| 1 | TEDx Talks | The Promise of Stem Cell Therapy | Neil Neimark, MD | TEDxAshland | 121137 | 2169 | 234 | 67.4 | positive | 17:36 | let me start by asking you all a question how many of you here have ever injured yourself if you've ever fallen down and scraped the knee or twisted an ankle maybe strained your back or got a paper cut or a splinter or something like that please raise your hand now and keep it up for a moment great now all those of you who've healed from your injury please put your hand down now but if you're still suffering from a chronic old injury please keep your hand up for a moment great think you can all put your hands down now all those of you who've healed from a prior injury have experienced first hand the healing power of stem cells how because all tissue repair in the body is initiated by stem cells and in the words of dr. Harry Adel s'en and orthopedic stem cell specialists anytime you have healing after an injury it's a stem cell mediated event now those of you who are still suffering from a prior injury your pain or loss of function is due to the fact that either you do not have enough stem cells to fully heal the damaged area or the stem cells that you do have are simply not functioning optimally but here's the good news there are other areas of your body where you have plenty of stem cells that are functioning beautifully for example the bone marrow or your adipose tissue that's fat tissue does anybody here have a little extra fat they'd like to get rid of most of us do and if you take the stem cells from that fat where they are plentiful and you transplant them to an area of the body where they're in short supply then a tremendous amount of healing can occur and this is the essence of what we call regenerative medicine utilizing the body's own stem cells or stem cells from an outside source like the umbilical cord or and the otic tissue of a healthy baby delivery in order to stimulate tissue he and repair now as a family doctor for over 35 years I've seen the positive results of stem-cell therapy in my own practice and in reviews of the current literature and I truly believe that the next great advance in medical care will not be a magic pill it will be a miraculous cell called the MSC the mesenchymal stem cell and it will change the landscape of medicine as we know it over 30 years ago dr. Bernie Siegel the Yale author and surgeon used to say as a surgeon I cut into the body and I rely on it to heal I don't have to yell into the wound and tell it how he understood that the healing system lies within us what he didn't know at the time is that it is the MSC that mesenchymal stem cell that is the conductor of that healing system and it initiates and orchestrates the healing process now in this slide you can see the MS CS are the are the pink cells here lining the capillary bed and most remarkably the reason dr. Siegel never have the yell into a wound and tell it how to heal is because the MSC's yell into the wound for him they don't use regular words of course they use chemical words called signaling molecules and these are natural drug like compounds that stimulate tissue healing now whenever there's damage in the body these pink cells the MS CS go to the damaged area and they survey the area they begin to collect data and they communicate with the other cells in that area and then they intelligently respond by releasing a variety excuse me by releasing a variety of drug like molecules that initiate tissue healing and repair this is why dr. Arnold Kaplan who's a stem cell researcher at Case Western Reserve says that the MSC is an injuries cific drugstore because if you take an MSc and you put it in and damaged injured knee it will produce very different drug like molecules then if you take that same MSC and you put it in an inflamed lung or a damaged liver that's because MSC's are stem cells that are data-driven from the local information they're intelligently responsive to that information and their injuries specific drugstores now where do these drug stores exist in the human body well they exist in an area that we call the universal stem cell niche and that's where all tissue healing and repair occur now in order to explain this concept to you I had to create a fairly complex medical slide so be patient with me I promise I'll walk you through it slowly and even those of you who just don't get science will get it I promise so here it is the universal stem cell niche okay I'm kidding it's not a complex slide but I want to point out a couple of things the universal stem cell niche is simply the location it's the concert hall if you will where all the members of this healing system Philharmonic Orchestra play now leading the orchestra is the MSC who waves the baton and sends these signaling molecules to all the members of the orchestra to ensure that they play their parts that is they do the healing to the best of their ability now here in the front section we have the stringed instruments which are the progenitor cells these are called tissue-specific stem cells and every organ in the body has progenitor cells that only create cells unique to that organ so for example this bone progenitor cell only creates new bone cells and the heart progenitor cell only creates new heart cells and the same is true for every organ in the body now in the middle section where the woodwinds and brass are we have the vascular players these are the capillaries the red blood cells white blood cells and platelets that carry all the healing elements to the body and to the damaged tissue and lastly we have the peri sites this is the percussion section these parasites are those pink cells you saw in that electron micrograph and they have these little finger-like projections that go on to the capillary wall and they monitor they keep their finger on the pulse the rhythm the beat of the local scene and whenever there's damage they break off they go to the conductor's podium and they recruit a whole new healing system Orchestra to initiate tissue healing and repair now the universal stem cell niche is so vital to our well-being that in the words of dr. kristin Camela a leading stem cell scientist if you didn't have stem cells you could only live for about an hour now as amazing as that fact is even more amazing is the fact that these stem cells are helping real patients in real life medical situations get well one of my favorite quotes of all time comes from the American poet Muriel Rukeyser who said the universe is made of stories not of atoms so I want to tell you Jim W story Jim first came to me in August of last year complaining he needed a preoperative clearance for a left hip he needed a total hip replacement now he had been having a lot of pain a lot of clicking and he could no longer walk his dog honey so he was miserable now a year before he had had a total hip replacement in his right hip and that recovery was complicated by an infection and it took him over three months to heal and he was miserable during that time so when I mentioned to him the possibility of doing stem-cell therapy he was interested but he was a little skeptical because his doctor had told in his hip was bone-on-bone so he said only surgery is gonna work nevertheless he was willing to give it a try so under ultrasound guidance I injected about 8 million MSc stem cells into his left hip the whole procedure only took about 15 minutes it hurts no more than a blood draw basically and we put a bandaid on and Jim walked home and I said to him Jim be patient it takes about 3 to 4 months to see results well at the 3-month point I saw Jim and he was a little discouraged he was only about 25% better but I said to him Jim be patient let's give it a little longer so in February of this year at the six-month point I saw Jim again and he was ecstatic he was in virtually no pain he could barely tell the difference between the left hip and the right hip and most importantly he was able to take his dog honey out on 45-minute walks pain-free now Jim's a little camera-shy but I was able to catch this photo of him back on the happy trail with honey again now let me show you what happened inside Jim's hip when we put those stem cells in what happened is the stem cells go up to the conductor's podium they assess the area they assess the damage and then they send these signaling molecules to the progenitor cells to the tissue specific bone stem cells and cartilage stem cells that exist in that area and they've always existed in that area the problem is as we get older they decrease in number and then with wear and tear sometimes they get a little sleepy and tired and they get weak and weary and they lay down and take a nap so when we put those MSC's in they awaken Jim's napping progenitor stem cells they reenergize them and they come to life and they start creating new cartilage new bone new ligaments that lead to the growth and repair of that hip now stem cells don't only work in area in aging painful joints they also work in any can anytime in the body where there's excess inflammation immune system problems or wear and tear now this is a list of clinical trials being studied by dr. Neil Riordan an author and stem-cell researcher down in Panama all with very positive results and when you see this list of seemingly diverse conditions all responding well to MSC therapy everything from autism to asthma to osteoarthritis rheumatoid arthritis spinal cord injury you begin to appreciate the power of the MSC to awaken our healing system now I want to tell you one other example of how stem cells have helped patients with diabetes prevent pain and suffering in this study by dr. Prochazka at the University Hospital in Ostrava in the Czech Republic he studied 96 patients with what we call critical limb ischemia that's low blood flow to the feet and he divided these patients up into two groups now mind you all these patients were at risk for amputation because diabetics easily get in little cuts on the bottom of their feet that can get infected it can spread to the bone and often necessitate an amputation so in the first group the patients were given stem cells and these stem cells were taken from their bone marrow and they were injected along the leg here and along the foot ulcer base and in that group of patients 79 percent went on to heal completely by the 90 day point unfortunately 21 percent of those patients did require an amputation now in the group - that did not receive stem cells 44% of them required an amputation that's over twice as many patients needing an amputation they could have been entirely prevented by a single stem cell injection in a procedure that basically took an hour and a half to complete now I want to show you what happened beneath the sir or on the foot first with this critical limb ischemia you can see it they 0 this big wide gaping wound by day 30 it's a fraction of what it was in ninety days after a single stem cell injection it's almost completely healed now if you look beneath the surface at the blood flow what we have here is called an angiogram this is a picture of the blood vessels that go down to the feet on the left here this is the the foots down here and this is the top of the leg the calf you see what this is before stem cells it looks like a little country road or two barely carrying any blood down to the foot now ninety days after a single stem cell injection what you see here looks like a major metropolitan freeway system carrying massive amounts of blood down to the feet and remember the MSC not only heals tissue but it's also what we call angio genic it stimulates new blood vessel formation and because these MSC's like to live along the capillaries the more blood flow you have the more stem cells the more stem cells the better the healing the better your health I want to leave you with a quote from one of my personal heroes Norman Cousins who used to say the doctor has a role beyond the prescription pad to invoke the patient's own bodily resources for healing what this means is we need to just stop throwing a drug at every problem we need to learn how to harness the regenerative powers of our own healing system not only through advanced stem cell technologies but also through better nutrition better lifestyle choices better stress management and living a life of contribution purpose and mean but it's up to each and every one of us to get the word out about stem cells why because no drug company or surgical device company is gonna tell you about all the benefits of stem cell therapy because it disrupts their industry it eats into their market share and their profits so there's not going to be any fancy TV ads or print ads telling you all about the amazing benefits of stem cell therapy the task is ours it's up to us but if we rise up to that task this is what the future holds every patient with heart attack or stroke will immediately receive a series of MSC infusions that will help minimize scarring of the heart and limit the neurological damage and disability every child with autism will receive a series of MSC infusions that will help reverse the inflammation in their brain and help reintegrate that child into a healthy normal life and every patient with autoimmune disease whether it's diabetes lupus MS or rheumatoid will receive a series of MSC infusions that will help reset their immune system at the root cause level and help them to minimize their exposure to dangerous drugs and dangerous side effects there's an ancient teaching that says whoever saves a single life it's as if they saved the entire world so please share this information with just one loved one one co-worker one family member who may benefit from stem-cell therapy and together let's help save just one person's life let's help alleviate just one person suffering and let's help make a better healthier world through the promise and the proof of stem cell therapy thank you [Applause] | ↗ |
| 2 | TEDx Talks | Stem Cells: The Future of Regenerative Medicine | Valentina Vasquez | ... | 28815 | 556 | 31 | 63.7 | positive | 7:57 | Transcriber: Jay Kallem
