Richards underwent the procedure, in which stem cells are derived from bone or fat and injected into the injury site in hopes of repairing and regenerating the damaged ligament, on Monday. There is no guarantee the procedure will be successful, but doctors should know in six to eight weeks if it is.
“Garrett weighed all the evidence that was given to him through MRI exams, he researched the process, talked to people who have gone through the procedure and people who have not and came to this decision,” Angels General Manager Billy Eppler said. “We support him.”
Richards, who went 1-3 with a 2.34 earned-run average in six starts, had all but resigned himself to Tommy John surgery, which would have sidelined the hard-throwing right-hander for the rest of this season and most, if not all, of 2017.
If stem-cell therapy, which Eppler termed a “conservative care route,” doesn’t work, Richards, 27, could have surgery in July and be ready for 2018.
“He got input from numerous sources, both players and doctors, and felt this was the best course of action … to heal and get healthy,” Manager Mike Scioscia said. “I don’t think you want to jump into any kind of surgery, let alone one the magnitude of Tommy John surgery.
“That puts you out for this season and most of next season. Garrett has a few months to evaluate where his elbow is. He really isn’t having many symptoms at all, so I know he’s confident with this course of action.”
Eppler said there are pitchers “who have had this procedure and are pitching well in the big leagues,” but he declined to name any.
New York Mets right-hander Bartolo Colon underwent stem-cell therapy in March of 2010 to help repair ligament damage in his elbow and a torn rotator cuff. Colon, now 43, missed all of 2010 but returned in 2011 and has gone 68-53 with a 3.67 ERA in 155 games since his stem-cell treatment.
If the treatment is successful, Richards could resume throwing by mid-July and return sometime in August. Fellow pitcher Andrew Heaney also opted to forgo elbow surgery in favor of a platelet-rich plasma injection in April.
Angels left fielder Daniel Nava left Monday night’s game in the fifth inning because of a left groin strain and will undergo an MRI test Tuesday. Nava spent three weeks on the disabled list in April and early May because of patella tendinitis in his left knee. …
C.J. Wilson, sidelined since the start of spring training because of shoulder inflammation, threw a 40-pitch simulated game Monday. The left-hander hopes to return by mid-June. “He looked good for a first workout against some hitters,” Scioscia said. “It’s encouraging, but it’s still a long process.” …
Tyler Skaggs, out for three weeks because of biceps tendinitis, was cleared to resume throwing after passing a strength test Monday. …
Closer Huston Street (left-oblique strain) has extended his long-toss program to 140 feet and hopes to throw off a mound Wednesday. … Reliever Javy Guerra cleared waivers Monday and was outrighted to triple-A Salt Lake.
Adistem Ltd. Announces Formal Ethics Approval For a Human Clinical Trial onOsteoarthritis Using Activated Platelet Rich Plasma Technology.
Melbourne, Australia (PRWEB) July 12, 2011
The Directors of Adistem Limited (Hong Kong) were delighted to hear that they were granted formal ethics approval for a clinical trial on knee osteoarthritis using their proprietary Activated Platelet Rich Plasma (PRP) Technology.
The study is titled “Intra-articular injection of platelet-rich plasma in patients with knee osteoarthritis: A randomized controlled trial,” and will enroll approximately 30 patients presenting with mild to moderate knee joint osteoarthritis.
The Principal Investigators are Dr Kade Paterson from the Australian Catholic University (Melbourne) and Dr Dan Bates from the Lakeside Sports Medicine Centre (Melbourne). The study is being carried out at the Lakeside Sports Medicine Centre (Melbourne, Victoria Australia).
The Australian Catholic University Research Ethics Committee has reviewed this study and has given approval to conduct this research. This study conforms to the principles set out by the National Statement on Ethical Conduct in research involving humans and according to Good Clinical Practice Guidelines
“The approval and commencement of this clinical trial for osteoarthritis is an important milestone in the strategic development of Adistem’s technology platform,” said CEO, Dr. Nick Ede. He continued, “This formal clinical trial will add to our on-going clinical trials in the EU and Asia, escalating Adistem’s impressive track record of product development, commercialization and clinical applications in the cellular therapy field.”
“The Company is at an exciting stage, largely due to its expanding clinical trial initiatives, now with 3 major clinical trials underway, one for Idiopathic Pulmonary Fibrosis and another for Autism Spectral disorder”, said Mr. James Thornton and Dr Vasilis Paspaliaris, founding Directors, Adistem Ltd.
Adistem discovers and develops new technologies and methods to help clinicians use autologous adult stem cells to address degenerative disease conditions – and to assist in certain cosmetic and plastic surgery procedures. Clinicians in 26 different countries are currently using Adistem’s stem cell technology. Specifically Adistem is developing several peptide therapeutics against a number of chronic disease targets including HIV, pain and Type II Diabetes.
For more information: visit http://www.adistem.com/trial-osteoarthritis.htm
TIM Fletcher became a “human guinea pig” last week when he had stem cell therapy to try to repair a painful old knee injury. The top real estate agent is one of only five Victorians to have had the treatment. Mr Fletcher suffered years of pain caused by bone grinding on bone. It was the success of stem cell therapy on animals that gave him the confidence to proceed with a medical technique still in its infancy. “I had nothing to lose and I was very prepared to take the risks,” Mr Fletcher said. “No one really knows what the downsides are, but the upsides are out there and well known.” It was his family vet who tipped him off to the success of stem cell trials on animals. “Given all the positive feedback I had heard about stem cell therapy in animals I was perfectly comfortable to proceed,” he said.
The Herald Sun previously reported that stem cell trials on dogs in Melbourne had shown stunning results. Once crippled canines were able to run again. Mr Fletcher had the treatment on Wednesday last week and was back at work on crutches the next day. “By the third and fourth day I had noticed an improvement, though I have been having some pain again since then,” he said. But he was happy to be a human guinea pig. “It also compared favourably with surgery to have an artificial knee fitted because once you undergo the surgery, it is not a reversible procedure,” he said. Sports medical specialist and North Melbourne Football Club doctor Dan Bates treated Mr Fletcher. “I treated my first patient, a 43-year-old former state soccer player, last year, and MRI scans before and since have shown new cartilage growing in his injured knee,” Dr Bates said. “Of the other handful of patients I have treated,
all have become either pain-free or are below the levels of pain before treatment.” Dr Bates will publish the results of his trial soon. Mr Fletcher said the treatment took three hours at Dr Bates’s Lakeside Sports Medicine Centre, starting with “uncomfortable” stomach liposuction to remove the cells. “They took fat cells from my stomach, which they mixed with blood and then counted them out. They needed 20 million cells and, within an hour, they squirted it into my knee.”
The Bartolo Colon story has intrigued me since it first broke in May. Colon is a former AL Cy Young winner whose career seemed to be lost but who is now pitching effectively again for the Yankees at age 38. I did more than raise an eyebrow when I heard that his incredible comeback was aided by a relatively unknown stem cell procedure. As an injured pitcher who is also 38, I had to know more. It didn’t take long for me to find Colon’s doctor, Joseph Purita of The Institute of Regenerative and Molecular Orthopedics in Florida.
I spoke on the phone with Dr. Purita’s medical assistant, Jeremy Carreno, and he walked me through the procedure, the science and the benefits. Carreno asked me to send my medical records, which included radiology reports from 2009 and 2011 MRIs on my left shoulder. I knew I had a rotator cuff tear and also one in my labrum. I pitched with the tears in 2010, eight months after I originally suffered the injury, but it wasn’t feeling right this year.
