What’s common between a neuron in your body, your hair, and your favourite piece of meat? The fact that all of them can be artificially grown from tiny stem cells.
These lab experiments aren’t just for fun though. Stem cell therapy, or treatment of medical conditions using stem cells, is a growing area in the medical field. So much so that the government wants to list stem cells as drugs, in order to regulate their use in therapy.
But what exactly is stem cell therapy? Where can it help? What are its benefits? Who can get it? Here’s a low-down on the latest buzzword in town.
What Is Stem Cell Therapy?
Stem cells are the building blocks of our body. They can renew themselves through cell division. When a stem cell divides, each new cell has the potential either to remain a stem cell or become a specialised cell, such as a muscle cell, a red blood cell, or a brain cell.
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Stem cells regenerate and repair damaged tissues and organs affected by age, disease and congenital defects.
Under certain experimental conditions, they can be induced to become tissue- or organ-specific cells with special functions. This is the basis of stem cell therapy.
Stem cells extracted usually from human bone marrow, circulating blood or umbilical cord blood are used to treat serious medical conditions. For example, if healthy blood cells have been destroyed in a patient due to any medical condition, they can have bone marrow stem cell transplants from healthy donors. This will allow their bodies to start making healthy blood cells again.
Where Can Stem Cell Therapy Be Used?
From blood-related disorders to orthopedics to even heart damage, stem cells have been used to develop a wide variety of treatment options. But here’s the catch.
Some stem cell procedures have been well established and are used to treat patients. And several other stem cell therapies are only in research stages and are carried out as clinical trials.
Globally, there are several studies which have been carried out to show how stem cells procedures can show improvement for neurological disorders like cerebral palsy, autism, blood disorders, orthopedics and even heart damage. But these have been achieved in very small groups of patients.
Mainly the treatments which are approved in India are related to haematopoietic stem cell transplantation which is transplantation of bone marrow, circulating blood or umbilical cord blood stem cells.
However, the new government notification which aims to regulate the field, has proposed a definition of which treatments can doctors provide to their patients.
Speaking to FIT, Dr Rohit Kulkarni, Vice President, Stem Cell Society of India, welcomes the move and explains:
"Any treatment where a patient’s own stem cells are being collected, minimally treated and then infused back into the patient as a part of the doctor’s regular medical procedure will be allowed and doesn’t need extensive approval. But if you’re substantially altering that cell, you’re multiplying it, you’re taking it from different tissues, propagating it further, then you have to do a clinical trial to prove safety and efficacy."
This proposed amendment to the Drug and Cosmetics Act says any treatment involving greater modification of stem cells will be treated as a drug and will have to seek the regulator’s approval.
However, Indian Council of Medical Research (ICMR) who has been spearheading the framing of guidelines for stem cell therapy, feels this needs more clarity. Dr Geeta Jotwani from ICMR says stem cell therapy is being exploited across the country and it should be defined more clearly.
"Stem cells are currently being used for genetic disorders, dementia, autism, etc, without explaining to patients or relatives that such cells transplant is not going to benefit them in any way." - Dr Geeta Jotwani
From Where Can Stem Cells be Harvested?
Stem cells can be harvested from menstrual blood, cord tissue, placenta, tooth extract, adipose tissue and dental pulp. They are stored in sterilised labs and have a life span of over 20 years.
But Dr Jotwani says that most of these are not allowed as per the guidelines. “Right now only banks registered with the Central Drug Standard Control Organisation can store stem cells derived from cord blood but not even cord tissue,” adds Dr Jotwani.
Bone marrow, circulating blood or umbilical cord blood are the approved areas for collecting stem cells.
How Much Can Stem Cell Therapy Benefit?
Stem cell therapy is quite a vast field in medicine. So understandably, its benefits depend on how and where the procedure is being used.
For example, for certain neurological disorders like cerebral palsy or autism, there aren’t alternate treatment options. So if stem cells can give even 10-12 percent improvement, it’s really good, says Dr Rohit Kulkarni.
Dr Yash Gulati, orthopedic surgeon, Apollo Hospital, says that stem cell therapy is still very niche and shouldn’t be seen as a mainstream treatment that could replace traditional treatment in orthopedics. “But I hope in the next 10-15 years it becomes mainstream with enough research,” he adds.
"Patients need to understand that every study they read on the internet can’t be implemented as it is. Many start coming for osteoarthritis or spinal cord injuries, but it’s not meant for that yet. There’s no evidence to support it works. There are one or two areas of cartilage loss where stem cell therapy is approved in orthopedics. But some still carry out other treatments, however, efficacy of those hasn’t been proven." - Dr Yash Gulati, Orthopedic Sugeon, Apollo, Hospital
Are There Any Side Effects?
Truth be told, not much is known about it. That is why the guidelines stress on carrying out clinical trials before any treatment is offered to patients. The trials won’t just tell whether stem cell therapy works for different diseases but also point out side effects if any.
For the treatments which have been approved, there aren’t any considerable side effects.
For example, a 2016 study on stem cell therapy for cerebral palsy, five of the 17 patients reported side effects like mild headaches, fever, or vomiting, all of which resolved in a few days. And there were no reports of any serious event.
All in all, it’s a growing field which promises better treatment options, but there’s still a long way to go to establish credibility.
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