Stem cell therapy and treatment in Germany
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Cell therapy is considered the most promising medical field. It is expected that it will be possible to grow new organs or rejuvenate the body with their help in the future. Good progress has already been achieved in the treatment of many diseases, namely, stem cell transplant can now treat leukemia and other onco-hematological diseases. Stem cell injections help restore many organs and systems affected by degenerative diseases, autoimmune inflammatory processes, or ischemic necrosis. Some German clinics use cell therapy to treat Alzheimer's disease, autism, multiple sclerosis, optic nerve atrophy, strokes, and many other pathologies.
Content
- Autism
- Optic nerve atrophy
- Alzheimer's disease
- Multiple sclerosis
- Diabetes mellitus
- Myocardial infarction
- Stroke
- Liver diseases
- Where can you undergo stem cell therapy?
Autism
Autism, or autism spectrum disorder, is a disorder disrupting a child's psychological development. It manifests itself at an early age, usually up to age 3. This pathology is accompanied by the impossibility of full-fledged social interaction, the development of communication skills, the desire for stereotyped behavior, and repetitive actions.
Here are some of the minor symptoms that do not always occur:
- selective eating;
- attacks of anger, fear, autoaggression;
- epileptic seizures;
- mental retardation.
Autism is an incurable disease. The causes of its development can only be established in under 50% of all patients. Organic or functional disorders in the brain are usually detected and these can be associated with genetic mutations or be negative effects of certain factors (the environment, drugs, etc.) on the body of a developing fetus.
Typically, autism is characterized by a brain lesion, which can be identified by modern diagnostic methods. It is impossible to restore these regions with the help of conventional treatments. However, in recent years, cell regenerative therapy has been actively developing. The use of stem cells has already given encouraging results and allows parents to hope that soon, their children will be able to completely recover from autism or at least reduce its manifestations and adapt for an independent life.
The standard treatment methods include:
- behavioral therapy;
- antipsychotic medications.
The use of stem cells opens up new perspectives for autism treatment. This method is not currently considered standard and is not included in the protocols for providing medical care to children with an autism spectrum disorder. Nonetheless, many reputable clinics in the world are engaging in clinical trials aimed at the confirmation of cell therapy effectiveness. After their completion and the analysis of the results, the technique will probably begin to be used more widely. Thousands of drugs, procedures, and medical manipulations used in the world to treat a wide variety of diseases, have already passed this process. One of the major trials to evaluate the effectiveness of stem cells in autism was conducted at Duke University (USA). Its second phase was completed in 2018.
But today, stem cell treatment is available to patients in the world's leading clinics. The experiences of both doctors and patients, shows that the application of the technique allows doctors to obtain excellent results.
Clinical case
Samantha, USA: Last year, our life turned into real hell! Our child started having epilepsy seizures. He cried and hit his face with his hands without any obvious reason. Similar seizures occurred almost every day! They mostly happened in the morning, almost immediately after waking up. I decided on stem cell treatment and we flew to Germany to undergo the procedures. The improvement followed right away and the child had no seizure the next morning. I can see that the child has begun to sleep better and rarely shows any negative emotions now. Now I can see a smile on his face more often! I hope that the result from the stem cells will remain forever and improve after the follow up procedures.
Most doctors consider stem cells to be the most promising area of treatment for diseases of the central nervous system. So far, it is generally accepted that "nerve cells cannot be regenerated". However, the use of cell therapy in the past few years, refutes this thesis. Many clinical trials test the effect of the patient's own stem cells and donor stem cells, embryonic and fetal stem cells, on the body. The doctors usually get good results – in 60-70% of cases, parents of patients note improvements in their child’s behavior.
It is assumed that the mechanism of action of stem cells in autism is associated with the restoration of the damaged brain structures. Although the first results from therapy can be obtained immediately, they are expected to improve over the coming weeks and months due to the restructuring of the problematic parts of the central nervous system. The doctors mostly practice the introduction of autologous (the patient's own) stem cells, since this procedure is absolutely safe.
Scientists are still obtaining further evidence of the effectiveness of cell therapy. A 2015 study by Michael Chez demonstrated the restoration of the ability to initiate social interactions and form relations after stem cell treatment in more than 50% of patients. A study at Duke University (USA) showed alleviated autism symptoms (according to a survey of parents) in 60% of patients.
Thus, the use of stem cells for autism is a promising area of treatment. It may be used as a standard treatment method in the future. But so far, this treatment method is not available to all patients, since it is expensive and only available in a limited number of clinics. Many parents go with their children to Germany for treatment. If they do not have the funds to do this, they can raise them through charitable foundations or crowdfunding.
