World first: Hadassah uses adult stem cells to help patients
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Judy Siegel-Itzkovich , THE JERUSALEM POST Nov. 22, 2007
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Neurologists at Jerusalem's Hadassah-University Hospital, Ein Kerem, are the
first in the world to help multiple sclerosis (MS) and amyotropic lateral
sclerosis (ALS) patients by injecting their spinal columns with large numbers
of adult stem cells taken from their bone marrow and multiplied in culture.
The clinical trial, while "encouraging" and "promising," remains highly
experimental, as all the patients have undergone a single injection with no
untreated control group for comparison. With the first patients having received
it two years ago, it is too early to know how successful it will be in the long
term.
Prof. Dimitrios Karousis, a senior Greek-born neurologist at Hadassah for the
past 19 years, told The Jerusalem Post on Wednesday that the clinical trial was
"the first in the world with this type of stem cells." There have been, though,
unproven and much-criticized claims of the doubtful scientific value of stem
cell injections in desperate MS patients at private clinics in Russia and
China.
Karousis added that a hospital in England recently announced that it would soon
launch a program for stem cell injections similar to Hadassah's.
Among his collaborators were Prof. Shimon Slavin, the world-renowned stem cell
expert at Hadassah who has just retired and moved to Tel Aviv Sourasky Medical
Center, and Hadassah neurology department head Prof. Tamir Ben-Hur. The team
first experimented on lab mice with a model of MS and found that after a month
or two (a year or two in human time), 90 percent of their neurons remained
intact without any breakdown of their myelin sheath, despite the disease.
MS and ALS are incurable. One can live with MS for decades, but with growing
disability; ALS, however, is usually fatal within a few years.
The researchers received official permission to conduct a small study with 25
patients - nine with MS and 16 with ALS, none of whom responded to conventional
drug treatments - from the hospital's Helsinki Committee on Human Medical
Experimentation. They are waiting for permission from the Health Ministry's
Supreme Helsinki Committee to conduct a much larger study, Karousis said.
The ministry is asking a lot of questions, such as exactly what elements are in
the culture medium, he added.
In addition to Israelis from various parts of the country, the patients in the
trial have come from as far away as the US, South Africa and Italy to get the
treatment.
"It is a Phase 1-2 trial, aimed at testing to see how safe it is. While most of
the patients' conditions are improved or are stabilized, it's impossible to
know how long it will last or how significant the improvement is, as there was
no control group," Karousis said. "Yet we are encouraged, as these are patients
with advanced cases, many of them in wheelchairs. There were no side effects so
far except for a passing fever or headache."
One "dose" of adult stem cells is removed by a needle from the hip bone, then
processed and "cleaned" and grown in a special culture. After two months, pure
adult stem cells numbering some 50 million are produced and injected into the
patient's spinal column. The spinal injection is given only once.
"We are optimistic," said Karousis, "as the use of stem cells is not far into
the future. They have already shown some promise in the treatment of joint and
bone diseases, immune conditions and ischemia of the heart."
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