Stem cell research

[Sweet_Pea]

Are you for or against it?

Stem cell hope for liver disease
By Rachael Buchanan
BBC News



John Jones took part in the trial
Researchers have begun a pioneering trial using patients' own stem cells to treat their chronic liver disease.
A team at London's Hammersmith Hospital is attempting to reverse cirrhosis of the liver by harnessing and enhancing the body's own repair mechanism.

They are using adult stem cells extracted from patients' bone marrow to generate new tissue in damaged areas.

A Japanese group is also testing adult stem cells as a treatment for liver fibrosis.

Liver disease is dramatically on the increase in the UK - something doctors mostly blame on burgeoning lifestyles of excess.

Deaths from alcoholic liver disease have doubled in the last 10 years, with figures for the condition in young people increasing eight-fold due to binge drinking.

Add to that a growing obesity problem and a predicted trebling of the disorder from viral hepatitis in the next 20 years and it is clear that this condition is becoming a major challenge for the NHS.

Longsuffering organ

The liver is a forgiving organ and can tolerate, and recover from, a certain amount of abuse so long as the damage is not too advanced.

However, the liver is also rather stoic and there are often no warning signals until it is too late.

There is no equivalent dialysis machine for liver disorders so patients with chronic disease are eventually left with two stark outcomes, organ transplantation or death.

Putting aside the rigours of a transplant operation and a life on immunosuppression regime, patients often do not even get offered that choice.

Only a few will be deemed suitable for transplant and although there are about 600-700 liver transplants a year, for every donor organ there are 10 patients on the waiting list.

Which is why other options are urgently needed.

Five patients have now received this novel stem cell treatment at the West London hospital.

The last was John Jones, who owns a hairdressing salon in Shropshire.

Rare condition

John's condition is rarer. It is not a product of his lifestyle but is due to his body's immune system attacking his own organ.


Professor Habib is excited by the potential

It was picked up during a routine prostate examination six years ago and since then his condition has deteriorated to the point of liver failure.

Although a little daunted at undergoing an experimental treatment, John signed up for the trial because he could not face the alternative.

"It was worth the risk and I would go through it again," he told the BBC News website just two hours after his operation.

"I didn't want to have a transplant and spend the rest of my life on anti-rejection drugs, so I thought I would grasp at a straw."

John and his four fellow patients had their blood filtered and their stem cells separated out.

These were then injected into the hepatic artery in the liver under local anaesthetic, while the red blood cells were returned to the body through the arm.

Tests

The five patients are being regularly monitored for any signs of a reaction to the treatment or signs of improvement.

Laboratory tests have shown the function of the liver can be improved by repopulating it with stem cells.

You are taking the patients' own cells, making them behave like a liver cell and then giving them back to the patient, so they treat themselves

Professor Nagy Habib

As this initial trial was just designed to check the safety of the procedures, with only a small amount of stem cells being put into the liver, no real recovery in function was expected.

However, Professor Nagy Habib, head of liver surgery at Hammersmith, who is leading the research, is encouraged by the early results.

He said: "The icing on the cake was that some of the blood results were already improved."

He is now looking forward to the second phase of the trial this summer, which will see much larger preparations of stem cells injected into the livers of a greater number of patients, and is designed to test the treatment's ability to actually reverse disease.

"I think it would be very exciting if it works because you are taking the patients' own cells, making them behave like a liver cell and then giving them back to the patient, so they treat themselves."

Huge promise

Alison Rogers, chief executive of the British Liver Trust which campaigns for patients with liver disease, is also hopeful of the promises this treatment holds out.

"Like many new technologies under development they take time and you hear of exciting results that in the end don't come to fruition, but stem cell technology represents a huge leap forward in treating many diseases.

"In liver disease in particular it has the potential for tremendous advances.

"We have seen that stem cell technology can do so much in general medicine so we can be confident it will really help in liver disease - the question is just when this starts to be seen in the clinic."

[MrMean_]

I'm for if it helps cure diseases. Simple

[Mourad_A]

I'm for it also, if it helps to cure disease.

My next door neighbour, a young man, has recently had a kidney transplant. The man had to wait YEARS for it. He had to suffer dialysis for years and really suffered. His wife and children experienced a lot of stress and worry, especially as his eldest son is now developing the disease because it is genetic.

So yes, I am for it.

[Sweet_Pea]

Originally posted by Mourad_A
I'm for it also, if it helps to cure disease.

My next door neighbour, a young man, has recently had a kidney transplant. The man had to wait YEARS for it. He had to suffer dialysis for years and really suffered. His wife and children experienced a lot of stress and worry, especially as his eldest son is now developing the disease because it is genetic.

So yes, I am for it.

Mourad this is terrible. There are so many of these stories but finally there is light no? I am with you and mean on this

[Mourad_A]

The generousity of a total stranger saved him. The donor had completed an organ donor card, so when he died someone else (my neighbour) could live.

Following on...has anyone here on this board completed the organ donor card? I have. I thought about it for quite some time - about five years actually.

