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For Those Considering
Doing Stem Cell Therapy Abroad By Dr. Anthony G.
Payne If you do a
Google search using “stem cell clinic”, you’ll come up with 3,550 websites (This
and other searches done on January 1, 2008) “stem cell
treatment” -- 132,000 websites "adult stem
cell therapy" – 51,000 websites Only a fraction of these listings are
actual facilities offering some form of stem cell therapy, but even so how does
one figure out who is on the up-and-up? That is, who is offering legitimate,
safe forms of stem cell therapy, if
any? And for which diseases or conditions do the various kinds of stem cells
being offered actually work, if any?
Critics, skeptics, and many others
are often quite strident in their denunciation of just about every private,
commercial outfit that offers stem cell treatments – be it fetal cell, umbilical
cord, or other adult stem cells. Many academicians and university-based stem
cell researchers in the US dismiss reports of stellar clinical benefits in
patients treated by private foreign stem cell clinics or hospitals as being
”scams”, “frauds” or the like. Most
argue that no one should be seeking out such treatments, at least not outside of
formal, government sanctioned clinical trials. With regard to the “scam” aspect, I
would ask readers to keep this in mind (This is a quote from an article by
“yours truly” that concerns the almost knee-jerk negative reaction of many stem
cell experts to the ongoing cord blood stem cell work of Fernando Ramirez Del
Rio, M.D. in Mexico. The entire article can be accessed by clicking this link:
Is Something
Amiss?) In
the world of biomedicine, the question of whether a particular drug or procedure
is effective or not is settled in the arena of science – namely, well designed
and executed clinical studies. One doesn’t dismiss a treatment or procedure that
has a rational foundation (i.e., doesn’t violate established scientific laws or
principles) a priori – which is to
say, before conducting tests. But this has been exactly what many experts in
stem cell biology have done when it comes to the observations and data collected
and reported by SRI. Rather than suggest the need for controlled studies to
determine whether or not the clinically significant improvements reported in
scores of patients treated with purified cord blood stem cells in Mexico for
non-blood maladies pan out, many of these scientists have dismissed the entire
treatment as “a scam”. This
is not the kind or degree of informed open-mindedness one would expect of highly
placed researchers in major institutes and universities. Of course, people with conditions or
health challenges that can be managed, ameliorated or such using extant standard
medicines or therapies should steer clear of exotic, experimental or unproved
treatments, drugs, therapies or such. But what about those wrestling with an
intractable or terminal condition like ALS (Lou Gehrig’s), metastatic cancer,
end stage kidney disease, Alzheimer’s, or the like? People for whom waiting to
participate in future clinical trials or to be treated with stem cell therapies
approved in the wake of such trials is not reasonable, as some will die long
before their particular malady has a scientifically proven method of treatment
that will slow or abort their descent? And while many of the intractably ill may
not die, they may be faced with a narrow biological window of opportunity for
improvement that will close if something isn’t done in the near-term. To wait might mean that what could have
been improved today, will be beyond remediation in a few months or years. Is it unreasonable or irrational for
them to reach out and embrace an experimental treatment or therapy (Provided it
has a rational basis – which is to say doesn’t violate known laws of physics or
chemistry, has already been disproved, or carries more risk than benefit)? I think not. This creates a perplexing, sometimes
gut-retching situation in which the medical consumer – the patient – or his
caregivers – must sort through treatments and clinics and come up with “a safe,
best bet”. Even highly intelligent,
educated professionals who are artful in the use of logic and critical thinking
can wind up uncertain, confused, or even overwhelmed. Are there any guidelines that can
help determine which stem cell therapy providers are offering safe,
substantively effective or at least promising treatments? There are. Disclosure I am not a stem cell expert or
biologist, but rather a theoretician. In short, I spin hypotheses and create
inventions geared to improve human health or otherwise benefit folks. But this
said I have been involved in stem cell therapy as an observer, a gatherer of
patient responses, and a communicator of what I’ve learned along the way (I
coauthored Umbilical
Cord Stem Cell Therapy). From March 2003 to June 2007, I was resident
theorist and senior science writer with the Steenblock Research Institute. SRI,
in turn, was retained by Fernando Ramirez Del Rio, M.D. to gather information on
patients treated with adult stem cells at his clinic in Mexico, generate papers
and such concerning our findings, introduce innovative treatment approaches, and
