Today, I’d like to continue and possibly complete our discussion of Regenerative Medicine. I want to consider where it stands today, and how Christians can navigate the complex maze of treatments. As you may recall, in the previous issue of this magazine we discussed that Regenerative Medicine is man’s attempt to re-create organ systems. We described how fetal tissue was attempted to be used, due to its low rate of rejection by the people receiving it. Medically speaking, it was problematic in that, if used on a large scale, it would require large amounts of aborted fetuses. Later, embryonic stem cells were studied in depth. Here, embryos, which are newly conceived humans in their earliest stages, are dissected (cut apart) and stem cells are taken.
Think of stem cells as indolent, immature adults, who live in their parents’ basements, without direction, not knowing what they want to do with their lives. With a little encouragement and direction, they can finally find their way, finding a specialized skill and important role in life. In like manner, scientists have discovered ways to “program” these stem cells, “encouraging” them to become specialized into types of cells, such as nerve, heart, blood, and insulin producing. These cells would then be grown in a lab, then used to repair or replace the diseased or injured tissue.
However, “taking” stem cells from embryos results in his or her (the embryo’s) destruction. This is obviously problematic for Christians, knowing that one of the seven things that the Lord says is an abomination is …hands that shed innocent blood –Pro 6:17. Additionally, the sixth commandment directs, Thou shalt not kill –Exo 20:13. Because these objections were recognized by the scientific community, there was pressure to find an alternative.
The Apostle Paul states, There hath no temptation taken you but such as is common to man: but God is faithful, who will not suffer you to be tempted above that ye are able; but will with the temptation also make a way to escape, that ye may be able to bear it –1Co 10:13. His words are as true today as they were 2000 years ago. While Christians suffer from disease just as commonly as non-Christians do, modern medicine can present the “temptation” of a treatment and relief from disease or injury that is actually immoral. But God is faithful, and his escape is twofold. First and foremost, He gave His son to bear our burdens. It is to this Great Physician that we should always turn to first.
In the case of stem cell treatments, it so happens that it was discovered that these immature stem cells are not only found in human embryos, but they are also found in all people, from infants to grown-ups as well. This may be the physical “escape” for His faithful children. These immature stem cells (usually obtained from a patient’s fat tissue or bone marrow) can be grown, cultured, and used just as well as embryonic stem cells. It turns out that “Adult Stem Cells” have actually been more clinically effective, since they are “custom designed” for each individual, and since they come from that person’s own body; therefore, there is very little problem with rejection.
Umbilical cord stem cells have also been shown to be useful, particularly in bone and cartilage treatments. Just as there have been obstacles to overcome when using embryonic stem cells, so too there are problems with developing treatments using adult or umbilical cord stem cells. Think again of a stem cell as an immature, indolent adult. Just having him “hang out” with a master carpenter will not make him a master carpenter if all he does is find entertainment on his cell phone. Stem cells, like an apprentice, need intense, focused training and direction to become specialists in their chosen field of expertise. Learning how to turn these “switches” on is perhaps one of the greatest challenges. The main idea here is that just injecting stem cells that have not been “programmed” or “trained” into damaged or diseased tissue will not automatically make them “know” what to become or how to function.
Similarly, just putting a young electronics apprentice on a bus that is traveling into a city that just had a power grid failure will not result in restoring the power. Here the parallel is placing stem cells into the brain of a stroke victim or a paraplegic accident victim, hoping that the stem cells will “know” what to do, and which specific connections to repair in order to restore function. This may not work as hoped. It would be fruitless to expect success unless and until these problems are also addressed.
Then there is the lingering problem of these eager youngsters (stem cells) knowing when to stop. The problem with fetal tissue turning into cancerous tumors is also a problem to be dealt with in stem cells. Considering this, there is one exception: umbilical cord stem cells are generally not known to turn malignant.[1]
Here is a short list of treatments that are in development that would use stem cells:
• Macular Degeneration—Repair a damaged retina.
• Spinal Cord Injury/Stroke—Repair nerve tissue.
• Burns—Repair skin tissue.
• Congestive Heart Failure—Repair damaged heart tissue.
• Diabetes—Replace or increase the pancreatic tissue that makes insulin.
