that now theyre getting it off-label, so to speak, and basically theyre taking their chances, said Barry.

I can understand why someone might want to do that, but its not authorised. I would hold out a great deal of hope that when all the work is done there will be strong proof supporting this kind of treatment. But at the moment you can spend a huge amount of money essentially for nothing because there isnt the evidence to support treatment.

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Stem cell therapy: why we need to be suspicious about cure-all claims - The Irish Times

The Abu Dhabi Stem Cell Centre (ADSCC) has now treated more than 2,000 patients suffering from Covid-19, with 1,200 already fully recovered from the effects of the virus.

ADSCC announced today that it had succeeded in ramping up the number of treatments from 73 in the initial clinical trial.

The large increase was as a result of a major effort by staff at the centre to treat as many people as possible following the UAE Government's decision to make it available free of charge to all moderate-to-high risk Covid-19 patients in the country.

Also read: UAE expects Covid-19 vaccine by end of 2020 or early 2021

The Government's decision came after the treatment, branded UAECell19, demonstrated efficacy and an impressive safety profile reflected in the absence of significant changes in adverse events reported, an absence of any unexpected serious reactions (such as anaphylaxis, allergic reactions or sudden death) and an absence of any lung complications as determined by radiological exams from inhalation of the nebulized product.

A team of doctors and researchers at ADSCC, led by Dr Yendry Ventura, announced in May that they had developed a new treatment for Covid-19 patients. UAECell19, an autologous stem cells based therapy, appears to help the body fight the virus and makes the disease less harmful.

Following an initial trial, researchers were able to conclude that UAECell19 reduced the duration of hospitalisation from 22 days to just six, when compared to patients who had received standard treatment.

Further analyses revealed that patients treated with the stem cells were 3.1 times more likely to recover in less than seven days than those treated with standard therapy, and 67 per cent of the patients who received the stem cells treatment owed this recovery to the new treatment.

ADSCC has since secured intellectual property rights protection for UAECell19, which opens the way for the treatment to be shared widely so more patients can benefit.

ADSCC said researchers are at various stages of several investigatory efforts to establish effectiveness (Phase 3 trial), optimal efficacy of dosage, and efficacy to treat other respiratory diseases such asthma, COPD, and cystic fibrosis.

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UAE stem cell therapy for coronavirus treats over 2000 patients, 1200 fully recover - Khaleej Times

Summary

A review of 423 patients treated at MSK finds that most people with cancer dont fare any worse if they get COVID-19 than other people who are hospitalized for that infection.

In the early days of the COVID-19 pandemic, many doctors worried that people undergoing treatment for cancer would do particularly poorly if they became infected with the virus that causes the disease. Thats because treatments for cancer, especially chemotherapy, can lower a persons immune defenses and put them at higher risk for all kinds of infections.

But according to a new study from Memorial Sloan Kettering published June 24 in Nature Medicine, most people in active cancer treatment dont fare any worse if they get COVID-19 than other people who are hospitalized with the infection. Further research is needed to look at the effects of certain drugs mainly immunotherapies called checkpoint inhibitors, which did seem to make COVID-19 worse. But the researchers say their findings suggest that no one should delay cancer treatment because of concerns about the virus.

If youre an oncologist and youre trying to figure out whether to give patients chemotherapy, or if youre a patient who needs treatment, these findings should be very reassuring, says infectious disease specialist Ying Taur, one of the studys two senior authors.

Infectious disease expert Ying Taur has cared for many MSK patients who were hospitalized with COVID-19.

The study looked at 423 MSK patients diagnosed with COVID-19 between March 10 and April 7, 2020. Overall, 40% were hospitalized for COVID-19, and 20% developed severe respiratory illness. About 9% had to be placed on a mechanical ventilator, and 12% died. The investigators found that patients taking immunotherapy drugs called immune checkpoint inhibitors were more likely to develop severe disease and require hospitalization. But other cancer treatments, including chemotherapy and surgery, did not contribute to worse outcomes.

The big message now is clear: People should stay vigilant but not stop or postpone checkpoint immunotherapy or any other cancer treatment.

Factors that did make COVID-19 worse were the same as those seen in studies of people who didnt have cancer. We found that being older, as well as preexisting conditions like heart disease and diabetes, are all drivers of severe COVID-19 illness, says MSK Chief Medical Epidemiologist Mini Kamboj, the studys other senior author. This wasnt surprisingbecause these connections are well established.