Reviewer: Sarah Abdelrahman [Stem Cells: The Future of Regenerative
Medicine: Valentina Vasquez] When I say the words terminal illness,
what do you think of? Oh, unfortunately, the word that
comes to my mind is death. In 2019, 121,500 deaths were recorded
due to Alzheimer's disease. But what if this disease
could be reversed? And what if stem cells were the answer? While diseases like Alzheimer's
are devastating, I can't help but wonder how these
neurodegenerative diseases manifest in one's brain and why scientists
have yet to find a cure for them. I remember when I was younger, I had
a conversation with my parents, and they told me that when my
brother and I were born, stem cells were taken from my mother's
umbilical cord and stored in a cell bank. Naturally, I was confused, so I asked why? They said that stem cells were being
used for neurodegenerative diseases such as Alzheimer's, Parkinson's,
and Huntington's disease, just to name a few, and that these cells
would be useful for me later in life. I was so amazed at this concept, that a part of me could
be used to heal myself from possible diseases I may
acquire in the future. These minuscule cells furthered my
love for science and medicine, and I became more interested in learning
about the foundation of life itself. Cells or in this case, stem cells. Stem cells have the unique ability to
develop into practically any cell within the body. But before I explain
the nitty gritty, let me first tell you how stem cells
really came to my attention. So after that conversation with my
parents, I didn't put too much thought into stem cells,
or the fact that I had some stored in a cell bank for quite some time. But my amazement with these cells
started up again when I gained a new found interest in dementia and the
influence it had on people's lives and the effect it had on their brains. I started to research Alzheimer's,
which is a form of dementia, as dementia is just the umbrella term for several diseases affecting
cognitive function. And I came across the term stem
cells more frequently. But at that time I didn't know much about the topic other than what
my parents told me about the advances being made in medicine
using stem cell application. Now, if you want to have a basic
understanding of stem cells, you have to understand basic human
development as it begins with pregnancy, which happens after a sperm cell
fuses with a woman's egg, which then develops into a zygote
and then a blastocyst. And this is where the magic happens. A blastocyst is a cluster of
dividing cells made by a fertilized egg roughly five
days after fertilization. This is where the enormous surplus of
embryonic stem cells are located, and it is at this stage, in particular, where these pluripotent
stem cells show the most promise. And I know, I know,
most of you are probably thinking, Valentina, you can't
be throwing words like embryonic stem cells and pluripotent around with no
explanation. But don't worry, I got you. So any person that begins to research stem
cells will naturally become overwhelmed by the many components and
groups that seem to overlap somehow. Because I know I was. So let's start
with the word pluripotent. Pluripotent was a term I often encountered and I was under the impression that it
was this big group of stem cells with smaller groups, and within one of those
groups being embryonic stem cells. But this is not the case. The word
pluripotent actually means many potentials. So in other words, these cells have the potential to develop
into any cell within the body. So embryonic stem cells are pluripotent. You can think of these cells as
like the roots of a tree. Just as tree roots give rise to different
branches and leaves, pluripotent stem cells have the ability to differentiate
into various cell types within the body, forming the branches and trees of
the body's tissues and organs. Now, adult stem cells are another
type of stem cell group typically found in developed
tissue throughout the body. You can find them in
the brain, skin, heart, liver, and bone marrow, and these cells
typically have the job of repairing dead or damaged tissue throughout our body. And these are the cells that
heal cuts on our skin, for example. They're also referred to as somatic stem
cells because they're non-reproductive and they also typically scarce. This
makes them challenging to study. There are also multipotent, which means they do have the ability to
develop into more than one cell type, but means they are. They just have a more limited ability than
pluripotent stem cells. Now, iPSCs or induced pluripotent stem
cells are another type of stem cell group made by reprogramming adult stem cells. This process includes introducing a set
of factors such as dermal fibroblasts, which are cells that help heal
the skin from injury. These cells are then genetically
reprogrammed to an embryonic stem cell like state
or a state of pluripotency. iPSCs show much promise in being used in
personalized medicine due to their ability to develop into more than one
cell type when programmed to do so. Now, the last type of stem cell group I want to share with you all today are
MSCs or mesenchymal stem cells. MSCs are adult stem cells commonly found
in the bone marrow and umbilical cord. And these are actually the cells that my
brother and I have stored in a cell bank. Despite being found in the umbilical cord, MSCs are classified as adult stem
cells, solely based on property and function rather than tissue origin,
also meaning that they are multipotent. Stem cells are being used in ways people
50 years ago would have believed to be science fiction, but they still
have a long way to go. The field that stem cells are being used
in today is called regenerative medicine, and it’s centered around implementing
and creating new treatments to aid the body and naturally
healing and repairing tissue and replacing lost functionality brought
on by aging, illness, injury, or defect. Adult stem cells show much potential
from being able to be used to treat type one diabetes, which they would
provide insulin producing stem cells and cardiac cells to replace damaged
cardiac muscle after a heart attack to neurological diseases
in which they would regenerate lost neurons in the brain or spinal cord. In a study done by Stanford’s
Dr. Marcus Wernig, stem cells were found to reduce brain abnormalities
typical of Alzheimer’s in mice. This is actually a really good indicator
that it will be promising in humans, as mice have a similar anatomy. Stem cells have also begun to be tested
in sports medicine regarding the treatment of damaged tendons,
torn ligaments, and other muscle and bone injuries. To put it into perspective, imagine you
are a great athlete who tears their ACL. Typical surgery would mean
a long recovery process and uncertainty about your future career. But with stem cell therapy, the damaged
area would be injected with stem cells, leading to a shorter and less
invasive recovery process. So what does this mean for our future and
the future of regenerative medicine? And mesenchymal stem cells are also
being used as an extensive tool for diseases such as stroke
and Alzheimer's. But the reason that there’s
no cure for these diseases yet, is that stem cell therapy will
only replace damaged cells, but not cure the genetic root cause that
most of these neurodegenerative diseases typically arise from. So what does
this mean for our future and the future of regenerative medicine?
Well, firstly, let’s celebrate an already successful treatment
used in medicine today, which is a blood stem cell
transplantation typically used for cancer patients to replace dead
and damaged cells within the body. And back in In 2018, Japanese
scientists conducted a clinical study where they used
neurological material derived from iPSCs to treat Parkinson's disease. And while the results were very promising, this treatment is years from clinical use. I believe that the future of stem cell
therapies will transform disease outcomes for many patients and lead to many more
groundbreaking scientific discoveries, and it’s why scientists and
doctors should continue to advocate for the importance of stem cell research. Because as this amazing area of
medicine continues to expand, I urge you to support stem cell research
by donating to stem cell initiatives that work hard to advance
this area of medicine and share their findings while doing so. And as you walk out of here today, I want you to think about how stem cell
research is reshaping modern medicine as we know it and is changing lives and
could one day change yours too. Thank you. (Clapping) | ↗ |
| 3 | TEDx Talks | Tissue Engineering for Regenerative Medicine | Warren Grayson | TEDxBa... | 54904 | 943 | 25 | 63.5 | positive | 11:22 | I'm a little bit more focused on my music. I'm a little bit more focused on my music. I'm a little bit more focused on my music. Close your eyes and visualize someone close to you. Maybe a mother, a close friend, maybe a favorite uncle. Open your eyes. For most people, given that exercise, they're going to see the face of the person or the close loved ones. Not their elbow. And so the reason is that the face is closely associated with our identities. The face is what we see when we look at other people. This is how they recognize us. It's associated with our sense of self. And so as we examine what are the definitive features of the face. Let's look at this iconic beauty, Grace Jones. Only the first things you might recognize might be the non-traditional haircut. It might be the piercing stare. But I would also suggest that the other things you see are the broad forehead. You can see the angular features, the high cheekbones, the square jaw, the pointed chin. These things are dictated by the structure of the underlying facial bone. Our facial bone determines our appearance. It determines our sense of self. And when that bone becomes damaged, it damages our sense of self. Here's a patient. Let's call her Jane. Jane had a bone cancer on the left side of her face. That had to be surgical removed and it dramatically altered her appearance. Jane's left eye is drooping. Her nose is indented. And though it may not be very easy to see right here, her face is also sunk in on the left side. This is what the medical imaging shows us about Jane. On the right side, the bone is completely intact. On the left side, that orbital bone that kept her eye in place has been removed. And then her eye is drooping. The entire mid-facial bone had to be removed. Pancy changes to appearance of a nose and a face. A patient like Jane is going to require a bone graft to reconstruct her face. But she's not unique. Every year within the United States, there are up to 200,000 people who require bone grafts for skull and facial reconstruction. At a health care cost of up to $1 billion. So let's imagine someone like Jane who's living in the United States, one of the most technologically advanced countries in the world, with access to the best health care, with access to the most talented surgeons, how would she be treated? This is how they treat them currently. This is the state of the art treatment. It's called autografting. Where I'm going to take a bone from another part of your body, often it's a leg bone. And I'm going to transplant it into the facial region. This is what Jane looks like during surgery or surgical planning. That leg bone has been broken up into four different pieces and reconstructed like a puzzle trying to put it back to reconstruct that facial appearance. This is going to result in a marginal improvement in Jane's appearance. And I've come to believe that this approach is primitive. I, together with my colleagues, are working on approaching regenerate bone that has the appropriate anatomical structure. That is a living tissue so that the patient grows and changes that bone grow and change along with the patient. But also that bone to become a prize of the patient's own genetic material so that it doesn't have any rejection, doesn't suffer from any rejection. We call this approach tissue engineering. Tissue engineering, we start with a scaffold. And that scaffold is very important. So, its scaffold is going to determine the exact shape of tissue that is going to regenerate. And so we make that scaffold in the exact shape of the bone that we would like to regenerate in this patient. Discaffold is also porous. And what that does is allow cells and blood vessels to grow inside of it. So we can form living tissue, healthy tissue. But the scaffold has another really critical feature. Once that new bone forms, that scaffold should degrade away, leaving only biological tissue. So that scaffold, we are going to add stem cells. The stem cells we get from the patient's own fat tissue. So for those of us who bear begots, love handles, this is our evolutionary advantage. We can take those stem cells and isolate them from that fat tissue. And we keep it in a solution. And that solution we're just going to take and drip onto that scaffold so that it spreads uniformly throughout. So that when the cells go, they can form bone throughout that entire scaffold tissue. But the cells have an important characteristic. The stem cells can form different types of cells within the body. And so it's important that when you put those cells inside of that scaffold, they appropriate signals so that they know they should form bone and nothing else inside of it. And so we add to those stem cells and scaffold, we add bone signals. We had done this with any labs several years ago. We tried to combine all three of these features. These stems, these stem cells, these scaffolds, and the bone signals. And what we showed was that after a period of five weeks, we were able to grow a piece of jaw bone. This is the piece that is right at the top of the jaw. This part is in front of the air. It what's allowed us to open and close our mouth to speaking and to chew. And so we thought if we could regenerate piece of jaw bone