Stem Cells Can Restore Movement in Paralyzed Patients

By Pat Anson, PNN Editor

Stem cells derived from body fat can improve sensation and restore movement in patients paralyzed by a severe spinal cord injury, according to a small clinical trial at the Mayo Clinic. One man who was paralyzed from the neck down after a surfing accident is now able to walk again after getting stem cell therapy.

"This study documents the safety and potential benefit of stem cells and regenerative medicine," first author Mohamad Bydon, MD, a Mayo Clinic neurosurgeon, said in a press release. "In spinal cord injury, even a mild improvement can make a significant difference in that patient's quality of life."

The ten patients who participated in the Phase 1 study had adipose (fat) stem calls removed from their abdomen or thigh. After several weeks, 100 million new mesenchymal stem cells (MSCs) grown in a laboratory petri dish were injected into each patient’s lumbar spine. It’s believed the cells then migrate to the injured part of the spine. Participants were regularly followed for the next two years to assess their response to treatment.

The study findings, published in the journal Nature Communications, show that 7 of the 10 patients showed improvement based on the American Spinal Injury Association’s Impairment Scale. Improvements included increased sensation when tested with a pinprick or light touch, increased muscle strength, and the recovery of voluntary bowel function. Three patients showed significant improvement, four had a moderate improvement, and three had no response.

This Mayo Clinic video shows how the process works:

Perhaps the most dramatic improvement was in Chris Barr, a California man who was paralyzed in 2017 while surfing near San Francisco. He broke his neck in eight places when his head hit the ocean floor.

Barr was the first person enrolled in the Mayo study. Eighteen months after the stem cell injection, Barr was able to walk again and continues to show improvement in his mobility and quality of life.

"I never dreamed I would have a recovery like this," Barr told ABC News. "I can feed myself. I can walk around. I can do day-to-day independent activities."  

No serious adverse events were reported from the stem cell treatment. The most common side effects were headaches and musculoskeletal pain that went away after over-the-counter medications were taken.

Since safety is the primary goal of a Phase 1 study, further research will be needed to assess the improvements in movement and sensation. The use of fat-derived stem cells for spinal cord injury is considered experimental by the Food and Drug Administration.

According to the National Spinal Cord Injury Statistical Center, nearly 300,000 Americans currently suffer from a spinal cord injury, costing the healthcare system over $40 billion annually.  The estimated lifetime cost for each patient can reach millions of dollars.

The spinal cord has limited ability to repair itself. Patients who suffer a significant injury typically experience most of their recovery in the first six to 12 months. Improvements generally stop 12 to 24 months after an injury. Only about 5% of people who are paralyzed can expect to regain any feeling or movement.

"For years, treatment of spinal cord injury has been limited to supportive care, more specifically stabilization surgery and physical therapy," Dr. Bydon says. "Many historical textbooks state that this condition does not improve. In recent years, we have seen findings from the medical and scientific community that challenge prior assumptions. This research is a step forward toward the ultimate goal of improving treatments for patients."

Pilot Study Shows Stem Cells Effective in Treating Shoulder Pain

By Pat Anson, PNN Editor

A single injection of stem cells has shown promise as a treatment for shoulder pain caused by rotator cuff disease, according to the results of a small pilot study conducted by the Kessler Foundation.

Ten wheelchair users with moderate to severe shoulder pain received an injection of adipose stem cells derived from their own fat tissue. The participants all had spinal cord injuries and chronic shoulder pain for at least six months that did not respond to conventional treatment.   

The stem cells were micro-fragmented using minimal manipulation to preserve fat clusters and the cells’ regenerative properties. This micro-fragmented adipose tissue (MFAT) was then injected into shoulder tendons under ultrasound guidance.

The study findings, recently published in the Journal of Spinal Cord Medicine, showed nearly 80 percent of participants had a significant decrease in pain symptoms, and all but one reported improvement in pain and function. Symptoms steadily improved over the course of a year, suggesting the injections have long-lasting effects. There were no significant adverse events.

"These results show that the minimally invasive injection of micro-fragmented adipose tissue is a safe and efficacious option for wheelchair users with shoulder pain caused by rotator cuff disease," said Gerard Malanga, MD, a founder of the New Jersey Regenerative Institute and a visiting scientist at the Kessler Foundation.