talk with people considering undergoing treatment at his facility. I left SRI at
the end of June 2007 to assume the position of Director of Invention &
Development with Weller Health Institute. While I remain a technical consultant
to Dr. Ramirez, a great deal of my time is devoted to nutraceutical development
and promotion, creation of new health-related technologies and products, and
generation of hypotheses concerning novel approaches to advancing the human
condition. With this background in mind – which
yes, surely means I am not free of biases or blind spots – I will now offer some
of the ways medical consumers in need of stem cell therapy can go about whether a particular facility or
treatment provides safe and effective (or at least suitably promising) stem cell
treatments. Mind you, this set of guidelines and pointers is not slanted towards
any particular clinic, hospital, research center, doctor or group. In fact, I
will not list a single facility or stem cell provider by name. Instead, I will
try to provide readers with a fairly sturdy fishing pole and leave it to you to
do the fishing. Most of what I have to share is
informed by simple, good sense, critical thinking principles widely articulated
and embraced by skeptics and consumer advocate groups everywhere on the
Internet. A few of my pointers are derived from my own experiences and insights
gained from “being in the trenches” and are thus unique to having “insider
knowledge.” Sorting Wheat from
Chaff Stem Cell Types Used
by Most Private Stem Cell Treatment Facilities Private stem cell clinics around the
world by-and-large offer treatments involving adult stem cells - typically
fetal, umbilical cord stem cells, or various progenitor or other adult stem
cells taken from the patient’s peripheral circulation or various tissues. If you
are uncertain as to what is meant by the term “stem cells” or are unacquainted
with the different types, click this link: Stem Cell
Basics Some stem cell clinics and treatment
centers provide autologous bone marrow stem cell therapy, which in this context
means bone marrow is removed from a patient and either immediately reinfused
with or without growth factors, hormones or such, or else BM mesenchymal stem
cells are separated from a patient’s own marrow sample, are cultured and
possibly treated to differentiate (transform them into) special cell types, and
then reinfused.
And there are also clinics that take
a person’s own stem cells from fat or other body tissues, manipulate them in
some instances so as to favor their becoming specific cell types, and inject or
infuse them for therapeutic or cosmetic purposes. I have not mentioned use of embryonic
stem cells because, to my knowledge, no private stem cell clinic or center
anywhere in the world offers genuine embryonic stem cell therapy. Why? Embryonic
stem cells can cause cancer when implanted. For example, if you give embryonic
stem cells to 10 rats, 1 of these rats will develop a tumor celled a teratoma.
Critics point out that most of these
adult stem cells are limited as to what they will become, meaning that (for
example) a cord blood stem cell is not likely to become a functional neuron
(Unless manipulated in the lab and then infused into the patient). However,
there is evidence that some adult stem cells take cues from the tissue milieu
they engraft in and begin to assume characteristics of their cellular neighbors.
For instance, stem cell researcher, Dr. Paul
R. Sanberg and his team at the University of South Florida found that a
specific type of hematopoietic cell from umbilical cord blood “expressed nestin
and doublecortin, markers of endogenous neural progenitors” when transplanted
into the brains of rats” PMID
15048922 This finding gels with those of other animal
studies. However, it is not even necessary for
an adult stem cell that migrates (or is directly implanted) into a diseased or
injured organ to behave like the surrounding cells in order to have a salutary
effect. Many studies have shown that at least some adult stem cells produce
specific cytokines and growth factors that can promote local repair or otherwise
foster improved function PMID:
16730351.
Evidence of
Efficacy People looking into stem cell therapy
tend (in my experience) to have an intractable condition or an incurable one or
else are a caregiver or relative or friend of someone in that boat. This can
lend folks to jump; to make decisions based on hunches or hope informed by
“Well, if that guy got better then maybe I will too”. Desperation is surely the
father of gullibility, something that has transformed P.T. Barnum’s (or was it
Joseph
"Paper Collar Joe" Bessimer’s?)
famous observation that
“"There's
a sucker born every minute" into both gospel and
prophecy. It’s understandable that people find
solace and hope in testimonials. Most of the leading private stem cell clinics
and treatment centers maintain websites that “runneth over” with patient
testimonials. If you have non-familial ALS – and there are 4 case histories
posted that were written by people with non-familial ALS who did stem treatment
y and saw improvements – then isn’t that reason enough to believe you will too?
