Stem Cell Therapy: A 2020 Review and Research Update

Trying to keep up with the latest stem cell therapy evidence? There are more than 240,000 scientific publications published on "stem cell' on the National Library of Medicine (PubMed). As of July 2020, more than 7,000 studies have been launched to investigate the potential of stem cell therapy under the U.S. Clinical Trial Registry. Just on UC-MSC (Umbilical Cord derived Mesenchymal Stem Cells) alone, there were 178 registered clinical trials and 98 publications about cell therapy that employ UC-MSC, for the years 2007–2017.
stem cell research summary
Stem Cell Therapy Research Summary

Stem cell therapy has gained popularity as a promising treatment option for conditions where the current medical treatment protocols have been exhausted. However, there is also a lot of confusion due to the overwhelming mixing of credible scientific information and marketing hypes available on the internet.

Due to the fast-changing pace of research and technology, new evidence accumulates rapidly and clinical guidelines need to be periodically updated.

If you are new to stem cells, check out stem cell basics.

We have compiled and summarised essential information below in layman's terms so that you can understand and make a better informed decision.

This article contains information and links to list of stem cell therapy and research in various categories. This list is a work-in-progress list as new evidence might be added from time to time.


STEM CELL THERAPY EVIDENCE AND RESEARCH BY CATEGORY

Here, we have listed and compiled all significant scientific publications related to stem cell therapy. The list was complied by running various searches on PubMed. Each study is hyperlinked to the abstract in the U.S. National Library of Medicine or the full text article to make it easier for healthcare providers or scientists to access more details. The list was complied by running various searches on PubMed.

In order to make it consumer friendly, we have tried to summarise the studies and minimise the technical jargons.

Here is the list by category.

1. Stem Cell Therapy and COVID-19

Can stem cell therapy be used for the treatment of COVID-19?

As of July 2020, there are 69 studies that have been launched to investigate the benefits of stem cell therapy and COVID-19. You can review the status and details of these trials on Global COVID-19 Trial Tracker

Mesenchymal stem cells are used as immuno-modulators for severe COVID-19 patients and some of the trial projects are launched in combination with other medications such as interleukin (IL) 6 inhibitors  e.g. tocilizumab. IL-6 inhibitors have been studied mainly for their potential to calm down the 'cytokine storm' associated with ARDS (acute respiratory distress syndrome), a severe COVID-19 lung complication.

For a more comprehensive review, check out Can Stem Cell Therapy Help Against the Latest Coronavirus?


2. Stem Cell Therapy for Knee Pain (knee osteoarthritis)

Some doctors and media channels argue that there is very little evidence to support the use of stem cells to treat orthopaedic conditions. However, there are more than 250 publications related to the use of stem cells in treating knee orthopaedic conditions alone. 
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Here, we have compiled a few significant studies related to stem cell therapy for knee pain.

In 2016, a study on knee osteoarthritis has shown a 25 million of adult human bone marrow, allogeneic (source from different individuals) mesenchymal stromal cells to be the most effective dose tested for knee joint pain reduction.

study published in 2012 by a team in Singapore, led by Dr Lee KB showed injections of mesenchymal stem cells with hyaluronic acid for knee joint repair (new technique) to be comparable with the conventional technique but with the advantage of being less invasive.

In 2013, a team led by Dr Saw from Malaysia published a controlled study of 50 patients with knee pain treated with autologous (source from self) peripheral blood stem cells (PBSC) sowed better improvement as compared to the group without stem cells.

In 2016, a 9 year follow up study of 2,372 patients in 18 clinical facilities was published by Centeno et al. Treated areas of the body included the knee, hip, ankle/foot, hand/wrist, elbow, shoulder, and spine. There was no evidence to suggest that treatment with mesenchymal stem cells (MSCs) of any type in this study increased the risk of cancer.

There are four FDA approved adipose derived stem cell clinical trials at Sanford Health: osteoarthritis of the knee, osteoarthritis of the wrist, rotator cuff tear, and facet joints.

Several other comparative studies have demonstrated good evidence in the treatment of osteoarthritis. However, there are several approaches and cell lines used. More well-designed and randomised controlled trials are needed to evaluate the best approach and universal consensus. As studies continue, the methods, forms and combinations of stem cell preparations are improving, and outcomes are expected to improve as well.