This wasn’t a quality-of-life issue for me; my arm was fully functional and feeling pretty good. My injury was manageable. I could play catch with my son and throw batting practice. I just couldn’t crank it up in the low 90s anymore, and if a minor medical procedure could help me do that again I wanted to give it a shot.
Dr. Purita reviewed my records and said I was a good candidate for the procedure. He said my shoulder wasn’t nearly as damaged as Colon’s. My next decision was weighing the cost versus the reality of me ever pitching again professionally. The usual cost is $4,800 for everything. That includes drawing stem cells from my fat and bone marrow and re-injecting them into my shoulder plus 2-3 rounds of platelet rich plasma (PRP). The entire process would take 9-12 weeks, depending on how much time I took between PRP sessions; a minimum of four weeks is recommended each time.
That price was better than the $7,500 I was quoted from a different doctor last year. His process was somewhat similar to what Dr. Purita does but instead of immediately injecting me with my own bone marrow and fat stem cells on the same day, the other doctor harvests them for approximately a month first. Manipulation of stem cells is frowned upon by the FDA and considered much more risky. Dr. Purita believes he has the more effective, safer way of executing stem cell and PRP therapy.
The price was justifiable but Dr. Purita gave me an even better deal knowing that treating professional athletes was good exposure for his business. I made my appointment for mid-July, booked my flight and was soon in Dr. Purita’s office in Boca Raton, Fla.
Dr. Purita’s office is like any other doctor’s office you’d expect to see in South Florida; I was the youngest person in the waiting room by 40 years. After my initial consultation with Dr. Purita I was brought down to the third floor, where the 4-5 hour process began.
The first step was to draw the fat. Dr. Purita was concerned that I didn’t have enough, but then he grabbed my love handles and said, “Oh, here we go.” I lay on my left side while the fat was extracted from my waist, 5-6cc. It was relatively painless. An anesthetic was administered and I only felt an occasional slight prick or burn.
Dr. Purita left after the fat was drawn. I waited about 20-30 minutes in a waiting area and they went back to start the bone marrow extraction process.
This is slightly more intimidating but is not what you think. In this process, a hole is not drilled into the bone but rather a soft spot is found and bone marrow is drawn with a needle. After anesthesia, Dr. Purita put a sizable needle in me and then told me I’d feel some tapping. He literally used a small hammer to tap into the left side of my lower back. There was practically no discomfort at all.
During my phone consultation the topic of HGH had come up, and it came up again when I arrived at Dr. Purita’s office (I didn’t initiate either conversation). It was made clear to me that while they usually administer a small dosage of HGH in the procedure, they do not do so when treating athletes.
I prodded Dr. Purita just to try to learn more about the advantages of mixing HGH with stem cells and PRP. He told me the IGF-1 in synthetic HGH helps stimulate the stem cells and helps the cells to do their job better. The amounts used are so small that the suggestion that HGH is performance-enhancing in this instance is absurd.
Dr. Purita actually brought up former big leaguer Andy Pettitte, who admitted using HGH in 2002 to help recover from an elbow injury. He said in a case like Pettitte’s, HGH therapy made perfect sense. There is no performance-enhancing involved, just an aid in injury recovery.
I found it interesting though that he said to some degree PRP therapy does something very similar to HGH. PRP is a process that essentially separates your blood, leaving part of it extremely strong. This stronger, platelet-rich plasma contains your own IGF-1 and helps heal an injury, just like HGH. It’s all a very fascinating and natural use of your body to heal your body.
The World Anti-Doping Agency was skeptical at first, but has since stated that PRP treatment is not performance-enhancing as long as it is not administered with HGH or IGF-1 injections. As of Jan. 1 the agency has cleared PRP.
Once all my liquids were extracted, it was time to spin them. At 2,000 RPMs, my blood, fat and bone marrow were placed in a centrifuge for 13 minutes. This was the process that isolated the platelets.
After he took the containers out, Jeremy examined them and said, “Wow!” He told me I had a lot of usable stem cells. He said on average most people produce about 60 percent of what I produced. He said genetics and healthy living contributed to this.
We were getting closer to the final injections, but the second-to-last step was loading the bone marrow, blood and fat into syringes and putting them under an LED light. This light is apparently the latest and greatest thing in stem cell therapy.
The way it was described to me, this LED light kick-starts the cells. Each syringe was under the light for 20 minutes. Once those sleepy cells were awakened they were ready to be injected into my shoulder and become tiny miracle workers.
Because I am a producer of strong bone marrow and stem cells, there was a lot of liquid in each of the syringes. This was the most uncomfortable part of the day. Dr. Purita used a low radiation X-ray machine while injecting me. This machine could be moved around as he worked, and the images were in real time on two monitors above me. It helped him to find the most effective location for me to be injected. The injections came in my labrum first and rotator cuff second. More pinches and pricks, slightly unnerving but very tolerable.
The tightness and soreness in my shoulder was almost immediate. It was reminiscent of the PRP I had a year and a half ago but not nearly as bad. Dr. Purita believes he has the most advanced PRP system in the United States.
My arm was in pain the rest of the day and the flight home was pretty uncomfortable. The PRP intentionally inflames your muscles and tendons, and because your arm is inflamed you can’t take any anti-inflammatory medicines for 2-3 days. As a pitcher, you know your body well and a handful of Advil would have hit the spot after the procedure, but also would have defeated the purpose.
I had been training and strengthening my shoulder for over a month before the treatment. That program will have to slow down a little because of the soreness, but to maximize the effects of this procedure I have to keep exercising. I’m hoping to be back in full training mode in a few days.
By all accounts I’ve read, Colon really dedicated himself during the time he had the procedure and that was just as essential to his successful comeback as was the therapy itself. Dr. Purita said Colon was pitching six weeks after the procedure.
I was given a host of natural supplements to take over the next couple months that will also help the stem cells do their work: Shark liver oil, L-Arginine, Melatonin and a product called Stem XCell. Dr. Purita ran these by the Major League Baseball Players’ Association to make sure they were OK to take.
Certainly I hope this procedure gives me the results I’m looking for and a chance to do what I love again. But bigger than that is the future of stem cells in sports medicine. I’m fascinated when I think about what’s going on in my shoulder right now.
I asked Jeremy if he thought this therapy could be used proactively. After a few years of professional baseball, all pitchers have tears in their arm to some degree. When I had my first MRI, Dr. James Andrews told me I had a rotator cuff and a labrum tear, but that the labrum tear had been there for years. I was amazed by this; I’d been pitching full speed for years with a torn labrum.
I wondered if after a long baseball season, stem cell and PRP therapies could be given to seemingly healthy pitchers to strengthen weakened and slightly torn ligaments and tendons. My thought was that they would decrease the chances of a pitcher getting seriously hurt. Jeremy said, “You know, that’s a pretty good idea.”
We’ll see. It’ll be pretty difficult to convince a healthy pitcher to intentionally inflame his arm and make it hurt temporarily because he’ll be better off in the long term. In one form or another, though, you have to believe stem cell and PRP therapy is about to go mainstream in sports. It will take some more research and open-mindedness on the part of those who make decisions, most notably league commissioners and team doctors. It will also take time, but progress always does.
