Allogeneic and autogolous stem cell therapy combined with physical rehabilitation - A case report on a chronically injured man with quadriplegia

This is a research paper written by Rebecca Johnston, Daniel Leonard's sister. She recently graduated from a Physical Therapy degree program, and wrote her Capstone paper about Daniel's stem cell therapy treatment in Panama.

Daniel is presented anonymously in the paper, but Rebecca and Daniel have given their permission for this paper to be shared. Daniel's ASIA scores (pre and post treatment) are in the appendix of this paper.



Allogeneic and autogolous stem cell therapy combined with physical rehabilitation: A case report on a chronically injured man with quadriplegia

Abstract:

Background and Purpose: Stem cell therapy for SCI is a potentially promising treatment with increasing interest. This case report describes the use of a particular stem cell therapy protocol for a patient with chronic spinal cord injury, and describes his subsequent therapy and outcomes.

Case Description: The patient is a 29-year-old male who is chronically injured from a cervical spinal injury, resulting in quadriplegia. The patient was treated with a combined protocol of intrathecal (IT) and intravaneous (IV) allogeneic MSC and CD34+ cells and IT autologous BMMC at 6 ½ years post-injury. The results track the patient’s physical therapy progress until 6 months following stem cell treatment.

Outcomes: Recovery of strength in upper extremity and lower extremity muscle groups was noted, along with a functional increase in grip strength, ability to ambulate with assistance, and a significant decrease in daily medications.
Discussion: This case supports further investigation into treatment of chronically injured SCI patients with stem cell therapy followed by physical therapy.

Manuscript word count: 4321

A few highlights:

"After the patient underwent the stem cell treatment and returned to outpatient physical therapy in his hometown clinic in the United States, his MMT scores were tested over the period of 5 months post-stem cell treatment.... The patient did not decrease in strength in any of the muscles tested, and experienced improvements in 6/13 upper extremity muscle groups, and 8/9 lower extremity muscle groups."

"The patient also had an increase in grip strength. His grip strength was measured by his occupational therapist to be 5 lbs on the right and 25 lbs on the left at one month before his stem cell treatment. Six months later, his grip strength was measured to be 22 lbs on the right and 36 lbs on the left. The patient reported that this increase in grip strength led to functional improvements, such as being able to self-catheterize, which he was completely unable to do since his injury."

"The patient was also able to ambulate for the first time in 5 years at approximately 4 months after finishing his treatment. He was able to ambulate in partial weight bearing with the harness and max assist of two for 40 yards at .5 MPH."

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The original post on Daniel Leonard's blog can be found here.

Liposuction methods can adversely affect adipose tissue-derived stem cell yield and growth

Adipose tissue-derived mesenchymal stem cell yield and growth characteristics are affected by the tissue-harvesting procedure which was published in Cytotherapy (vol. 8 issue 2, 2006, pages 166-177)states that:

"Ultrasound-assisted liposuction resulted in a lower frequency of proliferating adult stem cells, as well as a longer population doubling time of adult stem cells, compared with resection..."

Those seeking adipose stem cell therapy should ask their doctor if he or she is using ultrasound assisted liposuction to collect the fat sample.

*Stem Cell Institute does not use ultrasound assisted liposuction.

Adipose tissue-derived mesenchymal stem cell yield and growth characteristics are affected by the tissue-harvesting procedure
M.J. Oedayrajsingh-Varma1, S.M. van Ham2, M. Knippenberg3, M.N. Helder4, J. Klein-Nulend3, T.E. Schouten5, M.J.P.F. Ritt1, F.J. van Milligen, PhD5,

1 Department of Plastic Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, the Netherlands
2 Department of Immunopathology, Sanquin Research at CLB, Amsterdam, the Netherlands
3 Department of Oral Cell Biology, ACTA-Vrije Universiteit, Amsterdam, the Netherlands
4 Department of Orthopaedic Surgery, VU University Medical Center, Amsterdam, the Netherlands
5 Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
http://dx.doi.org/10.1080/14653240600621125, How to Cite or Link Using DOI
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Patients beware: "Point of care" fat stem cell separation and counting kits inaccurate and not US FDA approved for humans.

Informative paper by Mary Pat Moyer, PhD detailing why "same-day" fat stem cell kits that are becoming more prevalent in doctors' offices across the US can miscount "stem cells" by large factors leading to over estimation of stem cell counts by as much as 20 times or more.

It also states, "no complete harvest and cell isolation systems have been approved by the FDA for autologous SVF harvest for immediate use [in humans]." These are just a couple of the arguments presented that demonstrate why it's important to process adipose tissue properly in a professional lab setting.