3. Stem Cell Therapy for Diabetes Mellitus

There are more than 2500 publications related to the use of stem cells in diabetes mellitus and diabetic nephropathy (diabetic kidney disease).

Majority of stem cell research for diabetes is concentrated on Type 1 diabetes as it can be traced to the loss of a single cell type, the beta islet cell. Beta cells (β cells) are a type of cell found in pancreatic islets that produce and secrete insulin. In patients with type I or type II diabetes, beta-cell mass and function are diminished, leading to insufficient insulin secretion and high blood sugar.

Currently, two approaches are being used in research, using stem cells as beta-cell producing factories or as a beta cell repair catalyst. Both methods have the same goal which is to return the insulin to normal levels. Diabetes Research Institute (DRI) are running clinical trials and have a number of patients that are living insulin free after receiving a transplant of donor islet cells.

A review, published in the Progress in Stem Cell journal in 2019 suggested a combination of antioxidants, growth factors or hormones along with MSCs (mesenchymal stem cells) in optimal combinations and concentrations for the treatment of diabetic nephropathy.


4. Stem Cell Therapy for Autism

There are more than 400 publications related to the use of stem cells and autism.

Stem cell therapy for autism is an ongoing topic of research and is considered experimental by the medical community. Parents can find fee-for-service clinics that advertise stem cell therapy for autism, but most of these clinics are operating without FDA approval, and each clinic promotes their own approach, which creates a lot of confusion among parents about how to compare their treatment options.

Clinical trials have been performed to demonstrate safety and efficacy of stem cells autism management. As of July 2020, 19 studies have been launched to investigate the potential of stem cell therapy for autism under the U.S. Clinical Trial Registry. You can search the database to look for more details of the clinical trials including the countries and centres that are conducting them.


5. Stem Cell Therapy for Stroke

There are more than 3,000 publications related to the use of stem cells and stroke.

In this review (published in Nature), the authors examined the clinical research trends related to stem cell therapy products in the stroke space based on information obtained from the ClinicalTrials.gov website and International Clinical Trials Research Platform (ICTRP) portal site.


6. Stem Cell Therapy for Spinal Cord Injury

There are more than 1,800 scientific publications published related to "stem cell" and "spinal cord injury" on the National Library of Medicine. As of July 2020, more than 55 studies have been launched to investigate the potential of stem cell therapy for spinal cord injuries under the U.S. Clinical Trial Registry.


7. Stem Cell Therapy for Anti-Aging Research Update

There are more than 150 publications related to the use of stem cells and anti-aging.
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Despite the fact that there are many published studies on stem cell therapy for anti-aging, major media has been slow to report the findings.


8. Stem Cell Therapy for Kidney Diseases

There are more than 650 published studies related to the use of stem cells and kidney disease and more than 300 published studies related to stem cells and kidney failure.

The increasing incidence of kidney diseases raises considerable concerns regarding human health worldwide. A number of studies in recent years have attempted to identify the underlying mechanisms of renal repair in order to explore the potential regenerative capacity of the kidneys. Many papers have reported on the potential use of stem cells of different origins for treating many different pathologies, including kidney diseases.

Several clinical trials have confirmed the safety and tolerability of stem cells, and in particular of MSC-based therapies (Mesenchymal Stem Cell), in patients with renal diseases and kidney transplants (Int J of Mol Sci. 2019). There are currently more than 30 studies on stem cell treatment for kidney diseases under the U.S. Clinical Trial Registry.

Related: Stem Cell Treatment for Kidney Diseases in Malaysia


9. Stem Cell Therapy for Liver Diseases

There are more than 900 published studies related to the use of stem cells and liver disease and more than 600 published studies related to stem cells and liver failure.

Liver failure caused by liver cirrhosis, due to various long term liver diseases such as chronic hepatitis B and non-alcoholic fatty liver disease; was thought to be irreversible. A liver transplant is currently the standard treatment to end-stage liver cirrhosis.

However, not every liver failure and liver cirrhosis patients are eligible for a liver transplant in Malaysia. The shortage of matching donors and the high risk of surgical-associated complications further limits the success of a liver transplant.