Immune system work will help fight cancer
Three scientists who unlocked the secrets of the body’s immune system have won the 2011 Nobel prize for medicine. STOCKHOLM: Three scientists who unlocked secrets of the body’s immune system, opening doors to new vaccines and treatments for cancer, have won the 2011 Nobel prize for Medicine.
American Bruce Beutler and French biologist Jules Hoffmann, who studied the first stages of immune responses to attacks, shared the US$1.5 million award with Canadian-born Ralph Steinman, working in the US, whose discovery of dendritic cells was key to understanding the later stages.
“This year’s Nobel laureates have revolutionised our understanding of the immune system by discovering key principles for its activation,” the award panel at Sweden’s Karolinska Institute said yesterday. Lars Klareskog, who chairs the prize-giving Nobel Assembly, said: “I am very excited about what these discoveries mean. I think that we will have new, better vaccines against microbes and that is very much needed now with the increased resistance against antibiotics.
“I also expect that there will be some development in the area of attacking cancers from the selfimmune system. There are some promising things there.”
Annika Scheynius, a professor of clinical allergy research and a member of the panel, said: “We are definitely sure that these discoveries will lead to health improvement. They can improve the health of patients with cancer, inflammatory diseases, auto-immune diseases and asthma.”
Mr Beutler, 53, is based at the Scripps Research Institute in La Jolla, California. Luxembourg-born Mr Hoffmann, 70, conducted much of his work in Strasbourg. They will share half the prize money. The rest goes to Mr Steinman, 68, from Rockefeller University in New York.
The work of the scientists has been pivotal to the development of improved types of vaccines against infectious diseases and novel approaches to fighting cancer. The research has helped lay the foundations for a new wave of “therapeutic vaccines” that stimulate the immune system to attack tumours.
Better understanding of the complexities of the immune system has also given clues for treating inflammatory diseases, such as rheumatoid arthritis, where the components of the self-defence system end up attacking the body’s own tissues. Medicine, or physiology, is usually the first of the Nobel prizes awarded each year. Prizes for achievements in Science, Literature and Peace were first awarded in 1901 in accordance with the will of dynamite inventor and businessman Alfred Nobel.
The award citation noted that the world’s scientists had long been searching for the “gatekeepers” of the immune response by which man and other animals defend themselves against attacks by bacteria and other micro-organisms. Mr Beutler and Mr Hoffmann discovered receptor proteins that can recognise attacking micro-organisms and which activate innate immunity, the first step in the body’s response.
Mr Hoffmann’s pioneering research was actually conducted on fruit flies, highlighting how key elements of modern human biology have been conserved through evolution.
The immune system exists primarily to protect against infections but it can also protect against some cancers by targeting rogue cells before they can proliferate.
3 นักวิจัยสหรัฐฯ ลักเซมเบิร์กและแคนาดา คว้าโนเบลแพทย์ 2011 จากผลงานศึกษาการกระตุ้นระบบภูมิคุ้มกัน ที่ช่วยให้เราเข้าใจว่าแมลงหวี่และสัตว์เลี้ยงลูกด้วยนมนั้นมีระบบภูมิคุ้นกันพื้นฐานร่วมกัน รวมถึงเซลล์ชนิดใหม่ที่มีบทบาทต่อภูมิคุ้มกันของร่างกาย
รางวัลโนเบลสาขาสรีรศาสตร์หรือการแพทย์ ประจำปี 2011 มอบให้แก่ 3 นักวิจัยผู้ค้นพบเกี่ยวกับระบบภูมิคุ้มกัน คือ บรูซ บอยท์เลอร์ (Bruce Beutler) จากสหรัฐฯ จูลส์ ฮอฟฟ์มันน์ (Jules A. Hoffmann) จากลักเซมเบิร์ก และราล์ฟ สไตน์มัน (Ralph Steinman) จากแคนาดา อ้างตามเอเอฟพีทางคณะกรรมการรางวัลโนเบลแถลงว่าผู้ทรงเกียรติทั้งสามได้ปฏิวัติความเข้าใจของเราเกี่ยวกับระบบภูมิคุ้มกัน จากการค้นพบหลักการเกี่ยวกับการกระตุ้นภูมิคุ้มกันคณะกรรมการรางวัลระบุว่า งานวิจัยพื้นฐานเกี่ยวกับระบบภูมิคุ้มกันของทั้งสามคนได้เปิดหน้าด่านใหม่ในการโจมตีโรคมะเร็งและโรคร้ายอื่นๆ โดยพวกเขาได้ศึกษาระบบภูมิคุ้มกันอันซับซ้อนซึ่งส่งสัญญาณให้โมเลกุลปลดปล่อยสารภูมิต้านทานและเซลล์เพชรฆาตเพื่อตอบโต้กับเชื้อจุลินทรีย์ที่รุกรานเข้ามา ความเข้าใจในเรื่องนี้ได้เปิดประตูสู่การพัฒนาตัวยาใหม่ๆ และยังรับมือกับปัญหาภูมิคุ้มกันบกพร่อง อย่างเช่น โรคหอบหืด โรคข้อรูมาตอยด์ และโรคลำไส้อักเสบโคห์น (Crohn’s disease) ซึ่งเกิดจากร่างกายโจมตีตัวเอง
“งานวิจัยของพวกเขาได้เปิดเส้นทางใหม่สู่การพัฒนาการป้องกันและบำบัดรักษาโรคติดเชื้อ โรคมะเร็งและอาการอักเสบ พวกเขาสร้างความเป็นไปได้ในการพัฒนาวิธีใหม่เพื่อป้องกันและรักษาโรค ตัวอย่างเช่น การปรับปรุงวัคซีนที่ดีขึ้นเพื่อต่อสู้กับการติดเชื้อ และความพยายามในการจำลองระบบภูมิคุ้มกันเพื่อโจมตีเนื้อร้าย เป็นต้น การค้นพบเหล่านี้ยังจะช่วยให้เราเข้าใจว่า ทำไมระบบภูมิคุ้มกันจึงโจมตีเนื้อเยื่อของเราเอง ซึ่งจะชี้ทางสู่การบำบัดโรคที่เกี่ยวกับการอักเสบ” คณะกรรมการโนเบลแถลง
