Monthly Archives: May 2017

Stem Cells – Are they a magic bullet?

When the name stem cell rings in our ears, more conmen incidences runs through our thoughts. The science behind it has been over shadowed by the multi-crore businesses surrounding it applications. From the banking of umbilical cord stem cells to autologous transplant into the needed tissue its application has got widened pretty much since its entry into the scientific market. Not to forget the incidences of “60 minutes” show of CBS television, USA tracking down conmen offering stem cell therapy for a dearly price 6 years ago. But science have travelled a long way. From utilizing the embryonic stem cells to almost not using it nowadays we have got way advanced in this field. Let me give you some basic insights about stem cells here in this blog.

Stem cells are considered a blank slate, which can transform into any tissue depending upon the organ’s requirement. The potency and viability of stem cell are proven to decline as we age. Due to this, the repairing process declines too. So when we talk about autologous vs allogenic stem cell transplant (discussed later in this blog), this concept takes the center stage.

Types of stem cells:

ESCs are pluripotent whereas ASCs are multipotent. But many researches have stated that ASCs are pluripotent. This misunderstanding is a result of accepting in-vitro differentiation data that were generated by using non-physiological conditions and non-specific cell markers (These markers are used to track SCs once transplanted into the human body. Difficulties faced are fluorescence emitted by markers mimics auto-fluorescence by human tissue cells, markers can leak out and can stain normal tissue, harsh treatment required for tracking. These can give false positive results).

While we have so called ‘cures’ for many ailments, they address only the symptoms and not the disease per se. So patients have to bear the grunt of the disease. Stem cells are a promising option which address the underlying pathology of the disease rather than just resolving the symptoms. It helps in augmenting or accelerating the body’s natural regenerative capacity.

Does it sounds like a magic bullet? Now the main problem is that we are not able to utilize the full potential of stem cells. We either fail in the in-vivo differentiation process or being not able to produce a clinically significant regeneration. There is no uniformity in the understanding of stem cell behavior. Different researchers give their hypothesis for stem cell behavior. For example, few consider autologous stem cell transplant is better than allogenic as there is no immunogenicity as long we use MSCs (as they lack MHC-II). Whereas the ones who do allogenic transplant (stem cells obtained from human fetal waste tissues like umbilical cord or placenta after getting consent from the mother) claim that these stem cells taken from the fetal tissues retain the maximum potency and viability. The immunogenicity is addressed by removing the antigenic property by processing of these tissues prior to the transplant. This debate will be never-ending until the near future which will give us an answer!

We can see the sprouting of multiple stem cell treatment centers and storage banks within last few years. For the storage of the stem cells these banks charge around 50 thousand to 2 lac rupees till 26 years of the child age with an offer of additional two years free of cost. They even offer EMI options. The parents get paranoid by the proposals of the banking executives, that the storing of stem cells can be help full for the child and the sibling in case of blood cancers, storage disorders etc., in the future. But none of them actually know the whereabouts of the tissue storage facility and the quality control procedure. Imagine that these stem cells are stored in a facility where there is no proper maintenance of temperature and purity which could seriously compromise the viability of those cells. And what guarantee the client get that these companies will return their stem cells or even respond to them when they are in need of those cells after 26+2 years? The sense of fear of illness drives us towards these banking facilities. These stem cell banks lure their prospective clients with excellent web designs and trained executives who with their sugar coated tongue convince their clients. I am not trying to imply that that it’s not useful, but there exists a cloud of uncertainty surrounding their functioning.

With my research over stem cell applications in India, I found its use mostly in infertility, anti-aging, non-healing ulcers, critical limb ischemia (CLI) and in many orthopedic (non-union, ligament tears, OA, resorptive bone diseases etc.) and dental diseases (oral submucosal fibrosis, tooth regeneration etc.). Many other diseases like cerebral palsy, retinitis pigmentosa, cardiomyopathy and erectile dysfunction are being tried. As you can observe one thing from the above diseases that they don’t have any curative treatment options. So people’s desperation drives them to a better treatment. And I would say it’s their luck and sometimes their effort which takes them to an appropriate treatment center or doctor.

These practicing doctors are skeptical about publishing their results. Reason, many don’t know its scientific background. They purchase from the vendors who supplies it in the name of “product for research” (legal loop hole to evade convictions). Few don’t have the inclination and time to publish their research as they fall in to the category of “busy practioners” who openly proclaim their inability to publish their results due to time constraints. Few even claim that the journal rejects their manuscripts quoting their products as mere fibroblasts and sometimes they even say the West suppress Indians. I don’t argue about the genuinity of the their treatment here but because of this, stem cell therapy done in the private clinics remains a clandestine treatment option to the eyes of the actual researchers. Many research institutes in India like PGIMER-Chandigarh, AIIMS-New Delhi, Stem cell center for Advanced Research – Govt. Stanley Hospital Chennai  and many private hospitals namely Aravind Eye hospitals – Madurai, Narayan Health City – Bangalore provide commercial stem cell treatment options with concomitant research in that filed.

