Across Canada and the United States, scores aging baby boomers, injured athletes and scores of other patients have been going to private clinics that promise a cure for arthritis, disc problems, joint injuries, and skin conditions with stem cells.
Despite the warning from Health Canada and the U.S. Food and Drug Administration that many of these treatments are unproven and unsafe, the hype around the promise of a cure through stem cell therapy has driven even driven many to embark on medical tourism trips to places like Arizona, China, and Mexico.
But unregulated and unapproved treatments pose dangers to patients. Earlier this year, The New England Journal of Medicine reported on the separate cases of three women in the U.S. who became blind after undergoing intravitreal injection of autologous stem cells for age-related macular degeneration (AMD) at private clinics that were offering such a procedure for a US$5,000 fee.
Some researchers have labeled such practices as pure “quackery” and the people peddling purported cures as “snake oil” salesmen.
“…most of them are still untested in clinical trials. There’s a lot of fraudulent stuff going on in this area,” said Dr. Allen Eaves president and chief executive officer of Stemcell Technologies Inc. “But there are a lot of people in a sad situation, who have some terrible disease and would want to try anything for a cure.”
Vancouver-based Stemcell Technologies is one of the largest biotech firms in the country. The company develops cell culture media, cell separation systems, instruments and other reagents for use in life sciences research.
“Stemcell Technologies support legitimate stem cell research,” said Eaves. “We’re very careful to whom we sell products to.”
If the company believes its product is going to be used by a physician doing fraudulent work, he said, Stemcell Technologies will not sell to that individual or organization.
There is currently a handful of research work into stem cell treatments being carried out in Canada. Some have made their way to the clinical trial staged but it will take many years for any of the therapies to be available, according to Eaves.
The Canadian Stem Cell Foundation’s Web site lists the following areas where stem cell research is being done in the Canada: ALS, arthritis, autism, blood disorders, breast cancer, cerebral palsy, Crohn’s disease, diabetes, eye disease, GVHD, heart failure, liver failure, multiple sclerosis, muscular dystrophy, Parkinson’s disease, solid tumour cancers, spinal cord injuries, stroke, and wound healing.
Scientists are moving forward but very cautiously. The availability of a legitimate stem cell therapy has been estimated to be anywhere from 10 to 30 years away.
Cell transplantation is among the most exciting areas of stem cell research these days, according to Prof. Cindi Morshead, chair of the Division of Anatomy, Faculty of Medicine at the University of Toronto.
The Morshead Lab at U of T is focused on understanding the fundamental questions regarding the behaviour of neural stem cells. The lab’s researchers use in vivo and in vitro techniques, cell transplantation, imaging, genetic manipulations and animal models.
“What is best, safest, and most beneficial stem cell to transplant? When do you transplant? Where do you put it?” these are some of the questions that lab researchers attempt to answer she said.
Morshead said her team is currently actively pursuing the role of stem cells in models of disease such as stroke and spinal cord injury.
Considerable hurdles, however, continue to stymie Canadian stem cell research, according to Morshead.
“The federal government needs to put in more money into research to make us competitive in this area,” she said. “We need to be able to move from basic scientific research to clinical research.”
Eaves agrees. He believes that Canadian researchers could do a lot more stem cell research if they had enough funding.
He said the federal government has poured in a lot of money into scientific research recently, but we are still playing catch-up with our G7 counterparts.
Stemcell Technologies is one of Canada’s largest provider of tissue culture for growing stem cells and cell separation work. However, only three per cent of its sales come from Canada. Sixty-per cent of sales come from the United States, another 25 per cent comes from Europe, and the rest comes from China, said Eaves.
“If we fail in funding fundamental research and clinical trials, we are going to lose researchers who will go to countries like the United States” where most of the stem cell research is going on, he said.
Still, there a lot of hope for Canada’s stem cell research environment.
Among the notable stem cell research being undertaken include that of Prof. Timothy Kieffer of the University of British Columbia, Eaves said. Kieffer’s team believes that the best therapies for diabetes will come from stem cells that secrete insulin.
Eaves also mentioned the world-recognized Edmonton Protocol developed by Dr. James Shapiro’s team at the University of Alberta, some 17 years ago. The treatment uses specialized pancreatic islet from organ donors. The cells are injected into the liver of a patient with diabetes to help the body produce its own insulin.
Morshead said one of the promising stem cell research in the country is the breakthrough MS treatment pioneered by Dr. Mark Freedman and Dr. Harry Atkins of the Ottawa Hospital and University of Ottawa. The treatment involved disabling the patient’s immune system and then generating a new one using the patient’s own blood stem cells.
“Canada has become a hotbed of world-class fundamental research in the last 25 years,” said Morshead. “…We can become the hub of stem cell research.”
The Medicine by Design initiative is an example of the growing interest in the country in regenerative medicine. It was established in July 2015 with a $114-million grant — the largest single research award in U of T’s history. Medicine by Design aims to build a leading centre for regenerative medicine at the U of T.
Medicine by Design leans on the expertise of U of T researchers and scientists and its affiliated hospitals to create multidisciplinary collaborations involving experts in the field life sciences, engineering, mathematics, and medicine to foster breakthrough treatments for conditions such as diabetes and heart diseases, according to Dr. Michael Sefton, who is its newly appointed executive director.
“Think of it as a studio meant for designing and creating new stem cell strategies,” said Sefton, who is a Michael E. Charles Professor of Chemical Engineering and a faculty member in the Department of Chemical Engineering & Applied Chemistry and the Institute of Biomaterials & Biomedical Engineering.
“Toronto is likely in the leading edge of research in this field, but it will take some time to get to the next level,” he said.
“Rather than just more funding, we need smart funding. We should be focusing efforts and resources on long-term solutions rather than short-term hits,” Sefton said.
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