Girl Meets Stem Cells: A Short Story

Y’all know the little career interest boxes they make high school students designate on standardized tests? As if fourteen year olds should really know what they want to be doing 30 years later. Well, when I took the PSAT, a million or so years ago, there was an option for bioengineering, and I had never heard that term before. So naturally, I checked it and never looked back.

I correctly assumed that bioengineering would be the discipline in which smart people figured out what to do with stem cells, and I was obsessed with stem cells and the problems they would solve in my lifetime. At the time, the only stem cells I knew were embryonic stem cells, but the press was super convincing:

Embryonic stem cells can grow any tissue in the human body!

Embryonic stem cells can cure cancer!
(fact: they were actually causing cancer)

Embryonic stem cells will make you more popular and social!
(that was just a lie I told myself while hiding in the back of the AP chem classroom, but I think it was totally helpful)

As a person of adult age but soundly teenaged disposition, I have had to face this shocking but ultimately fantastic truth about stem cells:

The majority of stem cell media coverage will lead you to completely incorrect conclusions about them.

So today I’m covering the top five things you don’t know about stem cells but really should. Before I get into that, just to be clear, embryonic stem cells, and in fact all stem cells, will not make you more popular and social, no matter how fantastic a Disney movie that premise would make.

Now that I’ve cleared that up, let’s move on to the top five things you don’t know about stem cells but should!

 1. There are as many different kinds of stem cells as there are flavors of ice cream.

The term “stem cell” is as broad as the term “doctor.” In fact, the definition of a stem cell only provides two defining characteristics: they can make copies of themselves (self-renewal), and they can turn into a different kind of cell (differentiation). There are literally hundreds of different types of cells that meet this definition. Embryonic stem cells that can make exact duplicates of themselves OR turn into literally any cell type in the body. Hematopoietic stem cells can clone themselves OR turn into any blood cell. Mesenchymal stem cells, my personal favorite, along with making their own copies, can turn into connective tissue, cartilage, bone, and fat tissue.

Every type of stem cell has unique properties that make them suitable for very different applications. A hematopoietic stem cell is great as a part of leukemia treatment, but it’s as useless at bone healing as I am at break dancing. Neural stem cells can become new neurons and glial cells, which may one day be an incredibly powerful tool in the treatment of neurological damage. But you probably won’t want to use them to fix that bald spot you swore you wouldn’t inherit from your dad.

Each different type of stem cell functions correctly in a specific environment. Embryonic stem cells need the very specific environment only found in utero. If they are applied outside of that environment in a place where they cannot receive the intricately measured, timed, and delivered signals they need, they almost always cause a type of cancer called a teratoma. As I’ve explained a million times – embryonic stem cells are like adventurous children. If left to their own devices with no supervision, they’re probably going to play with matches and burn the house down. But, with the right signals (the ones only found in utero), they can make it out of childhood and become overly sarcastic scientists instead.

Mesenchymal stem cells, a type of adult stem cell, are primed to function in the human body at all ages – from infancy to your centennial years. Since their natural environment is your body, at whatever age you are, they do what they’re supposed to do when used in your body. That’s why my co-authors and I titled our review paper, “Mesenchymal Stem Cells: Environmentally Responsive Therapeutics for Regenerative Medicine.”

It’s incredibly important that anyone attempting to use stem cells in the treatment of any human injury or pathology chooses the right stem cell for the job. Nobody who ever needs brain surgery thinks, “I’ll just have this podiatrist down the street do it. A doctor’s a doctor, right?”

So when you hear the term “stem cell” you should always ask – what kind of stem cell? And so should every media outlet that covers stem cells, especially when people have done irresponsible things with them. The type of stem cell matters, and in my experience, when people choose to do irresponsible things with stem cells, it is because they don’t understand the most basic properties of stem cells, including the most obvious fact that all stem cells are not created equal.

For more information on the kinds of stem cells, including which ones are used in clinical practice right this moment, in this country, read this post that I haven’t written yet but will. Check back later for a live link, or join the email list!

2. Stem cells live in almost every tissue in your body.

Yes, your adult human body. They’re in your brain and in your muscles, in your bones, in your heart, and even in those jiggly parts you can’t lose without giving up carbs. Your body is literally chock full of stem cells at this very moment.

What does that mean?

It means that you and I are probably going to see some really wild stuff happen with medical advancements in the next 10-20 years. Most of my friends have heard me say this, so apologies to everyone who already knows: I fully expect to live to 120 and do handstands and cartwheels the whole time.

Because of stem cells.

#WhatATimeToBeAlive

 3. Embryonic stem cells are the most useless kind of stem cells.

Say whaaaaat?

I’ll say it again. Embryonic stem cells are the most useless kind of stem cells. For now at least.

You shouldn’t take my word for it though, so let’s break it down. Most of the applications in which we, living, breathing, hashtagging humans would want to use stem cells involve replacing or repairing some tissue inside our bodies. That means the stem cells would need to stay and live happily in our bodies.

You know who has a lot to say about what stays and lives happily in your body? Your immune system. It has two basic jobs: (1) distinguish between your body and not your body, and (2) destroy and eradicate anything that qualifies as not your body.

