May 31, 2020

The Niche

Knoepfler lab stem cell blog

Interview with Arnold Caplan, Part 3: challenges & opportunities for clinical use of MSCs

I recently had a phone interview with Dr. Arnold Caplan, the founder of the MSC field. You can read parts 1 and 2 of the interview here and here.

Today’s post, part 3, is focused on clinical use of MSCs.

I want to start off today’s post with a wonderful quote from Caplan:

“All MSCs are good if no one screwed them up!”

This statement by Caplan was in response in part to my asking about how different clinics handle MSCs is such dramatically different ways and how many of them somehow claim that their MSCs are unique. The latter claim, said Caplan, is in part a situation where businesses are looking to claim patent and IP rights.

The critical challenge, in my mind, is that some clinics (particularly those lacking training and expertise, but still jumping on the stem cell bandwagon) do indeed screw up the MSCs.

In our discussion of this challenge, Caplan said to me, “Don’t say that all medical tourism is bad”. Admittedly on my blog I have a habit of raising concerns about medical tourism and I don’t always differentiate between one type and another. They all worry me.

Caplan said that he does sometimes recommend that patients in certain situations go abroad for treatments that are not available in the US. He cited the example of recommending an MS patient go to a specific facility in Panama that Caplan says has the same level of quality as US hospitals, but is allowed to perform procedures with MSCs that are not permitted here in the US currently.

When asked if he himself would receive an MSC treatment from a non-FDA approved clinic if he was in that kind of health situation himself, Caplan responded (accurately) that it was a loaded question. Perhaps it was a bit unfair of me to ask since frankly I am not sure how I would answer it myself if I found myself in that kind of situation. But I am more skeptical about such treatments than Caplan.

I also asked Caplan about oversight and how we should handle clinics that are non-compliant here in the US and that lack expertise. I also mentioned ICMS as an example of an effort by the industry at self-regulation of a sort, albeit clearly imperfect. Caplan responded that he didn’t think that was the solution, “ICMS uses a hands-off process”.

He continued, “What we really need is for people in the stem cell field to do inspections of the clinics, but of course some will not allow that.” Indeed, it seems that some non-compliant clinics in the US will do what they can to avoid any kind of inspection.

Caplan said that he was very supportive of the FDA. He has some ideas and also a new proposal about stem cell regulation that will be the topic of the 4th and last post in this series.

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