So, What’s All This About Stem Cells?


Submitted by Geoffrey Ankeney, M.D., Kaiser Permanente Olympia Medical Center

Let’s start with what a stem cell is: They’re the proverbial “blank slates” of the body. When they’re first created, every cell in your body starts in an “undifferentiated” state, meaning they don’t have any specific purpose or task. Then they transform almost magically into specific cell types that make up your body. Every tissue in your body, from skin to bone to sclera to brain, started as a stem cell.

Figure 1: Stem cell division and differentiation A: stem cell; B: progenitor cell; C: differentiated cell; 1: symmetric stem cell division; 2: asymmetric stem cell division; 3: progenitor division; 4: terminal differentiation. Photo courtesy: Kaiser Permanente

As you might expect, lots of people are excited about stem cells because they’re basically the fountain of youth, right? It is surmised that by harvesting these cells and enticing them to differentiate into the cell type we want (say, pancreatic cells for a person with Type 1 diabetes), we could regenerate much or all of any lost tissue. Most of biological life is a process of cell death and over time especially, the regeneration of those dying cells is inadequate or doesn’t happen at all (like with an amputation).

This is exactly how stem cell therapy came into existence. Broadly speaking, stem cell therapy is the use of stem cells to treat or prevent a disease or condition. Probably the most common is for bone marrow transplantation, which has been shown to be effective in leukemias.

But we can imagine myriad possibilities for this kind of therapy including rheumatoid arthritis, Parkinson’s disease, Alzheimers dementia, osteoarthritis, stroke, traumatic brain injury, anti-cancer treatments and, yep, even male pattern balding.

There was a time when stem cell therapy was highly controversial because the cells were occasionally harvested from aborted human embryos.  Given the medical ethics and politics around this topic, focus has switched to obtaining stem cells from other places in adult human bodies, such as fat (adipose) tissue, bone marrow cells, and regular red blood cells.

Once cells are obtained, treatment with them is remarkably uncomplicated. Most commonly, the cells are simply injected into the site of damage or injury and, in theory at least, the new cells recognize lots of their friends “playing on the playground” and jump in the join the fun.

But right now it’s still just a theory. Although this therapy offers tremendous hope for new and effective treatments, for now that’s all that can be offered. Hope. Stem cell therapy is not FDA approved specifically because that approval is gained when a medicine or therapy can be proven to be both safe and effective.

It takes years of study and lots of instances of repeated good effect before a drug or therapy can be approved for use in the U.S. population. There are lots of medicine recipes sitting unused in a dusty basement because they either just didn’t work or worked GREAT but also harmed people. Once a therapy is approved by the FDA, insurance plans will start paying for it, and only then can most folks get the treatment. It’s a good system, but a slow one.

Stem cell therapy is in the research phase; there’s a ton of promise, but we’re not there yet.  While right now some providers are promising astounding outcomes, there’s no scientific research conclusively proving that it’s effective.  Patients can sign up for clinical studies to access the treatments and so we can all learn more, or patients can opt to pay themselves for the therapies.  In the meantime, we can work with our physicians to identify treatments that are scientifically proven and work to get us well and keep us well too.

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