Although the study wasnt large enough to make determinations about every treatment and every cancer type, patterns did emerge. Dr. Taur says there was initially great concern about people receiving high doses of chemotherapy for leukemia, especially those who had recently undergone bone marrow or stem cell transplants. Thats because transplants require a persons entire immune system to be wiped out with chemotherapy before they receive new blood cells, leaving them susceptible to all kinds of infections.

Surprisingly, though, Dr. Taur cared for recent transplant recipients who were infected with COVID-19 but didnt have any symptoms. If you think about it more, it makes sense, he says. Most of the complications seen in people with COVID-19 seem to be caused by the bodys immune response to the virus.

On the other hand, immunotherapy drugs called checkpoint inhibitors work by freeing up the immune system to attack cancer. Patients receiving these agents may develop a more robust reaction to the virus that causes COVID-19. This may explain why this study observed higher rates of complications in people with COVID-19 infection who were treated with checkpoint inhibitors.

Even with immune checkpoint inhibitors, though, these findings should not affect whether patients get treated. Everyone who needs these drugs should still receive them, Dr. Kamboj says. Its just important for doctors to be extra vigilant about testing and monitoring for the virus and for people with cancer to take extra precautions to avoid infection.

A study published in May 2020 by MSK immunotherapy expert Matthew Hellmann focused exclusively on people with lung cancer who got COVID-19. The researchers didnt find the same risks from immune checkpoint drugs as this Nature Medicine study. More research in this area is needed.

Dr. Kamboj notes that one aspect of this research that sets it apart from other studies is that it included at least 30 days of follow-up after a COVID-19 diagnosis. Also, it reported severe respiratory illness as a main outcome rather than death.

Having that follow-up time is something that a lot of other studies have not included because everyone is in a rush to get their data out. In addition, reporting death rates can overestimate infection-related mortality, especially in the early phase of an epidemic, Dr. Kamboj says. Also, the clinical spectrum and course of this disease is still not fully understood, especially in people with cancer. We wanted to give patients enough time to recover and make sure they didnt need to be readmitted to the hospital.

Even with immune checkpoint inhibitors, though, these findings should not affect whether patients get treated. Everyone who needs these drugs should still receive them.

She adds that another strength of the study is that patient outcomes were not affected by constraints caused by a lack of space or supplies even though MSK is in the heart of the COVID-19 epicenter in New York City, where other hospitals faced overcrowding and other issues. This gave researchers a true picture of how cancer patients fare with COVID-19. We saw a surge during the peak of the epidemic in New York, but everyone got the care they needed, Dr. Kamboj explains. We had enough ventilators for everyone who needed them. We never had to make decisions about who to admit to intensive care because of a lack of critical equipment.

Drs. Taur and Kamboj agree that this is just one of many studies that will need to be done on the connections between cancer and COVID-19. We still need to find out more. We need to look at the connections between COVID-19 and particular types of cancer as well as outcomes related to specific chemotherapy drugs, Dr. Taur concludes. But the big message now is clear: People should stay vigilant but not stop or postpone checkpoint immunotherapy or any other cancer treatment.

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Should You Delay Cancer Treatment Because of COVID-19? Study Says Most Treatments Dont Worsen Coronavirus Infection - On Cancer - Memorial Sloan...

How to help reverse the damage.

As opposed to visiting your dermatologist to treat a bout of hormonal acne or undergo a hyperpigmentation laser session, hair loss is something that most people are a little more reticent to discuss. Women especially might feel embarrassed or ashamed to admit that they are experiencing above-average thinning, when in reality,50 percent of women will eventually see excessive hair loss. Stress is just one of the many culprits that can cause you to shed upwards of 100 hairs in a dayas compared to the normal 50100 hairsbut considering that were in a global pandemic, in addition to addressing systemic police brutality, wed say that the timing is ripe for a little bit of balding.

Accepting that hair loss might happen right now is just step one. Step two is realizing that you can address it, even if you cant fix patchiness overnight. We spoke with dermatologist Dr. Jeanine Downie of Image Dermatology, and Shab Reslan, hair health expert at HairClub, to learn more about the relationship between stress and thinning hair, as well as the products and treatments that can help reverse the damage.

