Moving Mississippi Forward

Our Double-Barreled Flu Season; What to Do?

Posted by drbob2 on Oct 19, 2009

Everyone knows that this is a bad time for influenza in the United States. First, the whole world is battling a pandemic with a newcomer on the scene, first called the Swine Flu, then the Novel H1N1 Flu (because it carries genetic components of two types of swine influenza along with one type of avian, or bird flu, and one type of human flu), and more recently it’s being called the 2009 H1N1 flu. Second, because we’re just beginning the time that regular Seasonal Flu hits us in the Northern Hemisphere.

 

2009 H1N1 flu differs from Seasonal Flu in important ways. It disproportionately affects young persons and those with impaired immune systems, including pregnant mothers. The vaccine for this type of flu has just arrived and the CDC has advised that certain groups should be given top priority for receiving it. The priority groups are:

1. Pregnant mothers
2. Persons who live with or care for infants younger than 6 months of age
3. Health care and emergency medical personnel
4. Anyone between the ages of 6 months and 24 years of age
5. Anyone 25 to 65 years of age with medical conditions that put them at risk for flu complications

At the time of this writing, the graphs and charts depicting flu activity are blossoming, with 41 states reporting widespread activity and, to date; over 20,000 patients have been hospitalized with flu or pneumonia and over 2, 300 who have died from it. Those numbers are unheard of for October and are more consistent with the peak of Seasonal Flu, late January to early March. The cause of almost all this so far is the 2009 H1N1 flu. Seasonal flu is waiting in the wings.

 

So the flu is bad this year and likely to get worse. What can we do about it? Well, thank God, we have vaccines for both types of flu. Right now we have widespread availability of seasonal flu vaccine and a limited but increasing amount of 2009 H1N1 vaccine. Each type of vaccine should, starting 10 to 21 days after taking it, protect a majority – but not all - of those who receive it. There are some uncertainties, which relate to whether or not the types of flu in each vaccine change and how good your immune response is to the vaccine. The 2009 H1N1 vaccine is monovalent, that means it is formulated to protect against just the 2009 H1N1 influenza. The Seasonal Flu vaccine is trivalent, meaning it contains elements formulated to protect against the three types of flu predicted, but not yet proven, to be prevalent this time of year. So you need two flu shots this year. You can get your seasonal flu shot now and, if you are in one of the priority groups listed above, you should see your doctor and get a 2009 H1N1 shot as soon as you can.

 

Now, what should you do if you develop flu symptoms, like a cough, fever, and muscle aches?

Well here are two algorithms, or “recipes” that the CDC has developed to help doctors and patients decide when to seek treatment EVEN IF YOU HAVE HAD BOTH FLU SHOTS.

One is for adults 18 http://www.cdc.gov/h1n1flu/clinicians/pdf/adultalgorithm.pdf and over and one is for persons 17 and under http://www.cdc.gov/h1n1flu/clinicians/pdf/childalgorithm.pdf

 

Take home messages:

1. Please get your seasonal flu shot now.
2. If you are in a priority group for 2009 H1N1 flu, get that vaccination also now.
3. If you are not in a priority group for 2009 H1N1 flu, get that shot as soon as those with priority have had theirs.
4. Before and after you get your flu shots, keep practicing good hygiene to control coughs and sneezes, wash and/or sanitize your hands, consider wearing a surgical mask, and exercise good judgment if you develop flu symptoms: stay home and try to keep from passing the virus on to other.

“Your Local Hospital Could be Forced to Close”

Posted by drbob2 on Jul 28, 2009

As the primary topic for the last segment of Super Health Mississippi last week and this week (which I did not have time for), I called attention to the astute and documented editorial written by Dr. Norman Traverse, editor of the website HEALTH MadeEasy.com.  As you can read  from Your Local Hospital Could be Forced to Close  the current Democrat-sponsored HR 3200 is a disaster being cleverly and hastily pushed forward, as was the recent Cap and Tax bill. As details of this hasty and partisan attempt to take over American health care and extend the federal government’s control over all our lives are being discovered and made known, they are causing a firestorm of opposition. If you do not want to surrender control of your health care to bureaucrats who will not be subject to the very measures they are trying to rush through Congress, call your Representative and Senators and straighten them out!