in the lab outside of the body, the next logical step is to see what we can do inside the body. To do this, we work with mice. Now mice are interesting in that they regenerate really well. And so for us to test this within mice, what we did was to create two holes in the skull of the mice. Taking very good care, not the damage, the underlying bone, the brain tissue. Within those holes, what we did was to put scaffolds and stem cells and bone signals. This is a CT image of the mouse that shows only the bone. It's like a cat scan for mice. On the left side, you can see the hole that we created, one of the circular defects that we created that has is scaffold only inside of it. On the right side, we've put the scaffold and we've populated that scaffold with stem cells. And it could start to see the beginnings of some bone forming inside of the air, shown by the little nodules that you see on the inside of the circle. However, once we add those bone signals to that defect, we see a dramatic difference. We can regenerate large quantities of bone within that defect after a period of six weeks. That new bone that is forming is taking the shape of that scaffold that we've implanted inside of that defect. And so for us, what we feel is that we have the fundamentals of a way to revolutionize the way that patients like Jane would be treated once she comes to the clinic. So how would that change the way Jane is treated currently? Currently, we will take a CT image as we've done before of this patient. So the surgeon will take a CT image when the patient comes in. What if the patient is missing bone? Well, we can digitally include that bone inside of it. And so at the end of this, whether it's a cancer patient or someone with a congenital defect would never have had bone in that place, we can still render what that three-dimensional bone volume would look like. With that three-dimensional bone volume, we can take it and we can 3D print scaffolds in the exact shape of the bone that we are trying to regenerate. Or what is unique about this 3D printing? Can anyone with a 3D printer at home do the same thing? This 3D printed material is made out of a bio-degreeable polymer. So that over a period of time is going to disappear within the body. But not only that, we also created new materials so that within it, the bone signals can actually be included while we are doing this 3D printing. So this is what we're going to take. And this is what we're actually going to take back to the surgeon, give to the surgeon so that while this patient is on the operating table, the surgeon can extract her stem cells, he can open up this scaffold sterile. As you would do with any bandage or any plaster, but the difference is here that in this case, we have a customized bone for that patient. You put the stem cells into the scaffold and then immediately transplant that scaffold back into the surgical, into the bone defect. And this is how we're going to start within a few weeks to regenerate bone inside of that patient. This is going to revolutionize the way that patients like Jane, cancer patients, trauma victims, soleas coming back from birth, from walls or accident victims, or even children born with missing bones. We're going to revolutionize the way that these people are treated in the healthcare system. We're going to change the face of medicine. My colleagues and I feel blessed that we can work on such challenging, but also a very rewarding topic. We, and so each day as we go to work, as we work on these, and innovating new paradigms, we never forget the fundamental aspect of our system. We never forget why we do the research. Thank you. Applause | ↗ |
| 4 | TEDx Talks | Promises and Dangers of Stem Cell Therapies | Daniel Kota | TEDxBrooki... | 603261 | 5616 | 538 | 59.1 | negative | 12:39 | I'm here to tell you that stem cells are probably coming to a clinic near you, but that's not necessarily a good thing. You see, whenever people find out I'm a scientist, they usually ask me, how's this whole stem cell thing going? And I'll be honest with you, I, for the longest time, I had no idea how to answer that question. You see, I'm from Brazil, as you can tell. And you, and you, and you, and you're, in Brazil, when you tell people your scientists, there's, there's no follow up question. There's only this look on people's faces, you know? It's a mixture of sorrow, concern, a little bit of disappointment, you know? It is really the look of a father whose daughter just brought a boyfriend home and is going, of all the choices out there. I mean, that's what you decided to go with. And, and yes, and so I stuck with science. And I was really fortunate to have the opportunity to come to this great country. And for the past 10 years, I have immersed myself in stem cell research. Now, the, but in here, people are really interested in science, right? And like everything else nowadays, the only time people are really interested in science, is in social media discussions, isn't it? In social media discussions, science seems to be such a winning argument. I mean, if you drop a scientific fact, then you basically win the discussion, right? Which is basically why we have discussions anyways, I guess. But as a scientist, that has always bad for me, okay? Because if there's one thing I learned in science, is that David Freeman was right when he said, the more we know, the less we know, and the less we know, the more we think we know. So quite honestly, what people want to know is when can I go to the doctor get some of it? Simply, and it's fair. And I think there's only one way to describe the current situation we find ourselves in as it relates to stem cells. And that is to say, we have reached a critical point in the history of stem cells. A point that can only be described as this. What you see is a massive number of different stem cell treatments out there. And really, the only thing between them and us are regulatory agencies, such as the FDA and the US. But the number of stem cell treatments out there are getting so overwhelming, the sum are just falling through the cracks. And the question then is, how did we get here? And what does that mean to you? So the first thing we have to understand is that stem cells really exist within a relative large spectrum. Okay, it starts with the embryonic stem cells, goes through your postnatal adult stem cells, all the way to adult cells that we can now genetically reprogram to become embryonic like stem cells. We call those induced pre-reportant stem cells or IPS cells. Now we knew from the beginning that embryonic stem cells offer perhaps the greatest differentiation potential, which is by the way what defines a stem cell. It's a cell that can replicate and giving the right cue, it can differentiate you to something else, hopefully something useful. But we've always known that great differentiation potential also means the greatest risk. And it's a very simple concept to grasp, right? We tell our kids, I tell my kids, they can be anything they want when they grow up, right? Don't you? Except the chances of my son become a professional basketball player are probably really slim, right? But I don't tell them that. But we also know that there are very specific conditions in environmental factors that have to be present just for a kid to become a functional contributing member of our society. And more often that we like to admit those conditions are not met, they're not in place, and a lot of the kids end up going astray. Unfortunately, when it comes to embryonic stem cells and IPS cells, going astray really means turning each cancer. And that's the last thing we wanted. Now as I speak and I say in an upset a lot of scientists by oversimplifying something very complex, there are many scientists working precisely on deciphering those conditions. And in the future it's quite possible that the choice between using embryonic stem cell and IPS cell will come down to a moral choice. And with that being said, I have to tell you that both embryonic stem cells and IPS cells represent a very small fraction of all the stem cells out there. What makes the bulk of them are really adult stem cells. And going in, we knew that adult stem cells have a limited differentiation capacity. After all, they already decided to be something or on the road to become something. But then 10 years ago something happened that can only be described as a paradigm shift. These cells are better, a subset of these cells, we call them mesenchymal stem cells or MSCs for short, were able to treat and improve a lot of experimental models of disease from heart attack, type 1 diabetes, neurological diseases without ever needing to differentiate into anything. And after 10 years of research I can tell you that the way they accomplish such features is by simply going at it, is by simply doing everything a cell can possibly do. In fact that's why we still call them adult stem cells because you do find them at various ages. But can you imagine that there were teenagers stem cells? I mean, first of all they wouldn't like to go there because they would be boring, right? But they would get there and they wouldn't do anything. It just being tied up that the whole disease would just treat itself because they were there. I mean nothing would get them, right? But as responsible adult stem cells, they go to work. And they employ a plasera of different molecular mechanisms, things like genetic transfer, transfer of mitochondria, secretion of venting flammatory proteins, secretion of gold factors that combine we modulate key systems in our body. I'm talking about your vascular system, your immune system. And there may be other stem cells that have in your body. And they modulate them towards healing as simple as that. And I challenge you to think about any disease or condition. And I can guarantee you it would benefit from either one, if not all of these interactions. And that's precisely what's causing the stem cell revolution we see today. But that's not all. Something else happened. It turns out we discovered we can find these cells virtually in every organ in your body, including your adipose tissue, your fat tissue. So what I'm telling you is that you could have a stem cell treatment at the same time you have liposcopy. And in a country like the US where the number of liposcopyers or liposperate procedures reaches almost 300,000 cases a year, you combine it with a relatively simple method to isolate those stem cells. Then you create the perfect environment for the resurgence of doctor's staining. And I'm not saying doctor's staining had embedding tensions in his heart. In fact, I think we should have followed this whole snake oil thing. But the fact is that in the US, particularly, the FDA has not yet approved a single stem cell treatment apart from stem cell per bone restoration in some cancer cases. All the other stem cell treatments are not yet approved by the FDA. And the FDA is really strict. Actually, it's the strictest regulatory agencies in the world. But I do tensioning towards safety as well. Because that's what we're really talking about. And there are hundreds of clinical trials which are really dead. That trials, studies, assessing safety in efficacy in a very limited number of patients. And I think it's quite simple to understand why someone would be concerned about those cells. Cells are not drugs. I could manufacture a drug here, send out to Brazil, and they would manufacture the exact same drug. But I cannot guarantee that my stem cell, in your stem cells, will act and behave the same. And I think that everything else needs to be a little bit different. And what's worse, if I can get your stem cells, I start growing them and I give some to my colleague down the hall a few weeks later, and when we come back and compare them, they might be different. And the last thing is, we know they do a lot of things. But we don't know quite how to control them. And once really rare, Dr. Stainless is popping up everywhere in the country. And we then come to horror stories. And I'll share two of them with you today. First one is a middle-aged woman, a woman who saw an advertisement for facelift in stem cells. Facelift in stem cells. Now, I know a few scientists who work with stem cells, none of which work with facelift. But this physician, in particular, decided it was a good idea to inject stem cells in this patient's face around her eyes. And a few weeks later, she woke up, and every time she blinked, she heard a click. And you can think that's cool for a second and two, start freaking out. And it turns out that stem cells in her face decided to turn it to bone. So she needed to have them surgically removed. And granted, this happened 10, more than 10 years ago. The second story is really recent. It happened this year. There were three older patients who suffered from a degenerative disease of the eye, and they also saw an advertisement for stem cells. And the physician, in that case, decided, well, let's go step further and inject these cells inside her eyes, directly into her eyes. And a few weeks later, I'll win blind. And what's worse about this case is that the physician, he had the trouble to go to the FDA and start a clinical trial. So he could falsely advertise that his procedures were somehow legit. And so we have really come to a point in history in which the most reliable source of information when it comes to stem cells are really scientists. And that's very scary. I'll tell you that. There was a survey done in Florida in which they asked people, how do you first hear about scientific discoveries? And out of 13 different possibilities, scientists ranked number nine, which means more people learn about scientific discoveries by the way done by scientists. Through comic books, sitcoms, and movies. That's how people hear about scientific discoveries. And I think that's largely fall of the scientists ourselves. We are largely a focus. You know, being from Brazil, I think the biggest difference between Americans and Brazilians are Americans that should take themselves a little bit to serious. And I think it's because you guys don't have enough problems. You don't. Right? In Brazil, there's so many issues, so many problems. We can't afford to make ourselves another one. We wouldn't get out of bed. But here, people tend to think themselves a little. I'm not saying we shouldn't take what you do seriously, because I think we do. And we must. But we shouldn't take ourselves to seriously. And scientists fall from the same disgrace. And what we really need, I think, is scientists, as scientists, we need to get out of our heads a little bit and reach out and inform people about STEM cells. Because quite frankly, a simple message could have prevented those disasters. And a simple message would most likely prevent future ones. Because STEM cells are coming. We just have to make sure the good ones make it. Thank you. | ↗ |
