Stem cell misadventures: shady stories from hot places

ResearchBlogging.org
A man staggers off a plane on to a hot tarmac. He’s flown thousands of miles in the hope that this visit to a country famous for its beautiful beaches, among other things, will mend his broken heart — medically, not metaphorically. The man isn’t here to loll around the beaches or bars even though he’s come loaded with cash.

Pseudo stem cell "therapies". Credit: MDI Digital, Popular Science magazine

He’s here to fork over the money for the privilege of hopping on to a surgical table in a private clinic. Here, he will open up his veins to a cellular infusion that the clinic’s doctors have touted as a magical cure-all. The rest of the story is in the July issue of Popular Science. Read it – it has a happy ending, so far, allegedly.

There have been lots of such stories sprinkled around in recent years about these so-called “stem cell tourists” who spend small fortunes traveling to Thailand, China, India, Brazil, Costa Rica, the Dominican Republic, etc., etc., for stem cell “therapies.” The small but very important detail that these stories either don’t mention or significantly downplay is that these procedures and their outcomes haven’t been subjected to any kind of scientific scrutiny or regulatory oversight.

There are hundreds of “clinics” out there offering to “cure” everything – from wrinkles to autism, diabetes, heart disease and dozens of other ills – with injections of stem cells taken from fetal tissue or of autologous adult stem cells (stem cells from the patient’s own blood or bone marrow). The rationale of course is that stem cells can act as a repair kit by differentiating into specialized cell types that can replace the ones that aren’t working. The danger is that stem cells can spawn tumors when cell division gets out of control – a drawback that researchers are currently addressing in the lab and a problem that needs to be resolved before stem cell trials can proceed on a large scale.

But the offshore stem cell “clinics” are operating under the guidelines of profit, not safety. And the maddening thing is that these places are getting away with convincing potential stem cell tourists that anecdotes and selective patient testimonials (“The procedure instantly made me feel better and life is now worth living” is a typical sentiment) on their websites are an acceptable substitute for hard medical data. None of these places or the people practicing “medicine” in them have actually published anything in peer-reviewed scientific journals.

Stem cell researchers have always condemned these pseudo therapies pretty forcibly, but I’ve always thought their protestations have lacked punch. Direly ill patients and their desperate families are not going to be swayed by experts objecting to these procedures based on observations made in experimental animal models.

Well, a more effective deterrent might be another sort of news that’s just begun to trickle in. It’s hard, empirical, irrefutable evidence compiled via biopsies, genetic and molecular tests that these procedures are delivering anything but cures in people.

The Journal of the American Society of Nephrology published a paper on June 17th that details the aftermath of a procedure performed at a Thai clinic on a patient who suffered from lupus nephritis, an autoimmune disease caused by the patient’s immune system attacking her kidneys. In 2006, stem cells prepared from the patient’s blood were injected directly into her own kidneys. The clinic has provided no details about what the outcome was in terms of the patient’s recovery. The patient’s happy ending, if there even was one, lasted six months.

Six months later, she was back on a surgical table, this time in a real hospital, where doctors found a four-centimeter mass on her left kidney and smaller masses in the kidney, liver and adrenal gland. The mass on the kidney, which the doctors removed, wasn’t a cancerous tumor (at least not yet), but an “angioproliferative lesion” – an entirely new term that the operating doctors coined to describe the mess of blood vessel and bone marrow cells that they found in the mass. They are now trying to figure out what caused these masses to form by trying to reproduce the procedure done on the patient in animal models.

The most direct proof to show that the injected stem cells caused the masses would be to show that the cells in the masses bear the same genetic signatures as the stem cells. As researchers did in this paper that came out last year.

In this case, a young boy suffering from  ataxia  telangiectasia — a severe inherited brain disorder — was injected with neural stem cells derived from fetuses at a private clinic in Moscow in 2001. Five years later, the patient arrived at a hospital in Israel complaining of severe, recurrent headaches. Guess what? The patient not only had a brain tumor, but also tumors in his spinal cord. This time, the doctors performed genetic tests that proved that the cells in the tumors were not the patient’s own, but rather that they came from two different donors, one of whom was female. Yikes.

And if that isn’t scary enough, then take the case of the Bio-Cellular Research Organization, a Newark, Delaware–based company with a manufacturing plant in Slovakia and offices in Malaysia, Taiwan, India and Switzerland, which brags that it’s treated hundreds of patients by injecting them with stem cells from fetal and newborn rabbits. Double Yikes.

Some scientists have declared war on these dubious clinics in a practical way. A bunch of them have banded together to form the International Society for Stem Cell Research, which recently launched a fantastic website that takes a closer look at stem cell treatments. In addition to providing a very basic, useful, and understandable FAQ, the ISSCR also acts like a global detective agency that will investigate clinics and treatments when patients considering offshore treatments submit an inquiry.

Stem cell research has already, unfairly, earned public mistrust and notoriety. And while adverse reports such as the papers highlighted above are currently scarce, it’s entirely possible that more of them are in the offing. One can only hope that such scientific descriptions of tragic outscomes will force an end to these dubious treatments and their practitioners before the inevitable bad press brings all stem cell research to a crashing halt.

Thirabanjasak, D., Tantiwongse, K., & Thorner, P. (2010). Angiomyeloproliferative Lesions Following Autologous Stem Cell Therapy Journal of the American Society of Nephrology, 21 (7), 1218-1222 DOI: 10.1681/ASN.2009111156

Amariglio N, Hirshberg A, Scheithauer BW, Cohen Y, Loewenthal R, Trakhtenbrot L, Paz N, Koren-Michowitz M, Waldman D, Leider-Trejo L, Toren A, Constantini S, & Rechavi G (2009). Donor-derived brain tumor following neural stem cell transplantation in an ataxia telangiectasia patient. PLoS medicine, 6 (2) PMID: 19226183

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One Response to Stem cell misadventures: shady stories from hot places

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