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Your hair is never just stagnantthe follicles, or roots of your hair, are in a constant cycle of growing, shedding, and resting. Dr. Downie explains that the anagen or growth phase is genetically determined, and according to Reslan, it can last anywhere from three to five years (sometimes longer). The catagen or transitional phase occurs after the anagen phase, signalling the end of active hair growth for about two to three weeks. Finally, theres the telogen or resting phase, which lasts for roughly three months, wherein the hair remains in the follicle until it is pushed out by new growth. According to Dr. Downie, this is the phase that can be made worse by significant stress, which shifts your hair into the resting phase when it is more easily shed.

While hair loss is a constant problem for which people seek treatment, both Dr. Downie and Reslan are seeing more patients during this period of extreme stress and anxiety, even those who have never struggled with hair thinning before. When youre feeling stressed, your body is experiencing an increase in its cortisol levels. Dr. Downie explains, Cortisol is pumped out of your adrenal glands, which sit on top of your kidneys. Once this is in your system, cortisol interacts with your hormones and can cause your hair to go into the resting phase. This resting phase is when your hair is most susceptible to falling out. And aside from seeing increased hair shedding, she notes that stress can also cause your scalp to itch, which might in turn lead you to scratch and prompt those hairs to fall out.

Says Reslan, The true culprit of stress-induced hair loss is inflammation and its damaging effects on the cells in our body, namely our hair follicles. New studies have shifted the focus on hair loss from managing stress hormones, such as cortisol, to instead preventing stress itself. This is why were noticing more adaptogens (natural stress relievers) being incorporated in hair supplements, hair products, and wellness products all around. In other words, incorporating an at-home wellness practice like meditation or acupressure might be a wise decision right now.

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Dr. Downie urges her patients to remember that treating any type of hair loss is a long gamethe only real short-term options are regularly trimming your hair and using deep-penetrating protein conditioners at home. Reslan breaks the treatment cycle into four pillars: using a gentle shampoo and conditioner to maintain a healthy scalp; using topicals to nourish your follicle and stimulate growth; taking supplements to boost your nutrient intake and reinvigorate your hair growth; and visiting your hair-treatment professional to undergo laser sessions.

Navigating the world of hair supplements can be tricky, as there is little in the way of regulation. Dr. Downie recommends Nutrafol or Viviscal to everyone experiencing hair loss, stress-related or not, which can help you see results in four to six months. Be advised, you cannot target hair regrowth to just your headyour hair will grow everywhere.

In terms of lasers, there are a few options that she offers her patients depending on the severity of their case. KeraLase is a treatment option wherein you open the channels of the hair follicle with a laser and then put in Kerafactor, which is a cytokine and stem-cell-rich patented formula that works better than PRP [platelet-rich plasma] to grow hair. And while you may have heard about low-level-laser light therapy caps, she does not recommend them for her patients, nor does she suggest direct PRP treatment. Reslan does reveal that shes seen results from clients and friends who use a laser cap regularly, so when in doubt, speak with your treatment specialist for her own recommendation.

In case you cant get in to see your dermatologist for the foreseeable future, Dr. Downie does endorse using Rogaine (aka Minoxidil), but only the 5-percent foam formulation, although she feels that it is quite sloppy in terms of results. Otherwise, eating a balanced diet, exercising regularly, getting enough sleep, and avoiding any and all heat-styling tools will all promote healthier hair growth and reduce the likelihood of stress-related hair loss. Just remember to be patient with yourselfregrowth is not an overnight process. Says Reslan, Hair grows half an inch every month, so you can expect to see fuller-looking hair around three to four months [after starting treatment and embracing lifestyle changes]. And even though it might be traumatic to experience stress-related hair loss, it is an acute problem, and if you act fast, it is reversible.

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Expert Advice for How to Treat Stress-Related Hair Loss - Coveteur

Two small studies published recently suggested most men hospitalised with COVID-19 are bald, generating headlines around the world.

While this may sound strange, science does offer a plausible explanation.

Male pattern baldness is associated with high levels of male sex hormones called androgens. And androgens seem to play an important role in the entry of SARS-CoV-2, the coronavirus that causes COVID-19, into cells.

So its possible high levels of androgens might increase the risk of severe infection and death from COVID-19.

This hypothesis is important to identify people at risk and raises the possibility of new treatment strategies for COVID-19.

Its been obvious from early in the pandemic. Men are at greater risk of severe infection and death from COVID-19 than women.

