I’d like to tell you a story today, a story of what I believe is, and a story of what could be. And I’m going to start this story with an image of this beautiful young woman that I’ll call Dania, who is 28 years old in this photograph.
Dania was brought to me at 14 years of age by her mother, from Jamaica, with a rare, progressive neuromuscular degenerative disorder called spinal muscular atrophy. Spinal muscular atrophy is a genetic disorder whose hallmarks are autoimmune disease and inflammatory types of reactions. It leads to progressive weakness in muscles and ultimately a decline or a collapse in the spine. That collapse crushes the heart and lungs and would have killed her very shortly. I found a very courageous spine surgeon in New York who was willing to try to reverse some of that curve and prolong her life in doing so.
And to give her more time, essentially, to spend with this miracle of hers, her daughter, who is now 11 years old Dania is 37, but she is declining from this disease. She has never walked by herself, she has never rolled over in a bed by herself, she has never bathed herself, she has never fed herself. She has been one of the most extraordinary and important influences in my career, and for the last 23 years, I can honestly say that there hasn’t been a day that’s gone by that I don’t think about ways to try to slow down progression of diseases like this. And I also know that if I knew 20 years ago what I know now, I could have done that for her.
So this is obviously a very extreme case, but I challenge you and say that we are all faced with autoimmune and inflammatory types of diseases in our lives, every day. Aging is hallmarked by a process of inflammatory reactions, altered blood flow to organs, tissues and structures that lead to degeneration. So, in fact, we could actually call aging a disease, if we wanted to. We’re faced with it in the form of thyroid diseases, cardiac disease, diabetes, lung diseases, dermatological type of diseases and arthritis, the most common of which is osteoarthritis. The prevalence of osteoarthritis is actually staggering, somewhere in the neighborhood of about 50 million people suffer in the US alone and about 15 billion in the world. We have a responsibility to try to slow down the progression and the suffering from diseases like this. We also have innate structures that are built in that help do this, in the form of stem cells.
Now, stem cells have a myriad of functions, but two of the functions that I am particularly interested in are inflammatory and something called angiogenic. Angiogenesis is just a fancy word that means to regrow blood vessels. And I just told you that two of the hallmarks of the diseases associated with aging are inflammatory and altered blood flow. This would be an amazing mixture, if we could just fit stem cells into the treatment of these types of entities that we all deal with.
Now, what are stem cells? What do they look like? This is a solitary, isolated stem cell. This is a stem cell going through cell division, or mitosis. These are stem cells attached to blood vessels. They flatten out and encircle the blood vessels; that’s where they live. Stem cells also produce over 3,000 different growth factors, or what we call trophic factors, which are proteins. And it’s these little bundles, or microvesicles, that are really this sort of worker bees.
These are the things that we’re looking for. But where do we isolate stem cells and these growth factors from? In fact, we can get these stem cells from almost any tissue in the body, but some of the most plentiful and potent sources are actually from postnatally derived tissue: umbilical cord, amniotic fluid, placental tissue. One single umbilical cord can treat hundreds of patients. This is staggering to me. There are a growing number of countries in the world that allow the processing of these forms of stem cells from post-natal tissue.
Some of them are listed here and include South Korea, Japan, Israel, India, Panama – the list goes on. Not yet in the United States, and I hope that’s coming very soon. I can imagine, therefore, a world where we can harness the power of these structures that we have available to us. One of the challenges that we face is that there’s an inverse relationship between our age and the number and potency of stem cells that we have. So when we’re born, you see we have about one stem cell for every 10,000 or so bone-marrow cells.
But by the time we’re 80, we have only one stem cell for approximately every 2 million. This is exponential attrition rate, and it really plays a big role when we’re trying to decide where we’re going to get the source of cells or tissue to treat different clinical conditions. Obviously, as is the case most of the time, younger is better. So we are inundated in our lives, through the internet and social media, with what I call “information overload.” How do we sift through all this? How do we know what’s true? How do we know what’s safe? I get articles almost every day from my patients, talking about cell types, cell safety, cell harvesting, cell culture, cell application, cell delivery, cell expansion, to cell or not to cell? I don’t know anymore; it’s very confusing.
Now, in the course of all this – in my career – about ten years ago, I got very sick. I was infected with Lyme disease, which invaded my central nervous system. I had severe cognitive changes, with short-term memory loss, word-finding difficulties – which I’m experiencing right now. I had severe burning muscle pain; I had joint pain. I had balance and coordination problems, I had low-grade fevers, I had fatigue.