Hope for future treatment of thousands of stroke sufferers from stem cells
Hope for future treatment of thousand of stroke suffers from stem cells
Brain damage caused by strokes could be repaired thanks to a new treatment which could revolutionise the treatment for the deadly condition.
By Rebecca Smith, Medical Editor
Thousands of lives a year could be changed thanks to the breakthrough by Imperial College which involves injecting a patient’s stem cells into their brain.
The treatment, that has been hailed as ‘one of the most exciting recent developments in stroke research’, gives new hope to the 152,000 who have strokes in Britain every year.
Doctors said the procedure could become routine in ten years after larger trials to examine its effectiveness in a wider group of patients.
Hopes have been raised of a future treatment to repair the damage caused by strokes after scientists found improvements in patients who had their own stem cells injected into the brain.
Lead author Dr Paul Bentley, from the Department of Medicine at Imperial College London, said: “Currently the main form of treatment is an unblocking of the blood vessel and that only helps one third of the patients who are treated and only ten per cent are eligible anyway.
“So we said what about the other 90 per cent?”
The team targeted patients who had suffered massive strokes involving a blood clot in the blood vessel in the middle of the brain. Typically there is a high mortality rate in these patients and those who survive are often severely disabled, are unable to walk, talk, feed or dress themselves.
The experimental procedure was carried out on five patients aged between 40 and 70, all of whom showed improvement over the following six months and three were living independently.
More than 152,000 people suffer a stroke in England per year and the research team said that the new procedure could eventually help most of them.
Dr Madina Kara, a neuroscientist at The Stroke Association, said: “Previous studies have shown that a type of stem cell, called CD34+ cells, shows promise to aid stroke recovery. These latest results suggest that this type of treatment could be administered safely and we’re looking forward to seeing the outcomes of further studies to see exactly how they are aiding recovery.
“This is one of the most exciting recent developments in stroke research; however, it’s still early days in stem cell research but the findings could lead to new treatments for stroke patients in the future.
“In the UK, someone has a stroke every three and half minutes, and around 58 per cenrt of stroke survivors are left with a disability.
“One of the few existing treatments which can limit brain damage caused by stroke is thrombolysis. However, this drug can only be used to treat strokes caused by blood clots and must be administered within the first 4.5 hours after a stroke. There is an urgent need for alternative treatments to help prevent the debilitating impact of stroke.”
The experimental procedure involves several stages, first the patient’s own bone marrow is harvested, which was then sent to a specialist laboratory so the specific stem cells, called CD34+ can be selected.
Then the patient undergoes a procedure in which a wire is inserted into a vein in the neck and up into the area of brain damage. Once there the stem cells are released and the wire retracted.
During the trial the whole process took half a day but it is hoped that with refinement this could be reduced.
It is thought the cells work in two ways, they grow into small blood vessels which allow the brain to grow new nerves and brain tissue surrounding them and also they release anti-inflammatory chemicals which encourage tissue repair.
Doctors said there are two ways the treatment could develop for use in routine cases. The patients could do through the exact same process in the first few days following their stroke, or the chemicals that the stem cells produce could be recreated and administered to stroke victims when they first arrive at hospital.
Dr Paul Bentley said: “If we find that the is the chemicals causing most of the improvement then it would be easier to inject those.”
Dr Soma Banerjee, a lead author and Consultant in Stroke Medicine at Imperial College Healthcare NHS Trust, said: “This study showed that the treatment appears to be safe and that it’s feasible to treat patients early when they might be more likely to benefit.
“The improvements we saw in these patients are very encouraging, but it’s too early to draw definitive conclusions about the effectiveness of the therapy. We need to do more tests to work out the best dose and timescale for treatment before starting larger trials.”
Professor Nagy Habib, principal investigator of the study, from the Department of Surgery and Cancer at Imperial College London, said: “These are early but exciting data worth pursuing.
“Scientific evidence from our lab further supports the clinical findings and our aim is to develop a drug, based on the factors secreted by stem cells, that could be stored in the hospital pharmacy so that it is administered to the patient immediately following the diagnosis of stroke in the emergency room.
“This may diminish the minimum time to therapy and therefore optimise outcome. Now the hard work starts to raise funds for this exciting research.”
Dr Tim Chico, Reader in Cardiovascular Medicine at University of Sheffield and a consultant cardiologist, said: “It is important to understand that this study is only the very earliest step towards a possible new treatment for stroke and does not prove the stem cell treatment improved these patients recovery.
“A much larger trial will be needed to compare stem cell treatment with no stem cell treatment. Anyone who has seen the suffering a stroke can cause will be encouraged that doctors and scientists are continually exploring new ways to treat this devastating disease. This study is only one small piece in a very large puzzle.”
Prof Robin Lovell-Badge, Head of Developmental Genetics, at the National Institute for Medical Research, said: “This is no more than a small safety trial, with such low numbers of patients that the authors themselves state: “this proof of concept study was not designed with a control group, or powered to be able to detect efficacy”.
“Although they mention some improvement of some of the patients, this could be just chance, or wishful thinking, or due to the special care these patients may have received simply because they were in a trial. There is no evidence about mechanism from pre-clinical (animal) studies and, although it is possible that the bone marrow cells produce factors that can aid recovery, I would prefer that further research was done on this prior to any larger trial being initiated, even if the current work showed no adverse effects.”
Source: The Telegraph