No it isn’t. Consider: How many people with
non-familial ALS did the treatment and saw no response? And of those with a
positive response, to what degree were they improved and how long did it last on
average? If 4 patients out of 100 saw minor improvements that lasted only a few
months – and the treatment cost (say) $20K – would you say the balance sheet
tallies up in favor of forging ahead and doing it? Well, maybe I’ll be one of the lucky
four? But what if 2 of the 4 were using a novel drug or regimen prior and/or
following their treatment (Something not picked up by the treating clinic and
reported)? Or these 4 happen to
have a genetic variant of ALS that lends them to experience remissions of a sort
– minor improvements that last a short time? Yes, the treatment would be
credited for improvements it would likely have not played a role in effecting.
Indeed, some therapies and drugs kick in even after being discontinued.
Keep in mind that in the world of
science, testimonials are the weakest kind of evidence. At best they may point
to something happening or working, which might justify doing a formal evaluation
(Controlled studies). I am not arguing that they be discounted totally, only
scrutinized. Resist lending them too much credence. And ask your stem cell
clinic contact to provide some figures on their failure rate (number & type)
of treated patients with your disease or condition. If they don’t have this information or
state that there are very few or no failures, they are likely either dishonest,
mistaken or prone to filter out failures or narrowly define them (An all too
human failing that can only be overcome by well designed studies that minimize
human failings). In my dealings with various stem cell
operations throughout the world, I have found most providers to be genuinely and
sincerely devoted to helping people get well or better. Most are not scientists,
but typically clinicians who feel that their particular cell therapy approach is
producing tangible healing responses with respect to certain kinds of diseases
or conditions. I have heard of, but yet to chat with or meet any stem cell
clinic administrator, provider or clinician who makes claims that are genuinely
extraordinary. They appear to be few in number. Most I’ve interacted with admit
they have “their fair share of successes and failures.” Many of the stem cell therapists I‘ve
informally surveyed define clinical success in nebulous terms, but at the same
time appear to have a genuine dilemma when it comes to quantifying some kinds of
improvement. For example, in some patients with neurologic issues, a single
improvement – say, slightly moving a left pinky finger that didn’t move
previously – is a substantial gain; and this even if other paralyzed limbs or
body parts remain as “dead as a doornail”. In light of this, yes, there is a
subjective element to patient responses that makes quantification in some
instances problematic. Especially if patients with specific conditions like
chronic stroke show responses that are clinically but not statistically
significant (And then, too many can show an improvement that is difficult to
measure – say, being able to make a vowel sound they couldn’t prior to treatment
– and for which no objective changes are detected on brain scans or such). But, and this is a big but, stem cell
providers should be willing and able to articulate not only their failures, but
also communicate some idea of general
trends. For example, were most
of the motor skill improvements in children with cerebral palsy treated with
“stem cell z” minor (in the judgment of their parents and physical therapists or
pediatricians back home)? Or major?
Both? (And if both, what was the major improvement trends overall – as well as
the minor?) Also, ideally the stem cell provider
will maintain not just a roster of “good responders” who are willing to phone or
e-mail chat with inquirers, but also a list of “poor or non-responders” who are
willing to share their experiences or lack of same. This isn’t an unreasonable
thing to expect of clinic operators, though granted some will not have been in
operation long enough to accrue this kind of information or (in the case of
those that have) may not have many “poor or non-responders” willing to step up
to the plate. There is an element here of weighing all considerations – being
skeptical – but not necessarily to the point of tossing the baby out with the
dirty bathwater. One other way to get a handle on any
downside of a clinic’s treatment is to search blogs maintained by patients,
consumer advocates, specific disease associations and foundations and such. I
have seen patients, for example, with ALS treated at various clinics in China
post their thoughts – pro and con – on various ALS foundation blog sites.
