Here is a stem cell therapy, just now entering practical clinical use, that is great because illustrates the future of medicine: it fixes the underlying problem. Make the problem stop happening. A person's own cells extracted from muscle can strengthen bladder muscles and cure incontinence.
CHICAGO - Austrian researchers are successfully treating incontinent women with the patient's own muscle-derived stem cells. The findings of the first clinical study of its kind were presented today at the annual meeting of the Radiological Society of North America (RSNA).
"Urinary incontinence is a major problem for women, and for an increasing number of men," said Ferdinand Frauscher, M.D., associate professor of radiology at the Medical University of Innsbruck and the head of uroradiology at University Hospital. "We believe we have developed a long-lasting and effective treatment that is especially promising because it is generated from the patient's own body."
The stem cells are removed from a patient's arm, cultured in a lab for six weeks, and then injected into the wall of the urethra and into the sphincter muscle. The result is increased muscle mass and contractility of the sphincter and a thicker urethra. Many patients have no urinary leakage within 24 hours after the 15- to 20-minute outpatient procedure.
Stress incontinence affects nearly 15 million people — primarily women — around the world. It occurs when the urethra narrows or becomes otherwise abnormal, or when the sphincter muscles that help open and close the urethra become weak or diminished, causing urine leakage when an individual exercises, coughs, sneezes, laughs or lifts heavy objects.
Twenty females, ages 36 to 84, who were experiencing minor to severe stress incontinence participated in the research. Muscle-derived stem cells were removed from each patient's arm and cultured, or grown, using a patented technique that yielded 50 million new muscle cells (myoblasts) and 50 million connective tissue cells (fibroblasts) after six weeks. When implanted into the patient under general or local anesthetia, the new stem cells began to replicate the existing cells nearby. One year after the procedure, 18 of the study's 20 patients remain continent.
"These are very intelligent cells," Dr. Frauscher said. "Not only do they stay where they are injected, but also they quickly form new muscle tissue and when the muscle mass reaches the appropriate size, the cell growth ceases automatically."
Since the stem cells must be in contact with urethra and sphincter tissue for the procedure to work, a major factor in the success of this treatment was the development of transurethral three-dimensional ultrasound. "With real-time ultrasound, we are able to see exactly where the new cells must be placed," Dr. Frauscher said.
This treatment is a far greater economic value because it is of similar cost to existing treatments but works better because it actually fixes the cause of the problem.
Dr. Frauscher said the cost of the stem cell procedure was comparable to two popular treatments for incontinence: the long-term purchase and use of absorbents, such as adult diapers, and collagen injections, which show improvement during the first six months but often result in symptoms returning after a year. Dr. Frauscher also said the stem cell treatment appears to be more successful with women at this time. For men, incontinence is often caused by prostate surgery, which may result in scar tissue formation, where the stem cells do not grow very well. In men without scar tissue stem cell therapy seems to work as well as in women, Dr. Frauscher said.
Think about the economic value of stem cell treatments. Our problem in the United States isn't that we spend $1.6 trillion (as of 2002 - surely higher now) per year on medical care. Our problem is that so much of that care does not really fix the underlying causes of various medical conditions. Imagine medical treatments were capable of fixing everything that breaks just as auto mechanics can fix cars. Imagine you could therefore live in perfect health. Then I for one would not complain if that takes 15+% of the GDP.
Curiously, the one woman who gained no benefit from the procedure was 84 years old. One plausible explanation for the failure in her case is that her muscle stem cells are too old to form vigorous muscle cells.
The team is currently treating eight to 10 women per week and long waiting lists are building up.
Frauscher, head of uroradiology at University Hospital in Innsbruck, Austria, said his team has plans to start using this technique at other centers. "Next year we will start in three centers in Austria, two in Germany, one in Switzerland and one in the Netherlands," he said. "We are also planning to perform this in the USA."
The needed cells were extracted from the muscle cells and grown up by a company called InnovaCell. They claim to use some patented processes to accomplish this.
What I find great about this report is that it shows that stem cell therapies that really fix what is wrong are moving into regular clinical practice. Stem cell therapies are not some distant prospect. They are happening now and every year that goes by from here on out we will have more stem cell therapies that successfully treat more diseases and disorders.
|Share |||Randall Parker, 2004 December 05 12:57 AM Biotech Organ Replacement|