STEM CELL TREATMENT (Part III) – Blog Post by Hasan Jamal

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·      The best way to try stem cell treatment

If you want to look into stem cell treatment, experts say the best way is to ask your doctor whether any reputable medical centers are conducting clinical trials focused on your disease. You can find trials at the National Institutes of Health’s website clinicaltrials.gov, but there is another caveat: “Some clinics say they are doing a ‘patient-funded study,’ and they’ll even list it on the government website, but when you look at the details, there are a lot of red flags,” Turner says. One of those is being asked to pay thousands of dollars to participate (reputable studies typically ask only that you pay your own travel fees). Turner also doubts the veracity of the data from these so-called trials. He and others are of the opinion that some clinics are simply trying to legitimize risky treatments.

 Experts say that for now you should steer clear. Mayo Clinic has started a regenerative medicine consultation service and tells patients that:

·      The current standard of care for nearly all medical conditions is still the best. If you have arthritis in your knees, for example, physical therapy, medication, or even knee replacement surgery will give you much better odds than experimental stem cell treatments, says Shane Shapiro, M.D., program director at Mayo Center Regenerative Medicine Therapeutic Suites.

On the flip-side, clinics point to success stories as reasons to try their stem cell therapies. Seven years ago, Amy Klein, a freelance writer in New York City, received a “stem cell face-lift” to get rid of a tired complexion and dark bags under her eyes. Stem cells were taken from her stomach fat and injected into her face. “So many years later, my skin still looks really good. Not only are my bags gone, but the quality of my skin is back to the dewy tightness of my youth,” she says.

But when small numbers of patients claim good results, scientists call it “Anecdotal Medicine” and stress that it is not strong enough evidence to base treatment advice on. “Before you can call something a success, you have to repeat your findings with a large number of patients over a long period of time,” Dr. Shapiro says. Until those major studies are done and it is proven that stem cells are safe and effective for the conditions for which they are being advertised, patients are simply rolling the dice.

·      Three steps to be taken before you try stem cell therapy.

Despite warnings, some patients with serious degenerative diseases who have tried all the conventional treatments choose for-profit stem cell clinics. “If someone thinks it is better to take a low-percentage shot as opposed to waiting for a degenerative disease to progress, that may not be an entirely irrational way to view things,” says Dr. Murry. “The problem is, it is nearly impossible for the average patient to evaluate whether an unproven treatment has evidence for safety or efficacy. This is why the clinics need regulatory oversight.”

How to protect yourself if you do decide to proceed:

·      See what the evidence shows. The federal database pubmed.gov lists results of most published studies. If you read reputable journals to see what the evidence reveals, you’ll be less likely to fall prey to a clinic’s overselling. If there is zero research on the use of stem cells for your condition, be especially concerned.

·      Know that some treatments are riskier than others. Procedures that inject cells into vital organs, like the brain, nervous system, heart, or eyes, have the potential to do more serious damage if the treatment goes awry than those aiming to fix joints or appearance.

·      Choose a clinic with care. “If they tell you a treatment they are selling has no risks that are a big red flag: They are either woefully lacking in knowledge or not being honest, and I would walk away,” says Paul S. Knoepfler, Ph.D. Keep your doctor informed. You’ll want to let your physician know you are planning to do this, and then see your doctor soon after your treatment, Dr. Murry advises.

Stem Cell Research --- In Pakistan.

Stem cells have proved to be of great therapeutic potential as this treatment is replacing traditional ways of treatment in different diseases like cancer, aplastic anemia, stroke, heart disorders. The developed and developing countries are investing differently in this area. The output and clinical translation of research greatly vary among developed and developing countries.

Many advanced countries (USA, UK and Canada etc.) are investing heavily in stem cell research and treatment. Different developing countries like Iran, Turkey and India are also following the developed countries and investing a lot in stem cells research.

 Pakistan is also making efforts in establishing this genre to get desired benefits but unfortunately the progress is very slow. If the government plays an active role along with private sector, stem cell research in Pakistan can get the boost.

 The publications from Pakistan are much less in number, compared to the developed and neighboring countries. Pakistan also has very few institutes working in this area of research.

Major research project related to stem cells in Pakistan

Higher Education Commission (HEC) and Pakistan Science foundation (PSF) has approved many research projects on stem cells recently:

·      Dr. Asmat Salim doing research on “Role of preconditioned and genetically modified mesenchymal stem cells in the regeneration of cardiac tissue” University of Karachi

·      Dr. Fridoon Jawad Ahmad is on “Development of Stem Cell therapy for Patients Suffering from Heart Disease in Pakistan” King Edward Medical University, Lahore.

·      Ongoing project by PSF is “Preconditioning of the stem and progenitor cells to increase their cardio-myogenic potential”

·       Besides this, there are few other projects which are going on in collaborations with American and European universities and research institutes and Pakistani researchers visit those labs and work there.

Stem cells research institutes in Pakistan

As stem cells have created a great hype all over the world so stem cells research institutes/centers are also increasing in Pakistan. There is no specific institute or center that is fully dedicated for stem cells research but there are many institutes which have dedicated labs for stem cells research. The major centers in Pakistan that are working in the area of stem cells are:

Serial #	Institute/Hospitals	Website link
1.	Centre of Excellence in Molecular Biology (CEMB)	www.cemb.edu.pk
2.	Center for Advanced Molecular Biology (CAMB)	www.camb.edu.pk
3.	Dr. Punjwani Center for Molecular Medicine and Drug Research, Karachi.	www.iccs.edu
4.	Shaheed Zulfiqar Ali Bhutto, Institute of Science and Technology (SZABIST)	www.szabist.edu.pk
5.	Lahore University of Management Sciences (LUMS), Lahore	www.lums.edu.pk
6.	King Edward Medical University (KEMU) Lahore,	www.kemu.edu.pk
7.	Quaid-i-Azam University, Islamabad	www.qau.edu.pk
8.	Pakistan Institute of Medical Sciences (PIMS), Rawalpindi	www.pims.edu.pk
9.	Atta ur Rehman School of Applied Biology (ASAB), NUST, Islamabad	www.nust.edu.pk/INSTITUTIONS/Schools/ASABZ
10.	Agha Khan University (AKU), Karachi	www.aku.edu
11.	Armed Forces Institute of Pathology, Rawalpindi	www.pnac.org.pk
12.	School of Biological Sciences, University of the Punjab, Lahore	www.pu.edu.pk
13.	National Institute of Blood Disease and Bone Marrow Transplantation (NIBD), Karachi	(http://www.nibd.edu.pk)
14.	CryoCell Pak	(www.cryocell.com.pk).

Conclusion:

Stem cells research is at its initial stages in Pakistan and there is a great need to bring government, academia and industry together so they could make serious efforts to promote research in this very important field. This will help millions of patients suffering from incurable disorders and will also reduce economic loss, ultimately.

References:

1.     https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445703/

2.      https://stemcells.nih.gov/info/basics/1.htm

2.

3.     http://www.isscr.org
Stem cell information for the public from the International Society for Stem Cell Research (ISSCR).