| 5 | TEDx Talks | The Potential of Regenerative Medicine | Stefano Sinicropi | TEDxMinne... | 822 | 25 | 11 | 58.7 | positive | 17:59 | Picture this. You're 23 years old, about to go home from a great night out with friends when you accidentally fall off a third story parking ramp directly onto your head, shattering your cervical spine. It's becoming instantly paralyzed and told that you'll never be independent again. That's Christina or picture being 47, a hardworking laborer, sometimes putting in 80 hours a week to support your family, suddenly facing a disabling mid back injury where doctors tell you your only hope might be major spinal surgery for most a frightening situation with significant risks along recovery and no guarantee that you'll ever be able to go back to that grueling occupation. That's John. But what if I tell you, their stories don't end in despair. They end in hope powered by the body's own healing intelligence. These stories aren't just about mending spines. They're about unleashing the untapped potential in every human body. For 300,000 years, humanity has thrived on self-repair mechanisms. Our immune systems constantly survey for invaders, they eliminate damaged cells, our bodies heal wounds and knit broken bones. This self-regulating intelligence has been the silent engine behind our continued human existence. The modern science has achieved astonishing feats over the last century, conquering many infectious diseases, enabling the repair of severe injuries with precision and even defying illnesses that would have previously resulted in certain death. We still face many conditions that cause profound human disability. He's often stemmed from a breakdown in that very same self-healing process. This is where the power of facilitating and cultivating self-healing becomes truly revolutionary. Now my love and connection to the spine began in 2001 as an orthopedic resident at Columbia University in New York City. I was captivated by its intricate balance and how its disruption can lead to severe pain and immobility. I made it my life's work to restore that balance by becoming a master mechanic of the human body. But the more patients I encountered, the more I felt they're profound, sometimes crushing limitations of a purely mechanical solution to what was also clearly a biological problem. I remember one patient, a professional dancer, that we treated for severe spine injury. We repaired it mechanically with no complications. The X-rays looked perfect. She recovered without any issues, but yet she was unable to successfully dance at that same professional level again. And stories like hers that haunt me as a spine surgeon and fuel a quest to always look for improved solutions. Can we be more than just human mechanics but enablers of the body's own ability to heal itself? Could stem cells, which were being touted as treatments, truly hold the key? My initial stance was deeply skeptical. That research was accelerating, demonstrating the body's remarkable self-healing capacity. The weight of that evidence and stories like Christina's ignited a fire, it fueled a passionate belief that evidence-based regenerative options using FDA allowed stem cell therapies should be offered as powerful biological solutions to enhance self-healing, whether alone or in conjunction with surgical interventions. After that tragic three-story fall, Christina arrived to the hospital. She was barely able to shrug her shoulders or move her arms. She remembers being told her life as she knew it was over. She had reconstructive spinal surgery, but initially she had no significant improvement secondary to the crush injury to the spinal cord. Imagine the darkness, that terrifying finality. Yet she didn't accept her fate she fought. She pursued aggressive conventional treatments, yet hope felt elusive until serendipitously, almost one year after the date of her accident, she became a patient in a groundbreaking male clinic stem cell trial for spinal cord injuries. Doctors extracted cells from her fatty tissue, spurned them down in a centrifuge, and then reintroduced them to the area of the traumatized spinal cord. Slowly, she regained significant arm and even some hand function with tendon transfers, allowing her to feed herself, live independently, and go back to work. Today, she counsels other spinal cord injury patients, passing on that hope that she and other recipients bravely ignited. Seven out of ten patients in that male clinic trial had measurable functional improvements. The Yale stem cell study echoed that hope with 12 of 13 showing benefit and over half showing measurable motor improvements, like gripping objects or taking steps, proving that stem cells can unlock partial recovery. Now this crisis touches everyone, whether individually or through seeing it with friends and family. Globally one billion people suffer from back and neck pain, the leading cause of disability worldwide, in the US alone 25 million people suffer from chronic daily pain with spine conditions being a primary cause. On top of that 18,000 new spinal cord injuries occur each year. These aren't just figures, they're lives undone. Nature stolen, apparent unable to hold their child, a worker sidelined by agony, a life trapped with no independence. This profound dream on human potential costs the global economy hundreds of billions and exacts an even greater toll on lost work, broken dreams and strained families. Adding insult to injury, hope is often cruelly withheld. Pervasive myths about stem cells abound, that stem cells are only embryonic, that they're dangerous, that they're a magic cure all, that they're always tied to cloning. These myths block patients from accessing therapies now. These myths truths are sadly amplified, not just by ignorance, but by an unseen barrier. The corporization of healthcare, with no middleman to benefit from the patient's own cells being reintroduced into their own bodies, the financial incentives that fuel the promotion of other interventions simply don't exist. This lack of financial champions for regenerative therapies slows their broader adoption, keeping people trapped in the dark, desperate for a light that already exists. Remember John? He was one of them, suffering from agonizing pain and not getting better with conventional treatments. He sought multiple opinions, and the consensus was surgery might give him the best option to reduce his pain. The uncertainty cast a shadow over his life as he was concerned about the risks, the recovery, but most importantly, the prospect of not being able to go back as a laborer, the only work he had ever known. He stumbled upon a provider that offered him a regenerative path with the understanding he still may require spine surgery. He elected to have concentrated stem cells taken from his hip and then introduced with precision injections into the area of his injured spine. In just two months, his mobility remarkably improved and his pain became manageable. He returned to a functional life, regaining his identity and future, not only avoiding surgery, but regaining joy in the simple things like playing catch with his child. So how is this possible with stem cell therapies? The science is breathtakingly elegant. Let me tell you about something as simple as cutting your finger. The first day, the bleeding stops, redness and swelling rush in as the body responds. If you watch carefully over the next few days, the magic unfolds. The wound closes, the skin rebuilds, all directed by stem cells that flock to the area like first responders orchestrating repair and regeneration. This everyday miracle is exactly what happens on a larger scale with these regenerative therapies. When we introduce these mesenchymal stem cells, these master gardeners, like internal architects, redesigning your body's blueprint, an incredible series of events occurs. These cells have a biological GPS signal that precisely directs them to the chemical SOS signal of inflammation and damage. This process is called homing. Once they arrive, they set up their nests like long-term command centers right at the area of inflammation and damage. From there, they work continuously as a living pharmacy, eluding tiny messengers that decrease inflammation, reduce scarring from the formation of new blood vessels, and direct the cells around them to repair and rebuild. Dr. Arthur Kaplan, who coined the term mesenchymal stem cells, brilliantly suggested changing the name to medicinal signaling cells to better capture the essence of how these cells work. In Christina's case, those cells honed to the area of damage in the spinal cord sparking regeneration. What about John? In those two months, those cells went to work to decrease inflammation, promote healing, allowing him to improve his pain, and increase his mobility. His triumph is echoed in a compelling 20-23 meta-analysis of 608 patients, which showed that patients getting injections of stem cells for disc disease had a significant improvement in their pain scale and a 12-point reduction on a standard disability index, a truly life-changing rest-storation. Christina's recovery, John's restored future, the undeniable data from rigorous studies. These are more than just isolated victories. These are postcards from the future of medicine, a future that's already here with therapies accessible now, a future where we move beyond simply managing disease with medications and mechanical solutions and focus on cultivating the bodies and eight wisdom. Crucially, while today our focus has been on the spine, these regenerative therapies are creating a massive impact in so many other areas of medicine. In orthopedics, for example, in osteoarthritis, for shoulder hip, knee, and ankle injuries, tendonitis, and beyond, clinical studies are looking at stem cell therapies for brain disorders. Psychiatric conditions, autoimmune disorders, and other systemic illnesses. There is a palpable excitement around the science of regenerative medicine because it is showing so much benefit in a vast spectrum of conditions. But this vital race against time and this broader revolution is hindered. A deep skepticism beyond simple misinformation persists. I know I was one of them. We are trained and rigor and change feels challenging, sometimes even unsafe. Many physicians like myself are trained in traditional interventions and get mired into these professional silos. And sometimes we are not able to open our minds to the possibilities of something newer like regenerative medicine. The public, wary from misinformation, becomes understandably hesitant and add to that the inertia of old systems and the corporatization of healthcare. People are blocked from accessing these therapies, especially when they are most effective earlier in the disease. Where would Christina be if she had received her stem cells on day one instead of on day 365? How about the dancer? Could we have improved her recovery by the addition of these stem cells to get her back to those professional heights? This is why I am here today. This is my message to you. I ask you to become a messenger of this ancient story, the story of the body's own power. You do not need a medical degree to challenge the status quo. Physicians and providers break those silos because our patients deserve every tool to reduce human suffering. These become the CEO of your own health. Don't less misinformation block you from true hope. Ask providers about therapies available today. Your mobility is worth fighting for. To everyone, share this message, consider donating to research, start conversations in your communities about this healing from within. Together, we can build a future where this philosophy of empowering the body's own innate healing abilities transforms human longevity, dramatically enhances recovery and performance, and reduces the devastating global burden of chronic pain. A world where a grandmother dances at her granddaughter's wedding not just because of a pill or knife, but because we've unlocked the healer inside of her. Let's shed these old narratives and let's champion this truth. The most powerful healing force on the planet is already locked inside each one of us. Thank you. | ↗ |
| 6 | TEDx Talks | What you need to know about stem cell therapy | Ernst von Schwarz, MD ... | 125563 | 2661 | 319 | 50.3 | positive | 18:08 | No transcript | ↗ |
