An Adult Stem Cell Bill Advances in the Colorado State Legislature

Currently in the state of Colorado, there are only three hospitals in which the systematic collection of umbilical cord blood is routinely performed after the delivery of babies. In all the rest of the hospitals throughout the state, as in most other states, this precious source of pluripotent stem cells is discarded as waste. Democratic House Representative Dianne Primavera sees this as “an opportunity to turn medical waste into a medical miracle.” Indeed, patients such as Sheila Gannon agree. Diagnosed with advanced leukemia over two years ago, Sheila received an adult stem cell transplant from donated umbilical cord blood. As she stated in her testimony before the State House Health and Human Services Committee, “We are extremely grateful for this technology and for the medical community that administers it. I often think about the moms who graciously donate their umbilical cord blood. There is no doubt that without this I would not be here today.”

Many others enthusiastic advocates joined Representative Primavera and Ms. Gannon in supporting what is known as House Bill 1372, which, if ratified, would create the Adult Stem Cell Cure Fund: a voluntary income tax checkoff that would appear on future state income tax forms, revenue from which would promote the proper collection and storage of umbilical cord blood throughout the state of Colorado.

As Representative Primavera described, she sees an analogy between the umbilical cord as a “lifeline for a baby” and a lifeline for someone with a disease such as cancer or multiple sclerosis. As Sheila Gannon added, “I cannot think of a better way to pay it forward than to give all women the opportunity to donate the baby’s umbilical cord blood.” Doctors testifying before the Committee stated that there are roughly 80,000 births each year in Colorado, less than 1% of which currently result in a cord blood donation. If House Bill 1372 is passed, it is hoped that the money raised by the income tax checkoff could be used both for promoting education on the topic as well as for the actual cryogenic storage of donated cord blood, possibly for as long as 20 years for each donation. According to Dr. Chris Carey, who runs the OB-Gyn department at the Denver Health Medical Center, “It is my belief that this bill offers a tremendous opportunity to improve the health of Coloradans for a relatively small expense.”

Thus far, the new measure has passed the Committee unanimously. Next, it advances to the House Appropriations Committee.

Mesenchymal Stem Cells Discovered in the Eye

Mesenchymal stem cells (MSCs) are recognized as one of the most important types of stem cells, with one of the longest and most clinically advanced histories. Although bone marrow is the usual source from which MSCs are derived, they are also known to exist in many other types of tissue such as umbilical cord and placental blood, menstrual blood, peripheral blood, muscle and teeth.

Now researchers in India have discovered MSCs in the limbus of the human eye. After examining the epithelial cells of limbal tissue from patient biopsy samples collected during eye surgery, the scientists identified cells with a spindle-like morphology. The cells were then characterized for a number of parameters including morphology and immunophenotyping, and upon expansion in the laboratory the cells were found to possess a phenotype similar to that of MSCs that are derived from bone marrow. Most significantly, the cells were found to be capable ot differentiating into adipocytes (fat tissue) and osteocytes (bone and cartilage tissue).

Why would stem cells which are capable of differentiating into cartilage and bone exist in the eye? The answer to questions such as this may shed light not only upon the role that these cells play in limbal stem cell transplants but also on the role of MSCs in wound healing and regeneration in general. Especially in ocular injuries and surgeries, the identification of various subsets of stem cells in the human limbus that are similar to bone marrow-derived MSCs is particularly relevant. Already by 1999, a publication in the New England Journal of Medicine (Tsubota et al.) had reported 70 corneal epithelial stem cell transplants in which a statistically significant improvement in vision had been observed.

The presence of MSCs in the eye represents what the discoverers refer to as cells that are “unique to the adult stem cell niche.” Scientists are now investigating further the precise properties of these unique cells, for additional clues into the nature of molecular and cellular regenerative mechanisms.

Alzheimer’s Slowed by Stem Cells From Umbilical Cord Blood

More than 5 million people in the U.S. alone are currently afflicted with Alzheimer’s disease, and the global number is increasing dramatically each year. Now, researchers at the University of South Florida, in collaboration with Saneron CCEL Therapeutics, Inc., an affiliate of Cryo-Cell International, have demonstrated the ability of cord blood stem cells to slow the progression of this debilitating disease.

In this study, mice with symptoms mimicking those of Alzheimer’s were treated with a series of infusions containing stem cells derived from umbilical cord blood. The scientists then tested the mice for the two main markers of Alzheimer’s, and found that the myloid-beta proteins had been reduced by 62%, and cerebral amyloid angiopathy had been reduced by 86%. Currently, Alzheimer’s disease is considered to be irreversible since an effective conventional medical therapy does not exist. This study, however, demonstrates that Alzheimer’s disease can in fact be reversed with the potency of certain types of adult stem cells such as those derived from umbilical cord blood.