Mosquito Activity Forecaster

Posted by drbob2 on Jul 8, 2009

Mosquito Activity Forecaster

 

As I mentioned on the program this morning, I ran across this website which purports to forecast the activity of mosquitoes in your city or zip code. Since we are just entering the West Nile Virus “season” and since prevention is most important for this disease, I hope it will prove useful. Mosquito Activity Forecaster

 

What You Can Do to Make Healthcare Safer

Posted by drbob2 on Jun 23, 2009

What You Can Do to Make Healthcare Safer

 

On the broadcast/webcast this morning I made a point of exploring in some detail a one page

Consumer Fact Sheet published by the National Patient Safety Foundation.

That document is available at: What You Can Do.

 

As you see when you access that link, there are 5 categories of actions to take to do what you and I, as patients, can to protect ourselves from medical errors.

 

1.      Become a more informed health care consumer.

There’s a wealth of information available in seconds on the internet about all sorts of illnesses and conditions but you have to use your common sense in interpreting it. What you find may either scare you witless or minimize the realities of your specific problem. Perhaps the best use of information you find is to generate questions to ask your family doctor or the specialist, if that is the most appropriate person. If the answers you receive don’t make sense to you, remember that you always have a right to a second opinion and you should not be shy about obtaining one, either on your doctor’s referral or one you obtain by yourself. If you do seek a second opinion, be sure to ask the doctor providing it to obtain your medical history and all test results from your first doctor.

 

2.      Keep track of your history.

Many patients assume that your doctor has an up to the minute record of everything you have told him or her and all the test results and medicines that you are taking and why you are taking them. While that may be the case, especially if your doctor cares for you within the concept of a Medical Home, don’t count on it—we’re talking about your health now. Take the time to write down, either on paper or on a computer document—which I strongly recommend—all the aspects of your health over the years: Illnesses, hospitalizations, operations, (with the years, if possible) current medications (and past meds, if relevant), any family history of disease and any  allergies, bleeding tendencies, cortisone use, diabetes, or blood clots (in legs or lungs) in your past. Also include any tests that were done and their results (remember, you have a right to all medical test results so ask your doctor to give you a copy of them.)  In this personal medical history it’s important to be complete and accurate and as specific as possible. It’s also a good idea to include the names, addresses, and especially phone numbers of all your doctors and other healthcare professionals who’ve treated you. If you take dietary supplements, aspirin, or herbal products, include them.

 

Once this is written down and dated, update it at least yearly and keep a copy handy. If you’ve entered it on your computer, you can copy it to a USB stick memory and keep it on your keychain in case you wind up in the Emergency Room. Just give it to the ER Staff and tell them to print it for your ER doctor to see and for a copy to be kept with your chart.

 

3.      Work with your doctor and other health care professionals.

One way is to share your written medical history with them. Whenever you go to your doctor, take a minute or two to write down all the things that are on your mind about your health and be sure that your physician addresses them AND that you write down his or her responses to your questions. Sometimes it’s good, within the bounds of your privacy, to share your draft list with your spouse or another family member. They may have noticed something that you forgot to put on your list. Another reason to share is that they will reinforce the idea that you need answers to your concerns and you need to write them down.

 

If your doctor recommends an invasive test or a surgical procedure, part of that recommendation should include the goals and risks of what’s been recommended. If you do not fully understand what’s been recommended, and why, and what the risks, if any, are, just say NO until you understand everything and decide to go ahead with it. Remember, don’t be shy!

 

4.      Involve a family member or friend in your care.

Again, this is just common sense. If you have any condition that affects your memory or judgment, it’s important to have someone that you trust who cares about you with you when you see your doctor. Ideally, you will have shared your written questions and concerns with that person so that, even if you forget to ask or record the answers, they will remember and get it done.