| 7 | TEDx Talks | The Beauty Of Pluripotent Stem Cells | Muhammad Khan | TEDxBrentwoodCo... | 8204 | 107 | 4 | 50.2 | negative | 6:46 | What if I were to tell you that in the not too distant future, will it reach the point where things like cancer, diseases like cancer will be viewed as something whilst being really horrible or preventable? Now, I actually think that this is not too far away. Sorry, I think that we are actually not too far away from this. Stem cells have actually been used recently in curing some specific types of cancer, for example, leukemia. leukemia is a cancer of the bone marrow. Now, inside the bone marrow, you'll find there are stem cells. These stem cells can become into very specific other types of cells, for example red blood cells. And if someone has leukemia, those cells become cancers. And one way that we actually prevent this is by doing something called a bone marrow transplant. Now, when that happens, the stem cells inside of the bone marrow will then start producing healthy cells that can then kill off the cancer cells. Now, that is just one example of cells that are being used to ameliorate some forms of cancer. But I'm talking about something much larger. Now, before I can really get into this, we really need to understand what stem cells are. Now, at some point in time, we were all a small ball of cells that then decided to specialize into, for example, heart cells, into cells that went into our lungs, into skin cells that then made us who we are today. We consider stem cells to be the building blocks of life. Now, since then, we've realized that we could harness these powers of stem cells. And what scientists discovered was, within the first four to five days of embryo development, we could take the embryo out and use those stem cells into creating fully functional cells that we can then use in regenerative medicine. Until one day, Shinnyaya Manaka came along. And I'm going to tell you a little bit about him. He was an orthopedic surgeon. And what he found was a lot of the time people would come to him, and they would have spinal cord injuries, and there was nothing he could do for them. If someone came in with a spinal cord injury, he would look at them and think, you know, I want to do everything I possibly could. But there isn't much. And with because of this strong controversy behind embryonic stem cells, he couldn't really bring the research that he needed. And it's something that frustrates me so much. And like it frustrates me, Shinnyaya Manaka was frustrated. And what he thought was, okay, well, what if I made my own stem cells? What if I could take something, like, for example, skin cells, and then force them into doing what I want into becoming stem cells? He called those induced pluripotent stem cells. He then dedicated the next 10 years of his life into researching this. And what he found was absolutely amazing. After the 10 years, he found four factors that, when he injected into the skin cells of a rat, like the rat's skin cells think that they were stem cells, and they would start when they were dividing, they would become more and more like these stem cells. At the moment, skin cells are unipotent. We're always growing skin cells, right, to make sure that we have a strong layer of skin on us always. But what Yamannaka did was he took that, something that could only become a skin cell, and he made it into something that could very well become any type of cell. And as a matter of fact, it is because of Chinya Yamannaka's research that I think that we have unlocked a strong potential, and we've gotten over that controversial boundary that embryonic stem cells have brought forward with their ideas of sort of, with the whole fact that because their embryos, it's unethical to use them. And what I want to move on is, because of these induced pluripotent stem cells, we can now start creating cells without that sort of controversy, without the sort of need to have to worry about research funding and things like that. And so people have actually pushed forward with this. And in one specific lab in Tokyo, they, what they did was they went and took induced pluripotent stem cells from rats, from rat skins, and they turned it into human liver cells, or liver cells that could be used for medical purposes. They actually managed to make not a fully functioning liver, but parts of a liver that were fully functioning, but it wasn't actually the whole liver. And so what they did was they put that into the rat, into various parts of rat, and amazingly enough, a vascular system grew around the liver, and the liver integrated itself very well into the rat, and it was actually fully functioning. But why would this matter to us at all, if we can somehow put livers into rats? I don't, like, obviously that doesn't apply to us right now, because there are rats and we're humans, it might not be the same. And whilst that is true, they foresee that in the next 10 years, this might become commercially available. And that is why I think that this is such an important science, because I mean, a lot of you guys probably around six, seven minutes ago didn't even know what stem cells were. And that, to me, was absolutely tragic. Because of Shinnyamunaka's work, I think that we should be much more aware of these cells. And I think that we should actually start thinking about integrating into medicine, which whilst we are, I really see that coming within our lifetime. And that is why I think it's something that everyone in this room really needed to know about. Thank you. Thank you. | ↗ |
| 8 | TEDx Talks | Disease avatars : Chasing precision medicine through cell reprogrammin... | 1615 | 19 | | 49.0 | | 14:15 | What I would like to do today with you is to walk with you through a frontier in medicine and to share with you the excitement for how this frontier is enabling us to ask new questions about health and disease to interrogate in new ways our bodies in space and time. It is a frontier that is enabled by a transforming technology, a real radical breakthrough called cell reprogramming, but it's about so much more than just technology because it's about changing our gaze, the way we look at patients, the way we look at ourselves, and it's something that is going to affect our lives in our lifetime. So changing about gaze, it's basically about going from living things out, from excluding things that are put in them in brackets to include things, to bring them back in and in fact to the fore in the petri dish of a lab with very important clinical implications. What do I mean by that? Well, let's go to Meshephokol who is an archaeologist of knowledge, that's how he defined himself, and who was looking at how medical doctors looked at disease and patients in the 19th century. But that gaze is still very much with us, except that it's a legacy under strain. So in his words, to the pure and nozzological essence, so to the essence of disease, the patient adds his predispositions, his age, his way of life, and the whole series of events that appear as accidents. He who describes a disease, so the medical doctor, the physician, must take care to distinguish the symptoms that necessarily accompany it and which are proper to it, from those that are only accidental, such as those that depend on the temperament and the age of the patient. It's of course the language of their time, but the punchline comes here. Paradoxically, in relation to what he's suffering from, so the disease, the patient is only an external fact. The medical reading must take him into account only to place him in parenthesis, right? So we are looking at patients, but since we are thinking about diseases, the patient in its individual configuration must be bracketed out. Right contrast with the view of precision medicine. This is a website from the initiative that Obama launched last year. Several similar initiatives have, I mean, well, flourished around the world. And the idea here is that the things that we had to brag it out are actually the very things that we want to focus on. And this is becoming possible to envision through the conflation of a number of technologies. First of all, on the one hand, the possibility to sequence very fast at an affordable price our genomes, so to actually read our DNA. On the other hand, the amazing capacity to compute large amounts of data is the so-called big data deluge that I'm sure you will have already heard of. But today I'm going to focus about what is here in the middle. One of the enabling technologies that allows us to bridge the gap between genes and the environment, genes and clinical data. And that is every programming. And so I would like, first of all, to thank my team members because it's important to realize that in science, when we change the game, we change the game in a team. And to paraphrase new term, we actually change the game only on the shoulders of giants who have changed the game before us and in fact, who set for us the table on which we can start playing the game to start with. So this is my team in Milan. And giants of game changing, like Corridd Woddington, in the 50's gave us tools for thinking about development by making an analogy of the very first cells in the early embryo to a marble that is sitting at the hill. And it has various options in going downhill. And these options are the various fades that can happen to that cell. It could become a neuron, it could become a skin cell, it could become muscle. And of course, you see that it's downhill. So the analogy here is between a development and gravity, a process that once it unfolds, it is irreversible, it can only go downhill. To the extent that another giant of game changing, Spayman, reminds us that we are standing and walking, like me now, with parts of our body which could have been used for thinking, had they developed in another part of the embryo. So crucial moments at the top of the hill, very early on, cells are still very plastic, but those decisions will unfold all the way through. Now the game has radically changed. It has radically changed thanks to decades of research which culminated in the towering achievement of Nobel Prize Shinya Yamannaka 10 years ago, who showed us that by tinkering with just very few genes, four genes out of the 25,000 that we have, it was possible to reprogram a fully specialized cell, like my skin cell, that only knows how to behave as a skin cell all the way back to the top of the hill, to bring it to that stage so that now, in vitro, in that pit redish I was telling you about, it can actually be moved forward again. So we go uphill and then we can go downhill again, but we can do it in vitro. What are the implications? Well, the reason why this is changing medicine is because this is actually enabling to make the body outside of the body. What has been the problem so far, the key rate limiting step in medicine, not having access to the cells that we most wanted to have access to, the disease cells of a patient? Well, because quite obviously these cells are inside people's bodies. Think about brain, but in fact, for most of the diseases, these walls and remains a fundamental problem. Now however, you can actually externalize tissues and cells of the patient. Because what you do is you reprogram skin cells, you have these induced pluripotent stem cells, they are induced because we induce them to do this transition, they are pluripotent because they are at the top of the hill, so they can do all the tissues of our bodies, but in vitro, and they are stem cell because they can keep doing it basically forever. Once we externalize, once we bring them outside, they are immortal. And so in the dish, we can build avatars of our tissues, representations of our tissues in both health and disease that we can mine and probe for a number of medical questions. And of course, it could even be possible that some of these cells then can go back into the patient to regenerate parts of its alien bodies, but today we are focusing on what we can learn outside of the body. So what does the eye in IPS really stand for? Of course, the original meaning is induced because we were downhill and we induced them to go back up. But of course, you can't help notice how that eye resonates with so many small eyes that label the devices that populate our digital social life. Starting, of course, with the internet, one of the words that Steve Jobs mentioned in his speech in which all of these small eyes were actually connected to the launch of the eye-mac, and the internet with the idea of the constant connectivity. And if you think about it, these avatars are actually all the time potentially connected to us because once you reprogram from your skin these pluripotent stem cells, they are there. They can be banked, they can be stored in lab, and you can go back to them to ask medical questions because these cells have your genome, and these are the cell types that you want. And of course, information, because it is true that in a couple of days we could sequence the genome of all of us here today, but the truth is that we still understand very little of that information. And the only way we go about closing that gap of knowledge is actually having a system in which we can experiment on that level of information. And now we have the way to do it because it is outside of the body. I don't think I need to tell you why it is inspirational. You just need to look at me and to how I'm excited about these developments in my and several other labs. And of course, the individual, because this is the thrust of this frontier. Thinking about that patient going from being within a bracket and being left out to actually coming to the fore in a petri dish in a way that samples the specific configuration of each one of us for a range of medical questions throughout our lifetime. So the challenge, of course, is monumental because we have clinical data, we have genetic data, and we need to bridge them in vitro through a number of molecular features that we have to see and discover in these avatars of ourselves. And so I'm just telling you very briefly towards the end, what we are doing in the lab in which we study cancer and neurodevelopmental disorders or intellectual disability and autism. And they're going to tell you just about a pair of diseases and just to make sure that we are on the same page. Because all of ourselves have 46 chromosomes, these contain about 25,000 genes, the two diseases I'm briefly telling you about are due to the fact that very few genes, about 26 from chromosome 7, are actually present either with one copiless or one copi moor. So most of us have two copies of each gene, including these famous 26 genes. But children with Williams syndrome have one copiless. And