Does this sound like a lot of
digging, investigating, analyzing, comparing and thinking? Well, it is. But
you’d probably do no less when it comes to buying a new or pre-owned car, right?
You’d kick the tires, check under the hood, make sure it’s mechanically sound,
check out online reviews and comments from folks who own a similar machine, and
do some price comparison shopping to boot. So would want to put less effort into
evaluating a foreign stem cell operation than they would the purchase of an
automobile? So we’ve considered the issue of
evidence (or lack thereof) of efficacy. And yes, again, while a consensus
derived from many randomized controlled clinical studies is what is needed to
reliably determine efficacy, this kind of proof simply does not exist yet when
it comes to private stem cell operations. The best we typically see is a pilot
study or clinical experiment such as Fetal Cells Given
in Ecuador Helps Mend Hearts - 2005 that may justify further, more formal
investigation by scientists. What we see by-and-large are patient testimonials
in written and video form. There is no surefire way to reliably determine
effectiveness of a particular stem treatment for condition x from these, but
with some “due diligence” (careful research and digging and such), it is
possible to detect whether that white stuff you think you see is smoke or dust
caught in a wind gust. Issues Related to
Safety The first issue with respect to
safety and any kind of stem cell treatment is disease screening. Of course, this
is not an issue when it comes to use of autologous (A patient’s own) stem cells.
But for allogenic cells or those that come from a donor, screening for major
infectious disease-causing microorganisms such as HIV, Hepatitis A, B & C,
cytomegalovirus, and so forth is imperative. Most of the private stem cell clinics
I have surveyed (since 2003) are careful to provide only cells that have been
rigorously screened by a reputable independent laboratory. Some clinics that
rely on cells from an affiliated hospital get their testing done in-house – in a
lab that utilizes the very latest & best disease screening technology.
For medical consumers, nothing can be
taken for granted. Ask for a copy of the specific lab test results for the batch
of cells you are slated to receive. You should see a lot # that corresponds to
the vial(s) or IV bags that are to be used for your treatment. There should also
be a company or department name and phone number. Call the lab and check things
out. Look up the lab or department online or in a business or phone directory to
make sure the address and/or phone # on your lab results matches that of the
contact information in the directory listing. Keep in mind that some foreign stem
cell clinics get their cells from an in-house lab or independent one that
imports cord blood or fetal material that was disease screened in the exporting
country. For example, clinic x in Mexico gets their cord blood stem cells from
disease-screened cord blood that’s imported into Mexico from America and
processed in an in-house, but FDA standards compliant lab. In this instance, the
clinic or its affiliated lab should be able to show the US disease screening
certification that accompanied the UC blood that was used to produce the cells
that will be used to treat a given patient. Naturally, legitimate stem cell
clinics and treatment centers are concerned about the quality of care they
provide their patients. In this day of ultra-quick dissemination of information
on the Internet, it doesn’t take long for a lousy clinic or provider to be
exposed, cussed and discussed. This is good for patients and their caregivers,
and also for the stem cell treatment providers too – for it helps to keep them
honest. If they fall off in terms of the quality of their therapies or care,
word gets around fast and their revenue suffers (which, in turn, would tend to
get their attention and motivate them to remedy their deficiencies). Many
clinics that refuse to provide disease screening proof to their patients wind up
having this show up on Internet web & blog sites – making it easy for
browsers to learn about their recalcitrance with a simple Google search. This
alone can save time and effort when checking out a clinic or treatment provider.
Disease screening is one major issue.