Now, are you an embryo?

If you are, and you’re reading this, mazel tov – you’re probably the great white hope of this universe, and I hope you grow up to be kind and just funny enough to laugh at yourself all through middle school.

For the rest of you, you’re not an embryo. Even if you’re in the reading audience identifying as your spirit animal instead of a human, you’re not an embryo. Unless your spirit animal is an embryo, in which case we need to talk about all the other possible spirit animals you could have chosen. White tigers, unicorns, mermaids, leviathans (because I still have nightmares about that movie), those teacup raptors from every Jurassic Park movie, and REGULAR RAPTORS. But I digress.

Assuming you are not an embryo – if someone were to put embryonic stem cells in your body, what would happen? (Other than them doing their best to form a teratoma)

Your always on, omnipresent immune system would recognize those cells as not your body. Then those not your body embryonic stem cells would be labeled with the molecular equivalent of giant flashing lights that say “DESTROY ME IN THE MOST VICIOUS WAY POSSIBLE IMMEDIATELY.” And then your immune system would do its job and kill them.

So ignoring the fact that we still aren’t great at telling embryonic stem cells which type of cell to turn into, ignoring any of the many passionate views people have about them for personal/religious/financial reasons, embryonic stem cells are the most useless type of cells because they are not your cells. And as such, they can’t live in your body without copious amounts of immune suppressing drugs, just like an organ transplant.

Important Note: There is a specific type of embryonic-like stem cell made from your own body that may turn out to be the next great advancement in medical science. I’ll cover them in detail in another post, because there’s way too much information about them and way too many cool things being done to cover them in this post.

4. Clinical stem cell treatments are available in the United States, right now, and they DO NOT cost $50,000 – $100,000 cash.

I have personally assisted hundreds of adult stem cell cases using mesenchymal stem cells from bone marrow. No, I was not there for procedural assistance. I’m not a medical doctor, y’all. Do you know how much med school costs???

Because I’ve personally seen these cases, I know that there are hundreds if not thousands of qualified, trained physicians specializing in orthopedics, spine, pain management, obstetrics, aesthetics, and even some general practitioners who offer treatments utilizing adult stem cells from the patient’s own bone marrow. So why haven’t you heard of this yet?

Believe it or not, doctors aren’t great at marketing, nor do they really learn much about it in med school. So most of them are depending upon word of mouth, or their favorite scientist, to get the word out.

I say most, because there are some who are fantastic at marketing. They also often happen to be people who are charging what I would label as highway robbery prices. In this particular story (<– click the link), you see that one patient paid $30,000 for a stem cell treatment (administered in Mexico, which is a whole other issue).

That’s not normal.

You do not need to go to another country, and you do not need to pay tens of thousands of dollars or mortgage your home to get a legitimate stem cell treatment. I’ll do a separate post on which treatments are clinically sound and which you should avoid at all costs, because I could write an encyclopedia on that topic. For now, let’s just focus on the average and reasonable costs for adult stem cell treatments from bone marrow. For a single procedure, let’s say the most common – a knee arthritis treatment, you’re looking at an average cash price of about $5,000. Some places will be a little more, some places will be a little less.

Where are these places? There’s this one in Colorado, this other one in Colorado, this one in Dallas, this one in Portland, this one in Cleveland, this one in Tyler, and a whole slew of others that I don’t have the time or space to list on this page.

You know what else is awesome? Just last month, an insurance company announced that they will begin covering bone marrow derived adult stem cell treatments as a way to provide better care to their customers. You can bet that more will follow, and I predict that within three years, all major insurers will have jumped on this band wagon. These kinds of treatments are better for patients, and they’re actually about 1/5 – 1/10 of the cost of currently available and covered treatments.

5. Stem cells are not magic. Stem cells are science.

If you’ve attended any of my presentations, you’ve heard me say this ad nauseum. Stem cells are not some kind of magic bullet panacea that will fix anything we throw them at. When physicians (or people posing as them) assume they are, people get hurt, sometimes irreparably.

In order to use their powers for good, we (the scientific and medical community) have to educate ourselves on the mechanisms by which stem cells can or could treat a particular injury or pathology. We need to consider the environment from which they are coming as well the one in which they will be placed. We need to read up on the literature. We need to understand how this group grew cartilage with their patient’s bone marrow derived stem cells, and how this doctor treated osteonecrosis with them. We need to appreciate the science behind this doctor’s treatment of fractures that wouldn’t heal.

There is a wealth of information on stem cells, a 30+ year history of safe and effective use of bone marrow derived stem cells in orthopedic treatments, and textbooks full of information on why this particular cell type seems to work so well.

Do we have all the answers?

Absolutely not.

But do we have enough of them to make operating in the dark, closing our eyes and hurling them at macular degeneration or cerebral palsy, inexcusable?

Absolutely.

When we embrace the knowledge behind stem cells, everyone wins.

And that, y’all, is science.

Image adapted from ZEISS Microscopy from Germany [CC BY 2.0], via Wikimedia Commons