children who have one copi moor, so who have three copies, end up having autism or attenurate a severe speech impairment. So these are two conditions that give us also an incredible glimpse into foundational traits of the human condition, like the acquisition and use of language and the acquisition of social interactions. Williams children are gregarious, hyper sociable, the clinicians used to refill them as having a coptile party personality. If you have one copi moor of the same genes, so a very subtle change, you end up with autism. So this is just a more detailed view because it's not only about cognition, but it's also at the level of the facial features that changing the dosage, the quantity, the amount of genes, or very few genes, ends up in having these symmetrically opposite phenotypes. So what we did was to actually reprogram skin cells from these patients and their families and build these avatars. And then ask the questions. Once we have brought these cells back to the top of the hill, like the marble I showed you, what can we learn? What is the impact of having one copiless or one copi moor of these apparently fundamental genes? Well, we discovered surprisingly that already very early on, already once we added the top of the hill, we find major alterations caused by these imbalance in dosage. And the desalteration then is amplified as you go down the hill. So the problem is seeded very, very early on when you are at the top of the hill. So this is then a summary of our project and these kind of projects which can really be applied to any kind of disease that has a genetic component. Here you have a disease that has a combination of features. You can now resolve them. You can destructural them in vitro by building from that patient with that genome, with that disease, the tissue types that together then you can reassemble to start the both these disease is really about. And in fact, I refer to this as the factory of avatars because this is for example an induced purportant stem cells that we reprogram from one of these patients in the lab and we are able to push it in vitro towards the progenitors of the face, right here or towards the neurons of the cove text. To the extent that now this is very recent data from a lab, we and others are actually pushing a new frontier which is making from these cells not just neurons but three dimensional aggregates that mimic the development of the brain cove text in vivo. But it's happening in vitro. So we have models avatars which recapitulates the step in which we form a brain but again outside of the body. And so I would like to finish with Archimbaldo, a real game changer in art where this amazing skill of capturing humanists, features of the human condition, not only of human anatomy, by assembling other aspects of life and sometimes even all life in a way that at the end you actually reconstructed this model of humanists. And the technology I told you about today which is really a foundational tool for precision medicine is about capturing the humanists, the humanists of a specific patient in a dish by resolving and deconstructing the disease and then bringing it once back on into a coherent hole. A very exciting time which again will hopefully affect all of us because it will give us new tools to push ahead this frontier. Thank you very much. | ↗ |
| 9 | TEDx Talks | Advances in Regenerative Therapy:Mesenchymal stem cells | Nirupa Vyas ... | 14525 | 289 | 26 | 41.6 | neutral | 16:43 | Hello everyone, I am Nirupa Vyas and I am the co-founder and managing director of two stem cell companies, total potential cells private limited and social innovations and wellness private limited. We have been researching stem cells since 2007 for clinical applications. Now you may wonder what are stem cells and how do they work? Let me paint a picture with some examples. Picture this, wherein in a football match one of the players suddenly gets injured on the field. The sports medicine doctor makes a diagnosis of an anterior cruciate ligament tear. This is followed up by a surgery to repair the tear. After that it takes weeks of healing and months of physiotherapy and physical rehabilitation before the player actually gets back to the field. Or a tennis player or a cricket player suddenly develops a tennis elbow pain and has to take time out from the court. He or she may have to resort to steroid injections to resolve this pain. Another situation where a 45 year old office goal gets debilitating leaping. It is diagnosed as second stage osteoarthritis. The advice that is given by mainstream medicine is to get a knee replacement done. Doesn't matter that the life of the implant may be only 15 years and a revision surgery may be required after that. Finally think of a 75 year old grandparent who gets diagnosed with Parkinson's disease. They are put on medication which will have to be taken for a lifetime. All that can be done is to manage symptoms but this will not cure or reverse the disease. The classic scenario for all these conditions would be to give multiple drugs and surgical interventions. But with the advances in regenerative therapy all these conditions have been helped with the help of meez and kymal stem cells which is done at our labs. When regenerative therapy is opted for the football player with the ACL injury would have stem cells injected from his or her own bone marrow which would help repair regenerate and renew the cartilage much faster. This would enable the player to return to the field much faster and cut back on medical expenses. The tennis player gets an injection of a dose of stem cells made out of his own bone marrow at the site of the pain and his pain is gone. The 45 year old is given two stem cell injections into the knee made out of their own adipose tissue which will help regenerate the worn out cartilage. The natural joint is and the person gets 5 to 7 years to do physiotherapy and physical rehabilitation to push back the knee replacement surgery. The same process can be repeated the stem cell therapy can be repeated after 5 to 7 years if the pain starts again again pushing back the knee of the knee replacement. The grandparent who was diagnosed with Parkinson's disease can be given stem cells from their own bone marrow into their spine thus delaying the onset of the disease and maintaining the quality of life. These are just some of the uses of meez and kymal stem cells in regenerative therapy. What is regenerative therapy? Let us just elaborate this term a little further. Regenerative therapy is the therapeutic application of stem cells based on their potential to stimulate repair mechanisms and restored function in damaged body tissues or organs. Regenerative therapy utilizes human cells and tissue products. So the example is stem cell therapy platelet rich plasma therapy to name a few. The human cell tissue product secret compounds called growth factors and cytokines that aid in treatment with chronic and degenerative diseases. This therapy stimulates natural healing process by stimulating the reparative response to aging, diseased, dysfunctional or injured cellular tissue. Some of the relief to the symptoms is immediate. The inflammation is cut down and the pain is gone. But some will the process of regeneration takes the investment of time depending on the damage and the immune system of the person. Let us understand what are stem cells and how do they work. Stem cells are unspecialized cells in our body that can differentiate into various cell types and thus can help the process of regeneration. They have a property of angiogenesis that is they are capable of forming new blood vessels. They are anti-inflammatory and antimicrobial in nature. They also have the property of immunomodulation that is they can modify the body's immune response. And lastly, they stimulate regeneration at the site of the damaged or injured tissue. So they are capable to repair, regenerate and renew damaged tissues or organs. Now let us take a deep dive into what are mesenchymal stem cells. The definition of mesenchymal stem cells is that they are multi-portant stromal cells that can differentiate into a variety of line-ages. That is they have the ability to differentiate into cell types of different germ layers. That is the ectoderm that's the skin, mesoderm, the bones and the cartilage and endoderm, the organs. Stem cells derived from the ectoderm for example that is the skin can translate to form neural cells in the brain. So this phenomenon is referred to as cell trans differentiation or plasticity. Mesenchymal stem cells are immunonive. That means a person's immune response will not reject the mesenchymal stem cell transplant. Thus this therapy can reach a number of people. There are various sources of mesenchymal stem cells. The bone marrow derived mesenchymal stem cells are most commonly used and well researched. Addipous tissue of fat provides a more abundant and easily accessible source of stem cells. Ambelical cord blood, ambelical cord that's the vortngel and placenta are also rich sources of stem cells. The autologous cells are defined as the cells that come from a person's own body and allogenic cells come from a donor tissue. So bone marrow, adipose tissue, menstrual blood, dental pulp all fall under autologous sources. Ambelical cord, cord blood, placenta are the allogenic sources. I can safely point out that many of the children who are sitting in the audience would have had their cord blood and cord tissues saved. In a private cord blood bank, so in case at the time of the birth, if there was a complication, these tissues would have come in very handy for the child. Typically if the child is not crossing milestones, the pediatrician or stem cell clinic will advise injecting the stored cord blood to achieve normalcy. But the parents and grandparents don't have that tissues stored and that is where autologous regenerative therapy is very convenient wherein their own tissues can be taken and processed in the lab and re-injected back at the damaged area to regenerate the damaged tissues. So if anyone of you requires stem cell therapy, all that you need to do is to look inside your body. So, Mies and Kamil's stem cells find a lot of clinical applications in regenerative therapy. These we have been working since 2007. In the laboratory that we have set up to work on stem cells, we were granted a clinical trial by Department of Biotechnology, Government of India. The trial was to study adipose derived stromal vascular faction for the treatment of arthritis of the knee, that is osteoarthritis. 25 patients were selected for the clinical trial who had grade 2 to grade 4 osteoarthritis. The lab process was carried out at our GMP Class 5 facility. The process of harvesting the stem cells has many steps. First, the plastic surgeon takes the patient into the operation theatre and with specialized cannulas, the belly fat is taken out. This is known as lipo aspirate and the process is known as lipo aspiration. This tissue is then moved back to our lab where the cells are harvested and a sufficient number of cells are brought out for treatment. Finally, the Mies and Kamil's stem cell dose travels back to the operation theatre where the patient is and a qualified orthopedic surgeon will give intraarticular injections straight into the knee. Following criteria were evaluated to study the success of the therapy. First was the range of motion. There was an improvement of knee society score for range of motion criteria in all the patients after 12 months, then the pre-treatment. The pain was reduced, the walking score was improved, climbing of the stairs improved then from the pre-treatment. There is a visual analogue score which talks about which is subjective but it is highly indicative of the patient's satisfaction. At the end of year 1, 24 out of 25 patients scored between 9 to 10. So to stem it, sum it up, it establishes the safety and the efficacy of the adipose derived Mies and Kamil's stem cells for the treatment of osteoarthritis of the knee. The study has been published and we have been awarded a process patent. I would like to describe my own journey with stem cell therapy. I had a ligament tear which impacted all my mobility and I couldn't even walk properly. A surgery was advised which I did not want to undergo. I was given three rounds of stem cell therapy over a period of four years. With constant physiotherapy and physical rehabilitation, I have been able to regain 95% of my joint health and movements. Other uses are for neurological conditions. Research suggests that stem cells have neuro protective effects which can help for treatment like Alzheimer's and Parkinson's diseases. By promoting neural repair and reducing neuro inflammation, Mies and Kamil's stem cells could help preserve cognitive function as we age. Children with cerebral palsy are being given injections of stem cells into their spinal cord and ample scientific data has been generated to show that the children start crossing the milestones after receiving stem cell therapy. During COVID, patients were given high doses of steroids to bring down the inflammation in the bodies. This subsequently developed a vascular necrosis of the hip that is they would require a hip replacement to be done. 19-year-old, 20-year-old young adults were being advised to do hip replacement. Here, autologous cell therapy using stem cells from the bone marrow were injected in their hip joints and the hip replacements was avoided and they had good results. Mies and Kamil's stem cells are also being used for anti-aging therapies. So, as we age, our cells accumulate damage and they enter into a state of senescence, wherein they no longer divide or function properly. The MSCs have been shown to secret growth factors that can reduce cellular senescence and promote the regeneration of the diseases. Chronic inflammation is a hallmark of aging and is linked to many age-related diseases. So, the stem cells, the Mies and Kamil's stem cells possess strong anti-inflammatory properties which can help reduce the inflammation. Other applications in anti-aging are for the rejuvenation of the skin and hair. Plastic surgeons and dermatologists aspirate the belly fat out of which we make nano fat and micro fat, which is rich in stem cells and in growth factors. This is being used in place of dermal fillers and Botox. It improves the skin elasticity, reduces the wrinkles, it promotes a more youthful appearance by stimulating the collagen production. Hair fall and hair thinning is affecting youths to adults. So, Mies and Kamil's stem cells along with platelet rich plasma is given in the hair follicles. It is injected into the scalp in the hair follicles to stimulate and regenerate the follicles to achieve hair growth. The images that you see are the images of my 19-year-old son who started getting a balding patch. Mies along with PRP were injected in his spot and in six months we had results that the entire balding patch was gone. There are challenges to the Mies and Kamil's stem cell therapy. Different laboratories use different protocols which can result in varying cell quality and potency. So, it is very important that standardized procedures need to be developed which will help ensure consistency across treatments. The production and administration of Mies and Kamil's stem cell therapies is expensive so it doesn't reach the masses. Lifestyle modifications are very important to the success of stem cell therapy. A smoker or drinker cannot expect any results out of stem cells if they do not quit their smoking and drinking. So, what I leave you all with is that the next time around, someone near you needs some medical treatment. Please do research whether stem cell therapy can be an answer to that and definitely do ask your doctor about it. When all of you sitting here in the very near future, pick careers, research in the field of stem cells is an exciting proposition and I request you all to definitely apply your minds to it. Thank you very much. | ↗ |