Although conservative groups often promote the use of adult stem cells over embryonic stem cells for ethical reasons, scientists are increasingly turning to adult stem cells over embryonic stem cells purely for scientific reasons. Increasingly, studies such as this indicate significant success with adult stem cells while embryonic stem cells still remain plagued with numerous unsolved scientific problems. According to Mercedes Walton, Chairman and CEO of Cryo-Cell International, an organization of cord blood banks which funded the study, “The scientific community has only skimmed the surface in uncovering the many potential therapeutic uses for cord blood stem cells, and this new research in Alzheimer’s disease may pave the way for discoveries around the use of these cells for a host of neurodegenerative and other chronic conditions.”

According to Dr. Jennifer Roback Morse, a senior fellow in economics at the Acton Institute for the Study of Religion and Liberty, “The use of umbilical cord blood is more humane than the use of embryos for two reasons. First, no human life has to be destroyed to produce the umbilical cord blood. Second, the use of umbilical cord blood will undoubtedly be less costly than the use of embryonic stem cells. The supply of umbilical cords is pretty much umlimited.”

Ever since 2004 when a South Korean woman who had been paralyzed for 20 years was able to walk again following cord blood stem cell therapy which repaired the damaged tissue in her spine, this particular source of adult stem cells has been a topic of of intense interest by numerous researchers and clinicians around the world. According to Cryo-Cell, cord blood offers one of the most viable sources of stem cells, as cord blood has already been used in over 7,000 transplantations since 1988, and stem cells derived from cord blood have been clinically administered to human patients for the treatment of more than 70 life-threatening illnesses, which include cardiac injury, neurological injury, type I diabetes, type II diabetes, leukemia, multiple sclerosis, and numerous other types of diseases and injuries.

Next, Alzheimer’s disease may also be added to the list.

Disease Susceptibility Traced to Specific Genes in Human Embryonic Stem Cells

Embryonic stem cells are known to carry a number of risks, not the least of which is genetic mutation which may later cause a variety of diseases in any recipient of the embryonic stem cells. Meanwhile, the human genome, which contains the total DNA content of all 46 chromosomes, reveals a wealth of genetic information. Now, researchers at UCLA are examining the specific contents of this information in order to identify certain embryonic stem cell lines that should not be developed therapeutically because of an increased genetic risk of disease.

The researchers used a high-resolution technique known as “array CGH” (comparative genomic hybridization) which allows analysis of certain genetic properties that are below the limit of detectability by standard karyotyping procedures, such as those commonly used to screen for prenatal abnormalities in amniocentesis evaluations. With a resolution that is 100 times sharper than previous techniques, array CGH can detect properties such as duplications or deletions of genes, alterations in single DNA pairs, and chromosomal translocations that are known to increase the risk of certain diseases including some types of cancer.

After examining a pair of human embryonic stem cell (hESC) lines, the UCLA researchers found genetic abnormalities in more than 7 distinct chromosomal locations. In particular, the scientists examined the “copy number variants” (CNVs), which represent differences in the numbers of specific genes, in these 2 hESC lines.

According to Dr. Michael Teitell, of the Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, and associate professor of pathology and laboratory medicine and a researcher at UCLA’s Jonsson Comprehensive Cancer Center, “Basically, this study shows that the genetic makeup of individual human embryonic stem cell lines is unique in the numbers of copies of certain genes that may control traits and things like disease susceptibility. So in choosing stem cell lines to use for therapeutic applications, you want to know about these differences so you don’t pick a line likely to cause problems for a patient receiving those cells. In studying embryonic stem cell lines in the future, if we find differences in regions of the genome that we know are associated with certain undesirable traits or diseases, we would choose against using such stem cells, provided safer alternative lines are available.”

Many studies throughout the world are currently underway in order to identify the specific genetic “signatures” of various diseases, which, once identified, would then be used to screen for such diseases in existing stem cell lines, before such stem cells would be developed for therapeutic purposes.

Typically, embryonic stem cells have proven to be highly problematic, with genetic mutation being one of the most common problems to plague embryonic stem cells. For this reason, embryonic stem cells have never advanced beyond the laboratory stage, unlike adult stem cells, which are characteristically free of such problems and which are already in clinical use. While the genetic screening of diseases in embryonic stem cells represents an important step in limiting the therapeutic use of such potentially dangerous stem cells, many scientists question whether or not it would be possible at all for embryonic stem cells to pass a thorough and rigorous safety evaluation.

