Dec 27 2012

More Stem Cell Quackery

Stem cells are an exciting area of medical research. They are cells that have the ability to transform into different cell types, a property known as pluripotency. Some stem cells, such as embryonic stem cells, can turn into any cell type, which is called totipotency.

The hope is that researchers will develop the technology to harvest or create stem cells, manipulate their properties if necessary, transplant them into patients with specific diseases or damage, and coax the stem cells to fix, support, or replace the diseased or damaged cells. This is a potentially powerful treatment in theory, but is very tricky in practice. Researchers are still, in most cases, working out the basics of the technology – getting stem cells to survive and do what they want them to do, without growing into tumors or causing other problems. Researchers are making incremental advances, but are mostly in the test tube or animal research stage. For some indications they are making the first forays into preliminary human research.

Public awareness and interest in stem cell treatments, however, is way ahead of the reality. It takes years, perhaps decades, to innovate an entirely new treatment paradigm such as stem cell therapy. Unfortunately some unscrupulous clinics have decided to cash in on the premature hype by offering bogus stem cell treatment for serious illnesses. Most of these clinics are in countries with lax health care regulations and oversight, hoping to lure in wealthy and desperate foreigners. In fact, one of my first blog posts was about one such clinic in China.

There has been a bit of a backlash against these clinics, but by all appearances they seem to be thriving. One such clinic in Ukraine promises fetal stem cell transplants for a variety of condition, including autism, ALS, cancer, and anti-aging. From reading the website you would think stem cells are the elixir of life, good for just about any condition. If the claims on the website were true it would mean that this Ukrainian clinic is decades ahead of rest of the world in stem cell research.

Strangely, there isn’t much of a paper trail of research to back up their claims. The website does have a page for publications, but they appear to be mostly paper presentations (presented at meetings, not peer-reviewed) of case series. This is the weakest form of evidence. They are not placebo-controlled trials, but simply a recording of their experience with treating patients. In other words, it is just a catalogue of bias and placebo effects. I tried looking up some of the listed papers, but they are not on Pubmed (meaning they are not published in recognized peer-reviewed journals). I also looked up the author’s name, Smikodub O.I., and received a single publication about the treatment of anemia.

So they managed to advance stem cell therapy by decades without publishing a single peer-reviewed paper. They claim to have extended ALS survival by 5 years – that’s about 200% or 10 times greater than the only existing proven therapy. Actual published research on stem cells and ALS still talk about the challenges and barriers to application, while being hopeful about existing animal research. No therapy has been proven in humans, however.

The clinic also offers treatment for autism, writing:

In autism, areas of brain regulating memory, concentration, attention, speech etc. are damaged. Stem cell treatment improves blood and oxygen flow to the brain (improved perfusion), replaces damaged neurons and stimulates formation of the new arteries. After some time, FSC acquire properties of cells surrounding them and multiply into these cells, which results in white and gray matter restoration and, consequently, in subsidence of neurologic symptoms and improved intellectual capacity.

The above paragraph bears no resemblance to what is actually known about autism. They claim that in autism areas of the brain are “damaged” – but there is no evidence for this. There is a decrease of connectivity in the brain, but no evidence that neurons are damaged or that there is any role of lack of oxygen delivery. The only publications I can find on stem cells for autism speculate about the potential future development of such a treatment.

Conclusion

While stem cell therapy continues to offer promise, we are not there yet. Do not believe the claims of clinics that offer current stem cell treatments for serious diseases. They are exploiting the hype of stem cells and the desperation of patients. There is enough actual research going on to make the treatments seem plausible and cutting edge, but at present such clinics are simply fraudulent.

The development of major new therapies is complex, takes years, and creates a record in the peer-reviewed literature of hundreds or thousands of published papers. Researchers play off each other, benefiting from the findings of other labs. It is extremely unlikely that one group or clinic would be decades ahead of the rest of the world. Further, if anything remotely like the results claimed by such clinics were possible and proven, such therapies would be widely available. You wound not have to travel to Ukraine to receive such a treatment.

International pressure to shut down fraudulent stem cell clinics needs to remain a priority. They victimize in numerous ways vulnerable populations and their families.

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