| 10 | TEDx Talks | Stem cell therapy -- beyond the headlines: Timothy Henry at TEDxGrandF... | 243320 | 1999 | 219 | 39.9 | positive | 17:54 | Hi, it's always nice to be back in North Dakota, even when it's 100 degrees colder than it is where I now live in Los Angeles. I think this is a picture's worth a thousand words. It says, I thought that was a figure of speech. I'd think about it a minute. I grew up in West Oat, North Dakota right on the Canadian border. And I'm an interventional cardiologist where my dad would say a glorified plumber. And I'm now the chief of cardiology at Cedar Side Eye Medical Center in Beverly Hills. It's a long ways from West Oat to Beverly Hills. What I'd like to do today is talk about stem cell therapy. This is the headlines on the USA Today on January 30th. It highlights our temperature difference. And I think it also announces a new stem cell breakthrough. I've been working with cardiovascular stem cell therapy for the last ten years. We've treated nearly 400 patients in Minneapolis at the May-Aprice Heart Institute or in Los Angeles. And so, cardiovascular stem cell therapy, it's here today. It's a reality. But it's complex and it's a very challenging process. And unfortunately, I don't think we always get the new on-sense. So there's considerable excitement about stem cell therapy. We live in a USA Today society. In fact, a USA Today online society. We get our information from sound bites. And stem cells are a perfect example. When I say stem cells, you think Democrat or Republican. You think left or right. But unfortunately, stem cell therapy has become a political dividing line with the focus on embryonic stem cells. This slide says, we're here to help you with your stem cell research. I'm a philosopher and he's a politician. And unfortunately, that's what it's like when we first meet patients. We spend a lot of time navigating through the nuances and to get to the truth. Another example of this divide is what we should do with stem cell therapy. On one hand, you have very principled outstanding basic science physicians who think that we should only do stem cell research with embryonic stem cells and only in basic science laboratories that we don't know enough yet to actually go into patients. On the other hand, you can pay $5,000 or $50,000 and go to Tijuana or Bangkok, do liposuction, take out the stem cells. Two hours later, they inject them and you'll be 10 years younger. Your hair will grow. You'll have more energy. All your diseases will be cured and sex will be better. So we have far too much controversy about stem cells and we have far too much hype. So this is how early you, someday, will have hair again. But the implication is that you'll get out of the wheelchair and walk. And what I want to say is with stem cell therapy, it's like any other therapy. We need to do well-designed studies. We need to understand the risk and we need to understand the benefits. So what I like to do today is talk and go to where the substance beyond the sound might. So what are stem cells? Stem cells are on specialized cells. They have two unique properties. They have the ability to self-renew or make copies of themselves over and over and over again. And the second, they have the ability to differentiate into specialized cells. And what they do is they serve as the body's natural repair mechanism. It's the way the body renews itself. Now there's a lot of a wide variety of stem cells. So when you say stem cells, it can mean a lot of things. The first, there are embryonic stem cells, which is what the controversy is on and we'll touch on that in a minute. And second, there's an interesting thing called induced pluripotent stem cells. What we're able to do now is we're able to take a cell in the body, move it backwards to the point where it has all the properties of an embryonic stem cells. So in some ways, obviating the need for embryonic stem cells themselves. There's stem cells in cord blood and then there's adult stem cells. All of you who are here are full of stem cells. We have circulating stem cells in our bloodstream. We have stem cells in our bone marrow. Stem cells that become red blood cells and white blood cells in platelets. Stem cells that become bone and cartilage. Then we have stem cells in all the organs of the body. So there's stem cells in fat, in muscle. When you take out a biopsy-framal muscle, it'll grow back and it'll stop growing. So it's a very controlled process. So what about embryonic stem cells? This is where the ethical comes, the diversity comes. It becomes because they come from embryos. They come from the inner cell mass. So embryonic stem cells actually have the potential to teach us a lot about bodies way that the body uses stem cells. So clearly there's a role, but as we just said, may not be that the controversy needs to be where it's at. So do stem cells work? There's three parts to this question. The first is, of course they work. That's how we're here. When you cut your skin at heels, every week you turn around your platelets. You have brand new platelets every seven days. If I take out half of your liver, your liver will grow back and not only will grow back, it'll stop growing. Which again shows you the complexity of the process. The ability not only to grow new cells, but to control that growth is a very important process. So what we're trying to do with stem cell therapy, our goal is to enhance the body's natural process of regeneration. That's what we're trying to do. So how are we doing? Well, first of all, we know that stem cells work in animal models. Clear cut. We know that we can multiple different stem cells, multiple different models. We can grow new blood vessels. We can grow new heart muscle. So we know that it works. But what about in patients? Are they effective in patient? We're going to come back to that in a few minutes. So how do stem cells work? This is another thing that's more complex and we're learning more about it all the time. In the natural process, stem cells become, the cells they're supposed to be. Stem cells for red blood cells become red blood cells. Stem cells in the muscle become muscle. But when we give stem cell therapy, that's likely to be a very small part of the process. Very few of the cells we give actually become muscle or actually become blood vessels. What they do is they work, they do singling. So they increase growth factors and they increase the use of endogenous or your own stem cells. It's what we call the paracorn effect. So what cell is the best cell? I love this question. It's acid scientific conference all the time. It's like asking the question, what antibiotic is the best antibiotic? And the answer is, what are you trying to do? What are you trying to treat? So if I'm Joe and I have severe blockages that, and I'm no longer a candidate for bypass surgery or stinting and I have terrible chest pain and I can't even walk a block, what I need is to grow new blood vessels. So I want to use a cell that grows new blood vessels. On the other hand, if I'm Bill and I had a heart attack 10 years ago, my heart muscle is damaged and it's scar tissue now and I'm short of breath. So I can't walk a block because I'm short of breath. I don't need new blood vessels. I need new heart muscle. So the goal there is to give a stem cell that grows new heart muscle and that's much more challenging. I think that's the holy grail for cardiovascular disease. So what is the evidence? What do we know so far? What have we learned now in 10 years of clinical trials? They're actually putting patients in trials. An example here is from the JAMA which is one of our major medical, in literature, it was published a year ago. It was a study sponsored by the National Institute of Health who had 86 patients, half of those got placebo, half of those got stem cells and they got the first generation of stem cells. So what we do is we put a needle in the hip. We take out the stem cells from the bone marrow and we process those stem cells and several hours later we inject them directly into the heart muscle. So it's sort of the first generation of stem cell and what we found in this study was the heart function improved by 2.9% so your heart muscle pump better. A modest improvement. The other thing we know from using stem cells that are very safe. There's now thousands of patients who have got the first generation of stem cells. It's very safe. But we learned something very more important from that and that is the improvement was related to the age of the patients so the older patients didn't do as well. And second about it was related to the quality of the stem cells in that person's stem cells. And this is a very important issue that we'll go in as we go forward in the next 10 years it's a very important one. It's shown in this slide. This is 29 different patients where we take out their stem cells and we grow them. So we'll notice that two patients did great. They have normal stem cells. They're in the blue. Everything works perfect for them just like healthy normal people. But other people look at patient number six didn't grow at all. Those are really bad stem cells. And I think it points it out what you see here is as we age the number of stem cells and the potency of the stem cells decline. And this is a mizinko moussel which is a very important style that shows it's the same thing. So this is a very important issue that we've now learned. So what are these strategies to enhance self therapy as we go forward in the next 10 years how are we going to get better? How are we going to make it better? So number one is we can increase the number of cells. So I give you 100 million cells. Now I give you a billion cells. Might work or I give it to you two or three times. Might work. It's one idea. What's the second one? The second one is to do selected cells. So if I want to grow new blood vessels let's give you a cell that grows new blood vessels. That's called CD34 positive cells. And I'll show you the example in here. This is an example of the complexity of what we do with the study. So this was 167 patients and these are all patients who have severe blockages that we can't fix. And they are still having chest pain despite all of the medical therapy have not candidates for bypass surgery, not candidates for stint. And we're keeping people alive longer. There's a lot of these people out there. Clearly and I'm at need if you can't walk to your mailbox your quality of life is bad. You get admitted to the hospital. So a very important group of patients and what we did was we gave one group got placebo, one group got low dose themselves and one group got high dose themselves. And I'm blinded. The patients blinded. It's the way you have to. So there's no bias in the study. And it's an important part of the scientific process. And what we saw was the patients who got stem cells had a significant decrease in their chest pain. So 6 or 7 episodes per week that's a lot. That means now you can walk to your mailbox. That means you can maybe play golf. And that changes your life. You also see the placebo patients got better. So just being in a clinical trial makes you better. And what we also saw the same thing is on the right the patients who got low dose and high dose stem cells could walk farther. More than a minute farther on the treadmill. So very important process, very important step that we can show that stem cells actually probably promote the growth of new blood vessels if you selected cells. So what's the third way? A third way is you take out the bone marrow, the first generation of stem cells. And you grow it for a few weeks. You increase the good cells. You decrease the bad cells. If we can figure out the good cells in the bad cells. And then you inject it in the patient several weeks after you've processed it, have you made it stronger bone marrow. This was just a headline in the Minneapolis Star Tribune just several weeks ago about a new study that's going to start in the United States is going to use