• Arthritis—Repair damaged cartilage.
• Autoimmune diseases (Lupus, Multiple Sclerosis) —Destroy the immune system that is attacking its own body and replace or “reset” it with a new immune system derived from one’s own stem cells.
• Leukemias—Destroy the cancerous blood cells and replace them with new stem cell derived blood cells.
• New organs—Replace diseased, damaged, or cancer-ridden organs, such as the kidney, liver, or pancreas, with organs derived from the patient’s own stem cells, grown in a lab, and transplanted surgically, without the need of anti-rejection drugs.
As you can see, there is a very long list of diseases and ailments that may result in effective treatments with stem cells. I am very optimistic that within a decade, remedies for many of these ailments will be commonly available. However, learning how to make stem cells that are expertly specialized into specific tissue types, learning how to turn stems cells on and then turning them off at the necessary time (once the job is finished), and learning how to “teach” the stem cells where and how to make repairs will take time.
I am not the only one who is excited about the possibilities. That is why hundreds of stem cell clinics have sprung up across the country, trying to get in on the excitement. But do the claims of any of these clinics align with reality? Which ones are legitimate? I know that there are many clinics offering stem cell treatments for various ailments, so let’s now look at some of the treatments that are available today—ones that have evidence of actually helping, as well as realistic expectations. Let’s also look at some of the possible complications, to help us make informed decisions.
First, the risks and complications
• Introduction of infection—For example, bacteria living on the skin can enter a joint space from a simple injection, resulting in destruction of the joint, even under the cleanest of conditions.
• Stems cells moving from their introduction site and not going where they are intended or not staying contained to the specific area of treatment—One study involving pigs treated with stem cells injected into areas of a damaged heart after a heart attack showed near complete return of function, but then the new heart tissue kept growing, eventually filling the heart’s pumping chamber, which caused all the pigs to die.
• Stem cells changing into unexpected or inappropriate cell types—Stem cells used for a facial cosmetic effect have actually turned to bone.[2]
• Growth of tumors—There are documented cases of different tumors, including brain and kidney tumors that have developed after patients were treated for stroke and kidney failure using stem cells.
• Failure to work as expected—There are documented cases of people with macular degeneration, who were treated with stem cells injected into the eye, that have resulted in blindness.
• Stem cells can’t be withdrawn—Unlike medicines such as a pill or an injection, if something goes wrong, one can’t just withhold the next dose. Once stem cells are introduced, they can’t be taken back. The course that has been set will continue.
The rates of complications are hard to know, since there are no reporting requirements when performed outside of formal clinical investigations.
Next, the known benefits
The FDA (the governmental Food and Drug Administration that is tasked with health safety) has approved stem cell treatments for dozens of blood cancers (leukemias) and blood diseases using umbilical cord stem cells. Though not FDA approved, studies have shown some benefit for using stem cells for orthopedic applications, particularly arthritis of the knees. (Using stem cells for such orthopedic uses, without the need to stimulate them to become cartilage cells beforehand, appears to be the exception to the rule. Remember most stem cells need to be specialized before being used.) That’s it! Aside from this, most other uses for stem cells should only be considered either highly experimental or highly suspect of exaggerated benefits. Could there be other beneficial treatments that are not FDA approved? Perhaps, but it’s important to realize that the claims have often far outpaced the science.
So how is one to know? Here are some things to consider when choosing providers of stem cell treatments, as well as red flags, to tell you if there are better places to go for your health care. (These points are also true for just about any other treatment):
1. Informed consent—Every medical treatment has risks and benefits. These should be routinely discussed with you beforehand, without you needing to ask. Any practitioner who claims there are no risks, only benefits, either is not sufficiently knowledgeable or is not sufficiently honest!
2. Can they handle the complications? —Joint injections can sometimes result in infection. These can be severe infections that can potentially destroy the joint. Such complications are not just simply treated with antibiotics, but with surgery. These stem cell treatments are better handled by an orthopedic surgeon or practitioner that has a close relationship with one, if complications should arise. Likewise, treatments involving nerves should be done by neurologists or neurosurgeons.