 

5.      Follow the treatment plan agreed upon by you and your doctor.

Write down any instructions that you receive or get them from your doctor in written form. It’s ok to ask how much something costs, whether it’s a medicine, a test, or whatever. If the doctor doesn’t know, they should and your question should motivate him or her to find out. Take any and all medicines just the way they are prescribed. If something is to be taken once or twice a day, that’s easy; just take in the morning or the evening or at both times. If something is to be taken three or four times a day, it’s a good idea to ask your doctor so that you both have aligned your expectations about timing. If a medicine makes you feel bad or makes you sick, the first thing to do is to CALL the doctor who prescribed it. If you can’t get a call back pester them until you do so that 1. your doctor knows what’s going on and 2. they will give you advice about what to do, whether it is to take a med with meals, or decrease the frequency of doses, or change to a different med or just stop it. You should expect that your doctor will make a note in your medical record of your reaction and what he or she did about it. If a medicine makes you sick and, instead of CALLING the prescribing physician, you just take it less frequently than prescribed or even stop taking it, you may be endangering your health—and your doctor still thinks you are taking it as prescribed!

 

Remember the title of this very helpful fact sheet:

What You Can Do to Make Healthcare Safer

If you have a topic you’d like me to address, just send me an email via

the “Contact” page of this site.

 

 

 

 

Some Reasons to Oppose the NIH Draft Guidelines for (Destructive) Human Embryonic Stem Cell Research

Posted by drbob2 on Jun 1, 2009

As a physician and father of seven wonderful children who began their lives as embryonic individuals, I write to present my comments in opposition to the DRAFT National Institutes of Health Guidelines for Human Stem Cell Research presented over the April 17, 2009 name of Dr. Raynard S. Kington, Acting Director, NIH. Guidelines

 

Of course, as one who adheres to the Hippocratic Oath, my opposition to the proposed Guidelines is based primarily on their inherent and unwarranted devaluation of human life, which, in this context, is to be killed in the name of “science.” There are many more reasons to oppose these Guidelines.

 

Throughout the Guidelines, cells derived from the intentional killing of little human beings are described in terms of their “use.” When they are deemed, by their parent or donor owners, to no longer be useful to provide an implanted embryo, intrauterine fetus, and born child, they are relegated to be killed and used in the name of “research.” Echoes of the testimony provided at the Doctors Trials at Nuremberg in the late 1940’s (and of the Tuskegee Study) are now sounding loudly in America. Is anyone in Washington listening? One is reminded that the secret of Schindler’s List was that Oskar Schindler found ways to portray the usefulness of born human beings to bureaucrats of the Third Reich. In so doing, he saved many otherwise slated for death or lethal “research” at the hands of physicians and scientists. Pragmatic Utilitarianism is not only impractical but, neither then and there nor here and now, is it anything but barbarism.

 

In my second paragraph I noted that my unfailing objection is rooted in the immoral and unethical action of directly killing one human being for some reputed “higher purpose.”  When that “higher purpose” is based on smoke, mirrors, and fantasy, the entire enterprise becomes incredible and demeans its proponents. Human embryonic stem cell research has been carried on for over 10 years in the U.S., largely but not entirely funded by non-public dollars. At this time, before EO 13505, our country was spending more on this destructive research each year than the rest of the world combined!

 

In spite of this level of funding for this period, no human clinical trials have even begun, although one—very cautious and very small—has now been approved by the FDA. The scientific reasons are, no doubt, known to the author(s) of the Guidelines: human embryonic stem cells have not been controllable and are prone to form a variety of tumors; additionally, human embryonic stem cells always carry a genome distinct from any putative patient. Although this latter impediment may be addressed with immunosuppressive drugs, when balancing that regimen against the currently demonstrated effectiveness of cell therapies employing the patient’s own stem cells (without immunosuppression) or those employing donated but matched adult stem cells (with immunosuppression), the risks of using embryonic stem cells tips the scales against them.

 

It would appear, from my reading of the Guidelines, that Dr. Kington has made an unwarranted and unsupportable interpretation of the Dickey-Wicker Amendment, here presented as currently in force.

 

Dickey-Wicker Amendment

(enacted on March 11, 2009 as part of the Omnibus Appropriations Act, 2009,)

SEC. 509. (a) None of the funds made available in this Act may be used for–

(1) the creation of a human embryo or embryos for research purposes; or

(2) research in which a human embryo or embryos are destroyed, discarded, or knowingly subjected to risk of injury or death greater than that allowed for research on fetuses in utero under 45 CFR 46.208(a)(2) and Section 498(b) of the Public Health Service Act [1](42 U.S.C. 289g(b)) (Title 42, Section 289g(b), United States Code).

