R. Krawetz (Calgary, CA)

University of Calgary Cell Biology & Anatomy

Presenter Of 1 Presentation

Extended Abstract (for invited Faculty only) Stem Cells

1.0.2 - Stem Cell Tourism - The Scientist' Perspective

Presentation Number
1.0.2
Presentation Topic
Stem Cells
Lecture Time
12:15 - 12:30
Session Type
Plenary Session
Corresponding Author

Abstract

Introduction

As early as the 1700’s, it was observed that the potential of articular cartilage for intrinsic regeneration was minimal. Even very small cartilage defects cannot re-establish their essential low friction surface and tend to degrade further over time and a consequence of this inadequacy is osteoarthritis/OA, a chronic, degenerative joint disorder. Osteoarthritis is the fastest growing global health problem, with a total joint replacement being the only effective treatment for patients with end stage osteoarthritis. Many groups world-wide are examining the use of multiple stem cell/progenitor cells types to repair cartilage defects and/or modulate inflammation to promote healing in the osteoarthritic joint; however, little efficacy in promoting cartilage repair, or reducing patient symptoms over temporary treatments such as micro-fracture has been observed. One potential reason behind this lack of efficacy in clinical study results could be derived from the heterogeneity between patients, cell sources and even within cell populations (within a given patient) highlighting our need for more basic research into these progenitor and stem cell populations and their application in the treatment of osteoarthritis.

Content

Unfortunately this lack of evidence based research (both basic and clinical) has not stopped clinics from offering unfounded and unregulated cell therapies including ‘stem cell therapies’ for numerous chronic diseases. Many of the clinics that offer these services, target patients suffering from cartilage injury and/or osteoarthritis as there are currently no Health Canada or FDA approved therapeutics to treat this disease. While Health Canada has introduced a moratorium on these unapproved therapies and the FDA is pursuing injunctions against a number of clinics in the US, many clinics are still offered unfounded cell therapies to patients throughout North America.

At the present time, the limited amount of high quality published clinical research on these therapies, does not support the efficacy of these cell therapies for the treatment of osteoarthritis. In this presentation, I will discuss current cell therapies being offered as well the results of clinical and pre-clinical studies into the potential use of purified and characterized stem/progenitor cell populations for the treatment of cartilage injury and/or osteoarthritis.

While I believe that cell therapies including stem cell based approaches have promise for treating chronic degenerative conditions such as osteoarthritis, it is essential that we develop a better understanding of risks vs. benefits as well as the mechanisms underlying these therapies before they are offered to patients. Providing therapies not supported by strong basic and clinical evidence not only puts patients at risk, but may also irreparably damage the credibility of the field of regenerative medicine and our ability to translate evidence based therapies into the clinic.

Overall, as a field we require a deeper understanding of the role of tissue resident and exogenously delivered stem cells within the arthritic joint and base future cellular therapeutic approaches on a strong foundation of basic and pre-clinical science. Developing an effective disease-modifying therapy for osteoarthritis that uses patient-derived stem cells or that results in the patient’s own tissues repairing themselves would result in a paradigm shift in how precision medicine is utilized and delivered.

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Moderator Of 1 Session

Georgia Free Papers
Session Type
Free Papers
Date
07.10.2019
Time
14:15 - 15:45
Location
Georgia