The chance of rejection (Host vs. Graft or HvG) is another – at least with
respect to allogenic (non-self) cell treatments. When it comes to matching donor and
recipient in terms of HLA compatibility, this is a must when it comes to a cord
blood transfusion. However, this said it must be pointed out that mismatched
blood given intentionally to children with leukemia had a salutary effect, as it
is reported to have had in off-label use on ALS patients. But what about pure cord blood stem
cells? Well, some scientists have noted that pure cord blood stem cells have a
very low immunoreactivity, which is to say they do not appear to set off notable
adverse immune reactions in recipient animals and humans. For example, in one animal experiment
researchers found that when human cord blood stem cells were surgically
implanted into rats with induced spinal cord injuries, no signs of rejection
cropped up. And so far as I can tell from the
world scientific literature, pure cord blood stem cells seem to seldom trigger
Host v. Graft reactions. This gels with my own experience in which I tracked
over 500 patients treated with cord blood stem therapy by Fernando Ramirez Del
Rio, M.D. from March 2003 to June 2007 and saw virtually no adverse reactions
(Not even many, many months after treatment). This was true of both low dose
infusions (1.5 million cells), as well as high does (40 million cells+). Those
that were seen -- mostly mild rashes -- were found to be due to a failure to
remove the stem cells from the growth factor-rich media they had been cultured
in. Once the cord stem cells used by Dr. Ramirez were removed from the growth
media prior to final processing, all such reactions ceased.
This said, it is possible that very
low level immunoreactivity goes on and that this conceivably inhibits the
activity of the stem cells or even prompts their gradual elimination (Possibly
within days or week of infusion). A prudent precaution against this might be for
stem cell therapists to place their patients on an immunosuppressant drug such
as Cyclosporine
short-term. So far as I can tell, few if any private stem cell clinics do
this. Fetal cells taken from early stage
aborted fetuses also appear to have a very low probability of causing a Host vs.
Graft reaction. This said, the
disease screening and documentation discussed above with respect to UC-derived
stem cells applies to any sort of fetal cell therapy as well, as do
precautionary use of immunosuppressants. Issues Related to the
Treatment Provider or Chief Physician + Medical
Emergencies In some foreign countries that allow
stem cell clinics to operate legally, it is difficult to verify practitioner
credentials or standing. It is difficult, but not impossible. When asked for a
copy of their degree and license, most foreign doctors engaged in legitimate
stem cell work willing provide this by mail, FAX or such. Some post it to their
website. And when it comes to documents in an unfamiliar foreign language, this
possesses no problem as they can be readily translated to English using any
number of free online or commercially available translation software
programs.
Schools can be checked out using
UNESCO’s list of accredited institutions of higher learning throughout the world
UNESCO Worldwide
School Database Mind you, this list is not necessarily complete. If a school
doesn’t appear, check with the appropriate accreditation agency or authority in
the country in which the degree in question was issued. Once one is satisfied that the
treating physician is indeed a duly credentialed and licensed physician, there
is the question of qualifications to do stem cell therapy. Now, while it isn’t
necessary that a physician giving fetal or cord blood stem cells to patients be
a stem cell biology expert or hematologist or such, a background that includes
training in these areas or in cell or tissue transplantation is obviously a
plus. More importantly, a treating
physician should be trained and adept at spotting problematic reactions or side
effects and dealing with them using the appropriate, standard medical drugs or
other forms of intervention. If he or she is not versed in this area of
medicine, then certainly a physician should be on-hand or on call that is. This
is a legitimate concern and should not pose a problem for the treating clinic in
terms of providing evidence that satisfies the patient and his or her caregivers
and/or family. Seriously ill folks traveling to a
foreign country for any kind of stem cell therapy also need to ask about and
look into the availability of local emergency hospital services. While the odds
of getting hit by a sudden medical crisis may be low in most instances, it is
reassuring and prudent to know there is a well equipped ER in the vicinity
should (God forbid) an existing health challenge head south or a new one arise
unexpectedly. The availability of English fluent or near fluent doctors is a big
plus. Issues Related to Patient Pre-Treatment
Conditioning -- “To Prep or Not To Prep” Among the general trends that emerged
from my own involvement in tracking cord blood stem cell recipients and in the
exploration & development of pre- and post- treatment support protocols were
these: (1) The younger the patient, the better the healing response tends to be
(overall); (2) Adult patients with acute conditions treated early on have more
vigorous responses than those with longstanding (chronic) conditions, injuries
or health challenges; and (3) Older patients, especially elderly, often showed
the least impressive responses. This appeared to be especially true of those
patients who had abused their bodies and looked and had age-related biomarkers indicating they
were much older than their chronological age. The impact of aging and self-abuse on
physiologic responses to cell therapy isn’t really surprising. If one is
planting seeds in a field, fertile soil will always produce a better yield than
soil depleted of specific nutrients or laden with high levels of toxic compounds
or substances. In terms of older candidates for stem cell therapy, this comes
down to identifying remediable factors that might compromise stem cell integrity
or activity and reducing or eliminating as many of them as possible (I say
“remediable” because there are some antiproliferative or cytotoxic compounds
that accumulate in tissues over time that appear difficult if not impossible to
liberate and safely remove). This
perspective informed the development of screening recommendations and dietary
& lifestyle specific for older neurologic and non-neurologic patients by
staff members including myself at SRI during 2003-5. These included bringing
patient’s diet into conformity with our evolved nature (PALEODIET), as well as testing for heavy
metals toxicity, e.g., lead, mercury, cadmium, etc. and having the patient’s
doctor deal with this. Older
patients who religiously adhered to these protocols did, on a whole, fare better
in terms of responses to cord blood stem cell therapy than those who didn’t.