ทั้งนี้ บอยท์เลอร์ ในวัย 55 ปี และฮอฟฟ์มันน์ในวัย 70 ปี จะได้รับเงินครึ่งหนึ่งของเงินรางวัลทั้งหมด 10 ล้านโครนสวิส หรือ ประมาณ 46 ล้านบาทร่วมกัน โดยทั้งคู่ได้ค้นพบโปรตีนตัวรับ (receptor protein) ซึ่งเป็นก้าวแรกของการกระตุ้นระบบภูมิคุ้มกันของร่างกาย โดยโปรตีนดังกล่าวจะทำงานเหมือนเครื่องมือที่เข้าสกัดการจู่โจมใดๆ ที่เกิดจากการอักเสบ
สำหรับฮอฟฟ์มันนั้นเขาได้ศึกษาว่าแมลงหวี่ต่อสู้กับการติดเชื้อได้อย่างไร ระหว่างเขาทำวิจัยที่มหาวิทยาลัยสตาสบูร์ก (University of Strasbourg) ฝรั่งเศส เมื่อปี 1996 โดยงานวิจัยดังกล่าวได้เผยให้เห็นว่ายีนที่เรียกว่า “โทลล์” (Toll) ของแมลงหวี่ซึ่งมีส่วนในการพัฒนาของตัวอ่อนนั้น ได้ช่วยให้ร่างกายรับรู้ถึงจุลินทรีย์ที่เป็นอันตราย และจำเป็นต้องต่อสู้กับจุลินทรีย์เหล่านั้น
ขณะที่งานของบอยท์เลอร์ได้ช่วยให้เราเข้าใจการค้นพบดังกล่าวมากขึ้น เมื่องานของเขาในปี 1998 ที่มหาวิทยาลัยเท็กซัส (University of Texas) สหรัฐฯ ได้ค้นพบตัวรับที่เรียกว่า “แอลพีเอส” (LPS) ในหนูทำยานคล้ายยีนโทลล์ในแมลงหวี่ ซึ่งเป็นการพิสูจน์ว่าสัตว์เลี้ยงลูกด้วยนมและแมลงหวี่นั้นมีวิถีของระบบภูมิคุ้มกันพื้นฐานคล้ายกัน
ส่วนสไตน์มันวัย 68 ปีจะได้รับเงินรางวัลที่เหลืออีกครึ่งหนึ่งนั้น จากการงานวิจัยเกี่ยวกับระบบภูมิคุ้มกันทุติยภูมิที่เรียกว่า “การตอบสนองภูมิคุ้มกันแบบจำเพาะ” (adaptive response) โดยเมื่อปี 1973 เขาได้พบเซลล์ชนิดใหม่ที่เรียกว่า “เซลล์เดนไดรติก” (dendritic cell) และได้สาธิตถึงบทบาทของเซลล์ดังกล่าวในการปลดปล่อย “ทีเซลล์” (T cells) ซึ่งเปรียบเสมือนทหารปืนใหญ่ของระบบภูมิคุ้มกัน โดยทีเซลล์เป็นส่วนหนึ่งของความจำต่อระบบภูมิคุ้มกัน ซึ่งช่วยให้เข้าต่อสู้กับเชื้อโรคที่โจมตีในครั้งต่อไปได้เร็วและมีประสิทธิภาพมากขึ้น
สไตน์มันยังได้รับรางวัลลาสเกอร์ (Lasker Prize) เมื่อปี 2007 จากงานวิจัยที่แสดงให้เห็นว่าระบบภูมิคุ้มกันของร่างกายนั้นสามารถโจมตีเชื้อโรคที่เป็นอันตราย แต่หลีกเลี่ยงที่จะทำอันตรายต่อโมเลกุลของร่างกาย
การมอบรางวัลโนเบลสาขาสรีรศาสตร์และการแพทย์ล่าสุดนี้เป็นครั้งที่ 12 ของรางวัลอันทรงเกียรติที่ยกย่องงานวิจัยทางด้านระบบภูมิคุ้ม โดยครั้งแรกคือเมื่อปี 1901 ซึ่งมอบรางวัลให้แก่ เอมิล ฟอน แบห์ริง (Emil von Behring) จากการพัฒนาเซรุ่มที่ช่วยป้องกันโรคคอตีบ
เทศกาลประกาศผลรางวัล “โนเบล” เริ่มขึ้นแล้ว โดยประเดิมสาขาแพทย์เป็นอันดับแรกตามธรรมเนียม ตามมาด้วยโนเบลสาขาฟิสิกส์ เคมี สันติภาพและเศรษฐศาสตร์ ซึ่งผู้ได้รับรางวัลทั้งจะเข้ารับพระราชทานรางวัลปลายปีนี้
โนเบลแพทย์ 2011 มอบให้แก่ 3 นักวิจัย ผู้ค้นพบเกี่ยวกับภูมิคุ้มกันทั้งโดยกำเนิดและแบบจำเพาะ ส่วนมอบโนเบลฟิสิกส์ให้ 3 นักวิจัยผู้พบว่าเอกภพกำลังขยายตัวด้วยอัตราเร่งคงที่จากการศึกษา “ซูเปอร์โนวา” และโนเบลเคมีมอบให้นักวิจัยอิสราเอลผู้ค้นพบ “ควอสิคริสตัล”
อัลเฟร็ด เบอร์นาร์ด โนเบล (Alfred Bernhard Nobel) นักเคมีชาวสวีเดนผู้สร้างนวัตกรรมระเบิดไดนาไมต์เพื่อใช้ในกิจการระเบิดเหมือง (แต่กลับถูกนำไปใช้ในการเข่นฆ่ากันเองของเพื่อนมนุษย์) ได้ทิ้งมรดกคิดเป็นเงิน กว่า 8,300 ล้านบาทในปัจจุบันเพื่อเป็นทุนสำหรับรางวัลโนเบล (Nobel Prize) โดยมีพิธีพระราชทานรางวัล ณ สต็อคโฮล์ม คอนเสิร์ตฮอลล์ สวีเดน ในวันที่ 10 ธ.ค.ของทุกปี ซึ่งตรงกับวันครบรอบวันเสียชีวิตของเขา
วันที่ 3 ต.ค.54 เวลา 16.30 น.
มอบรางวัลโดย : สมัชชาโนเบล ที่สถาบันแคโรลินสกา (The Nobel Assembly at the Karolinska Institute) สต็อกโฮล์ม สวีเดน
ผู้ได้รับรางวัลได้แก่ : บรูซ เอ.บิวท์เลอร์ (Bruce A. Beatler) จูลส์ เอ.ฮอฟฟ์มันน์ (Jules A. Hoffmann) สำหรับ “การค้นพบเกี่ยวกับการกระตุ้นภูมิคุ้มกันแต่กำเนิด (innate immunity)” และรางวัลอีกครึ่งหนึ่งแก่ ราล์ฟ เอ็ม.สไตน์มาน (Ralph M. Steinman) สำหรับ ”การค้นพบเซลล์เดนไดรติก (dendritic cell) และบทบาทของเซลล์ดังกล่าวต่อภูมิคุ้มกันแบบจำเพาะ (adaptive immunity)”
(CBS) Have scientists finally discovered the fountain of youth? Results from a new study suggest a way to stop aging might not be too far-fetched after all.
Researchers at the University of Pittsburgh have developed a stem cell treatment that significantly stalls aging and increases life span – if you’re a mouse. But the study, which shows how stem cells influence aging, may provide new clues on aging that will one day help humans.
For the study, published in the Jan 3. issue of Nature Communications – researchers injected a combination of stem cells and a similar type of cells – called progenitor cells – into mice that were bred with the disease progeria. Progeria is a rare genetic disease that causes advanced aging in children.
PICTURES: Progeria: First black child with rare aging disease
Mice with advanced progeria usually live for only days, but when the researchers injected the mice with a single dose of stem cells when they were 17 days old, the mice’s life spans shot up, with some living up to 66 days.
What’s more impressive, according to study co-author Dr. Laura Niedernhofer, associate professor in the department of microbiology and molecular genetics at the University of Pittsburgh, was when the researchers injected the stem cell mix into mice with a milder form of the aging disease. Those mice typically would show signs of aging like weak leg muscles, walking hunched over, and trembling. Following two injections of stem cells spaced several weeks apart, the mice saw relief in 75 percent of their symptoms. That suggests the stem cells delayed the effects of aging.
“That to me is exciting,” Niedernhofer told CBS News. “It’s really keeping the mice as healthy as possible in terms of aging.”
