Stem cells: is there a little time left before the introduction into the clinic?
Healthy prospects
Vladimir Bibikov, "Union. Belarus-Russia", 06.05.2010
The development of the Union program for the use of stem cells is being completed. What does it provide for? What problems in healthcare will help solve? What are the results of scientific research in this direction? Academician-Secretary of the Department of Biological Sciences of the National Academy of Sciences of Belarus Academician Igor Volotovsky answers the questions of the "Union".
– Igor Dmitrievich, the interest in stem cells in society is not decreasing. Is there any excessive hype here? What do the studies conducted by our and foreign scientists and specialists show?– Promising technologies are being developed that can make a revolution in the treatment of serious diseases.
In the world, about a hundred research groups are actively engaged in stem cells. Treatment is also carried out. Autologous stem cells are most often used, that is, taken from the patient himself. According to official sources, in 2008 alone in the United States, 34 million patients suffering from spinal injuries, diseases of the nervous system, joints, heart and blood vessels, diabetes mellitus received treatment using stem cells. (The figure is incredible, but so in the original – VM.)
Europe's results are more modest. For example, in Italy, 2958 patients received treatment, in France – 2847. However, the achievements of foreign scientists concerning the production and use of material for treatment, as a rule, constitute know-how. There are no generally accepted standard technologies. The lack of detailed information forces us to go through the stages that someone already knows.
The first work on stem cells from bone marrow was carried out back in the 60s of the last century in the Soviet Union by A. Friedenstein and I. Chertkov. In principle, we know well what these cells are and how to isolate them. But we need standard approaches, clear protocols on how to do this. The material must be completely identical so that the consequences of its use coincide. It's not there yet. In one case, isolated stem cells are used, in another – cells with impurities, in the third – bone marrow, in the fourth – abortive material, and all this is passed off as stem cells.
– What is the situation in Belarus?– Work on stem cells in the country began a long time ago.
At NASB, they are conducted at the Institute of Biophysics and Cell Engineering. The Ministry of Health has Republican Scientific and Practical Centers of Hematology and Transfusiology, Pediatric Oncology and Hematology, Research Institutes of Epidemiology and Microbiology, the Belarusian State Medical University. Recently, a new large medical center has been created, also aimed at these works – the RNPC of Transplantation. Leaders have been formed in these scientific institutions, research directions have been formed, equipment is being purchased. So we are not standing still, and there are already some successes.
– Is it obvious that such a complex and time-consuming work requires the combined efforts of not only Belarusian specialists?– That's why the idea of forming an appropriate program of the Union State arose.
We submitted proposals back in 2005. There were objective reasons for the delay. The leadership in the Russian organizations – our partners - has changed. Nevertheless, we managed to continue forming the program. We are now at the finish line. We hope that in September the Council of Ministers of the Union State will consider the final version of the program and decide on its launch.
Why did we target the Union program and consider it useful? We want to exchange experience with our Russian colleagues. I am convinced that in 10 years stem cells will be used as widely as blood transfusion. What is important to decide here? What to do with biological material, how to fractionate it? How to create conditions for cells to divide stably? And for one procedure, you need to accumulate millions of stem cells. If we want to form chondrocytes – cartilage cells to treat joint diseases. Or cardiomyocytes to treat myocardial infarction. Or nerve cells to treat various degenerative diseases of the nervous system. Descriptions are full of what a particular disease is being treated, how successfully, what are the long-term results. But there is no basic: how the cells were isolated, cultured, increased cell mass, how they were injected into the body, which points must be taken into account.
– In what areas are the research being conducted?– The Institute of Biophysics and Cell Engineering of the National Academy of Sciences of Belarus has a joint project with the Belarusian State Medical University.
The task is to develop methods of treating trophic ulcers with stem cells obtained from the patient's adipose tissue. We will give them to surgeons – they will develop a treatment technology. Now such cells are already multiplying, in the near future we will begin to standardize them in terms of quantity, morphology, immune factors and genetic stability. I have no doubt of success. Moscow colleagues at the A. Burnazyan Center for Biophysical Research, who treated the victims of the fire in the Perm club "Lame Horse", received fantastic results – with 80 percent of body burns, patients treated with stem cells survived.
The RNPC of Hematology and Transfusiology deals with umbilical cord blood. It was possible to fractionate it. Stem cells are isolated. The Center for Pediatric Oncology and Hematology studies mainly cells derived from bone marrow. An original method of bone marrow transplantation in the treatment of leukemia has already been formed. During the transplant, stem cells are added to sick children. The survival rate of transplants has increased dramatically. This is a very good result. The topic of treatment of pulmonary tuberculosis with the help of stem cells is being developed. Experiments have been conducted to heal amyotrophic lateral sclerosis, when the spinal cord is affected. Another topic is the treatment of myocardial infarction.
– And how do you feel about using stem cells for rejuvenation?– You will not get a real rejuvenation of the body, but you can activate metabolic processes.
Stem cells contain and secrete many biologically active substances, but their number decreases with age. For example, a child has one stem cell per 500 thousand cells, and the elderly have one for 10 million. Stem cells treat everything. A finger was cut – stem cells rush here, and a scar is formed at their expense. In childhood, a skin wound heals in two to three days, and in old age - in two to three weeks. And if we are talking about a serious chronic disease? Here it would be nice to introduce ten million stem cells into the body or conduct a course of cell treatment. Stem cells are widely used in cosmetics. They are injected into the skin near wrinkles, and elastin, a protein that provides elasticity of the skin, begins to be produced there. Wrinkles are smoothed out for several months.
– Let's get back to more serious things. What is planned to be achieved under the Union program and for what period is it designed?– For 2011-2013.
There are several sections in the project. Fundamental, dedicated to the cultivation of cells and methods of their differentiation, transformation into specialized ones. We want to work out protocols that could be used in any organization where there are specialists with medical or biological education. The next section is devoted to cord blood, techniques and methods for obtaining stem cells, their preservation, cultivation. It is planned to create a bank of umbilical cord blood and stem cells isolated from it. They can be used to treat not only the patient himself, but also relatives, other people who correspond to donors according to immunological data. It is much easier to find a cell donor than kidneys or hearts.
Special sections will be devoted to the treatment of diseases of the cardiovascular, nervous system, musculoskeletal system, visual organs - depending on who will become our partner in Russia. The research topics should be the same. We have submitted proposals, we are waiting for a response.
– How much money will be required for the implementation of the program?– Relatively little – 120 million Russian rubles.
For these funds, we plan to complete all stages of research preceding clinical use. The next three years – we hope to continue the program – will be devoted to clinical trials, development of medical technologies. If the program is approved, we will jump forward sharply. Growth points have already emerged, where young researchers and doctors have rushed. This is a very fascinating problem. She's the future.
Portal "Eternal youth" http://vechnayamolodost.ru07.05.2010