However, the difference was oftentimes marginal or weak. This was disappointing
and frustrating, of course. Something more was – and is – needed; some factor or
factors that will help systemically rejuvenate the tissue milieu so that
existing (or native) stem cells can thrive as well as any stem cells introduced
exogenously. Or were
my colleagues and I at SRI wrong altogether? After all, many stem cell clinics
and center state that no special dietary changes, lifestyle adjustments or other
bodily prepping is needed to help bolster post-treatment response. While it is too early to say for sure
which point-of-view is right, there is now published research that seems to
favor prepping the tissue milieu. Here are two: Microenvironment
and stem cell properties for bone-marrow derived
mesenchymals “We discuss here how the
microenvironmental cues, and the growth factors that physiologically govern
commitment and subsequent differentiation, influence the properties of bone
marrow stromal cells and modulate their engraftment into host
tissues.” Scientists
determine stem cells' 'age' “Researchers
at the Salk Institute for Biological Studies said a stem cell's immediate
neighborhood -- a specialized environment also known as the stem cell niche --
provides crucial support needed for stem cell maintenance. But scientists
discovered that level of support diminishes during aging, thereby affecting stem
cells' ability to indefinitely self-renew. You can manipulate stem cells and
propagate them in a dish but many recipients of stem cell replacement therapies
will be older individuals. If the stem cell niche has aged, it might not be
capable of supporting the transplanted stem cells" (Assistant Professor Leanne
Jones) Of
course, even if the stem cell niche is compromised in older folks, how does one
rejuvenate it or otherwise create a more stem cell favorable environment? The
dietary measures and such cited above appear to confer some marginal benefits –
perhaps “rejuvenating” to some small degree the stem cell niche – but this alone
is insufficient. Barring development of a time machine, de-aging a person’s
bodily tissues looks to be an almost Herculean challenge. But it isn’t
insurmountable. There is, in fact, experiments in-progress at several private
and public research centers in various countries that may pave the way for
systemically “de-aging” tissues in older adults such that the stem cell niche
will indeed become more youthful. In
the meantime, the issue of prepping or conditioning older patients using
techniques and lifestyle modifications like special diets, heavy metals testing
and treatment of those found to have a heavy metal burden (toxicity), and such
boils down to a judgment call on the part of physicians doing stem cell therapy. To
prep or condition patients prior to stem cell therapy seems a logical,
straightforward, prudent measure, but this doesn’t mean that doctors and stem
cell treatment facilities that eschew this are wrong. Those interested in doing
stem cell therapy are certainly encouraged to learn more and discuss this with
those who will provide their particular form of stem cell therapy. Issues Related to
Mode of Administering or Implanting Stem Cells According to a survey I made during
2005, most private stem cell clinics or centers treat their stem cell patients –
regardless of whether they are utilizing bone marrow or cord blood stem cells or
fetal cells – by IV drip. This places the cells into the body’s circulatory
system where they presumably travel about until they either lodge in a tissue or
organ or migrate to same in response to specific signals generated by diseased,
injured or dysfunction tissues or organs (such as stromal derived
factor-1). Dr. Paul Sanberg’s
animal studies involving cord blood stem cells indicate that these cells tend to
migrate to newly damaged tissue, whether introduced in the peripheral vascular
system or directly into the afflicted organ (His studies focused on CNS damage
