Showing posts with label bone marrow stem cells. Show all posts
Showing posts with label bone marrow stem cells. Show all posts

Sunday, October 7, 2018

√ Animated Map Video Shows Wildfire Spread Of Us Stem Cell Clinics Lacking Fda Approval

There are now so many clinics selling non-FDA approved stem cell offerings across the U.S. that tens or hundreds of thousands of patients are at risk. How did we get here?


What if we had a way of understanding how stem cell clinics spread across the U.S. in the first place? For example, an animated map showing the spread of stem cell clinics selling non-FDA approved “treatments” across the U.S. would be useful. With publication of our new paper, the recent work of Leigh Turner and I provides just such a map (also see video below).



When Leigh and I published our 2016 Cell Stem Cell study showing almost 600 stem cell clinics selling non-FDA approved offerings across the U.S., many people were surprised at the extent of this for-profit, direct-to-consumer clinic industry in America operating without FDA approval. The first question many readers asked me was similar, “Where did all these clinics come from and when did they first pop up?” The same kinds of questions arose from the piece that came out just a bit later from a team led by John Rasko.


Our newly published Regenerative Medicine paper including the animated map provides a compelling visual answer.


There are now so many clinics selling non √ Animated map video shows wildfire spread of US stem cell clinics lacking FDA approval
Knoepfler & Turner, Regenerative Medicine 2018

As of 2008 we didn’t find evidence in Internet archives of stem cell clinics marketing on the web. Within the first few years after that there were just a handful of clinics (see screenshot above of 2010) and the early ones were in California, Florida, Texas, and Colorado, but in subsequent years their abundance exploded across the country. In just the last few years, about 100 or more new clinics have popped up yearly on the web leading to today’s seriously problematic situation.


A good portion of this wild growth of clinics selling potentially risky stem cells is attributable to lack of FDA oversight actions in past years along with aggressive expansion efforts by many of the clinics and clinic suppliers to raise profits by spreading in a way reminiscent of franchising. Imagine if the Obama FDA had taken some substantial action in 6-7 years ago on the non-compliant clinics? I doubt that we’d have the scope of masalah that we have today. Leigh, I, and others have been pushing the FDA for a very long time to act, but without much luck.


Will the new Trump FDA more actively and successfully rein in the clinic industry so less risk is posed to patients and the stem cell field overall? So far what I’ve seen is hopeful signs, but it’s a huge task that the agency has indicated they may not have the bandwidth to tackle in total. Still, the FDA needs to do relatively more and I’m hopefully they will. Even acting on say the top 20 firms that the agency views as the highest risk could have a positive domino effect.


In our new paper, Leigh and I also found that clinics marketing certain conditions and types of stem cells exhibited specific trends over the years. For instance amniotic stem cell clinics, while lagging behind bone marrow and fat stem cell clinics in numbers, show a sharp upward trend. This spike fits with increasing mainstream media advertising efforts by amniotic clinics.


While Leigh and I documented the nearly 600 clinics as of 2016, my sense is that there are likely to be upwards of 700 clinics today. What will the map of stem cell clinics look like in 2019 or 2020? What do you think? Fewer? More? Or about the same number of clinics? What would similar temporal maps of clinics in other countries look like?


The research we’ve done and published in the last few years hopefully will provide a foundation for future efforts to get additional hard data on the for-profit stem cell clinic arena including the direct-to-consumer marketplace that in my opinion poses the highest risks both to patients and the stem cell field.



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Sunday, September 9, 2018

√ 3 Bits Of Stem Cell Good News

Periodically I also try to post (as I am today) specifically about stem cell good news amongst all the swirling developments out there. You can see the most recent past installment focused on good news here that include vascularized organoids. I recently stumbled on this quote that for me linked up the potential of stem cells and good news, probably because I’m a stem cell scientist:


“Everyone has inside of him a piece of good news. The good news is that you don’t know how great you can be! How much you can love! What you can accomplish! And what your potential is!”


The above quote is attributed to the inspirational Anne Frank.


Here are 3 bits of recent stem cell good news.


The very important, long-term possibility of stem cells for chronic spinal cord injury moves a smidgen forward. A Cell Stem Cell paper entitled “A First-in-Human, Phase I Study of Neural Stem Cell Transplantation for Chronic Spinal Cord Injury” is a small, preliminary reason to see hope. The authors are appropriately cautious, “Despite these encouraging secondary data, we emphasize that this safety trial lacks statistical power or a control group needed to evaluate functional changes resulting from cell grafting.”


 specifically about stem cell good news amongst all the swirling developments out there √ 3 bits of stem cell good news
Baby Eliana who received an in utero stem cell transplant from her mother. Photo Credit Noah Berger of UCSF.

