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The human body has many different types of cells, each with a different structure and function. For example, your skin cells are built to protect your body while your nerve cells are built to transmit signals through your body.
Stem cells are like a blank canvas; they do not have a specific structure or function. However, they do have the ability to take on the structure and function of another type of cell (e.g. a skin cell) if they are placed in the right environment and under the right conditions. You can find stem cells all throughout your body. When a cell is worn-out, your body uses stem cells to grow a replacement.
Stem cell therapy is essentially taking these blank canvas cells and injecting them into the body to help the body repair and replace damaged cells (this is called regenerative medicine). Let’s talk about the three types of stem cells that can be used in stem cell therapy;
These stem cells are taken from the organs or tissues of the patient (autologous) or from a donor (allogeneic). They can grow into a specific set of cells based on where in the body they are taken from, this is called multipotency. For example, if you take stem cells from the skin of an adult, the cells will only be able to grow into new skin cells. They will not be able to grow into other types of cells (e.g. nerve cells).
In order to understand embryonic stem cells, we need to understand In Vitro Fertilisation (IVF). Many people struggle with fertility problems and are unable to conceive a child naturally. IVF is a procedure that can help these people conceive a child.
In IVF, a woman’s eggs are taken out of her body and fertilised in a lab setting. After 6 days, doctors will take one of these fertilised eggs and place them into the woman’s womb where it can develop into an embryo and continue as a pregnancy. IVF can be an expensive procedure, so doctors often fertilise multiple eggs in the lab to make sure that at least one of them can be used.
The remaining fertilised eggs cannot grow any further and can be donated for stem cell research with the woman’s permission. Embryonic stem cells are taken from these lab donations, so they are never taken directly out of a woman’s body.
Unlike multipotent adult stem cells, embryonic stem cells are pluripotent. This means that embryonic stem cells are unrestricted in their growth and they can turn into any type of cell in the body.
We now know that adult stem cells are restricted in their growth (multipotent) and embryonic stem cells are unrestricted in their growth (pluripotent). The third type of stem cell is an induced pluripotent cell; adult stem cells are altered in a lab so that they can grow into any type of cell in the body, just like an embryonic stem cell.
Just like any other type of medicine, stem cell therapy has to be proven as effective and safe through scientific research before it is made available to the public. Based on scientific research, there are three types of stem cell therapy that are considered safe and effective;
Stem cell therapy can be used to treat leukaemia, which is a type of cancer that affects the tissue inside your bones (also known as your bone marrow). Your bone marrow is in charge of creating new blood cells and leukaemia interrupts this process. To help someone with leukaemia create new blood cells, doctors will inject healthy stem cells into their bone marrow. These stem cells need to come from a healthy donor that is a good match to the patient in terms of tissue type, often a sibling or family member.
For patients with severe burns, doctors will use stem cells found in the patient’s skin to grow a skin graft (a skin transplant) that fits the patient. This reduces the risk of the patient’s body rejecting the transplant. However, this treatment is highly specialised and usually reserved for patients with life-threatening burns.
A new treatment called Holoclar® has just been approved in the European Union (EU) for damage to the cornea (the surface of the eye). It uses stem cells from a patient’s eye to help repair damage to the cornea and can restore a patient’s sight.
The risks and benefits will vary based on the type of stem cell therapy being provided. For the three types of stem cell therapy outlined above (blood/immune conditions, skin grafts, and damaged corneas), research has shown that stem cell therapy is safe and effective.
However, these three therapies still contain complex medical procedures and carry some risk. Your doctor should always inform you of these risks before a procedure. One example of a risk is Graft versus Host Disease (GvHD). GvHD happens when injected stem cells do not recognize their new environment and begin to attack the other cells in the patient’s body. Doctors will try to minimize this risk by finding a well-matched donor and by giving the patient medication to suppress their immune system. Another risk is a decrease in the number of red blood cells in your body (anaemia), leading to excessive bruising and a higher risk of infections.
Besides the three uses outlined previously, most uses for stem cells have not been proven as safe and effective by research yet.
Our cells are made of tens of thousands of different parts, so it is difficult to predict how our stem cells will behave when they are injected into a new environment. There is no scientific evidence to suggest that stem cells will automatically sense which environment they are in and which condition they are treating. In some cases, stem cells may cause more harm than good by growing into the wrong type of cell. More scientific research is needed to make sure that future uses for stem cells are safe and effective before they are made available to the public.
However, there are ongoing clinical trials all over the world looking at the use of stem cell therapy for many conditions including; macular degeneration, neurological conditions (e.g. Parkinson’s), diabetes, spinal cord injuries, heart disease, multiple sclerosis, and cartilage/tendon injuries (e.g. arthritis).
It is important to remember that experimental treatments carry significant risks and not all clinical trials are equally legitimate or safe. Before you decide to pursue an experimental treatment, you need to establish the legitimacy of the treatment and the risks and procedures involved in the trial.
Gather as much information as you can about the treatment before you make a decision. Here are some resources you can consult before you decide to pursue a stem cell therapy trial;
International Society for Stem Cell Research (ISSCR) Patient Handbook
This patient handbook explains the procedures and documents involved in a clinical trial. It also gives you a list of things to look for and things to avoid when considering stem cell therapy. It contains an extensive list of questions to ask the trial team before you commit to a treatment.
Talk to your doctors about any treatment being offered to get a second independent opinion. If possible, bring along any documents/forms that you are given by the trial team. Compare the clinical trial with any other available treatments where possible. If you do decide to pursue the treatment, make sure your doctors are informed.
At Tree of Hope, we support children and young people with a disability or illness by helping families raise money to pay for specialist care that is not freely available through the UK healthcare system. Should you wish to pursue stem cell therapy, we may be able to help you raise the money needed to pay for the treatment. For more information on what we can do for you, please visit our Service Offering page; http://www.treeofhope.org.uk/what-we-do/our-service-offering/
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Content Written by: Marissa Mes, PhD Candidate, MSc Health Psychology
UCL School of Pharmacy | Department of Practice and Policy | Centre for Behavioural Medicine
Marisa is a Dutch-Japanese student at University College London, working towards completing a PhD in Health Psychology at the Centre for Behavioural Medicine. Her PhD topic focuses on developing a Perceptions and Practicalities Approach (PAPA) intervention to increase adherence to asthma medication in a pharmacy setting.
Marissa holds an MSc in Health Psychology from the University of Bath and other research interests include patient health experiences, chronic illness in young people, and public health.