Optic nerve atrophy
Ophthalmology is one of the rapidly developing medical fields. The doctors can now easily cure many diseases that previously led to blindness or dramatically impaired vision. They can correct refractive errors using laser technologies, heal cataracts and glaucoma, and transplant the cornea. However, one problem remains unresolved: it is impossible to restore damaged nerve tissues of the optic nerves or retina.
At least, this was what was believed before the introduction of stem cells into clinical practice. Today, numerous studies show their effectiveness in the treatment of optic nerve atrophy. The cells are injected either into the eye or intravenously. Some clinics can inject autologous stem cells collected from the patient's blood, adipose tissue, or bone marrow.
The different methods of introducing cells that clinical trials use are:
- intravenous;
- subconjunctival;
- subtenon;
- parabulbär;
- intravitreal;
- suprachoroidal;
- into a canal that is formed after a radial optic neurotomy.
Cell therapy for optic nerve atrophy is not yet the standard treatment, but some clinics in Germany already use stem cells. These clinics are visited not only by Germans, but also by medical tourists from many countries of the world.
Clinical case
Mohammed, United Arab Emirates: I had advanced glaucoma, which caused optic nerve atrophy in both eyes. Doctors in the hospital told me that the left eye is "dead" and there is nothing they can do about it. The right eye sees a little, but it will soon be as affected as the left one and the operation may not help. I did not want to put up with this situation and went to Germany. There, I was treated with stem cells. They said that I need to wait a few more months to see the final results, but I can already see that the treatment is working. The left eye, which doctors claimed "dead", can already distinguish between shape and color. With my right eye, I can read text in large letters. A month ago, I could not even dream of such results!
Optic nerve atrophy cannot be completely cured. Nonetheless, stem cells can give impressive results. One study showed improved vision in patients with this disease after 6 and 12 months of monitoring. The injections were performed in patients with optic nerve atrophy and retinal pigmentary degeneration with an initial visual acuity from 0.01 to 0.1. After 12 months, this ranged from 0.05 to 0.7.
STEM CELL TREATMENT of Optic Nerve Atrophy
Alzheimer's disease
Alzheimer's disease is a neurodegenerative disorder which constantly progresses and is accompanied by a deterioration in memory, higher cortical functions, and ends with a complete degradation of intelligence and mental activity. This is one of the most common diseases found in the elderly. It affects 4% of all people aged over 70 years. Its prevalence increases to 32% after 85 years.
There is no effective treatment. There are drugs that can reduce symptoms, but the disease continues to progress. As a result, it leads to disability and the death of the patient.
The problem with Alzheimer's, is that parts of the brain die. The only way to restore the structures of the central nervous system is to use stem cells. They can be administered intravenously or into the cerebrospinal fluid. Some methods involve the use of nanoparticles, which attract stem cells and cause them to migrate in the patient's body, in the direction that the doctor wants.
Stem cells can develop in any tissue in the human body. They give unlimited, regenerative potential. Unfortunately, these cells are only effective in the early stages of the disease. If a person develops severe dementia, and he has lost all connection with society and the real world, this indicates severe brain damage. At this stage in the development of the disease, it is no longer possible to provide medical care to such a patient.
However, individual clinical cases show excellent results of stem cell use, even in cases of advanced Alzheimer's disease.
Clinical case
Agata, Spain: My grandmother had the last stage of Alzheimer's disease. The doctors said that she has about 6 months before she dies. They waited for us to just go home and wait for the death of my grandma. But instead, we went to Germany. There, we were offered the use of stem cells. The treatment took 4 months, with periodical injections. After this time, my grandma began to recognize relatives and talk with them. We did not expect such a result! It is now 3 years since we got the treatment. The results have deteriorated somewhat, but even now, the condition of my grandma is better than on the day when the doctor suggested we go home and wait for her death.
Studies show that after the introduction of stem cells, they reach the brain and differentiate into cholinergic neurons. In addition, stem cells secrete growth factors that stimulate the repair of nerve tissue.
Multiple sclerosis
Multiple sclerosis is a chronic neurodegenerative disease of unknown origin. It occurs at any age, including in young people. About 3 million people in the world suffer from this pathology. It is constantly progressing and cannot be completely cured.
There is no effective treatment. During the periods of exacerbations, the doctors use glucocorticoids to suppress inflammatory reactions of the brain. Symptomatic treatment serves to reduce the neurological symptoms, but the damaged nerve tissue cannot be repaired.