Since stem cells can be transformed into liver-like cells, the potential of stem cell therapy to treat liver failure and liver cirrhosis has been studied as an interesting new feasible option.


10. Stem Cell Therapy for Back Pain

There are more than 200 published studies related to the use of stem cells and back pain.

Do take note that back pain problems may arise from several causes and degenerative disc is just one of the many causes of back pain. Therefore, the importance of finding out the cause first (diagnosis) before treatment.

Stem Cell Clinical Trials for Back Pain and Degenerative Disc Disease - Update 2020

Most patients in these studies had significant pain relief. Some patients also revealed reversal of disc degeneration. No patients had any serious complications. Since stem cells are a new development in medicine, there is not an abundance of data. However, the data that exists shows that stem cell injections into the disc results in pain relief and improvement in function.

In this landmark study by Pettine’s group (published in 2016), 26 patients with lower back pain had their lumbar discs injected with stem cells which were extracted from the bone marrow. After 2 years, 21 patients (81%) avoided surgery and had pain reduction of 71%. Their function improved by 64%. Additionally, 40% patients had improvements seen on the follow up MRI’s. No complications were reported.

Centeno’s group followed 2372 patients (published in 2016) who had stem cell injections in various joints for 2.2 years. They reported no serious side effects.

Wu’s group performed a metaanalysis (published in 2018) of all the clinical studies regarding stem cells injection into discs and concluded that, Cell-based therapy is for patients who have discogenic low back pain associated with improved pain relief and Oswestry Disability Index.

Approximately 30 pre-clinical animal studies using stem cells to treat DDD (Degenerative Disc Disease) have been published, with many demonstrating positive outcomes and others reporting no or worsened effects.

As of July 2020, there are 13 studies listed on clinicaltrials.gov for stem cell therapy and back pain.

There is also a product currently in phase 3 clinical trials at the US Food and Drug Administration (FDA) called Mesoblast. If the results from that study are favourable, then we could have stem cells available for the treatment of degenerative disc disease very soon.

Another clinical trial that has just completed it's recruitment, studied Mesenchymal Precursor Cells (MPCs) in 100 Subjects With Lumbar Back Pain.

The iPSpine project, a pan-European clinical trial was awarded €15 million in 2019 under the Horizon 2020 programme, towards researching a solution for chronic lower back pain. The huge public-private consortium is comprised of 20 partners, and is coordinated by the Faculty of Veterinary Medicine of the Utrecht University (Netherlands).

The iPSpine consortium was formed to initiate a European-led research effort to identify a future advanced therapeutic strategy that can address the societal need for a radical new treatment of IDD-induced LBP (Intervertebral Disc Degeneration - induced Low Back Pain).

The aim of iPSpine is to investigate and develop a new advanced therapy medicinal product (ATMP) of the future, based on a novel developmental biology approach involving induced pluripotent stem cells (iPSC) and smart biomaterials.

Conclusion: Although some preliminary information has been obtained, much remains to be determined with respect to the best method of stem cell delivery, source of stem cell, numbers of cells to be delivered and the patient selection to receive such therapy. These considerations are common to all potential spine-related stem cell applications.


11. Stem Cell Hair Treatment

There are more than 100 publications related to the use of stem cells and hair loss.

2017 study by researchers at Rome University found that 23 weeks after treatment, hair density had improved by a third.

According to Dr Ioannis Liakas, who performs the stem-cell procedure at his London clinic, Vie Aesthetics, it has the potential to not just restore growth but even colour in grey hair.


12. Stem Cell Therapy for Other Indications

The public may search a database of NIH-sponsored clinical trials at www.clinicaltrials.gov. Enter the search terms of interest (e.g., Parkinson's Disease and stem cells) to search for applicable clinical trials.

For a list of diseases that can be treated with stem cell therapy, check out Listing of Diseases that can be treated with Stem Cell Therapy.


Conclusion

If there are any new major stem cell related evidence that we’ve missed, please let us know in the comments and we’ll add them to the post! Thank you in advance.

To find stem cell therapy clinics in Malaysia, check out Stem Cell Therapy Clinics in Malaysia.

Read more: Stem Cell

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