Neuronal Tissue Created From Uterine Stem Cells Used in the Treatment of Parkinson’s Disease

At the 2008 annual meeting of the Society for Gynecologic Investigation (SGI), held this month in San Diego, California, researchers from the Yale School of Medicine reported improvement in mice with Parkinson’s disease who were treated with uterine stem cells. A debilitating neurodegenerative disorder, Parkinson’s disease is characterized by insufficient dopamine action in the motor cortex and basal ganglia regions of the brain. In this study, stem cells that were derived from human endometrial stromal cells were successfully cultured to differentiate into neurons, complete with the characteristic axon-like projections and pyramidal cell bodies. When the differentiated cells were then transferred into the brains of the mice with Parkinson’s disease, the researchers observed not only the growth of new brain cells, but also an increase in dopamine levels in the brains of the mice.

According to Hugh Taylor, M.D., professor in the Department of Obstetrics, Gynecology and Reproductive Sciences, and chief of Reproductive Endocrinology and Infertility at the Yale School of Medicine, “Now we have found that we can turn uterine stem cells into neurons that can boost dopamine levels and partially correct the problem of Parkinson’s disease. The implications of our findings are that women have a ready supply of stem cells that are easily obtained, are differentiable into other cell types, and have great potential for other purposes.”

The scientists were awarded the SGI President’s Presenter Award for their publication.

Stem Cells in Bone Marrow Discovered to Play a Role in Recovery From Respiratory Disease

British scientists at the Imperial College in London have reported that respiratory diseases such as asthma and pulmonary fibrosis automatically trigger the release of the body’s own endogenous stem cells from the bone marrow, which is already recognized as an important site of stem cell activity. Not only are blood cells formed in the bone marrow through hematopoiesis, but mature granulocytes and stem cells such as hematopoietic stem cells, mesenchymal stem cells and fibroblasts are known to reside in the bone marrow.

Now the researchers have found that chemical mediators which are released by lung diseases into the blood stream can trigger the mobilization of these various cells from the bone marrow into the blood from which they are then recruited to the lungs, often with competing objectives, such as inflammation which is caused by the granulocytes, and tissue repair or remodelling which is promoted by the stem cells. Both processes, however, play a role in healing and recovery.

As the researchers explain, “Understanding the factors and molecular mechanisms that regulate the mobilization of granulocytes and stem cells from the bone marrow may lead to the identification of novel therapeutic targets for the treatment of a wide range of respiratory disorders.” Even before such mechanisms are fully understood, the administration of externally derived stem cells could also augment the body’s natural implementation of its own endogenous stem cells in the treatment of respiratory diseases.

Successful Treatment of Critical Limb Ischemia With Adult Stem Cells Wins Award

Dr. Porfirio Hernandez, the Deputy Director of Researchers at the Hematology and Immunology Institute in Cuba, and the main author of a publication entitled, “Autotransplant of Adult Stem Cells in Lower Limb with Critical Ischemia”, has now been awarded with the Dionisio Daza y Chacon prize, granted by the Spanish Magazine of Surgical Research for the best Spanish medical publication of 2007.

After years of conducting laboratory research with animals, Dr. Hernandez and his colleagues began their first adult stem cell clinical trials in 2002, at which time they began using autolgous (in which the donor and the recipient are the same person) stem cell therapy to treat patients who were suffering with peripheral artery disease in their lower limbs.

Similar to the ischemic cardiopathy that is caused by atherosclerosis, and to the cerebrovascular disease that increases the risk of stroke, critical limb ischemia affects the arteries of the lower limbs. Previously, the only form of treatment for the most advanced cases is amputation. Now, however, physicians around the world such as Dr. Hernandez are demonstrating that adult stem cells regenerate ischemic arteries by stimulating angiogenesis in the areas of damaged tissue, thereby restoring proper circulation to the limbs.

Such stem cell techniques are now also being extended to other applications, especially to those maladies that can benefit the most from increased vascularization, such as problems in opthalmology.

Insulin, Aging and Lifespan

Affiliated with Harvard Medical School, the Joslin Diabetes Center is the world’s largest research center and clinic devoted exclusively to the study and treatment of diabetes. Similarly, the Harvard Stem Cell Institute is one of the leading organizations in the world dedicated to scientific collaboration in stem cell biology. Now, researchers from both organizations have discovered that insulin plays a much greater and more important role, in many other physiological processes, than previously realized.

Primarily, insulin is well known for its importance in carbohydrate metabolism, and an insufficiency of insulin in diabetes has been understood for decades to cause a number of life-threatening problems. Additionally, since the 1990s it has been known that insulin inhibits a specific gene regulator protein known as FOXO, which is active not only in diabetes metabolism but also in tumor suppression, in the maintenance of stem cells, and in the control of a variety of genes that are involved in stress resistance.