Niedernhofer says their study suggests that stem cell dysfunction may be the cause behind some of the changes we see with aging.
Does that mean a stem cell therapy would reverse aging in humans?
It’s too soon to sell. But Niedernhofer said the study suggests that the healthy stem cells from young mice somehow rejuvenated the aging mice’s cells, as opposed to replacing them. This effect was seen when the mice’s brains became healthier, despite only being injected with stem cells through the stomach. Niedernhofer says if scientists discover the mechanism that “flips the switch” to rejuvenate older stem cells, people could potentially reverse aging – without even the need for injecting cells.
“In order to stay healthy and functional, your stem cells are really important,” Niedernhofer said. “We’ve got to find a way to replace them or improve their function. I think that will be a key goal for staving off a lot of aging-related diseases.”
HOUSTON, Oct. 1, 2012 /PRNewswire/ — The Houston Stem Cell Summit will host an extraordinary lineup of keynote speakers who represent the most accomplished stem cell scientists, clinicians and entrepreneurs in the United States. Joining these distinguished speakers will be Governor of Texas, Rick Perry , consistent champion of adult stem cell therapies.
The Houston Stem Cell Summit will be held October 26 – 27 in its namesake city and will highlight the latest therapeutic research regarding the use of adult stem and progenitor cell therapies. The Summit will also provide a forum for entrepreneurs to discuss their latest efforts to commercialize stem cell therapies, and to debate and discuss FDA and other legal and regulatory issues impacting stem cell research and commercialization.
Opening Keynote Address October 26, 2012 - Arnold I. Caplan , PhD, Professor of Biology and Professor of General Medical Sciences (Oncology) Case Western Reserve University
Dr. Caplan has helped shape the direction and focus of adult stem cell research and commercialization. Virtually every adult stem cell company and literally tens of thousands of research papers are based on Dr. Caplan’s original and ground breaking research. Professor Caplan is considered to be the “father” of the mesenchymal stem cell and first described this progenitor cell in his landmark paper; “Mesenchymal stem cells”, Journal of Orthopaedic Research 1991;9(5):641-650. Since that foundational study, Dr. Caplan has published over 360 manuscripts and articles in peer reviewed journals. Dr. Caplan has been Chief Scientific Officer at OrthoCyte Corporation since 2010. In addition, Dr. Caplan co-founded Cell Targeting Inc. and has served as President of Skeletech, Inc. as its founder. He is the recipient of several honors and awards from the orthopedic research community. Dr. Caplan holds a Ph. D. from Johns Hopkins University Medical School and a B.S. in chemistry from the Illinois Institute of Technology.
Summit Keynote Address October 26, 2012 - Texas Governor Rick Perry
Governor Perry is the 47th and current Governor of Texas. Governor Perry has long championed the role of medical technologies in building the future of not only Texas, but also the United States. In many ways, his strong advocacy on behalf of research and advanced medical technologies is one of his strongest and as yet underappreciated legacies. In addition to his service to the state of Texas, Governor Perry has also served as Chairman of the Republican Governors Association in 2008 and again in 2011. Despite a rigorous schedule, particularly in the teeth of this election season, Governor Perry has graciously made time to speak and encourage the researchers, patients, companies and physicians who form the fabric and future of the stem cell therapy community.
Texas Medical Center Keynote Address, October 27, 2012 - James T. Willerson , MD
Over the course of his career, Dr. James T. Willerson has served as a medical, scientific and administrative leader for each of the major institutions that are the foundation of the Texas Medical Center. Dr. Willerson is currently President and Medical Director, Director of Cardiology Research, and Co-Director of the Cullen Cardiovascular Research Laboratories at Texas Heart Institute (THI). Dr. Willerson was appointed President-Elect of THI in 2004 and became President and Medical Director in 2008. He is also an adjunct professor of Medicine at Baylor College of Medicine and at The University of Texas MD Anderson Cancer Center. He is the former chief of Cardiology at St. Luke’s Episcopal Hospital and the former chief of Medical Services at Memorial Hermann Hospital.
Dr. Willerson has served as a visiting professor and invited lecturer at more than 170 institutions.
Honorary Summit Keynote Speaker - Doris Taylor , PhD
Dr. Doris Taylor is one of the world’s leading cell therapy and cardiac regeneration scientists. Prior to joining the Texas Heart Institute, she was the Medtronic-Bakken Chair in Cardiac Repair and the Director of the Center for Cardiovascular Repair at the University of Minnesota. Dr. Taylor’s research blends the use of stem cells, genes, and devices to develop novel cardiac and vascular technologies – ones to prevent, treat, and hopefully one day, cure heart ailments.
Most recently, Dr. Taylor and her team garnered international recognition for “whole organ decellularization,” which is a technique for removing existing cells from hearts of laboratory animals and even humans leaving a framework to build new organs. They repopulated the framework with other adult stem cells then provided a blood supply, and the heart regenerated with the characteristics and functions of a revitalized beating heart.
Friday Industry Keynote Speaker - Silvio Itescu . MD, MBBS (Hons), FRACP, FACP, FACR. Mesoblast Limited.
Professor Itescu is the founder and Chief Executive Officer of Mesoblast, the highest market value stem cell company. In addition to his entrepreneurial successes, Professor Itescu has established an outstanding international reputation as a physician scientist in the fields of stem cell biology, autoimmune diseases, organ transplantation, and heart failure. He is currently an active faculty member of the University of Melbourne and Monash University and was previously a faculty member of Columbia University in New York. He has consulted for various international pharmaceutical companies, has been an adviser to biotechnology and health care investor groups, and has served on the Board of Directors of a number of publicly listed life sciences companies.
Saturday Industry Keynote Speaker – C. Randal Mills . PhD, CEO, Osiris Therapeutics, Inc.
Dr. Mills is one of the most experienced stem cell executives in the industry and has created a new approach to the traditional bio-pharma business model at Osiris Therapeutics, which not only created significant value for his shareholders, but helped to create today’s active stem cell market. Dr. Mills is President and Chief Executive Officer of Osiris, having joined the firm in July 2004. Among his many accomplishments at Osiris, Dr. Mills directed his company to receive the first FDA approval for an on-label, off the shelf stem cell based therapy. Prior to joining Osiris, Dr. Mills was an executive officer of Regeneration Technologies, Inc. Dr. Mills served in several leadership positions at RTI from its formation in 1998 until 2004, including Vice President of Business Development and Vice President of Operations and R&D, and is credited with several key initiatives, including the development and commercialization of RTI’s core technology, BioCleanse. Prior to RTI, Dr. Mills was a member of the founding management team of the University of Florida Tissue Bank, Inc., the predecessor company to RTI. Dr. Mills received a Bachelor’s degree in microbiology and cell science, and a PhD in drug development, both from the University of Florida.
Additional details about the Houston Stem Cell Summit and our celebrated lineup of keynote speakers are available online at www.stemcellsummit.com. Registration is now open.
Robin R. Young
Houston Stem Cell Summit Organizer
SOURCE Houston Stem Cell Summ
The Medical Council has given the green light for medical schools to conduct 11 types of stem-cell research with the aim of finding clues for regenerative medication.
Since the council issued a regulation to tighten control over controversial stem-cell research in 2010, approval has been sought for some 17 studies.
But the council has approved only 11 studies, which will include research into the most common diseases such as diabetes, arthritis, retina irregularities and the spinal chord, Dr Somsak Lohlekha, who chairs the council’s stem-cell research regulatory panel, said.
