Scientists in Japan celebrate this week after being the first in the world to successfully treat corneal disease with stem cells. Despite the hum of promise washing the community, many news sources suggest that these findings be met with skepticism. While it is important to exercise a measured skepticism when faced with any kind of novel medical practice, the current applications of stem cell treatments show real promise for the advancement of medicine.
"Stem cells are safe" says a neurologist for the Ukrainian clinic that uses stem cell treatments called ilaya. "Recently there has been speculation that stem cell therapy can contribute to the development of cancer. But there is no documented case of this anywhere in the medical literature." The company says in a statement about their stem cell clinic and associated therapies. Ilaya is one of many clinics globally that are offering new and promising medical treatments and therapies using stem cells.
As scientists from Japan, Oxford, and all over Europe and Asia report exciting news in the development of stem cell-related technologies, the US seems less positive. As some sources warn the US against "bad actors" and poorly instructed treatments. Which brings to surface questions about where stem cell research really sits in the eyes of science.
Pluripotent vs. Embryonic Stem Cells
Perhaps one of the most exciting, and arguably freeing, advancements in stem cell therapy is the discovery of induced pluripotent stem cells (iPSC). For years, much of the research surrounding stem cell advancement was incredibly reserved, due to the nature and procurement of embryonic stem cells.
Embryonic stem cells are those that are collected from blastocysts or the very earliest stages of fetal development. These cells are truly pluripotent, meaning, these cells are capable of forming tissues from all three primary germ layers (ectoderm, endoderm, and mesoderm). What this says to a layman is that pluripotent cells have yet to differentiate into specific types of cells. They can be anything, from liver cells, bone and blood cells, to the building blocks of the brain. They are truly capable of forming any layer of any part of the body. Both in human and animal models.
While for decades these embryonic stem cells were the only link that researchers had to accessible pluripotency, in 2006 however, this all changed.
In Japan, Shinya Yamanaka's lab discovered that by genetically "reprogramming" certain adult cells, one could convert adult cells into pluripotent cells. The concept was so novel and had applications so vast, that in 2012 Yamanaka was awarded the Nobel Prize for these findings. What this meant to the scientific community at large was that: not only could they be provided with pluripotent cells outside of the questionable collection from embryos, but that these cells were host-specific. Meaning that things like transplant rejection could effectively be a thing of the past.
The Growing Need For Stem Cell Clinics
The idea that adult cells could become the functional structure for almost any organ, organelle, or bodily structure- without concern of host rejection was something medicine had only dreamed of. "Think of the waiting lists that patients requiring donor materials. Some of the time expected to find a donor can far exceed the prognosis of the patient themselves. A large part of these waits isn't just lack of available organs, but also lack of donor matches. Now, what if that patient didn't need to be on a list, what if the specific replacement they needed could be grown from their very own cells." The company posits.
Ilaya and similar clinics aren't alone in this query. Outside of rejection statistics, the waitlist on necessary organ transplantation is often unrealistically long. In the US alone, there are currently 121,678 people waiting for necessary organ transplantation, and 13 people die every day awaiting kidney transplant according to the National Kidney Foundation. One global survey on the prevalence of corneal donation need alone, stated that there exists "only 1 cornea available for 70 needed", which makes Japan's latest triumph that much more exciting.
Drug Testing and Personalized Medicine
Not all organs even make it to people in need. Some are purchased solely for medical research, which can be a drain on the limited resources. Step in iPSCs. While iPSCs have shown great promise in individual treatments, these procedures still remain highly controversial throughout different communities.
One thing that seems widely agreed upon, however, is the use of iPSCs in pharmaceutical testing. iPSCs can be used for in vitro drug modelling. Historically, actual organs or cells were required to be able to see disease processes within specific human systems. Sometimes researchers use animal models, like rats or pigs, to be able to see how disease and specific treatments may affect the mammalian functionality. With iPSCs, researchers are now able to build organs and organelles, like neurons and cardiovascular cell systems.
Having these organ structures on hand, researchers can now begin to tailor treatments and medicine directly to patient-specific disease response. Making designer medicine within reach. As an added bonus, one study points out that by using iPSCs for patient-specific disease modelling and therapeutic agent design, they will inadvertently be able to understand the usability and application of iPSCs in and of themselves. Observing first hand how they can be best used in clinical translation. Which could be "a powerful approach that holds great promise for regenerative medicine in the future."
What the Future Holds
So while many treatments regarding stem cell technologies are still considered highly experimental. Clinics from all around the world are starting to display positive findings with the use of these cells and combating devastating and irreversible disease processes. From cardiovascular disease to psychiatric applications- such as autism and schizophrenia.
For now, the types of treatments that clinics are able to offer may be limited, but thanks to the ever-present rumble of science moving forward treatment, analysis, and procedure- we may be at the very tip of a very large iceberg of discovery. Only time, and experience will tell.
