Release the cells from the cage!

Put him in a cage
Scientists presented the first results of the use of the latest medical technologiesIrina Nevinnaya, Rossiyskaya Gazeta – Federal Issue No. 122-2013

Scientists are convinced that someday we will learn how to "grow" new hearts and other organs using the patient's own healthy cells. It's hard to imagine how much this will expand the possibilities of medicine. Moreover, it may be tomorrow: an innovative breakthrough in new medical technologies was vividly demonstrated by the completed session of the general meeting of the Russian Academy of Medical Sciences.

A doctor to himselfIt is necessary to "climb" into the cage if we want to live longer and healthier.

After all, many diseases are not amenable to either pharmacological or surgical treatment. Multiple sclerosis, Alzheimer's disease, diabetes mellitus, cirrhosis of the liver, some hereditary diseases, cancer... Finally, severe spinal cord injuries when a person loses the ability to move. In all these cases, medications support the patient. But it is often not possible to pull out the "root" of the disease.

The use of drugs based on cells – either donated, or, as scientists strive for, taken from the patient himself, can work wonders. It is possible, for example, to stimulate the growth of new cells to replace damaged or dead ones, to restore the work of an organ, whether it is a liver affected by cirrhosis or a heart after a heart attack.

– One of the most promising areas is the creation of autologous cellular preparations, – Academician of the Russian Academy of Medical Sciences, Academician–Secretary of the Department of Biomedical Sciences of the Russian Academy of Medical Sciences Vladimir Chekhonin told RG. – A small amount of healthy tissue is taken from the patient, it is processed in a special way, placed in a nutrient medium, and biomass is being built up. Then the drug is injected into the patient's body. This is how spinal cord and brain injuries can be treated as a result of injuries: today it is the cause of many deaths and severe disability.

We all know that nerve cells in adults practically do not recover. But, it turns out, there is one available area where the body has made an exception. Chemists working with aggressive substances know: inhaling acid vapors, you can lose your sense of smell for a while, but if the burn is not too serious, it is still restored. This is due to the stem nerve cells that are located on the surface of the upper part of the nasal passage. They repair the damaged epithelium, and the sense of smell returns. This property of stem cells, as well as their ability to regenerate into almost any type of tissue, is used by scientists together with doctors.

Test Tube HeartAnother absolutely amazing prospect:

three-dimensional technologies.

– Any organ consists of several layers, – explains Vladimir Chehonin. – You can repeat the nature in a test tube if you apply one layer of cells sequentially after another. Thus, as a result, a living mini-tissue is grown. It can be used in regenerative medicine.

Moreover, curiously, such an "updated" fabric may have additional good properties: resistance to stress, radiation, and other damaging factors. For example, with the help of this technology, drugs were obtained to repair damaged cartilage in case of a nose injury. The first experimental operations were also performed for transplantation of the grown trachea.

Cellular technologies are a real way to solve such a complex problem as the incompatibility of implants. Artificial material – it can be plastic, metal, ceramics – is used as a "frame" of the future construction.

Living own cells are applied to the surface, and the structure after implantation to the patient is perceived by his body as its own part.

Absolutely fantastic results are obtained by the use of cells in reproductive medicine – with intrauterine growth retardation of the fetus, its extremely low weight. Cells will also help those who only dream of becoming a parent today.

So far – outside the lawThe Internet is full of ads: rejuvenation with the help of stem cells.

The yellow media have repeatedly frightened with scary stories about the life and death of stars who have tested the effect of little-studied technologies so far. It is difficult to say what is true and what is fiction here.

There is still no regulatory framework for the use of cellular technologies. Therefore, commercial clinics offering such services actually operate outside the law.

But scientific developments are underway, and patients are treated within the framework of limited clinical trials conducted by leading scientific medical centers. This, in fact, gave our scientists and doctors the opportunity to get practical results, which were discussed for two days at the session of the Russian Academy of Medical Sciences.

