What role might stem cells play in the future of healthcare?
Could stem-cell treatments make doctors and healthcare professionals redundant? There are two things that worry me about stem cells. First and most importantly, there is the distinct possibility that this innovative treatment might ultimately put me out of the anti-ageing business. Second, gullible and desperate patients might be deceived by outsized promises and the hype of hucksters who deliver far less than is hoped for.
The commercial world may be light years ahead of the science and even for the trained professional eye this would be a challenge. The last time I went public about stem cells was when I wrote the concluding chapter in You have the power, detailing revolutionary treatments that were about to dramatically alter the landscape of the anti-ageing arena.
With colleagues telling me about having their stem cells isolated and re-injected for their rejuvenating potential, and my cutting-edge patients fronting up to clinics in this country for liposuction, not for cosmetic reasons but to have their reservoirs of fat utilised for harvesting stem cells for treating their arthritic joints and any other bits that might be ossifying, I thought it high time I familiarised myself with the stem-cell insurgency — a commercial reality threatening to reconfigure the face of healthcare.
Using our fat as a stem-cell source means we no longer have to agonise about the ethical dilemma and technological nightmare of siphoning off the stem cells of embryos. While having too much fat is abundantly bad for our health, there is a way we can now employ this giant repository of seemingly destructive sludge to provide the magical stem cells that can revitalise our ailing bodies and breathe new life into devastated tissue.
The Beauty about all this fat is that we can extract voluminous numbers of stem cells — much more than we used to be able to chisel out of bone marrow, where, until recently, we had to access stem cells, in itself an incredibly painful experience.
We can use these stem cells to make just about any cells we need, including cartilage, bone, muscle or nerve cells. And they are our cells, which means the problem of rejection goes out the window. Really, the potential is there to regenerate whole organs simply by collecting the stem cells that reside in our fat. We don’t know how far off this reality is, but pretty soon you may be able to front up for liposuction, get rid of the unsightly fat you don’t want and then have all those rejuvenating stem cells re-injected so the worn-out rest of you gets an instant revitalising makeover.
However, it’s important to make the point straight away that this technology isn’t available yet. The scientific community is still discovering how stem cells work and this involves painstaking research before human trials that explore the anti-ageing capacities of stem cells even commence. It’s pretty easy to get duped by unethical clinics around the world making outlandish promises they can’t deliver.
How can you tell if the cells that have been removed from your fat are even stem cells? One way might be through the specific antigenic signatures expressed by stem cells, which indicate they are present. Stem cells have name tags, which in medical terms means they can be identified by measuring certain components of the immune system that reside on their membranes, technically referred to as CD73, CD90 and CD105, resembling in some ways the codes found on the jumpers of sportsmen and women. Assessing their presence before and after treatment may be one way of telling if you’re receiving the real deal.
As mentioned, clinics in Sydney and Melbourne are already utilising stem cells derived from fat to regenerate cartilage in arthritic knees that have lost their functionality. They are also injecting stem cells to slow the ageing process, but they don’t appear to have any protocols for measuring whether and how this is making a difference.
If you want to find scientific justification for new technology, the website Pubmed is one of the best resources, as it contains all the scientific trials supporting these innovations. With regard to treating arthritis, all I could find was one paper describing how two patients were treated in a clinic in Seoul. One was a 70-year-old woman with a five-year history of knee arthritis who, after a number of treatments with fat-derived stem cells, experienced a 90 per cent reduction in her pain at the 12-week mark, with a significant improvement in her capacity to use her knees. An MRI scan also demonstrated a sizeable regrowth of cartilage. The other was a 79-year-old woman with a longer history of knee pain who enjoyed similar benefits.
Results from a placebo-controlled trial already conducted at the Royal North Shore Hospital in Sydney examining the benefits of this treatment on osteoarthritic knees will be released in 2013. Research centres around the world are busily conducting clinical trials exploring the capacity of these stem cells to treat a host of diseases, including diabetes, heart disease and spinal cord injury, to name just a few. The results of these trials can be viewed at clinicaltrials.gov.
While experts are enthusiastic about the enormous potential fat-derived stem cells have to not only treat a host of diseases but provide clues as to the possible cause of cancer, along with heart disease — still our primary nemesis — hence allowing for breakthrough treatments, they caution that we have yet to determine how stem cells exert their regenerative benefits.
More alarmingly, they raise the spectre of the risk of cancer, citing research showing that stem cells encourage cancer cells to grow and spread around the body and that they also secrete chemicals that shield cancer cells from the immune system. My stethoscope may not be relegated to the annals of history quite yet.
Dr Michael Elstein is a Sydney-based anti-ageing physician and writer. He is the author of two books, Eternal Health: The Comprehensive Guide to Anti-Ageing for the New Millennium and You Have the Power: Why didn’t my doctor tell me about this?
