Thursday, September 17, 2009

(PART 4) Stem Cells: Regenerative medicine--Hope or just hype

Human Face column: Stem cells from me, for me

 (Part 4-Conclusion)
Philippine Daily Inquirer/Special Report/by Ma. Ceres P. Doyo

IS THIS THE HOLY GRAIL of medicine in the 21st century? Is this new emerging field going to provide dramatic changes in the way diseases and injuries are studied and treated?

Stem cells and regenerative medicine are the new catch words in health care. Scientists have discovered the stem cells’ amazing characteristics and therapeutic potential.

But stem cell therapy in the Philippines is not without its skeptics for a variety of reasons. It could be a threat to drug-dependent therapy.

Doctors will have to get out of their comfort zones to learn new ways. It is still very expensive and labor intensive.

Dr. Alfredo Bengzon, president of The Medical City (TMC), is undaunted. He has flung the hospital’s doors open to the technology and eagerly awaits a new breed of Filipino scientists who will carry it through.
Leading Philippine universities are preparing scientists and doctors for this endeavor.

With Dr. Samuel D. Bernal leading the team, TMC recently acquired more high-tech laboratory machines to boost its regenerative medicine section of which stem cell therapy is one component. TMC’s “regen” department was introduced to the public on Aug. 19.

Convergence of disciplines
“Regenerative medicine is a convergence of disciplines—cell biology, electrophysiology, molecular biology, biochemistry,” Bernal explains.

“It is difficult to carry out, it involves a major investment for an institution and requires a culture that is committed to providing a customized, personalized approach. This is the advantage of TMC,” he said.
Regenerative medicine, which includes stem cell therapy, is defined as innovative medical therapies that involve the engineering of living cells, tissues and organs for the purpose of preserving and enhancing organ function.

It is meant to prevent disease and maintain wellness as well as to restore or replace organ function that has been lost or impaired due to disease, injury or aging and with the purpose of improving the quality of life.
Is this field meant for a special few who have the financial means? A study by experts shows that regenerative medicine can greatly benefit poor developing countries with huge unhealthy populations. But governments and institutions would have to invest in the technology.

Bioethical questions
Bioethical questions must be clarified. Only the use of human embryos as a source of stem cells is being questioned on moral grounds. Pope Benedict XVI, in his first meeting with US President Barack Obama in Rome last July, stressed opposition to abortion and stem cell research using human embryos which the Catholic Church considers to be human life.

And why is stem cell therapy very expensive? “Mabusisi (labor intensive),” Bernal quips.
The equipment, reagents and materials needed for this technology are costly and are imported. Personnel are not easy to come by and have to be trained. But in the future, when more people opt for the therapy, costs could be dramatically reduced.

10 promising applications
A couple of years ago an international panel of 44 experts embarked on a study to identify the 10 most promising applications of regenerative medicine in developing countries. The majority were from developing countries.

Among the areas identified for the application were: (1) insulin replacement and pancreatic islet cell regeneration for diabetes, (2) autologous cells (from the patient) for the regeneration of heart muscle after myocardial infarction and cardiomyopathies, (3) immune system enhancement by engineered immune cells and novel vaccination for infectious disease.

The study also showed that regenerative medicine could potentially be used to improve health conditions in poor countries. For this purpose local efforts in health biotechnology are ongoing in countries like India, China (with huge government funding) and the Philippines.

Government support
In the Philippines, government support has not been huge but the Department of Health and the Department of Tourism are promoting efforts in this area. National Kidney and Transplant Institute and Lung Center of the Philippines (LCP) have acquired expensive state-of-the-art equipment for stem cell therapy and research.
LCP’s bio-regenerative program began in the 1990s but it was shelved after the center was razed by a fire in 1998. Dr. Juanito A. Rubio, LCP director, revived the program.

LCP is the first and only government hospital in the Philippines that does intensive study of the treatment of lung diseases and multi-drug resistant TB through its bio-regenerative program.
LCP is now inviting cancer patients to volunteer for clinical trials.

Heading LCP’s bio-regenerative team is Dr. Ma. Teresa Barzaga. Also in the team is Dr. Francisco Chung Jr., doctor of pathology and molecular medicine. Pulmonologist Dr. Sullian S. Naval heads research and development.

Medical tourism
Tourism Undersecretary Cynthia Carreon and Director Cynthia Lazo are working hard “to get the word out” that the Philippines is very much in the health and wellness revolution.
Regenerative medicine is in the list of health services the Philippines could offer. A good number of health institutions have international accreditation.

Medical tourism had its bad days especially when underground organ trafficking in developing countries was exposed.

But stem cells in regenerative medicine is exposing the amazing potential and expertise in countries like the Philippines. Soon it will no longer be for a select few who have the access and the wherewithal, but for the many.

There all the time
Are stem cells hope or hype? Has the Holy Grail been found? The quest for new cures will never be over, but one discovery always leads to another. In the case of stem cells, they were right in there all the time, inside each one of us, from the moment we became life.

(Editor’s Note: The writer’s account of her dendritic stem cell therapy is in her Human Face column Thursday, Sept. 17, 2009. Feedback to