(b) For purposes of this section, the term “human embryo or embryos” includes any organism, not protected as a human subject under 45 CFR 46 (the Human Subject Protection regulations) . . . that is derived by fertilization, parthenogenesis, cloning, or any other means from one or more human gametes (sperm or egg) or human diploid cells (cells that have two sets of chromosomes, such as somatic cells).

 

To present these Guidelines as approving funding of research using human embryonic stem cells that were “derived” i.e. obtained by killing an embryonic human being, is disingenuous at best if it is meant to be within the actions approved by Dickey-Wicker. To consider this further, these Guidelines are meant to divorce themselves from the actual killing—presumably not funded by NIH—how can the “Eligibility” provisions not be interpreted as a wink and a nod to those who, although, perhaps, not directly funded by tax dollars, must meet specific NIH requirements so that their unfunded killing actions are allowed to generate a funding stream by using the products of the killing? If the “eligibility” provisions are not a clear attempt to tacitly approve actions contrary to the language and intent of Dickey-Wicker what are they?

 

Penultimately, these Guidelines become patently incredible when they promote the immoral, unethical, and increasingly outdated and unworkable destruction of human beings by providing the accurate definition of human embryonic stem cells as “cells derived from human embryos (that) are capable of dividing without differentiating for a prolonged period in culture, and (that) are known to develop into cells and tissues of the three primary germ layers.”  Contrast that definition with the same Guidelines definition of human induced pluripotent stem cells: “cells that are capable of dividing without differentiating for a prolonged period in culture and (that) are known to develop into cells and tissues of the three primary germ layers.”  Since the defined characteristics, as presented in the Guidelines, are indistinguishable, and since one involves the killing of a human being without their foreknowledge or consent, the reasonable reader must ask why Executive Order 13505 was issued and why these Guidelines were drafted?

 

It is clear the answer to that question is that President Obama is enthralled by the notion that human embryos are human enough to be used but not human enough to be protected. It follows that President Obama is here engaged in fulfilling a campaign promise to require taxpayer funding of increasingly irrelevant “research” which requires the killing of little human beings. As such the Executive Order and these Guidelines are morally corrupt. They devalue human life and demean and degrade scientific inquiry.

Just the Facts, Doctor!

Posted by drbob2 on Apr 21, 2009

It was a real honor to host Dr. David Prentice on the program today. He was Professor of Life Sciences at Indiana State University, Adjunct Professor of Medical and Molecular Genetics at Indiana University School of Medicine, and is now Senior Fellow for Life Sciences at the Family Research Council. Dr. Prentice has carried out ethical stem cell research and, from his position of authority, he made several important points. He reminded us:

1. That, scientifically, human life begins at conception;
2. That almost all of about 400 thousand embryonic human beings currently stored at IVF clinics are not about to be destroyed but are considered children by their parents–and, if need be, can be adopted by other childess couples;
3. That before President Obama mandated taxpayer support of destructive embryonic stem cell research the U.S. was already spending more on it than the rest of the world COMBINED;
4. That non-embryonic stem cell research, especially adult stem cell research, is the field that is already successfully treating human patients and adult and the new Induced Pluripotent Stem cells show greater promise than destructive embryonic stem cell research; and
5. That non-embryonic stem cell research is the field that private funds are supporting simply because it is more likely to be successful than destructive embryonic research. 

All in all, it was a refreshing and expert defense of the Culture of Life…I hope those in the media were listening!

Some Realities of Socialized Medicine

Posted by drbob2 on Apr 20, 2009

You may be aware of the Obama Administration’s plan to try and socialize American medicine.  So, what’s socialized medicine like?

 

 

Based on what I’ve read, the Canadian system seems like it gives everyone the right to medical care. The problem is, a lot of the time—and depending on the Canadian province you live in— although you have a right to it, you can’t get it!

 

How about England and its National Health Service? Several months ago I read in British papers accessible on the internet of an English woman who wanted to take an expensive drug for her breast cancer. Since it was not covered by the National Health Service, she was going to pay for it herself and take it along with the other treatment that the NHS did pay for. According to the newspaper reports, this was not an unusual situation but in her case, the NHS told her that if she did pay for the expensive drug herself, they would not continue her regular treatment! The story said that the government official did this because, even though the woman was planning to sell her house to privately pay for the medicine (which is expensive but widely available in America) the NHS felt this would be unfair to other NHS patients who might not have the money to do what she did. How’s that for government controlled medicine? If you want to pay for a treatment that’s not provided by the government, the bureaucrats will stop providing you the treatment they do approve!  

