It's not pulp fiction

Stem cell therapy is poised to become the next big thing in the treatment of major diseases. Even those extracted from dental pulp can be preserved for future use

Watching his five-year-old pull at his loose tooth, dad Shekar remembered something he had read in a dental clinic. Stem cells from teeth, called dental pulp stem cells (DPSCs) could be preserved and retrieved to treat his son if he had a major ailment in future. Stemade, a private company, would arrange to collect DPSCs through its Smile Clinics and store them in state-of-the-art labs in several cities across the country. His thought: Stem cell technology is the next big step in medical treatment. Banking SCs is medical bio-insurance for his kid.

Stem cell therapy didn't jump out of a box yesterday. We've heard of it being used in treating leukaemia. Patients with spinal cord injury have spent huge sums on it hoping to get up and walk. Some ask: If a house lizard can grow back its tail, why can't we get our systems to re-start with a million multiplying stem cells?

Kinds of cells

The best cells for banking are embryonic cells which are programmed to develop and grow. But harvesting these is banned. Ethical issues, you know. Adult SCs beyond the embryonic stage are classified as haematopoietic (from umbilical cord blood and bone marrow) and mesenchymal (tissues and organs). While haematopoietic cells are used in the treatment of blood-related diseases such as haemophilia, blood cancer and skin troubles, tissue cells are tried on all problems other than these. HSCs are collected only from the umbilical cord and bone marrow. Tissue cells are taken from many body sources such as bone marrow, placenta, menstrual blood, cornea, outer layer of the heart, liposuction waste and teeth pulp.

Among these DPSCs are perhaps the best option, says Shailesh Gadre, MD, Stemade Biotech. We all lose our milk teeth and cell extraction here is almost painless. As for the permanent teeth, we can harvest the pulp when people have to lose them for orthodontic (cosmetic) reasons, as when braces are fixed or teeth are extracted because of poor positioning. Of course, they need to be free of caries and other dental infections.

But as we age, our cells age too, so DPSCs are best extracted and preserved when we're very young, when the cells are virile and robust. DPSCs have extraordinary doubling properties that give them a huge advantage over other stem cells, says Dr. Julian Deepak, Medical Advisor, Stemade. They are derived from the same source as nerve cells, with the same capacity as neuron cells, making them a better option for treating Parkinson's, Alzheimer's and muscular dystrophy. Work is on to see their effectiveness in curing diabetes.

Back to the kid's tooth. After the dad's call, a dentist from Stemade will check if Milan's tooth is free of disease. At a Smile Clinic he will extract it and take a blood sample. The dentist will then place the tooth in a specially-designed vial of antibiotic solution. The vial will be packed in ice-gel to keep the temperature low during transport. At their lab (which I visited) in suburban Chennai, a visual inspection is done, the tooth is flooded with anti-bacterial solution and broken open. The pulp is extracted, divided into parts for quality control and sterility (aerobic/anaerobic) tests. The processing is done in zero-contamination conditions and the cells are put in 5 different vials and placed in the vapour phase of liquid nitrogen for cryo-preservation. It is complete, patented technology. The cells are stored in raw format and can be retrieved when needed. Shekar gets a certificate and a CR Management number which will be part of his son's medical records.

These are your own (autologous) cells and will need no matching should you need them for treatment of tissue-and-organ-related diseases such as spinal cord/bone/liver/cartilage regeneration, diabetes, eye-care, etc., says Shailesh. Adds Dr. Julian, Now for most diseases we just do maintenance therapy. With their regenerative property, stem cells will cure diseases in the future.

Fine, but for a few details. One, is the banking fee? Yes, you have to pay for the banking facility, but we can help you with EMIs, says Shailesh. Subsidies are given to the poor as part of CSR. We want to reach as many households as possible. Others are the right to will it and fool-proof identification of the cells. We may store DPSCs at six and may need them at sixty.

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It's not pulp fiction