3. Is the clinic adequately equipped? —Stem cells need to be handled appropriately. The transport of umbilical stem cells and improper thawing from the supplier can drastically reduce numbers, which may have a great deal to do with determining the success of the procedure. Additionally, these cells may be in a state of “shock,” unless they are appropriately re-cultured after being thawed. This allows them to re-enter a desirable growth phase again.[3] This may mean having a specialized lab and microbiologist on staff to properly grow and care for the stem cells, ensuring good quality control. This usually requires a university setting, not just a small clinic or office that has a nurse to thaw the stem cells after receiving them from an overnight delivery service. Glitzy web sites, colorful brochures, and informational dinners are not enough.
4. Guinea pigs and rats are “experimented on,” people go through “clinical trials.” —Please avoid any practitioner who says they are doing experiments. Clinical trials involving people, which have the oversight of ethics boards, only occur after experiments on animals have shown low risk of harm, and a good chance of success. If a treatment is very effective, the FDA has suggested that as few as 42 participants can demonstrate adequate safety to grant approval. This is not an outrageously high threshold to overcome. Additionally, patients involved in clinical trials are usually only expected to cover minimal costs, if any. Practitioners who “experiment” on people rarely do it for free.[4]
5. Realistic claims. —Does your practitioner claim 100 percent success? If so, it is better to run away (if your knees will allow you to) than to simply walk away! Knee treatments, for example, may only delay knee replacements for many people. Some may avoid surgery, but certainly not all. Do not expect a cure. Also, do they make claims well outside of what is commonly recognized? “Cures” claimed for Alzheimers, Parkinson’s, or other ailments that are not FDA approved? I cannot totally exclude the possibility that such treatments may exist at some future time. However, these practitioners should be able to point to (and provide to you) published studies. If there is a miraculous cure, the world should be able to benefit from it, and he or she should be able to patent it, so as to reap the financial benefits of sharing their techniques and discoveries with the rest of the world. By doing so, it is independently tested and verified. Anyone who has a “secret” cure, that they alone possess, should be avoided.
6. Does it make sense? —By simply injecting stem cells (that have not been induced by a lab into their specialty state such as nerve cells, heart cells, etc.) into the bloodstream to treat things like nerve disorders, for example, does not make sense. Clinical trials of legitimate treatments first specialize the stem cells, then directly apply them to the affected area. For example, specific types of nerve cells are injected directly into specific locations of the brain, and heart cells are injected directly into the scarred tissue of the heart. Remember the indolent adult (the unspecialized stem cell)? You can’t expect to put them on a bus (inject them into a vein), send them into the big city (the body), without instructions on what to do (leaving them unspecialized), not knowing where to go (to somehow find the diseased part of the body) and then magically expect success.
7. The hard sell. —Are you being told that or are you made to feel that you are “missing out” if you decline? Do the clinic advertisements have testimonial bylines, something to the effect of “Individual results may vary, and testimonials are not claimed to represent typical results and are not intended to represent or guarantee that anyone will achieve the same or similar results…”? As the old adage goes, if it’s too good to be true (especially if they actually tell you so), then it probably is. In these cases, consider the claims to be most likely somewhat exaggerated, and also consider working with someone who can give a more honest set of expectations.
I pray that God may grant you wisdom: If any of you lack wisdom, let him ask of God, that giveth to all men liberally, and upbraideth not; and it shall be given him –Jas 1:5.
Special Note:
I have had some interest expressed from
parents who are considering taking their children to Japan to be vaccinated
there, if we are unable to have the vaccines shipped to the United States. If
there are any readers of this magazine who are likewise interested, please
contact The Berean Voice, so that we can plan and coordinate accordingly. You
can find contact information inside the front cover of any copy of The
Heartbeat of the Remnant magazine.
[1] Chen G., Yue A., Ruan Z. Human umbilical cord-derived mesenchymal stem cells do not undergo malignant transformation during long-term culturing in serum-free medium. PLoS One. 2014;9:1–9.
[2] https://www.scientificamerican.com/article/stem-cell-cosmetics/?redirect=1
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279133/
[4] http://iacld.ir/DL/elm/95/clarifying%20stem%20cell%20therapy%60s%20benefits%20and%20risks.pdf
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