 

Here’s another example of the mindset of socialized medicine. About a week ago, a physician friend sent me a very revealing website www.18weeks.nhs.uk.  I invite you visit that site and see for yourself how at least some aspects of socialized medicine work. The whole point of this particular website is that, as a quality improvement measure, called the NHS Improvement Plan, begun in June 2004: “By 2008, no one will have to wait longer than 18 weeks from GP referral to hospital treatment.” When I first read that, I thought it was a joke, but no—it’s deadly serious—check it out yourself! Why did I think it was a joke? Because here in the good old USA, where medical care does cost too much,* whenever you have to wait 18 weeks to get in the hospital, it’s considered a Quality of Care PROBLEM, not a GOAL!  And, the NHS government bureaucrats thought that it would take them about 4 YEARS to achieve that goal! 

 

In trying to better understand this matter, I accessed the 18 weeks site’s Frequently Asked Questions (FAQ) page and found 24 pages of bureaucratic language that, if you’re a patient, you might find scary, not funny. In fairness, I did discover, (but it was not particularly easy) that the “18 week goal” is for those patients without an urgent need for care. Although what the NHS defines as urgent, I did not find and, considering the overall drift of the “18 weeks” program, I was not reassured that the NHS definition of “urgent” and this physician’s definition of “urgent” would be the same.

 

 

There is, of course, always the possibility that my perspective, after just reviewing the 18week website, and not being able to interview NHS physicians or their patients, is unfair; but I have tried to present the issue as it is presented on the website—which I invite you to visit yourself.

 

* I have some ideas about the causes and remedies of the high cost of medical care here in America that I plan to explore in upcoming blog entries. If you have specific examples of the high cost of American Medicine, please email them to me (no names please) at; drbob@superhealthms.com

 

If you have a topic you’d like me to address, just send me an email at drbob@superhealthms.com.

 

 

 

Brits Stop Funding for Cow-Human “Cybrids”; UK “Scientists” Howl

Posted by drbob2 on Mar 27, 2009

A recent article “Rival stem cell technique takes the heat out of hybrid embryo debate” in the British paper, Guardian, by science correspondent Ian Sample, merits wider distribution for many reasons. The main reason is that here in the U.S., where “news” is limited to an agenda crafted by only a few newsmongers, it is newsworthy. Another reason may be that the topic: the British government first authorizing, and now de-funding, the creation of cow-human embryos, (which some have termed “cybrids,” to be killed within 14 days so their cells can be studied) is gruesome.

 

The Guardian reported that, due to budgetary restraints and the advent of reprogrammed skin cells (called induced pluripotent stem cells) which have virtually all the benefits of embryonic stem cells without their inherent dangers, the UK’s Medical Research Council refused to finance the cow-human embryo research and, instead, favors the new (and ethical) technique of inducing skin cells to become pluripotent stem cells.

 

Several things need more explanation.

The whole idea of cybrids came about because human embryonic stem cells are always different from the human patient being treated and, therefore, subject to immune rejection, as well as other serious problems. This means that any human treatment using embryonic stem cells requires either cloning a human embryo identical to the patient, then killing the embryo and manipulating the stem cells into some form of treatment option or the use of immunosuppressive drugs. In other words, if you want to treat someone with embryonic stem cells, you can’t use stem cells derived from embryos created by in vitro fertilization facilities and then killed for their stem cells without suppressing your immune system. If you don’t want immunosuppression, you have to clone a replica embryo of yourself and then kill it and use it.

 

Now you can see that, to clone an embryo from each patient being treated is a tremendous logistical problem since cloning (euphemistically “called somatic cell nuclear transfer” by the cloners) requires that women donate unfertilized eggs to the researchers who remove the nuclei (containing just 23 human chromosomes) from those eggs and replace each with a nucleus (containing all 46 human chromosomes) taken from a cell from the patient. How cloning is done  Human eggs for this process are always in short supply—hence the dream of some “scientists” to replace human eggs (oocytes) with cow, rabbit, or pig eggs!