“We feel there is great potential for this therapy to help people with shoulder pain manage their symptoms and improve their quality of life.”

In addition to their regenerative properties, MFAT stem cells are believed to provide cushioning and to fill-in structural defects when injected into damaged shoulder joints.

Malanga and his colleagues are currently conducting a larger Phase 2 controlled study with 24 participants that will compare MFAT injections to corticosteroid injections for treating pain caused by rotator cuff disease or tears.        

Shoulder pain is a common occurrence among wheelchair users with spinal cord injuries because they rely solely on their upper limbs to perform everyday tasks. The pain is often caused by soft-tissue injuries such as inflamed rotator cuff tendons. Pain medication and physical therapy are typically used to treat shoulder pain, with surgery as a last resort – not a good option for someone with a spinal cord injury.

The New Jersey-based Kessler Foundation is a global leader in rehabilitation research and employment programs for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord.

Judge Rules FDA Can Regulate Stem Cells

By Pat Anson, PNN Editor

A federal judge has ruled that the U.S. Food and Drug Administration does have the legal authority to regulate stem cells made from adipose tissue – a patient’s own fat cells.

The decision is a blow to U.S. Stem Cells, a Florida-based company that produces and markets stem cells derived from body to treat rheumatoid arthritis, lupus and other chronic illnesses. At least three of its patients were blinded after having the stem cells injected into their eyes while being treated for macular degeneration.

The FDA has been struggling in recent years to rein in the fast-growing stem cell industry, which often markets procedures that the agency considers unproven and potentially dangerous.

“Cell-based regenerative medicine holds significant medical opportunity, but those in this field who do not operate in compliance with the law can potentially cause serious harm to patients,” acting FDA Commissioner Ned Sharpless, MD, said in a statement.

“The FDA has advanced a comprehensive policy framework to promote the development and approval of regenerative medicine products. But at the same time, the FDA will continue to take action — such as issuing warning letters or initiating court cases — against clinics that abuse the trust of patients and endanger their health with inadequate manufacturing conditions or by manufacturing and promoting products in ways that make them drugs under the law, but which have not been proven to be safe or effective for any use.”

The FDA sent a letter to U.S. Stem Cell nearly two years ago warning the company that its laboratory safety standards were inadequate and could lead to contamination.  A year later, the agency sought a permanent injunction against the company, which led to Monday’s court decision by U.S. District Judge Ursula Ungaro.  

“The clinic and its leadership have put patients at serious risk through their disregard of the law and prior FDA warnings. This decision today is a victory for the FDA’s work to stop these bad actors and to protect patients,” said Peter Marks, MD, director of the FDA’s Center for Biologics Evaluation and Research.

U.S. Stem Cell and its chief science officer Kristin Comella have yet to respond to the judge’s ruling. In the past, they have argued the FDA doesn’t have the legal authority to regulate cells derived from a patient’s own body tissue.

The Los Angeles Times has reported that Comella’s purported PhD in “stem cell biology” was issued by an unaccredited online university in Panama. Three-year doctorate degrees can be purchased at Panama College of Cell Science for less than $9,000. The college has been vigorous in defense of its most famous graduate.

“Through Dr. Comella’s leadership, she and her team have trained and certified more than 700 physicians worldwide in adult stem cell therapy,” the college said recently in a blog post.

KRISTIN COMELLA

“So it is understandable that against this backdrop, America’s most gifted adult stem cell clinician, Kristin Comella, should be singled out for attack, criticism, and personal smearing in an effort to chill and silence her activities, if not outright ban them. A federal lawsuit was even filed against her to stop her treatment of patients and to slow the progress of adult stem cell therapy.”

In addition to the lawsuit against U.S. Stem Cell, the FDA is also seeking a permanent injunction to stop California Stem Cell Treatment Center and Cell Surgical Network Corporation from producing cellular products for stem cell clinics without FDA approval.

The agency has also issued warning letters to a number of clinics, including one recently sent to R3 Stem Cell of Scottsdale, Arizona warning that its treatments for Lyme disease, diabetes, Parkinson’s disease, stroke, kidney failure and amyotrophic lateral sclerosis (ALS) are not FDA approved.