Stem cells transplanted in utero may have helped a baby Eliana (pictured above with her parents) with alpha thalassemia major. MIT Tech Review covered it with a concise piece entitled, “A stemcell transplant in the womb appears to have saved a baby girl.” From the piece, “The procedure: A team at the University of California, San Francisco extracted bone marrow from the mother-to-be between the 18th and 25th weeks of pregnancy and isolated stem cells from it. They then injected the cells into the fetus’s umbilical vein, allowing them to circulate through the bloodstream and develop into healthy blood cells.” I expect we’ll see more in utero stem cell transplants in the coming year and this current development checks a box on my prediction #5 in my top 20 predictions for stem cells and regenerative medicine for 2018.


Prizes! It’s also great to see researchers in the stem cell and regenerative medicine field getting more recognition including via prizes. The Niche blog gives out a yearly Stem Cell Person of the Year Award, while there are other awards out there too such as the Ogawa-Yamanaka Prize.


The newest one is the Sartorius & Science Prize In Regenerative Medicine And Cell Therapy, which began last year. The winner gets $25K and there are other components to this as well. To be eligible you must be within 10 years of your last degree. Nominations are now open for the 2018 Sartorius Prize. You can also always send me nominations for the Stem Cell Person of the Year Award as well.


What other recent stem cell good news is out there?



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Friday, July 27, 2018

√ ‘So You Don’T Get Eyeball In Your Hand’: Astonishing Swedish Medical Center Regen Med ‘Infomercial’

Swedish Medical Center in Seattle is now marketing regenerative medicine therapies including some things that in my view are not really scientifically proven to work. This is part of a bigger isu terkini where more legit medical centers have begun selling regenerative medicine “treatments” that are still being developed. Sometimes they even engage in questionable marketing of this stuff too. The latest entry here is unbelievable in some ways.



In the above segment sponsored by Swedish on a show called New Day Northwest on King 5 TV in Seattle, Swedish provider Adam Pourcho, D.O. touts platelet rich plasma (PRP) and bone marrow stem cells as great options for those suffering orthopedic injuries. Here is a partial text version of the TV video segment.


While there is a lot of enthusiasm amongst some groups of physicians around the world about PRP, rigorous clinical trial results have varied, with some reporting better results with PRP versus standard care (new study here), but others (e.g. here) showed no significant benefit from PRP above standard care. So PRP could have some benefits in the orthopedics arena, but it’s not some kind of magic bullet.


Still, at this level this TV segment is not that surprising a development even if it seems a bit concerning. However, in my opinion some specifics of Pourcho’s statements on this sponsored TV show seem inaccurate and some statements seem mindboggling, at least to me. For instance, we have these claims:



  • Platelets are the body’s natural healing particles.

  • If you were to get a cut on your hands, blood would go to the area and bring with it the platelets those platelets would get there and release growth factors, hundreds of them.

  • Those growth factors (released by the platelets) are the programming cells for your brain.

  • Those “growth factors” give signals to your brain. They identify injured tissue like muscle, tendons, or ligaments.

  • The growth factors tell the brain “please heal it” (meaning the injury) and what tissue is injured “so you don’t get eyeball in your hand.”

  • Your platelets tell your brain what kind of stem cells to send to the area.


Really?


He appears to be claiming that the human body is able to heal local tissue injuries with the right, location-appropriate cells because platelets communicate with your brain via growth factors to tell the brain what kind of stem cells to then send to the particular damaged area.


Swedish Medical Center in Seattle is now marketing regenerative medicine therapies includi √ ‘So you don’t get eyeball in your hand’: astonishing Swedish Medical Center regen med ‘infomercial’
Screenshot of Swedish’s Adam Pourcho talking about Regenerative Medicine on King 5 TV.

This is how the human physiology of injury response works? Not that I know of. Furthermore, how does this explain how injections of PRP produced from systemically isolated blood help specific tissue injuries?


How would your brain send different kinds of stem cells to different tissues? And what happened to the established roles of local populations of stem and precursor cells already in the affected tissues? I have many other questions too.


Dr. Pourcho is extremely upbeat. He says he has gotten these treatments himself. One of his patients also reported feeling better on the show. New Day NW host Margaret Larson seems super excited.


Overall to me this sponsored TV segment (Swedish paid?) almost had the feel of an unproven stem cell clinic infomercial.


I hope we don’t see more of these, but I bet we will.



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