 

So, the cloning of human embryos to kill them for their stem cells is a complicated process, notwithstanding the significant moral and ethical objections to it. And the prospect of using cow eggs doesn’t make it easier or ethical but harder and, if possible, more disgusting. This is especially so since the advent of induced pluripotent stem cells, or iPSC, which can be ethically developed from a prospective patient, and, thus do not contain immunologically foreign material subject to rejection. YDB Blog readers will know that iPSC are made from a patient’s skin, or other, cells and are ethically reprogrammed to have embryonic cell properties identical to the patient. iPSC are so important that Sir Ian Wilmut, who cloned Dolly the sheep, and who had been active in human cloning research, reported that he will stop trying to close humans and start using iPSC.

 

Nevertheless, last year, the U.K.’s Human Fertilization and Embryology Authority granted licenses to three groups to make human-cow hybrid embryos or “cybrids.”  Now, however, the funding for that research has been nixed by Britain’s Medical Research Council. Professor Stephen Minger of King’s College is one of the license holders. He said his cow-human embryo research has not even started because of lack of funds. One source quoted Minger, who, according to the Times of London, had left the U.S. for the U.K. because of England’s promotion of human embryonic stem cell research, “We put in a grant proposal last year but it wasn’t successful and we’re dead in the water.”

 

The coup de grace, to cybrid prospects may, however,  have come from research done here in America by controversial scientist Dr. Robert Lanza, Chief Scientific Officer of Advanced Cell Technology. Unencumbered by financial, ethical, or, apparently, licensure impediments, Lanza reports on his website Lanza the results of his comparative analysis of human embryos and cow-human and rabbit-human embryos,

Importantly, the human oocytes significantly upregulated Oct-4, Sox-2, and nanog (22-fold, 6-fold, and 12-fold, respectively), whereas the bovine and rabbit oocytes either showed no difference or a downregulation of these critical pluripotentency-associated genes, effectively silencing them. Without appropriate reprogramming, these data call into question the potential use of these discordant animal oocyte sources to generate patient-specific stem cells. (Emphasis added.)

 

In other words, in his lab here in the U.S., Lanza found that cow-human embryos and rabbit-human embryos don’t work!

 

If you have a topic you’d like me to address, just send me an email at drbob@superhealthms.com.

Human Stem Cell Research: Promises and Perils, Part 5

Posted by drbob2 on Jan 26, 2009

As I noted last time, when it comes to advances in ethical  (non-embryonic) stem cell research, it’s hard to know when to stop gathering information and start writing. A fascinating report just recently came along from Europe that put together a multinational and multispecialty medical team that used ethical adult stem cell research to successfully treat a young Spanish woman with a serious lung condition. More about that below.  In this, my last planned entry for this series on stem cell research, I will take note of:

1. The use of the ethical Induced Pluripotent Stem Cells (iPSC) created in late 2007 to treat sickle cell anemia—so far only in mice;
2. How a 2003 prediction for taking regenerative medicine beyond growing and modifying adult stem cells outside a patient’s body is being fulfilled; and
3. The successful treatment of a Spanish woman using a multi-national team which used the patient’s own adult stem cells to tissue-engineer a segment of airway and then successfully transplanted it to replace her narrowed bronchus. 

On November 20, 2007, the same day that Dr. Yamanaka reported his success in creating imps cells from a woman’s skin cell—which provided an amazing new tool for researchers to use, researchers also reported not only that they had duplicated Dr. Yamanaka’s experiment and produced iPS cells, but they had used them to successfully treat—in mice—sickle cell anemia.

This complicated but effective process is explained at  Sickle Cell Mice Cure

 

 

As a reader of this series on stem cell research knows, the advances in ethical adult and IPS stem cell research involve a process like this:

• Take adult stem cells from a patient’s bone marrow, brain, fat, skin, or other source;
• Grow and multiply them by cell culture in the laboratory;
• Use the right “recipe” of growth factors, culture media, and other substances to get the adult stem cells to change into just the type of cell the patient needs;
• Then find a way to put them back into the patient, right where they are needed; and
• See if they will regenerate needed tissue and restore lost or diminished function.

That’s what is being done right now with adult stem cells already in treating human patients with heart disease, Parkinson’s disease, and some spinal cord injuries.  It has been a useful process, and has even more promise, witness the enhanced possibilities of ethical research and human treatments using Induced Pluripotent Stem Cells.