Now, as the result of experiments conducted on the digestive system of C. elegans, a microscopic worm that is widely used as a research model in laboratories throughout the world, Harvard researchers have discovered that insulin inhibits a master gene regulator protein known as SKN-1, increased activity of which is known to increase lifespan. Additionally, SKN-1 is recognized as controling what is known as the Phase 2 detoxification pathway, which is a network of genes that collaborate to defend cells against oxidative damage such as that caused by free radicals and environmental toxins. As a result of these studies, a reduction in insulin signaling was found to trigger increased activity of both the FOXO and the SKN-1 proteins, thereby increasing resistance to stress and increasing longevity of life.

According to Dr. T. Keith Blackwell, a senior investigator at the Joslin Diabetes Center, associate professor of pathology at Harvard Medical School, a faculty member at the Harvard Stem Cell Institute, and the primary author of the paper, “We’ve found something new that insulin does and it has to be considered when we think about how insulin is affecting our cells and bodies. This has implications for basic biology since under some circumstances insulin may reduce defense against the damaging effects of oxidative stress more than we realize. The major implication is that we have found something new that affects lifespan and aging, and an important new effect that insulin and/or a related hormone called insulin-like growth factor-1 may have in some tissues. The implications go far beyond diabetes.”

Indeed, the work relates not only to diabetes but also to other diseases which are often secondary complications that result from diabetes, such as vascular and renal problems. Additionally, the findings also have much broader implications for health, stress, lifespan and longevity. According to Dr. Blackwell, “You can manipulate the expression of SKN-1 and the worms live longer.” Currently, Dr. Blackwell’s lab is focused on further delineation of the precise molecular mechanisms that regulate free radical resistance and aging.

Certain types of adult stem cells have already been shown to differentiate into the insulin-producing beta islet cells of the pancreas. Combined with Dr. Blackwell’s recent discovery, stem cells once again enter the realm not merely of disease treatment but also of longevity and extended lifespan.

Multiple Sclerosis Patient Improves With Autologous Adult Stem Cell Transplant

Leah Telder of Surrey, British Columbia, had enjoyed ballet dancing until struck with multiple sclerosis in her teens. The demyelinating, auto-immune disorder eventually robbed her of her vision and confined her to a wheelchair. Now 24 years old, Leah is the youngest of seventeen MS patients who have been treated in Canada with their own (autologous) adult stem cells.

Conducted in October of 2007 in Ottawa, the procedure was led by the neurologist Dr. Mark Freedman and the bone marrow transplant specialist Dr. Harold Atkins. In this procedure, stem cells are harvested from the peripheral blood of each patient and are then expanded in a laboratory and readministered after the patient has received a heavy dose of chemotherapy, which is administered with the specific intent of destroying the immune system. Although 16 of the 17 patients are improving as a result of the stem cells, one patient in the study died as a result of the chemotherapy. In fact, at these high doses, each patient has a 5% (or a one in 20) chance of dying from the chemotherapy. Whether or not the chemotherapy even needs to be administered at all is increasingly a topic of debate, and there is strong scientific evidence to support the claim that chemotherapy is unnecessary in this type of stem cell treatment.

Meanwhile, as a result of being treated with this particular chemotherapy procedure, and as a result of being successfully rescued by her own adult stem cells immediately following the chemotherapy procedure, Leah is once again able to walk by herself, and most of her blurred vision has been restored to normal.

Members of Congress are Briefed on the Successes of Adult Stem Cell Therapy

In a bipartisan briefing in Washington, D.C., members of Congress were updated both on the increasing number of successful cases of adult stem cell therapy, and on the increasing number of failures of embryonic stem cells, which have never advanced beyond the laboratory stage.

House Representatives Randy Forbes, a Republican from Virgina, and Daniel Lipinski, a Democrat from Illinois, co-hosted the event in conjunction with the Family Research Council (FRC). Among the researchers testifying before the Congressmen was Dr. Richard Burt of the Feinberg School of Medicine at Northwestern University, whose publication in the Journal of the American Medical Association in February of 2008 garnered widespread attention for its analysis of hundreds of adult stem cell studies that had been conducted between 1997 and 2007, and from which Dr. Burt gathered together an entire decade’s worth of quantitative proof that adult stem cells derived from blood and bone marrow have already been safely and effectively used to treat a number of cardiac and autoimmune disorders.

Congressmen Forbes and Lipinski are promoting the “Patients First Act”, which would legislate and prioritize the funding of stem cell research by stem cell type. According to a representative of the FRC, “Embryonic stem cells have yet to treat a single human patient and this is unlikely to change in the future. Adult stem cells are already providing therapeutic benefit to human patients for 73 diseases and condition.” Also appearing before the Congressmen were several patients who have been successfully treated with adult stem cell therapy, which included Barry Goudy who had been treated for multiple sclerosis, Amy Daniels who had been treated for systemic sclerosis, and Jill Rosen who had been treated for lupus. Each of these individuals spoke about their personal experiences with adult stem cell therapy.