Separately, the council has been asked to certify two other studies related to heart disease as standard treatment, but it has put them on hold due to opposition from Thailand’s Royal College of Physicians and Royal College of Surgeons.
“These two medical colleges found that patients with heart disease did not feel any better after getting stem-cell injections,” Somsak said.
Moreover, stem-cell treatment for heart disease had yet to be accepted by the international medical community as standard treatment.
“We found that many patients spent more than a million baht for this treatment and their condition did not improve,” he said
Of the 11 stem-cell studies approved by the council, one is being conducted at the Police General Hospital. The research team, led by Pol.Mai.Gen Dr Thana Turajane, has succeeded in developing adult stem cells derived from blood that can develop into cartilage tissue and be used to treat arthritis. It can also be used to culture a new set of stem cells.
Thana and his team had to wait more than nine months for a go-ahead from the Medical Council. In their application, they included a report on animal trials done by a Malaysian university to show that the use of stem cells was safe.
The hospital is now conducting clinical trials on 60 arthritis patients aged between 45 and 60, which should be completed next year..
Director of the Police General Hospital, Lt-General Jongjet Aojanepong, said the institute had set a five-year plan for stem-cell research and expected to have anti-ageing treatment by 2017.
It plans to extend its stem-cell studies to cover diabetes, heart and coronary disease, and also plans to create bio-printing for organ replacement.
“We plan to use stem-cell treatment in the next decade,” Jongjet said.
Stem-cell research is not only popular in the medical field but is booming in the field of cosmetics, even though the Medical Council has said it will never give approval for stem-cell research for cosmetic purposes.
Somsak said even though the council strictly controlled stem-cell research, some physicians and scientists were still conducting illegal research on cosmetic uses.
However, he said, the council had not received any complaints about the misuse of stem-cell treatment because it was strictly regulated.
Some truly remarkable medical research has discovered a new use for body fat: it’s a good source of stem cells which can be isolated and used to treat painful conditions.
An Australian trial is using stem cells to treat osteoarthritis, which lead almost 90,000 Australians to get hip and knee replacements each year.
New York—February 12, 2013
A study by researchers from Hospital for Special Surgery has shown that platelet-rich plasma (PRP) holds great promise for treating patients with knee osteoarthritis. The treatment improved pain and function, and in up to 73% of patients, appeared to delay the progression of osteoarthritis, which is a progressive disease. The study appears online, ahead of print, in the Clinical Journal of Sports Medicine.
“This is a very positive study,” said Brian Halpern, M.D., chief of the Primary Care Sports Medicine Service at Hospital for Special Surgery, New York City, and lead author of the study.
Several treatments for osteoarthritis exist, including exercise, weight control, bracing, nonsteroidal anti-inflammatories, Tylenol, cortisone shots and viscosupplementation, a procedure that involves injecting a gel-like substance into the knee to supplement the natural lubricant in the joint. A new treatment that is being studied by a small number of doctors is PRP injections. PRP, which is produced from a patient’s own blood, delivers a high concentration of growth factors to arthritic cartilage that can potentially enhance healing.
“You take a person’s blood, you spin it down, you concentrate the platelets, and you inject a person’s knee with their own platelets in a concentrated form,” said Dr. Halpern. “This then activates growth factors and stem cells to help repair the tissue, if possible, calm osteoarthritic symptoms and decrease inflammation.”
In the new study, researchers at Hospital for Special Surgery enrolled patients with early osteoarthritis, gave them each an injection of PRP (6-mL), and then monitored them for one year. Fifteen patients underwent clinical assessments at baseline, one week, and one, three, six, and 12 months. At these time points, clinicians used validated tools to assess overall knee pain, stiffness and function, as well as a patient’s ability to perform various activities of daily living. At baseline and then one year after the PRP injection, physicians also evaluated the knee cartilage with magnetic resonance imaging (MRI), something that has not previously been done by researchers in other PRP studies. The radiologists reading the MRIs did not know whether the examination was performed before or after the PRP treatment.
“The problem with a lot of the PRP studies is that most people have just used subjective outcome instruments, such as pain and function scores,” said Hollis Potter, M.D., chief of the Division of Magnetic Resonance Imaging at Hospital for Special Surgery, another author of the study. “But even when patients are blinded, they know there has been some treatment, so there is often some bias interjected into those types of studies. When you add MRI assessment, it shows you the status of the disease at that time, regardless of whether the patient is symptomatic or asymptomatic or they have good or poor function in the knee. You find out what the cartilage actually looks like. We can noninvasively assess the matrix or the building blocks of cartilage.”
While previous studies have shown that patients with osteoarthritis can lose roughly five percent of knee cartilage per year, the HSS investigators found that a large majority of patients in their study had no further cartilage loss. “The knee can be divided into three compartments, the medial compartment, the lateral compartment and the patellofemoral compartment,” said Dr. Halpern. “If we look at these compartments individually, which we did, in at least 73% of these cases, there was no progression of arthritis per compartment at one year. That is very significant, because longitudinal studies suggest a four to six percent progression of arthritis at one year.”
Treatment with PRP was also useful in improving pain, stiffness and function. The investigators found that pain, measured by a standard test called the Western Ontario and McMaster Universities Arthritis Index, significantly improved with a reduction of 41.7% at six months and 55.9% at one year. On a pain scale commonly used by clinicians called the Visual Analog Scale, pain was reduced by 56.2% at six months and 58.9% at one year. Functional scores improved by 24.3% at one year. Activity of Daily Living Scores also showed a significant increase at both six months (46.8%) and one year (55.7%)
“We are entering into an era of biologic treatment, which is incredibly ideal, where you can use your own cells to try to help repair your other cells, rather than using a substance that is artificial,” Dr. Halpern said. “The downside is next to zero and the upside is huge.” Dr. Halpern pointed out, however, that the study is a small case series and PRP needs to be pitted against a traditionally treated group in a randomized, controlled trial.
Osteoarthritis, which causes pain and joint stiffness, impacts over 27 million Americans and is a leading cause of disability. According to statistics from the Centers for Disease Control and Prevention, overall osteoarthritis affects 13.9% of adults aged 25 and older and 33.6% of those older than 65. The disease is characterized by degeneration of cartilage and its underlying bone within a joint as well as bony overgrowth. Disease onset is gradual and usually begins after the age of 40
Other HSS investigators involved in the study include Salma Chaudhury, M.D., Ph.D, Scott Rodeo, M.D., Catherine Hayter, MBBS, Eric Bogner, M.D., and Joseph Nguyen, MPH.
About Hospital for Special Surgery
Founded in 1863, Hospital for Special Surgery (HSS) is a world leader in orthopedics, rheumatology and rehabilitation. HSS is nationally ranked No. 1 in orthopedics, No. 3 in rheumatology, No. 10 in neurology, and No. 5 in geriatrics by U.S.News & World Report (2012-13), and is the first hospital in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center three consecutive times. HSS has one of the lowest infection rates in the country. From 2007 to 2011, HSS has been a recipient of the HealthGrades Joint Replacement Excellence Award. HSS is a member of the NewYork-Presbyterian Healthcare System and an affiliate of Weill Cornell Medical College and as such all Hospital for Special Surgery medical staff are faculty of Weill Cornell. The hospital’s research division is internationally recognized as a leader in the investigation of musculoskeletal and autoimmune diseases. Hospital for Special Surgery is located in New York City and online at www.hss.edu.