 

Yet over five years ago, Dr. James Prentice, an ethical stem cell researcher and member of President Bush’s Commission on Bioethics, recognized that, although the process was effective and promised to be even more so, there may be a better way. As Dr. Prentice’s testified at before the President’s Commission on Bioethics in 2003:

“…perhaps the best avenue eventually to pursue might be trying to isolate what these factors are (which deliver a signal to the stem cells in a patient and stimulate them) so that no stem cells would be needed at all. Instead, if you can identify those factors to stimulate regeneration within the tissue, they could be delivered directly.”

 

In other words, instead of finding, removing, culturing, differentiating, and reinjecting our own reparative or regenerative stem cells, Dr. Prentice predicted it would be much simpler to identify the specific growth factors needed and then give them to patients to activate their own stem cells—right where they are— to change into the type of cells needed to repair or regenerate a diseased or destroyed organ or tissue.

 

Working with mice, Harvard’s Dr. Douglas Melton reported (August of 2008),that his team had done just that; injected a selected set of growth factors incorporated into a virus into diabetic mice. The virus contained three growth factor genes: Ngn2, Pdx1, and Mafa. The pancreas contains many kinds of cells but the two cells of interest here are the exocrinecells—which secrete essential digestive enzymes like pepsin and trypsin into the intestinal tract and endocrine cells, like the beta cells which secrete insulin into the bloodstream. Three days after the growth factor genes were injected into the pancreas’s of diabetic mice, 20% of the exocrine cells changed (without becoming stem cells first) directly into insulin-producing beta cells. Although the new cells did behave like ordinary beta cells, secreting insulin in response to rising glucose levels in the mice which did lower the glucose level, they remained as single or clumped cells and did not organize themselves into little islands in the pancreas the way ordinary beta cells do and did not appear to communicate with other beta cells as ordinary beta cells do.  Even so, if this process can be safely translated into treating humans, it has tremendous significance.

 

The Cleveland Clinic is currently investigating the approach predicted by Dr. Prentice in human patients who have had a heart attack. First, they give patients growth factors to stimulate their production of adult stem cells. Then they give the patients a migration factor to see if they can induce the stem cells to migrate to the damaged heart muscle in hopes of repairing it. Even today that sounds like science fiction or something out of one of the Star Trek series.

 

A different and significant approach to treating humans with adult stem cells was recently announced. A multinational team of clinical researchers reported, in The Lancet, Early Online Publication, 19 November 2008, that they had successfully transplanted a hybrid section of a bronchus (breathing tube) into a 30 year mother of two. Mrs. Claudia Lorena Castillo Sanchez.

 

Mrs. Castillo-Sanchez, who lives in Barcelona, developed an unusual complication of pulmonary tuberculosis. The TB bacilli infected her left mainstem bronchus, the major airway which carries all the air from her trachea to her left lung. As a result of the infection, the cartilage in the wall of the bronchus, which keeps the airway open when we exhale, softened to such a degree that her airway became very narrow. Her doctors first inserted a stent to widen the narrowing but it was not successful and she became too short of breath to carry out her normal daily activities. To treat her, her doctors were considering removing her entire left lung.

 

In a remarkable multinational collaboration teams from Spain, Britain, and Italy carried out a treatment plan which involved “autologous tissue engineering.”  As Dr. Paolo Macchiarini reported in The Lancet, the process began by taking a three inch segment of bronchus from an organ donor, who had died of a cerebral hemorrhage; removing all the donor’s immunologically active cells and then covering the outside of the graft with cartilage cells derived from Mrs. Castillo’s own bone marrow and replacing the inner lining of the graft with Mrs. Castillo’s own bronchial lining cells.

 

Surgeons then operated and took out the narrowed airway and replaced it with the donor’s “bioengineered” normal size bronchus. Her operation, in June of 2008 was successful and, so far, measurements of her lung functions have gone from 55% and 62% to 100% without any sign of rejection or other problems!

 

At this rate of progress, who knows what good things will have happened by the next time I pick up this subject,

 

We live in especially interesting medical times for a number of reasons, one being the recent recognition that each one of us is a virtual walking warehouse of adult stem cells that, with the application of proper techniques, can repair and regenerate diseases and conditions for which other treatments have been ineffective. When we add to the current successes being made with adult stem cells the additional promise of induced Pluripotent Stem Cells, the ethical reader and ethical researcher must wonder why anyone persists in killing little embryonic human beings in the name of “science.”

