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Humankind has long wished for a real panacea, a simple cure for all that ails it. While that goal is still elusive, 2018 might be the year that history books decide a real panacea began. Stem cell therapy looks like it may be about to become practical and profitable.

One has known about stem cells and their promise to cure a plethora of human diseases and other conditions since at least 1998 — when separate researchers in the United States isolated human embryonic stem cells in their laboratories – but their uses have remained mostly theoretical ever since.

What Are Stem Cells?

Basically, stem cells are biological building blocks. People and animals start out with unspecialized stem cells in the embryo that turn into all the cells in the body. As one develops, they turn into specialized stem cells, such as in the bone and the blood, and they do not deviate from this specialisation. The theory was that while adult stem cells can be used to treat some diseases and other conditions, embryonic stem cells could treat many more.

The problem for many people, including some religions and anti-abortion groups, is that to extract these stem cells from embryos destroys them. They feared not only that existing embryos – such as surplus ones from in vitro fertilization and abortions – would be used, but that new embryos might be created solely so their stem cells could be harvested. These people regard this as murder, even if the embryos in question would otherwise be destroyed anyway.

Many researchers preferred to study umbilical cord blood – said to be able to treat more than 70 different diseases – and adult stem cells – derived from some human organs, such as mesenchymal from bone marrow – that did not have the same moral problems as embryonic cells, but also seemingly less potential. Embryonic stem cells can turn into any cell in the body; mesenchymal stem cells can turn into muscle, bone, tendons, ligaments, and fat.

So far, only one stem cell treatment, Alofisel, has been approved by the European Medicines Agency. In the US, the only stem cell treatments approved by the Food and Drug Administration are for blood formation utilising spinal cord blood.

Stem Cell Tourism

Some parts of the world are less restrictive than the US and Europe, and stem cell tourism exists.

In 2014, Michigan hockey great emeritus Gordie Howe, suffering from a stroke and dementia, was offered stem cell treatment in Mexico, sponsored by US-based Stemedica. Embryonic neural stem cells were injected into his spine and mesenchymal stem cells were delivered intravenously. Within a day, Howe seemed to be recovering. The extent of that recovery is disputed, as is how much the stem cells contributed. His family praised Stemedica at the time. Howe died in 2016.

Stemedica is still around but is facing travails, including delays due to lack of funding and lawsuits charging unpaid bills and misuse of funds.

Overall, the stem cell business seems to be booming, and 2018 might prove to be a breakthrough year for the industry.

In April, both Canada and the US reported patients cured of sickle cell anaemia (a blood disease) by stem cell-derived treatments. In Alberta, one woman was successfully treated. In Illinois, seven of eight patients treated were reported cured. (One died, though it was unclear whether it was due to the stem cell treatment.)

Also of promise is a new form of stem cells: induced pluripotent stem cells (iPSCs). These are adult stem cells that have been essentially turned into embryonic stem cells.

Other than blood treatments, stem cells have been used with some success to treat blindness. Other applications may include macular degeneration, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis, rheumatoid arthritis, and Alzheimer’s. They might also help in new drug testing, development of cancer vaccines, and even addiction cures.

Risks and Benefits of Stem Cell Therapy

While there is much promise of the medical miracles that stem cells might create – such a stem cell patch that could repair the heart muscle – there also are concerns (and some anecdotal evidence) that stem cell therapy may worsen heart damage. There’s also a risk of tumours caused by the stem cell treatment, or that they will develop into different cells than desired.

When one is desperate, as with the Howes, it might seem to be worth the gamble, but the risks do not stop at the health of the patient. There also is the financial cost.

A single stem cells treatment can cost as much as $10,000, not covered by insurance or FDA approved. One man’s ineffective treatment cost more than $9,000. A Florida woman spent almost as much to improve her macular degeneration and went completely blind.

A multiple sclerosis patient had better results, but it cost him $30,000.

Howe’s treatment would have cost $35,000, but he received it free, either for the professed reason of the respect the Stemedia people had for him, or the hope that his “cure” would raise awareness and investors for the firm.

Stem Cells and Addiction

Stem cells might have application in curing alcoholism. A study of rats who were bred to drink alcohol, and lots of it, voluntarily reduced their consumption by 90% after a single dose of human mesenchymal stem cells. Addiction is connected to inflammation of the brain or neuroinflammation, and mesenchymal stem cells can decrease it.

Another study found a similar result with addiction to opioids by reversing opioid tolerance.

Opioid addiction or dependence builds in part because the body develops a tolerance to the drug so that increasingly large amounts are required to experience the same effect, either pain control or euphoria. Eventually, the body may feel no effect other than the cessation of withdrawal pains – sensitivity to pain may even be heightened – which makes it extremely difficult to stop using the drug.

The US National Institutes of Health says repeated use of opioids “almost inevitably” leads to tolerance and physical dependence, and the UN World Health Organization says opioid-dependent people are the group most likely to die of a drug overdose. If this tolerance could be reversed, then it would be easier to limit the size of the dose or withdraw from the drug completely.

Mesenchymal stem cells, due to their “remarkable anti-inflammatory properties”, may help according to a study by the Cleveland Clinic and the Affiliated Hospital of Qingdao University in China. In the study of opioid-tolerant rats, tolerance was reversed within two days using mesenchymal stem cells with no adverse effects. Stem cells could be used in heroin rehab programs.

Yet, another study took a different approach. Instead of focusing on neurons, it looked at connections. Heroin disrupts the normal connections, and addiction is a result of the brain trying to make new corrective connections. By using glial stem cells, it may be possible in effect to rewire the brain.

Given these results and the still worsening opioid abuse and associated overdose deaths, their further study seems warranted.

Stem Cells and Investment

If there are risks and benefits for patients, so too are there for investors. The Motley Fool says it’s an exciting time for patients, investors and the stem cell companies themselves. Investment guru Jim Mellon says biotech, including stem cells, are a great investment opportunity, too.

Japan’s MAGiQ Therapeutics is hoping to develop cures for degenerative diseases such as amyotrophic lateral sclerosis (ALS), often associated with US baseball player Lou Gehrig, jazz musician Charles Mingus, or theoretical physicist Stephen Hawking. The brain loses the ability to initiate and control muscle movement, even to speak, feed oneself, or breathe.

The approval of Alfosiel is expected to net Takeda €15m. The global stem cell manufacturing market as a whole is projected to reach more than $14.5bn by 2023, up from $10.75bn this year.

Ireland has been a biotech Mecca in general, but not for stem cells, which it opposes.

But The New England Journal of Medicine warns that if the rollout of stem cell therapies is not handled properly, if they are based on anecdote, not sound science, and discredited by over-hyping – as in Florida – the promise of stem cell therapy may not reach its full potential. That would be tragic for everybody.

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