Stem cells could easily star in their own blockbuster mini-drama series. Since researchers first identified these life-rejuvenating cells three decades ago, the media has covered the field with a Jekyll and Hyde approach. On any given day, stem cells might be medicine's biggest breakthrough or its emptiest promise. Meanwhile, religious leaders have decried their use, and politicians have fought ferociously to prevent — or, depending on their party's dogma, to provide — funds for research. These continuing controversies hail from the late 1990s, when scientists experimented with fertilized eggs donated for research after being obtained initially for in vitro fertilization (IVF). Though stem cells from human embryos are rare in research today, the public often associates one with the other thanks in part to a legacy wrought by these loud, tumultuous battles.
Despite the confusion, recent opinion polls from the U.S. and Europe hint that the public is more supportive of stem cell research now than in the early 2000s. A couple of years ago, the Vatican hosted its second research conference to raise support and awareness for therapy that relies on stem cells taken from adults. Earlier this year, two global drug makers announced initiatives to pursue stem cell–based treatments. The French company Sanofi teamed up with a smaller biotech to investigate a therapy that might reduce or do away with the need for insulin injections in diabetic patients. Pfizer is working with researchers on a blood cancer drug that targets cancer stem cells. Researchers at U.S. universities continue to compete for major grants, like the one recently awarded to a UC Davis Health System team in California to research stem cells in HIV patients with lymphoma. Taken together, such developments seem to tip the scales back to stem cells as medicine's biggest breakthrough. Indeed, the global stem cell therapy market may be worth $40 billion in 2020, according to Frost & Sullivan, a market research consulting firm, which would be a huge jump from the past. (For perspective, IMS Health reports that the global cancer drug market was worth $91 billion in 2013.)
But positive headlines don't translate to the public's understanding of stem cells themselves. DLDsummer15 speaker Eckhard Alt, M.D., Ph.D., wants to fill this knowledge gap. He wants to demystify stem cells for everyone. Alt is board chairman of InGeneron, Inc., a biotech company in Houston, Texas, that currently uses stem cell treatment for patients and animals. It's just one of the many roles he fulfills after a 12-year career deeply steeped in stem cell work.
In his talk, he offered a summary of the field that rolls off the tongue: “Stem cell therapy is nothing but taking cells from one tissue and injecting [them] into the dying tissue which is in need of those cells." Nature, he explained, has given us a pool of regenerative cells that can be found in the blood vessels in every organ of the body, including the brain. We are born with plenty of these specialized cells. As we age, stem cells take longer to multiply, and eventually the pool is exhausted, thus slowing the supply of new cells to organs, and the body begins its gradual decline. What makes these cells so special? Stem cells self-renew for life. Conversely, regular cells divide, perform their specialized task, and then die. The other mind-boggling quality of stem cells is that when they divide, they can create another stem cell, or, for example, a liver cell. They can create something from nothing.
“It doesn't depend where you take stem cells from, you can take these cells from your heart, from your brain, from your muscle, from your skin," Alt said, describing the process of autologous adult stem cell treatment, or taking the self's cells and putting them back in the body. Stem cell therapy works, in part, by flooding a damaged organ with brand-new cells, which then literally begin to rebuild what was lost. Just like a lizard's tail.
Alt has documented some miracles to illustrate this process.
On the display screen during his talk, Alt flipped up an image of an open wound on the leg of an 85-year-old woman treated at the Houston clinic. The wound had persisted for six years. After a stem cell injection, the patient's wound began to heal. In another example, an X-ray photo revealed that a male patient had no cartilage left in his knee. One year after stem cell therapy, new cartilage had regrown completely between the bone joints. A 43-year-old man already confined to a wheelchair suffered from bone loss in his hip. Ten weeks after stem cell injections, the cartilage had regrown and the man walked without problems. A Texas man suffering from multiple-system atrophy, a rare neurological disorder, struggled to walk down steps or lift a fork to eat. Four weeks post-treatment, the 58-year-old moved more fluidly and easily waved his hands.
No talk on stem cell research would be complete without mention of the therapy's potential as an anti-cancer agent. Alt offered a preview of a therapy that could one day appear in the cancer drug pipeline. This drug would interrupt communication between cancer tumor cells and stem cells. Cancer cells rely on stem cells to create the overall infrastructure, or “house," of the tumor itself, Alt explained. Without a house, the cancer dies.
Then, just as quickly as Alt brought out a crystal ball for stem cell therapy's future, he tucked it away. He stopped short of reciting unanswered questions that block stem cell therapy's path to the mass market. For example, how does a cardiologist ensure that an injection of stem cells develop into specialized heart cells, and not lung cells? How long will a new supply of stem cells last inside a patient? What is the best way to generate enough stem cells for a transfusion to be successful?
But what is the purpose of mulling theory when people are practicing the results right before your eyes? Alt the physician has witnessed his patients walk where before they shuffled and heal where in the past they had stubborn open wounds. For Alt the realist, the promise of stem cell therapy is no longer in the future. It's already here.