Blood-spinning, in use since the 1980s, increasingly available on the NHS
Tottenham Hotspur’s Gareth Bale used the treatment on his ankle injury
When Tottenham Hotspur’s star Gareth Bale suffered an ankle injury earlier this month, he turned to a controversial blood-spinning treatment to get himself back on his feet.
This high-speed spin causes the blood to separate into its various components. Specifically, it allows platelets (the parts of blood that promote clotting and assist the healing process) and plasma (the liquid part of blood in which red and white blood cells are suspended) to separate from other components in the blood.
By removing the other components, it means the concentration of platelets in the plasma is up to five times higher than normal. Known as Platelet-Rich Plasma (PRP), it contains large amounts of natural growth factors — substances the body uses to heal tissue.
The patient’s PRP is then immediately injected back into the injured area of the body — in Bale’s case, his right ankle. The idea is that it jump-starts recovery, reducing pain and making the injury heal up to five times faster.
This quick and easy treatment has been shown to work for a range of ailments, from arthritic joints to foot pain, and it is increasingly being used within the NHS.
So should you try blood spinning for your creaky knees and old sporting injuries?
Dr Ralph Rogers, a private doctor specialising in sports and orthopaedic medicine at London’s Lister Hospital, believes the treatment holds genuine benefits. ‘Within our blood, we have cells that begin the healing process,’ says Dr Rogers, who has been using the PRP technique for four years. ‘When you injure yourself, the body’s first response is inflammation. This sends platelets to the site of injury, which kick-starts the body to repair itself.’
Drama: Gareth Bale during the Europa League match, when he injured his ankle. He is hoping that it will heal five times faster than normal with the treatment
The ‘super-shot’ of platelets boosts this healing mechanism, he explains, so recovery is faster.
Furthermore, this high concentration of platelets seems to enhance healing so that the body produces less scar tissue.
Blood spinning — or, as it is technically known, Platelet-Rich Plasma Therapy — has been around since the Eighties, when it was first used following open heart surgery to avoid giving excessive amounts of donated blood products, which could contain disease or trigger an immune reaction.
Since then, it has been used in orthopaedics to ease arthritic joints and painful knees, in neurosurgery, wound healing, ear, nose and throat surgery, and face and head surgery. It has even been used in cosmetic treatments, in a procedure called the Vampire FaceLift, which involves injecting a form of PRP into areas of the face to rejuvenate the skin.
Earlier this year, the government body NICE (the National Institute for health and Care Excellence) issued new guidelines acknowledging PRP as a treatment for tendon injuries, common in the elbow, knee and ankle, and plantar fasciitis — inflammation of the band of tissue that stretches from the heel to the middle of the foot.
This common condition affects around one in ten people at some point in their lives and can be triggered by long periods walking or standing, walking in flat shoes, over-exercising or obesity. Dr Rogers explains that the treatment seems particularly effective at treating tendons, which are notoriously difficult to heal due to their poor blood supply.
Over recent years, the PRP treatment has started to grow in popularity, especially for sports injuries, and is now available on the NHS for orthopaedic problems such as tennis and golfer’s elbow, shoulder injuries and Achilles problems, and privately at around £2,000 for three treatments.
Two or more injections may be needed, between four and six weeks apart, depending on the injury.
For best results, Dr Rogers says that physiotherapy should be performed alongside the treatment.
As yet, it is available in only around a dozen places on the NHS, and there are no figures on how frequently it is used. The slow uptake may be due to the fact that the technique has been mired in controversy, with some experts arguing there is still little proof that it works.
Indeed, while NICE says the treatment raises ‘no major safety concerns’, it adds: ‘The evidence on efficacy is inadequate in quantity and quality. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research.’
Mark Batt, professor of sport and exercise medicine at Nottingham University Hospitals, agrees that more evidence is needed before we can start routinely offering blood spinning to patients. ‘There may be some benefit in the use of these types of injections in the healing process,’ he says.
‘However, it is very difficult to find strong, coherent evidence that it works.’
A study of people with injured Achilles tendons — the fibrous tissue that connects the calf to the heel bone — published in The Journal of the American Medical Association in 2010 found that PRP injections were no more effective than saltwater.
Yet some of the world’s top sports stars, including footballer Jermain Defoe and golfer Tiger Woods, have used the PRP treatment for their injuries, and small studies show promising results.
Blood supply: The technique, available on the NHS, is particularly effective for healing tendons which have limited blood reaching them
One study of 15 patients with elbow pain published in the American Journal of Sports Medicine found that 60 per cent had improved symptoms after eight weeks, and 81 per cent at six months. There were no adverse effects or complications.
Dr Rogers says the UK has been slow to adopt the procedure compared with the U.S. and Europe. ‘The English sports medicine community has frowned upon this technique, with many doctors thinking it doesn’t work. As a result, the British have been latecomers to the technique. While it is true there is still much to learn about this treatment, in general PRP theoretically makes sense: it is the body healing itself.’
In Gareth Bale’s case, Spurs doctors hope PRP will do the trick. With treatment, it is hoped he will miss only a handful of games, and that the forward will soon be back to his top goal-scoring form.
Thai successes in stem-cell research have come despite a lack of funding or a national plan
Thailand is fascinated with “roadmaps”, but when it comes to life-or-death matters like regenerative science, the country has none.
Shinya Yamanaka and John Gurdon cheered regenerative scientists around the world, including those working on stem-cell body rebuilding in private and public hospitals here, when they were awarded the Nobel Prize for Physiology or Medicine on October 8.
But looking back at the environment at home, Thai scientists sighed. Local development of the technique has been direction-less and under-funded.
Stem-cell research has drawn attention from scientists around the world, including Thai scientists, ever since South Korea’s Dr Hwang Woo-suk and his team reported that they had successfully created human embryonic stem cells by cloning in 2005.
Even though much of this “breakthrough” research was later found to have been faked, many researchers and scientists in Thailand continued to follow their curiosity to discover how to effectively use stem cells for treatment.
Over the past decade, stem cell-related research centres have mushroomed at public and private educational institutions and hospitals across the country, such as centres for heart disease, diabetes, Alzheimer’s disease, Parkinson’s disease, thalassemia and leukaemia.
Already this year, at least three universities have reported success in stem-cell research.
Chulalongkorn University early this year proclaimed that it was the first in Thailand to produce human embryonic stem cells and established the country’s first embryonic stem-cell bank.
Police General Hospital has developed adult stem cells to treat arthritis sufferers. The hospital is now conducting a clinical trial on 60 arthritis patients aged 45-60. The human trial is expected to be completed next year.
Last week, a team of researchers at Mahidol University’s Siriraj Hospital said they had discovered a method to extract pure stem cells from human amniotic fluid, which they say could be potentially used to treat several severe conditions such as arthritis.
But looking behind their success stories, we can see that most of them had to rely on their own funds to establish their laboratories and conduct studies. Only a portion of the money came from the government.
“The government has never paid attention to supporting scientific research. We had to use our own funds collected from donations to do stem-cell research and conduct studies,” Lt-General Jongjet Aojanepong, director of Police General Hospital, said recently.
The hospital has spent about Bt3 million-Bt4 million to conduct stem-cell research on arthritis patients. The hospital also wants to conduct another study on how stem cells can restore severely damaged neurons next year, but still lacks a budget to carry on.
