Podcast file: 

You are missing some Flash content that should appear here! Perhaps your browser cannot display it, or maybe it did not initialize correctly.

2-24-10.mp3

Stem cell therapy strikes again, this time in cardiology.  Researchers in Brazil directly injected bone marrow stem cells into the left ventricle, in patients with refractory angina or heart pain.  These patients had undergone surgery, angioplasty and medical treatment, but had ongoing chest pain. 

"Adipose tissue is an extramedullary reservoir for functional hematopoietic stem and progenitor cells." Got that? No? Here's the simple translation: we now think blood can be made in the fat tissue, not just the bone marrow.

This is just coming out in Blood, a journal I keep up with as a hematologist.

For a blood doctor, this news is fairly mindblowing. We in hematology have this dogma that the blood is made in the marrow, and the presence of "functional hematopoietic stem cells" in the fat implies that at least some of the blood is made in adipose tissue.

Add diabetes to the list of diseases potentially treatable by stem cell transplantation. A small group of patients were evidently cured of their recently-diagnosed Type 1 diabetes according to a new clinical trial published in the journal JAMA this week. These are not the embryonic stem cells that have people up in arms but rather the patients' own marrow-derived hematopoeitic stem cells collected in the same way as they do with cancer stem cell transplants.

I was asked by a patient with severe knee cartilage destruction whether there were any experimental protocols using bone marrow stem cells to prevent surgery for the condition. I told her I would have to look into it but my gut reaction was to say no. So far I think bone marrow (adult) stem cells are being used to grow cartilage tissue in a petri dish for implantation surgically. This would be a better alternative than cadaver implants but would still require surgery. Also I have not seen this for orthopaedics but I admit I still have to research it.

Though this is a little more preclinical than I like to be on the site I couldn't pass it up. At least in mice it is possible to induce an adult neural stem cell to become an embryonic stem cell. I would call this pretty exciting. Would the evangelicals be opposed to this tactic? I can't wait for technology to make the "ethical" complaints moot. http://www.sciencedaily.com/releases/2009/02/090205133744.htm

Researchers are calling for clinical trials of high-dose IV vitamin C in cancer treatment since the discovery that the supplement reduces cell proliferation in mice independent of an antioxidant effect. This goes against fifty years of theory dating all the way back to Linus Pauling. Turns out the vitamin turns off gene expression in genes critical to cell growth. Who new? This goes back to the T.S. Kuhn concept of science defined by its tools and techniques. When you had ways of measuring things by their oxidation activity you called them antioxidants.

It's a question I have asked myself many times: "If we could just get this patient a new liver right away wouldn't they live longer?" The answer it seems is "not really." A randomized clinical trial of immediate transplant listing versus usual care for patients with alcoholic cirrhosis was published today in Annals of Internal Medicine. This bears thinking about: how many randomized clinical trials do we see in liver transplant? So while patients assigned to the "immediate transplant" group were a lot more likely to get a new liver they didn't live any longer.

A report out this week presents results of bone marrow stem cell transplant to treat multiple sclerosis. This is the second report this week showing that techniques usually reserved for malignancy are also useful for multiple sclerosis. Bone marrow stem cells are used to rescue the immune system after high dose chemotherapy is given to MS patients--similar to treatments usually reserved for patients with lymphomas and other types of malignancies. Are MS and lymphoma really the same disease just different manifestations?

Bone marrow stem cells regenerate mouse lung tissue This is a preclinical story but I am wild about stem cell stories and especially stem cell plasticity. I think a lot of the things you hear people talking about with stem cells assume that embryonic stem cells are the only game in town. As a hematologist I beg to differ. I think bone marrow stem cells are at least as exciting and are available right now from every patient seen in my office! There is the old fashioned way of harvesting them which involves a needle in the hip.

Fetal stem cells okayed for stroke research in UK. I usually don't cover stories that report the START of a trial mostly the COMPLETION of a trial but this one was too good to pass up. The idea here is that scientists will inject embryonic stem cells into the damaged brains of stroke victims and "see what happens." I can't wait to see what they will find. We are standing on the cusp of a major new way to practice medicine: the stem cell era. I call it "stemical" medicine as opposed to "chemical" medicine which is what we practice today.