There are several possible factors at play here. For one, men are more likely to suffer from chronic conditions known to pose a higher risk of serious illness from COVID-19. These include heart disease and diabetes.

Another is that mens immune systems are not as good as womens at warding off the severe effects of viral infections.

These factors are indirectly influenced by sex hormones. Now it seems sex hormones might also have a direct effect on SARS-CoV-2s ability to enter our cells and establish infection.

In one study of 122 male COVID-19 patients admitted to hospitals in Madrid, 79% were bald about double the population frequency.

Another small study in Spain observed a similar overrepresentaton of baldness among men hospitalised with COVID-19.

Read more: Starting to thin out? Hair loss doesn't have to lead to baldness

Male pattern baldness is strongly associated with a higher level of dihydrotestosterone (DHT), a more active derivative of testosterone, and one of the androgen family of male sex hormones.

Confirming this correlation between baldness and susceptibility to COVID-19 with larger samples, controlling for age and other conditions, would be significant. It would suggest a higher DHT level could be a risk factor for severe COVID-19.

SARS-CoV-2 enters human lung cells when a protein on the virus surface (the spike protein) latches onto protein receptors (ACE2 receptors) embedded in the cells surfaces.

How does this work? Recently scientists discovered that an enzyme called TMPRSS2 cleaves the SARS-CoV-2s spike protein, enabling it to bind to the ACE2 receptor. This allows the virus to enter the cell.

The gene that encodes TMPRSS2 is activated when male hormones, particularly DHT, bind to the androgen receptor (a protein on the surface of cells, including hair cells and lung cells).

So the more male hormone, the more androgen receptor binding, the more TMPRSS2 is present, and the easier it is for virus to get in.

A preliminary, non-peer-reviewed study which correlated the androgen levels of hundreds of people in the UK with COVID-19 severity supports this theory. Higher androgen level was associated with susceptibility to and severity of COVID-19 in men (but not women, who have much lower androgen levels in their blood).

The same researchers showed that inhibiting androgen receptors reduced the ability of SARS-CoV-2s spike protein to bind to ACE2 receptors on stem cells in culture.

Over- or underproduction of androgens in the body causes a variety of conditions in both men and women.

For instance, men with benign prostate enlargement overproduce androgen, as do women with polycystic ovary syndrome.

Many such conditions are treated with androgen deprivation therapy (ADT), which inhibits the production or effect of androgens. For instance, prostate cancer, in which cancer cell growth is fuelled by androgens, is routinely treated with ADT.

Conversely, some people have low androgen production, or mutations that affect the binding and action of androgens such as women with androgen insensitivity syndrome caused by mutations of the androgen receptor.

It will be important to find out whether, as the androgen hypothesis predicts, patients with over- or under-production of male hormones are at greater or lesser risk of COVID-19.

Read more: How can I treat myself if I've got or think I've got coronavirus?

If the androgen link holds up, this would encourage exploration of anti-androgens as a way to prevent and treat COVID-19.

Many anti-androgens are already approved for the treatment of other conditions. Some, like baldness treatments, have been used safely for years or decades. Some, like cancer treatments, can be tolerated for months.

A study which looked at men hospitalised with COVID-19 in Italy showed the rate of infection was four times lower in prostate cancer patients on ADT than in untreated cancer patients.

Perhaps a single dose given to someone who tests positive to SARS-CoV-2, or has just been exposed, would suffice to lower the chance of the virus taking hold.

But we need research to confirm this. Several androgen-suppressing drugs are now undergoing clinical trials to determine whether they reduce complications among men with COVID-19.

It will be important to verify that anti-androgen treatment works in the lungs as well as the prostate, and is effective in cancer-free patients. Wed also need to find out what dose is effective, and when it should be administered.

Anti-androgen treatments have several side effects in men, including breast enlargement and sexual dysfunction, so medical oversight is a must.

The androgen link could go a long way to explaining why men are more susceptible to COVID-19 than women. It also may explain why children younger than ten seem very resistant to COVID-19 because, until puberty, boys as well as girls make little androgen.

The more we know about who is at heightened risk from COVID-19, the better we can target information.

The androgen link also opens up an avenue for the discovery of drugs which might mitigate some of the impact of COVID-19 as it continues to sweep the globe.

Read more: COVID-19's deadliness for men is revealing why researchers should have been studying immune system sex differences years ago

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Coronavirus and sex hormones baldness may be a risk factor and anti-androgens a treatment - The Conversation AU