such as induce strokes). Cells administered by IV would not,
however, necessary breech the blood-brain barrier
that keeps most chemicals with a molecular
weight higher than 500 daltons
out of the brain. One
way to circumvent is to open up the BBB by use of a drug such as mannitol, which is what some
stem cell clinics do. Another and most likely surer way to insure delivery of
cells to the CNS is by direct catheter infusion or direct surgical implant. The
catheter infusion method typically involves introducing a catheter into the
femoral artery in the leg and snaking it up through the circulatory system into
the brain. Cells can also be implanted in the brain by stereotactic
surgery, a process in which a patient’s head is locked in a special
apparatus, very small holes are drilled in the patient’s skull very thin needles
are scanner guided to target, and stem cells are injected. Cells can be introduced into certain
spinal regions by direct surgical implant and intrathecal
injection. As the saying goes, “the right tool
for the right job”. For patients, say, with a specific brain injury, this may mean foregoing an IV approach –
as this would probably result in few cells reaching their injured tissues – and
having a catheter or direct implant done. So far as I have been able to
ascertain, only a handful of private stem cell clinics and centers in the world
have the personnel, equipment and experience to safely perform catheter infusion
and direct implant procedures. If you happen to find yourself or a loved one
faced with needing this type of intervention, look for a clinic that has
qualified, experienced medical personnel and the proper surgical room equipment.
For example, the surgical team needed for doing a catheter infusion typically
consists of an interventional
radiologist, an anesthesiologist,
possibly a neurosurgeon, and an OR (operating room) nurse and sometimes several
other techs or nurses. The
operating room should have suitable surgical scanning equipment for guiding the
catheter through the circulatory system, a proper anesthesia set-up, vital signs
monitoring devices, and equipment for resuscitation and other emergency
intervention should a medical glitch or problem arise. Concluding
Remarks This look into the issues and
concerns that confront those seeking treatment with adult stem cells abroad is
obviously far from exhaustive. It is hoped, however, that it will ably serve as
a basic template or framework readers can use to help shape their own queries
into this fascinating and controversial subject. Nota Bene: Readers are encouraged to share
their findings with me by e-mail. Those who have gone abroad for any kind of
stem, progenitor and other forms of cell
therapy are also welcome to send me their accounts – responses (if any),
impressions of their treating facility and doctor or doctors, any problems or
side effects that cropped up, and so forth. My e-mail address is biotheoretician@gmail.com © 2008 by Dr. Anthony G Payne. All rights
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Accreditation
(Educational): Accreditation Issues -
Wikipedia Entry “Despite
the widely recognized benefits and accountability of accreditation, some
institutions choose, for various reasons, not to participate in an accreditation
process. According to the United States Department of Education, it is possible
for postsecondary educational institutions and programs to elect not to seek
accreditation but nevertheless provide a quality postsecondary
education.” Anti-rejection
drugs:
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Biomarkers of aging: Biomarkers of Aging -
abstracts (Commerical Site) Critical Thinking: Carl Sagan's "The
Demon Haunted World" DR. CARL SAGAN - Wikipedia
entry Operation Clambake
presents: Baloney Detection Kit The
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Thinking Test Dr. Paul R. Sanberg’s Cord
Blood-Related Papers – Selected Sample (from PubMed) Shytle