The draft law on the circulation of biomedical cell products has been developed since 2011. RAMS has worked closely with the Ministry of Health from the very beginning. The bill will allow the launch of large-scale clinical trials of the most promising and safe developments. In addition, as the President of the Russian Academy of Medical Sciences Ivan Dedov said, in the near future we will have to open specialized centers for the development of cellular technologies and regenerative medicine. All this will speed up the path to new ways of fighting the disease – from the laboratory of a scientist to a clinic and a practicing doctor.

CompetentGennady Sukhoi, Academician of the Russian Academy of Medical Sciences, Director of the V.I.Kulakov National Center of Obstetrics, Gynecology and Perinatology:

– Until the law on cellular technologies is adopted, their wide application in our country is impossible. Nevertheless, there is an opportunity today to help patients, to use the experience of conducting limited clinical trials, as is done in Europe and North America. The topic is approved by the academic council, an ethics committee is held, a protocol is drawn up, and only then the actual clinical trials with the participation of volunteer patients begin. Of course, this is preceded by a lot of work: first, as we say in vitro, in a test tube; then the safety of the new technology is tested on animals; and only then the new treatment method is used on humans.

Our long-term joint work with the Institute of Developmental Biology of the Russian Academy of Sciences, where Professor Maria Alexandrova, the daughter of the great academician Alexandrov, works, led to the development of cell protection technology, that is, the protection of children's brains. These can be deeply premature infants, or children who have suffered during severe prolonged labor, who have suffered prolonged hypoxia, whose functions of the central nervous system are disrupted, brain cells die. The most severe consequences are cerebral palsy, which, of course, is a great tragedy for the family. It is very painful to make this diagnosis, realizing that in the future it is simply impossible to help such children at the current level of development of pharmacology, surgery.

But, if we do not miss the time in just a day, correctly assess the condition of the newborn, we can seriously improve his prognosis by introducing a drug from stem cells. In our center, we use such cellular protection of the brain together with the technology of controlled hypothermia. The child's body is cooled with a special device to 35 degrees. He is put into an artificial coma. As a result, the process of brain cell death slows down, and this gives us the opportunity to extend the so-called "therapeutic window" when the use of stem cells is most effective. All this must be done very quickly. The time factor is key. That is why it is so important to work with donors, to constantly have a bank of donor stem cells.

The same situation is with adult patients – with strokes, heart attacks, the use of cellular drugs gives very good results. But only in one case: if everything is done on time.

Alexander Gavrilenko, Corresponding Member of the Russian Academy of Medical Sciences, Head of the Vascular Surgery Department of the RSC of Surgery named after B.V.Petrovsky:

– In our country, 30-40 thousand patients have to undergo leg amputation surgery every year. The reason is ischemia of the legs, a complex disease that is difficult to treat. It affects about 4-5 million people. The prognosis for six months after this diagnosis is disappointing: only 40% of patients manage to save their legs, 40% have to be amputated, 20%, unfortunately, die. The trouble is that very often patients come to the vascular surgeon already in an extremely neglected state. The health care system is also to blame: the attending doctors are not oriented to immediately refer the patient to specialists.

The insidiousness of atherosclerosis is that it affects both large and small vessels. But if we perform classical shunting operations on large ones, then with widespread damage to small vessels, the situation is much more complicated. As we say, unfortunately, it is impossible to improve long-term results by "needlework". Surgery in this area is at the "ceiling" of its capabilities.

That is why the search for technologies that would improve long-term results after operations began in the centers of cardiovascular surgery. I had to work in Houston, with the great cardiac surgeon Michael Debakey. He died in 2008, just two months short of his 100th birthday. So, when I was in his clinic as a visiting professor, when cellular technologies were just emerging, I asked him: "Which direction is the most promising?" And he replied, "Genetic engineering."

For more than 12 years we have been cooperating with geneticists, with the late academician Nikolai Bochkov. Under his leadership, a genetic engineering complex was created. These are not stem cells, but specially "engineered" genes that stimulate the growth of new capillaries. Clinical studies were conducted at the RNC im. Petrovsky RAMS. Several injections are made, and after one and a half to two months, the growth of new tiny vessels begins. But this technique is not a panacea, it has its own indications and contraindications. Optimal results are obtained when reconstructive operations are combined with the introduction of genetically engineered complexes.

Portal "Eternal youth" http://vechnayamolodost.ru07.06.2013