exactly this process. Now all of the first three involve your own cells or what we call a thologous. So I take out your cells and then use those. But what if we could do something different? And number four is what if we could take a young healthy donor, kind of like a Olympic athlete. Take their stem cells, right? And then see if they can grow. What turns out it works. Specific stem cells you can take from a young healthy donor and you can give them to another patient and there's no rejection. And we just did a study, a very important study that's shown here. So you isolate the cells from a young healthy donor, you give those cells, you culture them. So now they're like on the shelf, they're sitting there ready. When you come in with a heart attack, when you have a heart, problems with your heart function, they're sitting there waiting for you. What a great idea, did it work? There was no immune reactions, it was important. The other thing we found is that the patients who had the stem cells died less, had less heart attacks, needed less angioplastia mitest. So they did better, a significant improvement, how they did. So this has moved forward, so now we've finished this phase and now we're starting a new study with more than a thousand patients. And if it confirms these results, then in fact stem cells might be ready for you on the shelf when you or your neighbor or the person you golf with or the person you sit next to in church comes in. So what about the last one? The last one's a very exciting development. So the heart has less stem cells than other organs. It's really the heart has the least ability to regenerate itself, but it does. And what we found is we can take cardiac drive cells and we take a biopsy of the heart muscle and we can grow those cells, we grow those for five or six weeks. And then we can take those cardiac drive cells and then direct them directly into the heart muscle. And what you can see is if you see it on the top, that's the CDA, the cardiac drive cells on the top at baseline, you can see the white here where the arrows are. That's scar tissue from a heart attack. And six months later you can see the white has gone away, the scar tissue went away. Whereas on the bottom with the control patient there's no difference. It was a big scar before, there's still a big scar. And if you look at that graphically you can see it here. So this is a really well designed study that at baseline the amount of scar for the control patients didn't change, absolutely same. The amount of tissue that actually pumped didn't change at all, no difference. But the patients who got stem cells had a decrease in the amount of scar at six months and even more at 12 months. And more importantly they had an increase in their functioning, showed we had the ability to actually regenerate muscle. So this is a very exciting finding and this too now has moved into the new stage that study that just started that's called All Star. We're really looking forward to see if our results are confirmed with that. So where are we with stem cell therapy for cardiovascular disease in 2014? Well we have significant patient needs. We've done a great job of keeping people alive. We've made major progress in the last 20 years. But we still have needs. There's patients who have severe blockages are having chest pain, their quality of life is terrible. We have a significant number of patients with old heart attacks who have heart failure. The most important and most expensive problem in the United States today. And really the end is only doing heart transplant or a cyst device. And if we could use cell therapy would make a major difference. And patients who have severe blockages in their legs. So there's huge patient needs. And there's significant promise. We know it's the way the body does it itself. We just want to enhance that process. And we know from the preclinical studies that it's positive it can work. So what we need to do is very well designed studies that actually teach us something and take us to the next step. And that's what we're trying to do. And that's why we want to put people in clinical trials. That's why you should be interested in science in trying to move the process forward. But it's challenging. It is not the slide that you get up out of the wheelchair and walk. It is not the hype. And people need to realize it takes time. It's a very complex process. It's a very complex process. And we need to understand it and do better. And there's significant challenges. But we can meet them. I have no doubt that we can meet them. So where are we now with cardiovascular stem cell therapy as now as we get close to valentine stay? Well, still not available at the florist, but getting closer all the time. So thank you for having me today. | ↗ |
| 11 | TEDx Talks | Translational research | Robert Bartlett | TEDxUofM | 14482 | 144 | 5 | 37.5 | positive | 17:10 | . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . life while we can figure out what the problem is and fix it. Now here's a diagram of the system. This machine I showed you, in fact, this is all there is to it. We put a big tube in the heart. We drain blood out. We pump it through an artificial lung, often a membrane lung, and we pump it back into the patient. And it will take over the function of the heart and lung for a significant period of time. This forum is about great, exciting new ideas. This is a great idea, but in no way is it new. This is a heart lung machine. First using the 50s for heart surgery. Then in the 60s, we know that people got working on making membrane type of lungs, which are safer and can be used for a longer period of time. And in the 70s, we treated the first newborn case, 1975, in fact, this little girl. And what do you know? She recovered and got better. Well, then we treated another one and another one. And after a while, we got to learn from our successes. We learned a lot more from the failures. And this technology started to grow in the area of newborn respiratory failure. We fought. We had to publish this work. None of the pediatric journals would publish it. Like, God, do you know there's a surgeon out there who's hooking babies to this machine? Oh, my God. Don't publish it. Other people might try and do it. But in fact, me and the technologists who were losing babies came to learn this technique from us. And we, more and more centers started up with this. And soon there were centers in academic centers around the country and in fact around the world who weren't able to do this. And they did the same things at home. Now there are about 50,000 patients who've been managed this way, not always successful. But about two thirds of them go home. Healthy and have long, healthy lives. Someone earlier was talking about saving lives. We never saved lives. We only prolong them. But if you can prolong the life of the baby for 70 years, that's worth doing. There are now about 200 ECMO centers around the world. You can see where they are. We share ideas and communicate with each other through an organization called the Extroportal Life Support Organization, or ELSO. It's based here in Ann Arb. Now you notice there are several centers in Australia and New Zealand. You might remember that swine flu epidemic that ran around the world in 2009. It started in the Southern Hemisphere. All right. All right. I can start again. I can start again. I'm just pointing out that the Australians are very good about keeping data in their health care system. So in that summer of 2009, which is our winter of 2009, they preceded our winter. It was their winter, our summer. They had 200 patients who were thought to be dying of this flu epidemic. You might remember all the press that went on. Actually, most of those patients got better with just good care. In an ICU, we had 68 of them were failing, looking like a little girl that I mentioned to you earlier. 75% of those patients walked out of the hospital. Pretty good for a fatal disease. And they published this very early so that those of us in the Northern Hemisphere learned from that planned about how many patients we might expect to have. And in fact, did pretty well with that particular epidemic. Now, medical research of the type I've been telling you about has been going on for centuries. If you're dealing with breast cancer, or cleft palate, or leprosy, or diabetes, or chronic kidney failure, or acute heart and lung failure, someone imagines that we can treat that problem better than we do now. They take that idea to the laboratory. They work on it there until they have some sort of solution, try it out in animals. If that works, take it on to patients. That's called clinical research back to the lab, back to the patients. And finally, may solve the actual problem that they started with. The NIH, about 10 years ago, invented a name for this type of research, translational research. We love that. It's the buzzword and grants these days. And it's practical, goal-oriented. Here's a problem. Let's see if we can solve it in a few years. To be differentiated from mechanistic research, I wonder why food fly genes make fruit fries, this or that, things like that. Wonderful stuff, but not going to apply clinically in a few years of time. So I'm really here to tell you about three new ideas that fall in the headline of translational research that spin off from the ECMO project. The implantable lung has completed that cycle. It's now gone to clinical practice. The artificial placenta is still in the lab phase, mulling down there. Eventually, we'll get to clinical trials. The organ bank, it's the most exciting idea, is still in the idea phase. So here's the problem. Patients who need a lung transplant with end-stage chronic lung disease, if they have an exacerbation, now they're admitted to the hospital, admitted to RICU, they come off the list. They're going to get pneumonia, they're going to get pakexia, ECMO can help a little bit, but not much, and they all die. Imagine if we had implantable artificial lung that would work for months at a time, the time it takes to get a donor for a lung, and if we had such apparatus, then patients could get up and out of bed, out of the ICU, exercise and get to be in good shape to receive a lung transplant. We've been working on this for about 15 years, in our lab, and a couple of labs in Japan and in Germany have focused on this, and we've learned the physiology and we've built artificial lungs that can be perfused by the right ventricle, and looked like they could solve this problem. The actually the first clinical trial was in Regensburg, Germany. This young lady has end-stage cystic fibrosis. She was admitted to the ICU, taken off the list, but then this device, which you see being held in the hand of the attendant, is attached to her pulmonary artery and her left atrium, had her right ventricle as pumping blood through this device. Did that for five weeks of time, a donor came up at this, when this picture's taken, she's on her way to Munich to get her lung transplant, which worked. This has now been done about 60 times around the world, so we're quite pleased with that. We've completed that cycle. What we thought might work is working quite. Well, we've done several of those patients here in an arm. Here's another problem, premature birth. The biggest problem in obstetrics and all of me in ecology, about half a million babies are born just the United States every year prematurely. If they're not too premature, the results are quite good, but the younger they are, the smaller they are, the worse the results, and 50 to 100,000 of those babies die or are permanently disabled every year. Imagine if we could maintain the fetal conditions of circulation and lung function while the lungs grew and then eventually unhook the baby from that system, we called an artificial placenta. Now, we've been at this for about five years and what we have learned is that using the ethno system, we can maintain the fetal circulation. That means no blood goes to the lungs, baby doesn't need to breathe. And in fact, we manage these fetal lambs in artificial amniotic fluid. This little oil is underwater breathing, but breathing amniotic fluid, which normal fetuses do. We can now do this for about three days when we can do it for a couple of weeks. We'll take it to the clinic. Here's another problem. Organs, which we take for transplantation in brain dead donors live for only six to 24 hours, six hours for hearts, liver, lungs, 24 hours for kidneys. After that, we can't transplant them. We have tissue culture. We can grow cells. We've been able to do that for a long time. We can put those cells in scaffolds and call it an artificial kidney, but it's really not just tissue culture. No one has ever been able to take an intact, vascularized organ and perfuse it for hours, days, weeks at a time to keep it alive. Why is that? What we think we can figure that out. Then you can imagine an unlimited supply of hearts, lungs, liver, kidneys, bone marrow, endocrine organs for elective transplantation. Not only that perfectly matched organs for transplantation, we could give gene therapy to the lung or liver and put it back in the patient gene therapy. Now it's too toxic to give to the whole patient. We could treat cancer and infection on the bench and we could do all this research on human organs, not animals. So we think about this. We can keep patients alive for a long time as I showed you. Could we keep organs alive for months of time? Well, our laboratory is applying the ECMO technology to answer that question. We're very good at perfusion. We've assembled experts in perfuseate what's stuff to use to perfuse organs. We've assembled experts who know about resuscitating damaged organs back to life. And so I hope to come back here in five years and tell you that we have solved this problem and up on the North Campus, there's a warehouse full of hard-slaunched labor's kidneys. Yes, sir. Come pick one that matches. Yes, sir. I thank you for your attention. | ↗ |