Remember, if you have a topic you’d like me to address, just send me an email at drbob@superhealthms.com.

Human Stem Cell Research: Promises and Perils, Part 4

Posted by drbob2 on Oct 11, 2008

In one sense it has been too long between log entries but, in another sense not long enough since, during the delay (occasioned by a vacation, among other things) “almost daily” scientific discoveries have been demonstrated once more in the field of ethical (non-embryonic human) stem cell research.

 

As I noted in my last entry, even researchers engaged in destructive embryonic stem cell, contrary to what has been widely reported by most of the media, recognized that they were destroying human life in their work. One example, as recounted by Justin Cardinal Rigali, was when “a very influential (embryonic) stem cell researcher, Kyoto University’s Dr. Shinya Yamanaka, was humbled when he was looking through a microscope at a human embryo in a fertility clinic” Rigali quoted a New York Times story which reported: “The glimpse changed his scientific career. ‘ When I saw the embryo, I suddenly realized there was such a small difference between it and my daughters,’ said Dr. Yamanaka, 45, father of two. ‘I thought, we can’t keep destroying embryos for our research. There must another way.’”  He went on to find a way to do just that.

 

Last November, in a breakthrough report, the very same Dr. Shinya Yamanaka reported that he had been able to take skin cells from a 38 year old woman and grow them in his lab. Nothing new about that. But then, using an ingenious but basically trial and error process, his lab identified four human genes (Oct3/4, Sox2, Klf4, C-Myc.) that produced cellular growth factors. In order to get these growth factor genes into the growing human skin cells, Yamanaka’s lab first put them in a special type of virus, called a lentivirus, and then infected, or as they reported “transfected” them into the skin cells they were growing. They kept an eye on the skin cells and noted that about one in several thousand “transfected” skin cells developed virtually all of the characteristics of human embryonic stem cells! Although one in several thousand may not seem very impressive to you or me, they were able to isolate and grow millions of the special cells— all they would need for research.

 

The same day that Dr. Yamanaka reported his results, Dr. James Thompson of the University of Wisconsin, and also one of the originators of destructive embryonic human stem cell research, reported a similar way to develop these iPSC, using a set of four growth factor genes, two of which were different from Yamanaka’s (Oct3/4, Sox2, NANOG, LIN 28).

 

These new cells appeared to meet all the qualifications to be ethical (they were, remember, not taken from a human embryo but from mature skin cells) and pluripotent (being capable of differentiating into virtually all types of cells). The cells, which Yamanaka called “induced Pluripotent Stem Cells” (iPSC), also had a new advantage. Since they could be taken from not only healthy individuals but also from patients suffering with, say Rheumatoid Arthritis, the iPSC may contain the same intracellular flaw(s) that caused the arthritis. When that’s the case, these cells, taken from an affected patient may be used to test the effectiveness of new medicines or combinations of medicines in the laboratory—without exposing that patient to the risks of trying out the new drugs themselves!

 

Although the scientific world was thunderstruck by Yamanaka’s and Thompson’s work, press reports were somewhat muted. Remember, it was the press that had pushed the agenda of destructive embryonic human stem cell research, either ignoring or simply pushing aside moral and ethical objections to the lethal nature of that work, even though the researchers were, as noted above, keenly aware of its destructive nature. It was the press, along with some researchers trying to get the public to pay for research that the free market would not, that pushed legislation in several states to publicly fund cloning human beings and then killing them for their stem cells. However none other than Sir Ian Wilmut, who devised many of the techniques of cloning and cloned Dolly the sheep, recognized what many in the press found hard to swallow, much less report. Sir Ian, almost immediately after Dr. Yamanaka’s paper on iPSC, went public with his determination to abandon his work on human cloning and use the new techniques instead.

 

I had meant this to be the last in this series of blog entries on human stem cell research but enough has happened since last November’s announcement of iPSC that it appears one more entry is needed to point out some of what has been learned since then and to report how the 2003 prediction of ethical researcher Dr. David Prentice is being fulfilled right now, just five years later.

Remember, if you have a topic you’d like me to address, just send me an email at drbob@superhealthms.com.