First DCGI approved stem cell trials and product is from a private company named Stempeutics. Their one of the product Stempeucel has got limited marketing license for CLI and have completed phase 2 trial for OA and diabetic foot ulcer. They along with School of Regenerative Medicine (SORM), Manipal University offer MSC and PhD courses on Regenerative medicine.

With regenerative medical and surgical procedures pacing up in developments for various cosmetic & therapeutic applications, stem cells therapies are finding its role, either scientifically or clandestinely, in varieties of unproven disorders with a miraculous promise of complete cure.

In lieu of having a negative notion on stem cell therapies, let’s have a discussion with the experts in the field of stem cell research and treatment. Multidisciplinary Research Unit of Dhanalakshmi Srinivasan Medical College, Perambalur is organising an one day National Symposium on Regenerative Medicine on June 3rd, 2017. I am being the organising secretary for the event, have invited speakers who are having more than a decade of experience in stem cell research and Treatment.

Opening talk will be by Dr. V.R Ravi, Consultant Orthopedician & the Director of Mother Cell Regenerative Centre (MCRC), Trichy. He is also the secretary of Indian Stem Cell Study Group (ISCSG). His talk will be followed by Dr.Sankaranarayanan’s lecture, who is Dental Surgeon and the Director of MCRC, Trichy. He is one of the pioneers in dental pulp stem cell (DPSC) research and have given successful results for patients with oral submuscosal fibrosis using DPSC. He also received the Best Innovator Award at the International Stem Cell Conclave on May 2017 organised by Antiaging Foundation, India in New Delhi. Myself, Dr.Natesh Prabhu, Assistant Professor in Pharmacology, DSMCH and Diabetic & Sexual Medicine Consultant at Manipal Specialty Clinic, Trichy will be giving a talk on Role of Stem cells in erectile dysfunction (ED) and Infertility. With an increasing incidence of diabetes induced ED and the high failure rate of PDE5 inhibitors (Viagra, Cialis, Tazzle) in these patients, stem cell therapy has shown to offer a promising restoration of erection for them. All these are in research stage and approved therapies are yet to hit the market. But this can’t be a reason to withhold a promising treatment option of autologous stem cell injection in the cavernous sinusoids of the penis. Various preclinical and few clinical studies (mostly abroad) have been done to support this claim. I will be explaining about ED and various treatment options in a different blog. My talk will be followed by the key note lecture from Dr.Rosy Vennila whose is the professor & Head of Microbiology department at Govt. Stanley Medical College, Chennai. She is the principal investigator of the Stem Cell Centre for Advanced Research which is the only government research body (supported by ICMR funding) to undergo stem cell research, on hepatocytes specifically, in Tamilnadu. Then we have three speakers from Bengaluru. Dr.(Lt.Col)Pawan Kumar Gupta, a hemato-pathologist and Vice President of Medical Affairs, Stempeutics Research Pvt. Ltd. Dr.Prathip Kumar, a consultant hematologist for Narayana Hrudayala Tissue bank and Stem cell Research centre at Narayana Health City. And Dr. Debasish Das who has done his postdoctoral research on stem cells at Karolinska Medical Nobel Institute, Stockholm and working as the Head of Stem cell Research Lab at Narayana Nethralaya. Final talk will be from our in-house oncologist Dr.Arun Seshachalam who is also the consultant oncologists from GVN hospital, Trichy. He is currently affiliated with many oncology trials  at GVN hospital and you can find his interviews to various channels like Sun TV on YouTube. And the last session is for the delegates to interact with our speakers during the panel discussion and clarify any of their doubts on stem cell research and treatment.

So don’t miss out on this humongous opportunity to learn about stem cells directly from the experts and clarify the enigmatic idea of whether the stem cells are really a magic bullet!

We have applied for 2 credit hours from Tamilnadu Medical Council

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National Workshop on R for Basic Biostatistics | July 19 -21, 2017 | AIIMS, Bhubaneshwar

The department of Pharmacology at All India Institute of Medical Sciences (AIIMS) – Bhubaneswar is organizing a “National Workshop on R for Basic Biostatistics” from July 19 -21, 2017. 

Aims of the Workshop:
To give an idea about the basic structure and functioning of R programming language
To manage, analyze (basic functions) and interpret the data generated from research projects and thesis using R as a statistical analysis platform

Target Audience
Anyone who is interested to learn and new to R
Medicine/ biology/ other health sector faculties, residents, scientists, research scholars and students

Prerequisites
Programming capabilities – NONE
A very basic understanding of statistics is preferable but not mandatory

Fee details
INR 5500/- for faculties, personnel from industry and scientists
INR 4000/- for residents, students and research scholars (researchers pursuing PhD)

The demand draft should be made in favor of “AIIMS, Bhubaneswar”, payable at Bhubaneswar. After making the demand draft, please mention your name, designation, place and phone number at the back of it using pencil. Fee once paid is non-refundable

For more details, click here.

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