I was worried at first in case they cut me up before I was dead, but I don't think this happens...well if it did....how would anyone know? But I still completed the organ donor card eventually......

Sorry to be so macabre....but it is an interesting ethical question also.

[Sweet_Pea]

Originally posted by Mourad_A
The generousity of a total stranger saved him. The donor had completed an organ donor card, so when he died someone else (my neighbour) could live.

Following on...has anyone here on this board completed the organ donor card? I have. I thought about it for quite some time - about five years actually.

I was worried at first in case they cut me up before I was dead, but I don't think this happens...well if it did....how would anyone know? But I still completed the organ donor card eventually......

Sorry to be so macabre....but it is an interesting ethical question also.

LOL funny you mention that, I think about it sometimes and I have the same fear. i don't know, it's for the right reasons but i'm still scared.

[Al-khiyal]

A breakthrough in restoring sight to the blind has been made with a study showing that a damaged eye can be repaired by transplanting light-sensitive cells. The results of an experiment on laboratory mice have been so successful, scientists believe clinical trials on blind people could start within 10 years.

If the breakthrough can be developed further it could lead to new forms of treatment for the 300,000 visually impaired people in Britain who suffer from age-related macular degeneration and the thousands of blind children with inherited diseases such as retinitis pigmentosa.

Mice that were born blind because of a genetic condition were able to see light for the first time after a revolutionary transplant operation involving stem cells * the key cells that develop into the light-sensitive tissue of the eye's retina.

The scientists behind the research believe that it is the first time that nerve cells at the back of eye have been successfully transplanted to restore vision, a development that promises to help millions of blind people throughout the world. "The most important thing is the principle that it can be done," said Robert MacLaren, a consultant surgeon at Moorfields Eye Hospital in London, who was part of the Anglo-American research team.

"We've discovered a biological principle, a healing mechanism that we can take advantage of, but it's still a long way to go before we can apply this to people. We are now confident that this is the avenue to pursue to uncover ways of restoring vision to thousands who have lost their sight."

The study, published in the journal Nature, involved blind mice that were born without light-sensitive "photoreceptors", which detect light when it reaches the retina and send the appropriate signals to the brain via the optic nerve.

Stem cells from the eyes of normal mouse foetuses were cultured in the laboratory before being transplanted to the eyes of the blind mice. Tests showed the stem cells developed into mature photoreceptors of the retina and could transmit signals to the brain.

Previous attempts at transplanting stem cells to a damaged retina had failed, it is believed, because the cells were too immature. The key difference with the latest research is that stem cells were transplanted after they had already developed along the route to becoming photoreceptors, Mr MacLaren said.

"We got them at the point of no return. It is the first time anyone has shown that it is possible to transfer photoreceptors successfully and timing was crucial," he said.

The 100 million photoreceptors of the human retina are like the pixels of a 100-megapixel digital camera and they come in two forms * cone cells for seeing colour in daylight and rod cells for seeing black and white in low light.

The study on the mouse only transferred rods * which are more common in mice, a nocturnal animal * so the scientists have yet to demonstrate that the technique will work with cones, the most important cells for discerning images at the centre of the human retina. It is hoped that to help people with age-related macular degeneration it may only be necessary to transplant the relatively small number of cones in the central part of the retina that are important for good daylight vision.

In the mouse experiment, the scientists knew that the mice could see some light because their pupils contracted and dilated in response to differences in light intensity, showing that the brain was actively processing information from the eyes.

"Remarkably we found that the mature retina, previously believed to have no capacity for repair, is in fact able to support the development of new functional photoreceptors," said Jane Sowden of the Institute of Ophthalmology at University College London (UCL).

Professor Robin Ali of UCL said that in future human clinical trials it may be possible to use embryonic stem cells, or even adult stem cells from within a patient's own eye, for the first transplant operations.

Mr MacLaren said that one obvious advantage of using a patient's own stem cells for the operation was that it would avoid the complication of tissue rejection.

Professor Anand Awaroop of the University of Michigan at Ann Arbor, who collaborated on the study, said the findings may lead to new ways of treating other diseases of the central nervous system.

"Rather than focusing on stem cells, we believed that if we could understand how cells develop and become photoreceptors or any other specific neuron our transplantation efforts would meet with greater success," Professor Awaroop said. "This technique gives us new insights in repairing damage to the retina and possibly other parts of the central nervous system," he said.

How sight is lost

* Macular degeneration affects about 500,000 people in the UK.

* The macula is at the centre of the retina, where the light is focused, and is essential for reading and writing and seeing colour.

* In affected individuals, delicate cells at the centre of the macula stop working for unknown reasons.

* Most cases are of the slow-progressing dry kind; there is no treatment.

* Wet macular degeneration is faster and affects 27,000 new patients a year.

* Most of these patients can now be helped by laser treatment, photodynamic therapy or drugs.

* Most patients pay for drugs because the National Institute for Clinical Excellence is not due to issue guidance on their NHS use until autumn next year.

Stem-cell transfer breakthrough raises hopes for blindness cure