Researchers need not only funding but also a national roadmap to steer stem-cell research and development.
Stem-cell therapy will be a key treatment in the near future. We need a formal forum to see the future together,” he said
Stem-cell research is booming in Thailand, but there is no central organisation to systematically manage the research budget and chart the direction of stem cell research.
Even though the government has set up the National Research Council of Thailand (NRCT) to oversee all research in the country, most of the budget was allocated to support research on agriculture, which is a priority need for the country.
The council gets about Bt10 billion from the government to support all research in the country, but only Bt60 million-Bt100 million per year goes to stem-cell research, said Dr Soottiporn Chittrmittrapap, secretary-general of the NRCT.
“I think the number of people who might benefit from stem cell research is only in the hundreds – [less than] in other fields,” he said.
However, he agreed with Jongjet’s idea of drafting a national roadmap so that Thailand can have a clear direction for researchers and scientists to conduct research.
The roadmap should focus on diseases that remain difficult to treat such as macular degeneration, which is the leading cause of blindness.
“We will come up with the stem-cell research roadmap by the end of this year, as we plan to organise a conference and invite all stem-cell experts to give their opinion on this roadmap,” he said.
In Thailand, there are at least four main agencies supporting stem-cell research – the NRCT; the Thailand Research Fund; the National Science and Technology Development Agency; and the Public Health Ministry. But these agencies work separately on stem-cell research.
To draw up the national stem-cell research roadmap, Dr Chatree Duangnet, vice president of Bangkok Dusit Medical Services (BGH), said educational institutions should be a key player in brainstorming ideas with stakeholders to designate the country’s goals, strategy, direction and financial support for stem-cell research.
“The government should speed up its work to come up with a national roadmap and policy for stem-cell research to support Thai scientists and researchers, as this kind of therapy will be the next generation of medical treatment,” he said.
Bangkok Hospital, run by BGH, has conducted stem-cell research in the treatment of heart disease, but had to stop after the Medical Council issued a regulation forbidding private hospitals from conducting such research.
The hospital has been limited to joining with foreign medical institutions, such as the University of Texas MD Anderson Centre, by supporting financial sources in the study of bone-marrow transplants.
“Stem cells will play an important role in treatment and estimate the risk of medicinefor patients in 10 years. So the stem-cell research roadmap would help us to see which way we should go,” Soottiporn added.
Doctors extracted fat and bone marrow stem cells from baseball pitcher Bartolo Colon and implanted them in his injured shoulder and elbow in April 2010 to help rebuild tissue. The 37-year-old Yankee is now pitching like he did when he was a younger man, leading some to question whether banned substances, such as human growth hormone, were involved. Can injecting some stem cells into a damaged joint really help that much?
Maybe. In recent years, orthopedists have been tinkering with the use of stem cells to help heal fractures, replace worn cartilage, and repair torn ligaments. As David Epstein explained in Sports Illustrated, the most popular technique is called micro-fracture surgery, in which the surgeon drills holes in the bone and allows the marrow to seep out into the area of the injury. The hope is that the stem cells in the bone marrow will release a cocktail of proteins and other chemicals to stimulate tissue repair. Researchers recently postulated that, if micro-fracture accelerates recovery, an even bigger shot of stem cells might speed it further. So they began experimenting with extracting bone marrow, centrifuging it to concentrate the stem cells, and injecting them into the injured joint. Implanting stem cells, either as the only treatment or in conjunction with micro-fracture surgery, has shown promise in a variety of animals, including horses and goats. But there have been very few trials on human patients, and it’s considered experimental at this point.
The few human trials that have been performed have yielded underwhelming results. The Maryland-based biotech company Osiris Therapeutics collected 55 patients with injured menisci, the disk of cartilage in the knee. After removing the damaged cartilage, they injected Chondrogen, the company’s special brew of stem cells, into some of the patients’ knees. After a recovery period, the patients who got the stem cells reported less pain than the control group. That’s nice, but the more important goal was regenerating cartilage, and there was no evidence of that.
Shouldn’t the animal trials be enough to prove the technique’s efficacy? Not really. Horses, for example, have thicker cartilage than humans, which may alter the healing process. They also get arthritis, one of the main disorders in the trials, in different places than humans do.
In fairness to Colon’s doctors, convincing evidence can be hard to come by for any surgical procedure. Unlike in animal studies, in which doctors can surgically impose the same injury on all the patients, every human injury is a little different. The human patients’ behavior after surgery, including their commitment to rehab, can vary widely. Surgeons are famously individualistic, each putting their own personal twist on the procedure. Some are also just better than others. All these factors combine to make it difficult to coordinate large-scale, well-controlled trials.
As for the murmurs about Colon’s surgeon including HGH along with the stem cells, there’s no evidence at this time. But the principle behind the two therapies is the same. HGH is a single- ingredient growth-promoter. Stem cells release a wide variety of growth-promoting chemicals. That diversity might, in theory, offer more benefit. Stem cells are also smarter than HGH, because they can respond to their environment. For example, if there is significant inflammation in an injured joint, the stem cells seem to ramp up their production of anti- inflammatory chemicals.
THOUSANDS of Australians are believed to be having unnecessary knee surgery despite evidence it could lead to life-threatening complications.
Research published in The Medical Journal of Australia today found that while several studies over the past decade had concluded arthroscopies were ineffective for osteoarthritis of the knee, Victorian surgeons continued to use the procedure on tens of thousands of patients.
Lead author Dr Megan Bohensky said about 8000 people had had the surgery in Victoria every year despite a 2002 trial showing arthroscopies were no better than placebo surgery in 180 patients.
That study, published in the prestigious New England Journal of Medicine, found no difference in pain and function in the two years after surgery.
Another study published in 2008 found arthroscopies offered no benefit over non-surgical treatments for osteoarthritis of the knee, and several systematic reviews since then backed this conclusion.
Dr Bohensky, of the Monash University centre of research excellence in patient safety, said although there was a temporary decrease in the rate of procedures being done in Victoria after the 2002 study, the trend was not sustained, suggesting surgeons rejected the findings.
An arthroscopy is a minimally invasive procedure involving the insertion of a camera and instruments into the knee joint to examine and repair it. Potential complications include nerve damage and life-threatening infections and blood clots.
In a review of this latest Victorian research, Melbourne rheumatologist Rachelle Buchbinder and Sydney orthopaedic surgeon Ian Harris said it showed ”the use of arthroscopy for knee osteoarthritis has been allowed to continue, exposing patients to an intervention that is at best ineffective, and at worst, harmful”
The pair said it had been ”difficult to shift the convictions of many surgeons” who probably had ingrained beliefs the surgery worked. However, they said financial incentives and patient expectations might also be at play.
Professor Harris said although he had stopped using the procedure, many surgeons might not appreciate the strength of the evidence against it. While it could help patients with loose matter in their knees, he said it would not provide lasting relief for ”the vast majority of patients”.
”When you think about it, it doesn’t make sense. Osteoarthritis is a degenerative wearing away of the lining of the knee, so sticking a camera in there and washing it out or shaving further cartilage away from the knee doesn’t reverse that problem. It’s still going to wear away just as fast,” Professor Harris said.
Dr Bohensky said given the lack of evidence for the procedure, GPs should encourage patients with osteoarthritis of the knee to try non-surgical treatments first.