Stem Cells

I came across this article this week about stem cells and Parkinson’s disease. Mohammad Ali’s daughter is currently collaborating with a research company to help further explore the use of stem cells for this condition. The article partially reads as follows:

In an attempt to help find a cure for her father, Rasheda has collaborated with a biotech company called “BrainStorm Cell Therapeutics,” which has been experimenting with stem cell treatment on patients with Amyotrophic lateral sclerosis (ALS) – also known as Lou Gehrig’s disease.  Through their efforts, many of these patients’ symptoms have greatly improved, and the degenerative properties of the disease have started to slow.
“If you can have these incredible results for what I think is the most severe…neurocognitive disease there is, what kind of promise will they do down the pipeline for other neurocognitive diseases such as multiple sclerosis and Parkinson’s?” Rasheda said.
After seeing the amazing results this company has achieved, Rasheda is convinced that stem cells hold the key to treating these diseases in the future.  

            Stem cell research has been around for a hundred years now and some good advancement has been made. The best example of success is in bone marrow transplants when stem cells are used to help cure some hematological disorders such as leukemia.

            As a neurologist I hope to one day see such a breakthrough in my field. However, the panacea of stem cells curing all neurological diseases such as Parkinson’s, spinal cord injury and Alzheimer’s is very far from fruition. In fact the results have been a little disappointing. Take for example a spinal cord injury where the nerves have been severed. The thought and hope was that a surgeon could take stem cells and place them into the area of the spinal cord that was injured. The stem cells would them turn into nerves and reconnect the injured neural pathways. Also, with Parkinson’s the thought would be that the stem cells would turn into the cells that make dopamine.

            However, the clinical trials have not yielded these results in any tangible fashion. All the research I have read that deal with humans (and not rats or any other nonhuman primates) show that the stem cells promote a healthy environment where injured cells can thrive. Instead of the stem cells turning into the cells needed, they instead help the injured cells by providing a nurturing environment for them to heal. Although not the intended response, it does show that stem cells do have an important role in the future.

            The question now is what is that role? Again, take spinal cord injury. During an injury a cascade of events occur, such as scarring, that make nerve repair almost impossible. Even under the most auspicious circumstances created by stem cells no reconnection of nerves could ever occur. However, current research on spinal cord injury is trying to produce drugs that will halt the negative cascade of events that occur after an injury. Thus, when these drugs finally materialize nerves will have a much better chance at repairing themselves after injury. At that will be the time and place for stem cells to be used.
            The scenario I foresee in the future is that after a spinal cord injury the patient will initially be stabilized. During this early period certain drugs will be administered which will halt and reverse the negative cascade of events that cause irreparable damage to the nerves. Other drugs will then be administered to help the injured nerves heal, grow and possible reproduce. Then, possibly, stem cells will be introduced to help enhance the overall process. Lastly, intensive physical therapy will help the patient return back to normal activity.

            What I see is that stem cells will be part of the cure and not the cure itself. When treating any neurological injury, other treatments will need to take place first or in conjunction with stem stems to create the tangible results we need for these patients. Stem cell will not be a cure-all but one of many viable options for these neurological conditions.

            When dealing with Parkinson’s there are a myriad of clinical trials being conducted right now that are both expanding our knowledge of this disease and creating new and novel treatments to help those afflicted with it. Personally, I don’t think stem cells will be the answer for Parkinson’s but I do see a concurrent role for it in other neurological conditions.