RD, Ehrhart J, Tan J, Vila J, Cole M, Sanberg CD, Sanberg PR, Bickford
PC. Oxidative stress of neural, hematopoietic, and stem
cells: protection by natural compounds. Rejuvenation Res. 2007 Jun;10(2):173-8. PMID: 17518694 El-Badri
NS, Hakki A, Saporta S, Liang X, Madhusodanan S, Willing AE, Sanberg CD, Sanberg
PR. Cord blood mesenchymal stem cells: Potential use in
neurological disorders. Stem Cells Dev. 2006 Aug;15(4):497-506. PMID: 16978054 Newman
MB, Willing AE, Manresa JJ, Sanberg CD, Sanberg PR. Cytokines produced by cultured human umbilical cord
blood (HUCB) cells: implications for brain repair. Exp
Neurol. 2006 May;199(1):201-8. Epub 2006 May 30. PMID: 16730351 Bickford
PC, Tan J, Shytle RD, Sanberg CD, El-Badri N, Sanberg
PR. Nutraceuticals synergistically promote proliferation of
human stem cells. Stem Cells Dev. 2006 Feb;15(1):118-23. PMID: 16522169 Newcomb
JD, Ajmo CT Jr, Sanberg CD, Sanberg PR, Pennypacker KR, Willing
AE. Timing of cord blood treatment after experimental stroke
determines therapeutic efficacy. Cell Transplant. 2006;15(3):213-23. PMID: 16719056 Human umbilical cord blood progenitors: the potential of
these hematopoietic cells to become neural. Stem Cells. 2005 Nov-Dec;23(10):1560-70. Epub 2005 Aug 4. PMID: 16081669 Anti-inflammatory effects of human cord blood cells in a
rat model of stroke. Stem Cells Dev. 2005 Oct;14(5):595-604. PMID: 16305344 Newman
MB, Willing AE, Manresa JJ, Davis-Sanberg C, Sanberg
PR. Stroke-induced migration of human umbilical cord blood
cells: time course and cytokines. Stem Cells Dev. 2005 Oct;14(5):576-86. PMID: 16305342 Nan
Z, Grande A, Sanberg CD, Sanberg PR, Low WC. Infusion of human umbilical cord blood ameliorates
neurologic deficits in rats with hemorrhagic brain injury. Ann
N Y Acad Sci. 2005 May;1049:84-96. PMID: 15965109 Borlongan
CV, Hadman M, Sanberg CD, Sanberg PR. Central nervous system entry of peripherally injected
umbilical cord blood cells is not required for neuroprotection in
stroke. Stroke. 2004 Oct;35(10):2385-9. Epub 2004 Sep 2.
PMID: 15345799 Infusion of human umbilical cord blood cells in a rat
model of stroke dose-dependently rescues behavioral deficits and reduces infarct
volume. Stroke. 2004 Oct;35(10):2390-5. Epub 2004 Aug 19.
PMID: 15322304 Do
hematopoietic cells exposed to a neurogenic environment mimic properties of
endogenous neural precursors? J
Neurosci Res. 2004 Apr 15;76(2):244-54. PMID: 15048922 Saporta
S, Kim JJ, Willing AE, Fu ES, Davis CD, Sanberg PR. Human umbilical cord blood stem cells infusion in spinal
cord injury: engraftment and beneficial influence on
behavior. J
Hematother Stem Cell Res. 2003 Jun;12(3):271-8. PMID: 12857368 Garbuzova-Davis
S, Willing AE, Zigova T, Saporta S, Justen EB, Lane JC, Hudson JE, Chen N, Davis
CD, Sanberg PR.Intravenous administration of human umbilical cord blood
cells in a mouse model of amyotrophic lateral sclerosis: distribution,
migration, and differentiation. J
Hematother Stem Cell Res. 2003 Jun;12(3):255-70. PMID: 12857367 Willing
AE, Vendrame M, Mallery J, Cassady CJ, Davis CD, Sanchez-Ramos J, Sanberg
PR. Mobilized peripheral blood cells administered
intravenously produce functional recovery in stroke. Cell Transplant. 2003;12(4):449-54. PMID: 12911133 Lu
D, Sanberg PR, Mahmood A, Li Y, Wang L, Sanchez-Ramos J, Chopp
M. Intravenous administration of human umbilical cord blood
reduces neurological deficit in the rat after traumatic brain
injury. Cell Transplant. 2002;11(3):275-81. PMID: 12075993 Zigova
T, Song S, Willing AE, Hudson JE, Newman MB, Saporta S, Sanchez-Ramos J, Sanberg
PR. Human umbilical cord blood cells express neural antigens
after transplantation into the developing rat brain. Cell Transplant. 2002;11(3):265-74. PMID: 12075992 Expression of neural markers in human umbilical cord
blood. Exp
Neurol. 2001 Sep;171(1):109-15. PMID: 11520125 Stem Cells Stem Cell
Basics - Clearly Explained.com The Paleodiet: “According
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(Amazon.com Review) |