What are stem cells?
Our bodies are made up of millions of cells. Most of these cells are specialized to particular locations and functions. The cells in your brain are different from those in your stomach. Heart muscle cells are different from bone cells. And so on.
If a part of the body needs repair, tissue of the same types of cells may be used. Two well-known examples are grafts and transplants. A piece of blood vessel or bone may be grafted from one part of the body to repair another. Or an entire organ may be transplanted to replace a defective organ.
Stem cells are a promising new approach to repairing diseased or defective tissue. Unlike other cells, stem cells are generally not yet specialized. They are like generic “blank” cells that can be adapted and reproduced according to what they are needed for. Imagine being able to “grow” replacement tissues that match a patient’s damaged bone, muscle, or brain cells! This gives you an idea how stem cells might work, and why people are so excited about their potential.
Currently there are a few medical applications of stem cells that have been proven effective and are in use at Bumrungrad and other advanced hospitals. Other stem cell applications are the subject of research and clinical trials around the world. Despite the vast potential for stem cells, there are several issues that need further study. For example, factors and mechanisms of how stem cells differentiate into specific tissue and organs are not yet clearly understood.
What are the potential uses for stem cells?
There are a variety of diseases and injuries in which a patient’s cells or tissues are destroyed and must be replaced by tissue or organ transplants. Stem cells may be able to generate brand new tissue in these cases, and even cure diseases for which there is currently no adequate therapy. Conditions that could see revolutionary advances from stem cell treatment at some point in the future include Alzheimer’s, Parkinson’s, diabetes, spinal cord injuries, some heart diseases, stroke, arthritis, cancer, and burns.
Stem cells may also prove valuable in genetic and pharmaceutical research.
What benefits of stem cells have been proven?
Stem cell therapy has proven useful in the treatment of certain cancers and diseases of the blood such as leukemia, Thalassemia, and certain immune deficiency diseases.
Stem cells in these cases can help restore the production of blood cells by the body. Blood cells are produced and developed by bone marrow, the soft tissue inside bones. The body’s ability to supply itself with enough normal blood cells can be affected by blood diseases and blood cancers. Blood cell production can also be damaged as a side effect of chemotherapy or radiotherapy in cancer treatment. Stem cells harvested from bone marrow or processed from circulating blood can help offset this damage.
While it is a widely accepted treatment, bone marrow transplantation remains a risky procedure with many potential complications. It has always been reserved for patients with life-threatening diseases.
How is stem cell treatment regulated in Thailand?
Before 2009, there was no specific regulation governing scientists researching human stem cell applications in Thailand. Existing Thai FDA regulations do not cover stem cells because they are not a food or drug.
To correct this lack of oversight, on 27 March 2009, the Thai Food and Drug Administration (Thai FDA) announced that stem cells and their products will be regulated as drugs. The regulations will not cover the use of stem cells in recognized, proven treatments for hematological (blood) diseases. However, for other kinds of treatments, healthcare providers and researchers should follow accepted research practices, including approval from scientific and ethics committees at institutional and national levels.
Additionally, the Thai Medical Council will soon issue parallel regulations to cover the use of stem cells by physicians. For experimental stem cell treatments, practitioners must register and comply with Council criteria.
Institutions must clearly inform patients of the unproven nature of the treatment. Patients must be able to weigh the risks and benefits of such treatment , in the absence of inducement, coercion, or profit motive. Several good studies of stem cell treatments are being conducted under these conditions in Europe and the US.
What is Bumrungrad International’s position?
Bumrungrad International is optimistic about the future potential of stem cells to treat various diseases. Where stem cell treatments have been proven effective in clinical studies – for example in the hematological diseases mentioned previously – Bumrungrad offers expert treatment by experienced physicians. In other stem cell applications, our doctors are following international clinical trials closely to determine if and when treatments prove safe and effective.
We will develop capabilities and offer such treatments to our patients when they are accepted by the international medical community. If our clinical research program does participate in any trials, we assure our patients of the following:
- the experimental nature of the treatment will be clearly explained;
- we will adhere to guidelines of the Thai FDA and Medical Council, even if such guidelines are not yet official law; and
- we will not attempt to profit from experimental treatments not yet proven.
Experimental treatments must be approached very cautiously, especially when they are sought by families as a “last chance” treatment for loved ones in critical condition. Patients and their families must be able to trust that their doctors and hospital have evidence supporting such treatment. The evidence cannot be merely that “some patients seem to have benefited from the treatment.” It must be subject to the stricter rules of scientific inquiry.