Cell therapy is a new word in neurology. Patients with multiple sclerosis can undergo high-dose immunosuppressive therapy, followed by stem cell transplant. This procedure can be performed in severe cases of multiple sclerosis, when other treatment options have been exhausted.
The technique was first used in 1995. Since then, the clinics in developed countries have performed many stem cell transplants for the treatment of multiple sclerosis. Great clinical experience and evidence base have been accumulated. The main advantage of the method is the long-term results of such treatment.
An autologous stem cell transplant procedure is less risky than one from a donor, which is why it is usually used in multiple sclerosis treatment. When the method was first used, the mortality rate was about 5%. The studies carried out in the twenty-first century show a decrease in mortality rate to 1-1.5%, while some medical centers show a mortality rate which is virtually zero. The increased safety of the procedure was the result of a more careful selection of patients for transplantation and the rejection of a high-intensity, conditioning regimen and too intensive (ex vivo + in vivo) lymphocyte depletion.
The results of the studies show outstanding results in multiple sclerosis treatment. The disease does not progress in most patients after a stem cell transplant. According to EBMT (European Society for Blood and Marrow Transplantation), 63% of patients achieve stabilization and regression of symptoms within 3.5 years of monitoring. Various studies show a lack of progression for 3 years after stem cell treatment in 60-80% of patients. And this is despite the fact that at the time of the procedure, all patients had clinical signs of disease progression or the appearance of new foci of brain demyelination on an MRI in the 12 months before transplant.
Recent studies show that after autologous hematopoietic stem cell transplantation, the 10 year survival rate of patients without the progression of multiple sclerosis, is 65% for the secondary progressive and 40% for the primary progressive variant of the disease. The procedure is effective even in a malignant course of multiple sclerosis that is resistant to ongoing drug therapy.
There are three situations when a stem cell transplant can be performed. These include:
- early stage of the disease;
- advanced stage of the disease;
- rescue transplant.
In recent years, patients are increasingly being offered stem cell transplant immediately after diagnosis. This helps prevent disability.
A late transplant can be performed when other treatment options have been exhausted. Many functions of the nervous system are irreversibly lost, but the procedure allows for stopping the formation of further foci or demyelination of the brain.
A rescue transplant can be performed in the most severe cases, in order to save the patient's life or prevent a deep disability. It is usually performed due to the high activity of the immunopathological process.
Diabetes mellitus
Type 1 diabetes mellitus is an autoimmune disease, in which, pancreatic cells that are responsible for insulin production are destroyed. The result is a severe violation of carbohydrate metabolism. Without insulin injections, the body is not able to absorb glucose. The disease cannot be cured, leads to serious complications, and shortens a patient's life by decades.
The existing conventional treatment options are dangerous and require immunosuppressive therapy throughout the patient’s life. Some clinics transplant the entire pancreas or only islets of Langerhans. However, in view of the obvious shortcomings, these treatment methods are not widespread. Lifetime insulin replacement therapy remains the standard treatment.
Today, scientists have learned how to isolate C-kit-positive stem cells. They can differentiate into pancreatic beta cells. The transplantation of such cells can normalize the production of endogenous insulin in the body again.
Myocardial infarction
Every third case of myocardial infarction ends in the death of the patient. Those who survive often suffer from heart failure. A heart attack leads to the death of a part of the muscle tissue, which provides contractions of the heart. This part of the muscle tissue is replaced by a scar. The scar consists of connective tissue. It simply preserves the integrity of the organ, but does not have contractility.
In recent years, scientists have made every effort to solve this problem. They are working at developing the methods of postinfarction cell regenerative therapy for the heart muscle to improve the patient's quality of life and increase its duration. The goal of regenerative therapy is to increase the number of muscle cells in the myocardium and improve their blood supply.
The leading German clinics use stem cell methods for treating postinfarction cardiosclerosis. There are two treatment options:
- Introduction of stem cells intravenously – they "settle" in the myocardium on their own and partially restore the damaged areas of the heart
- Stem cell transplant or cell cardiomyoplasty
Cardiomyoplasty mostly involves the use of a fraction of bone marrow mononuclear cells. It contains at least two populations of somatic stem cells, namely hematopoietic and mesenchymal ones. The studies show that direct intramyocardial administration results in improved myocardial contractile function when compared to patients in the control group.
