Unsubstantiated therapy

Autism: Stem Cell Clinics Offer Treatment despite lack of evidence that it Works

Alexander Alekseenko, "Express-News"

The prospects for autistic people are brighter today than 50 years ago, when many people live in society, not in institutions. But most severely autistic people cannot live independently in adulthood, exposing themselves and their families to significant social and financial pressure. Therefore, it is not surprising that some parents of autistic children seek to find a cure for this disease. According to a recent BBC Radio 4 report, stem cell clinics in the UK are now offering the treatment, despite the lack of evidence that it works. The correspondent of the IA "Express-News" tried to figure out the question.

Before we consider the viability of such a "treatment", it is worth learning a little about stem cells. Stem cells are special cells that can develop into many types of cells, such as liver cells, blood cells, or nerve cells. In an early developing embryo, stem cells can develop into cells of any type, but stem cells in adults have much more limited capabilities.

Adult stem cells can only develop into the cell types of the organ from which they originate. For example, stem cells originating from the bone marrow can only produce closely related cell types such as fat, cartilage, and bone cells, whereas stem cells in the brain can only differentiate into brain cells.

Stem cell therapy is aimed at regenerating or replacing cells that suffer from disorders and diseases. This can be achieved by isolating stem cells from a patient or donor and turning them into the right cells in the laboratory before transplanting them to the patient.

In an alternative approach, stem cells can be transplanted without differentiating them outside the patient's body, in the hope that the tissues will determine their fate. This idea is based on the assumption that each tissue contains specific signaling molecules that tell stem cells what to become.

Successful stem cell therapy depends on at least two things. First, it is necessary to know the type of tissue and cells affected by the disease or disorder. Secondly, it is necessary to use adult stem cells of the right type or early so-called pluripotent cells. If the disease is caused by degeneration of brain tissue, it is necessary to use a cell type capable of replacing nerve cells lost due to this condition. If the target is bone tissue, a type of stem cell that can replace bone cells should be used. Thus, the "one size fits all" approach is unlikely to work.

Clinics of insufficiently regulated stem cells

The prospect of stem cell treatment for disorders with limited traditional treatment options has led to the development of a significant industry offering stem cell treatment. Initially limited to developing countries, the number of under-regulated stem cell clinics is growing in developed countries, including the US, Germany, Switzerland and the UK. Most of these businesses exploit a loophole in the law that allows stem cells isolated from a patient's own body (so-called autologous transplantation) to be used for debilitating conditions that cannot be treated with existing medications. On the contrary, all other stem cell therapies should undergo a thorough assessment of quality, safety and effectiveness.

With an autologous approach, most stem cell clinics use cells isolated from the patient's bone marrow or adipose tissue. Although these cells are not capable of generating any cell types other than fat, bone, or cartilage, many of the stem cell clinics offer treatments for a number of conditions, including dementia, cerebral palsy, and autism. These treatments are not supported by scientific data and are expensive – about 10,000 pounds.

The procedure usually involves isolating cells from the patient's bone marrow or adipose tissue and injecting the cells back into the bloodstream in the hope that the transplanted cells migrate to the organ affected by the disease. Once in the target tissue, stem cells can promote regeneration by replacing faulty cells or increasing the body's ability to recover internally.

Although some common genetic and environmental factors have been identified in autism, little is known about the exact type of affected nerve cells. Indeed, a recent study published in the journal Science suggests that, in addition to nerve cells, people with autism may be affected by microglia (a type of cell that performs an immune function in the brain).

This makes developing a stem cell treatment for autism more difficult. What types of cells need to be replaced? Is this enough to strengthen the patient's own recovery capabilities? Even if these open questions are addressed in the future, what type of stem cells should be used? Is it advisable to use adult stem cells or do we need more powerful pluripotent cells? So, at least today, autism cannot be treated with stem cells.

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