Morrison DG, Hunt DA, Garza I, Johnson RA, Moyer MP*. Counting and Processing Methods Impact Accuracy of Adipose Stem Cell Doses. BioProcess J, 2012; 11(4): 4-17

Your Body's Stem Cell Bank Account

By Neil Riordan, PhD

Everybody is born with a certain amount of stem cells, specifically, "adult stem cells." This number may be thought of as a type of "bank account", from which each person may make "withdrawals" throughout his or her lifetime, as needed.

However, not all bank accounts are created equal. To continue with the analogy, some people are born rich, while others are born poor. Most people, however, may be thought of as "middle class." This fact helps to explain why some people are able to enjoy health and longevity despite very unhealthy lifestyles, while other people may enjoy neither robust health nor longevity despite healthy lifestyles. In other words, some people are able to "spend" their stem cells more extravagantly than others, simply because they have more to spend. Most of us, however, fall somewhere in the middle, where both the length and the quality of our lives may be influenced to some degree by our choice of lifestyle. Environmental factors also play a key role in determining how rapidly one's "bank account" of (adult) stem cells is depleted. However, even under ideal circumstances, stem cells continually diminish with age.

Our stem cells exist in every part of the body to repair damage, such as from broken bones, a paper cut, radiological or chemical exposure, etc., all of which require stem cells for healing. You may draw on your bank account at any time, whenever you need to do so, until you run out of stem cells. As your "bank account" of stem cells approaches zero, physiological healing will become increasingly difficult, until finally it ceases altogether.

Utilizing stem cells is like going to the ATM machine. Depending upon how you live your life, and whether you were born with a large or a small bank account of stem cells, you either may or may not be able to withdraw from your account. If you were fortunate enough to be born with a large amount of stem cells, then you might possibly be able to smoke and drink and eat unhealthy food and never exercise, and still live to a ripe old age, because regardless of how many stem cells you expend, there are still more to be spent.

On the other hand, if you were born at the opposite end of the spectrum, with a small amount of stem cells, then an unhealthy lifestyle will have a more immediate and detrimental impact upon the quality and length of your life. This is known as Nature's Law of Conservancy: the less stem cells that exist in your "account", the more stingy the ATM machine becomes in distributing the contents of that account. Most people, however, are born into the stem cell "middle class", which is to say that lifestyle choices can often make a noticeable difference in determining health and longevity.

When someone has a large number of stem cells in the bank, the ATM works very quickly and efficiently. But when the bank account is almost empty, which ordinarily happens in the latter years of life, the ATM machine does not distribute the stem cells as readily. In biological terms, this is because the division rate of the cells has slowed considerably. Simply changing the doubling time of stem cells from 24 hours to 72 hours can make a 90-day difference in the amount of time required to reach a "critical mass" of cells that are required to heal a wound. Michael Andreeff, M.D., Ph.D., a professor in the Departments of Blood and Marrow Transplantation and Leukemia Cancer at M.D. Anderson, has described cancer as a "never healing wound"; in some cases, the doubling time of the stem cells may never be fast enough to "catch up" and heal the wound. This is why the incidence of cancer increases with age. After childhood cancers (which arise due to genetic factors or to overwhelming environmental exposure), the incidence of cancer drops significantly until around the age of 40, when it starts to increase, shooting up dramatically around the age of 50, and then falling again around the age of 65.

When someone has fully depleted his or her stem cell reserve, the only possible way to get more stem cells is from an alternate source. This is where stem cell therapy comes into play.

Salamanders are a supreme example of stem cell billionaires. Salamanders have a seemingly unlimited supply of stem cells, as their "bank accounts" are virtually incapable of being depleted. If you were to look at the blood of a salamander under a microscope, you would see that all of the red blood cells (RBCs) are nucleated. In other words, all RBCs of a salamander contain nuclei, unlike human RBCs, which are not nucleated. This is why salamanders can regenerate entire limbs and humans cannot: every RBC in a salamander is a functional stem cell, floating around everywhere throughout the salamander's body. In humans, by contrast, our RBCs cannot replicate themselves once they have migrated out of our bone marrow. As long as the salamander is still alive, its ATM machine is fast and generous in distributing as many stem cells as may be needed for any task.

Although humans are not salamanders, the ability to regenerate entire limbs nevertheless offers a powerful example of the possible applications and implications of stem cells. Practically as well as theoretically, an enormous, mostly untapped, potential exists in the field of stem cell therapy.

Giving Birth after Stem Cell Treatments for Spinal Cord Injury || Video

Trish Stressman and her husband Scott discuss how stem cell therapy at the Stem Cell Institute in Panama allowed her to recover to the point at which she could safely give birth and care for her newborn daughter, Savannah Hope.

Prior to stem cell treatment, Trish had no core muscles and would not have been able to even safely hold a baby, let alone care for one. Since stem cells, that's all changed. Congratulations Trish, Scott and Savannah Hope!

See more of Trish's uplifting story here: http://youtu.be/zgSB1PtbiZg