By Judy Monchuk
|Alan Moore, CEO and president of Stem Cell Therapeutics.|
A new hormone treatment stimulating stem cell growth in immediate stroke victims could provide a breakthrough in repairing brain damage caused by stroke and offer hope to millions suffering its debilitating after effects.
Clinical trials are underway for the groundbreaking process, which uses drug therapy to activate adult stem cell production and replace the brain matter destroyed by stroke.
"Up to $100 million is being spent in Canada on stem cell research — a drop in the bucket compared with the United States, where the National Institutes of Health estimates that $2.119 billion will be spent in 2009."Stem cell research is the bleeding edge of science — offering the hope to cure or alleviate some of the most devastating diseases.
It's also been a controversial niche industry, but the emotional debate is fading as less work is being done with cells derived from human embryos.
Much of the research being done in 2009 involves adult stem cells and regenerative medicine, said Drew Lyall, executive director of Canada's Stem Cell Network, which uses federal funds to seek potential therapies for diseases including cancer, Type 1 diabetes, Parkinson's disease and multiple sclerosis.
New playing field
Japanese stem cell researcher Shinya Yamanaka changed the playing field in 2007 after discovering a method of reprogramming adult skin cells into embryonic-like cells. This created the potential for skin to become any kind of mature cell and to be used for experimental or therapeutic purposes, while eliminating much of the emotional controversy. His work stunned the scientific world.
"What Yamanaka did was blow the whole field wide open," Lyall said from Ottawa. "What that meant was that we could think about developing patient-specific stem cells." Scientists are now considering the potential of stem cells in repairing hearts or damaged spinal cords.
Fast history of stem cell research
The existence of stem cells was proven in 1961 by Canadian doctors at Toronto's Princess Margaret Hospital, and the first embryonic stem cells were isolated in mice in 1991. But it wasn't until scientists were able to derive stem cells from human embryos in 1998 that the research triggered an ethical uproar. The source of those embryonic stem cells were frozen embryos created for in-vitro fertilization that were about to be discarded.
Lyall estimates up to $100 million is being spent in Canada on stem cell research. That is a drop in the bucket compared with the United States, where the National Institutes of Health estimates that $2.119 billion will be spent on stem cell research in 2009. Embryonic stem cell research makes up $91 million of that total.
Although many believe funding restrictions put in place by former President George W. Bush had sharply limited the science, NIH figures show $2.053 billion was spent on stem cell research in 2008, with $88 million directed at work using embryonic stem cells.
Earlier this year, President Barrack Obama reversed the Bush policy, clearing the way for federal grant money to be available for stem cell research. Obama's change also allowed the National Institutes of Health to draft ethics guidelines for U.S. research. Previously, there were no federal restrictions on research done by private companies or states which chose to pursue the data.
In 2004, Californians voted in favour of Proposition 71, which allocated $3 billion on embryonic stem cell research programs over a 10-year period and created the California Institute for Regenerative Medicine. On Wednesday (Oct 28), California's state stem cell agency along with partners in Canada and the United Kingdom announced $200 million in research grants to develop new stem cell-based therapies. The grants are the first CIRM Team Disease Awards and are expected to generate clinical trials within four years.
"You've got a hole in your brain after a stroke and we're basically filling it," says Alan Moore, CEO and president of Stem Cell Therapeutics, a biotechnology company that has spent the past five years developing ways to fire up a patient's stem cells and other treatments to repair brain function lost to disease or traumatic injury.
Third-leading cause of death in North America
Thursday is World Stroke Day, a time to focus attention on the 5.7 million stroke deaths each year. Stroke is the third-leading cause of death in North America, killing nearly 145,000 Americans and 14,000 Canadians annually. Yet its greater cost is in the vast numbers of people left disabled after blood flow to the brain is disrupted, causing damage or destruction of brain cells.
Figures from the Heart and Stroke Foundation of Canada, a charity dedicated to eliminating heart disease and stroke, note that only 10 per cent of people who suffer a stroke fully recover. The Canadian Stroke Network, a nonprofit corporation working to reduce the physical, social and economic effects of stroke on patients and society, estimates that less than half of those who survive a stroke ever return to work — putting additional financial and emotional pressure on the patient's family.
In Canada alone, strokes are calculated to cost the economy billions of dollars each year in doctor visits, hospital costs and lost productivity.
Just as quick intervention is critical in limiting stroke damage, timing is crucial in testing recovery prospects. In Stem Cell Therapeutics clinical trials, patients must start treatment within 48 hours of suffering a moderate stroke. Researchers hope to gather 120 subjects by the end of 2009 from locations across Canada, the United States and India.
Breakthrough stroke therapy
Stem Cell Therapeutics researchers' strongly believe they have developed a regenerative process that could be a major step forward in stroke therapy. The 90-day program uses two successive protein-based hormones: The first causes stem cells to multiply, while the second permits the new cells to survive and directs them to become the grey matter lost in a stroke.
The research is built on work done by Sam Weiss, director of the Hotchkiss Brain Institute at the University of Calgary, who discovered that the adult brain produces stem cells to fix itself. Since then, scientists have been searching for ways to stimulate the cells and heal brain damage that follows strokes and traumatic brain injury.
Preliminary research in brain-injured rats that received the treatment found a dramatic improvement in brain activity after 90 days, compared with rats that had not received the drugs. MRI images of a man who has undergone the treatment show similar distinct changes before and after therapy. The latter images show the cavity of destroyed brain cells has largely been filled.
Neurologist Michael Hill, principal researcher for the clinical trials and director of the stroke unit at Calgary's Foothills Hospital, cautions that simply replacing the brain cells may not mean replacing the same brain functions. More research must be done to determine if the new cells must relearn all the information that previously took a lifetime to compile.
"I think it has promise, but I don't know to what magnitude," says Hill. He likens the regeneration process to the flip side of the popular anti-drug campaign showing a sizzling egg in a frying pan and the slogan, "This is your brain on drugs."
"You're born with a scrambled brain and you have to learn to put that brain in order," says Hill. "That's what life lessons are for. This is about regenerating your brain and you can't regenerate with the same connections it had before."
Yet if the process is successful, it could provide treatment potential for other conditions. Stem Cell Therapeutics has two other clinical trials set to begin later this year for medication aimed at reversing and/or modifying the damage caused by traumatic brain injury and multiple sclerosis. Results are expected in mid- 2010.
October 8, 2009 — Return to cover.