Here are some options as to where stem cells can be introduced after a heart attack:
- Into the myocardium. They are introduced into the scar area. This can be either a separate procedure or one of the stages of the myocardial revascularization operation (for example, coronary artery bypass grafting). If the introduction is performed as a separate manipulation, the cells will be administered through a ventricular catheter using electromechanical mapping. This helps direct cells to a viable myocardium. The experimental studies also offer stem cell implantation in fibrin glue.
- Into the vessels of the heart. The introduction of stem cells into the coronary vessels is a less traumatic, and therefore more commonly used procedure. This procedure involves the use of a coronary catheter. This method allows for distributing the cells more evenly.
- Into the ulnar vein. This is the simplest procedure, but only cells with a high homing ability (the ability to independently find the affected areas in the body) can be introduced in this way. The procedure requires the use of tens or even hundreds of times more stem cells than local coronary administration does. However, this method can also be used and it is quite effective. The experiments show that intravenously injected stem cells are deposited in a much larger amount on a damaged myocardium than on a healthy one.
Stroke
After a stroke, a part of the brain dies. This leads to a patient's disability. The subsequent rehabilitation allows patients to partially restore lost functions due to the neighboring brain regions or compensate for them with other acquired skills. Nonetheless, the dead parts of the central nervous system can no longer be restored, so many patients not only completely lose their ability to work, but also constantly need the care of other people after a stroke.
Perhaps the situation will change in the near future. More and more clinics in developed countries use stem cells to treat a stroke. It is expected that with their help it will be possible to achieve significant progress in the recovery of patients after a stroke.
The first attempts at cell therapy for this disease were made in the United States. In 1998, the specialists from the University of Pittsburgh (USA) performed neurotransplantation of stem cells collected from the teratocarcinoma line, into the brains of stroke patients. The first data recorded on the survival of stem cells after their implantation in the brain, were published in 2002. They had been existing in the brain for 2 years without showing signs of malignant degeneration.
The researchers in South Korea have described an effective treatment method, which involved an intravascular injection of stem cells into the middle cerebral artery pool after a stroke. The injections were performed 1 and 2 months after a stroke. After 12 months, the recovery results in these patients were better than in the control group.
The autologous stem cell transplant also yielded good results. Only hematopoietic cells can penetrate the blood-brain barrier, while mesenchymal stem cells are not able to penetrate it. However, treatment with this type of SC also showed good results with intracarotid (into the carotid artery) administration. The expected mechanisms of action involve the differentiation into neuronal cells, isolation of growth factors, and the stimulation of the formation of new vessels. Nonetheless, these are only assumptions, whereas the exact mechanisms for the development of the positive effect of stem cells in a stroke have not yet been established. It is difficult to find them out, since the patients participating in clinical trials cannot undergo a morphological study of their brain whilst alive.
Some German clinics practice the introduction of stem cells during the rehabilitation period after a stroke. This provides faster progress and better final results compared to those who do not use cell therapy.
Liver diseases
Many liver diseases, most often hepatitis and cirrhosis, lead to liver failure. Although this organ has good regenerative potential, it can lose its ability to recover, due to pathological processes.
There are effective treatments available for liver failure. Many patients undergo a transplantation of this organ. However, in practice, most patients die whilst waiting for donor material. In addition, this surgery is quite risky for the patient. The transplantation can cause reactions, such as a transplant rejection, infectious complications, or in a case of viral liver damage, organ failure can recur.
One of the alternative treatments available is mesenchymal stem cell transplantation. This method is safer. It allows for obtaining good treatment results in patients who are unable to undergo liver transplantation due to poor health conditions or the absence of a donor organ. After treatment, there is no need to use immunosuppressants that inhibit the immune system and increase the risk of infections.
Stem cells are administered intravenously. With parenteral administration, mesenchymal stem cells can migrate to the lesion, penetrate through the layer of endothelial cells, and accumulate in the greatest amount, precisely in the damaged tissue. The stem cells have the ability to transform into hepatocytes. They also have an immunomodulatory effect, therefore, reducing the severity of liver fibrosis.
Where can you undergo stem cell therapy?
To undergo stem cell therapy, you can go to Germany. This country is constantly conducting research in the field of cell regenerative therapy. Some University Hospitals develop methods for treating various diseases using SCs and implement them much earlier than in other countries. In particular, the Clinic of Advanced Biological Medicine in Frankfurt-am-Main actively uses stem cell therapy in clinical practice. The average cost of stem cell treatment in the Department of Alternative Medicine is €22,006.
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Authors:
The article was edited by medical experts, board certified doctors Dr. Vadim Zhiliuk, Dr. Nadezhda Ivanisova. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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