I recently conducted an interview with Dr. Joanne Kurtzberg of Duke. You can see Part 1 of the interview here.
Today in Part 2, I asked Dr. Kurtzberg some broader questions about the stem cell field.
1. How concerned are you about non-compliant stem cell interventions here in the US as well as stem cell tourism? Perhaps because of my blog, I get contacted by parents of pediatric patients lately at least once a week about possible stem cell treatments for CP, autism, and other diseases. They generally are not asking about clinical trials, but rather expensive, dubious treatments abroad. What can we do about this situation?
I share your concern. I think the biggest risks associated with these therapies are infection, tumors, and immune mediated reactions, particularly when cells are delivered directly into the brain or spinal fluid. The financial risks are high too. Desperate families are not likely to respond to someone saying the treatment is not promising. As an alternative, I take the approach of educating parents who approach me with similar questions about the questions they should ask about these therapies. These questions include:
- 1. What kind of cells are being used in this therapy?
- 2. Where do the cells come from?
- 3. How are they tested for the risks of transmitting infectious and genetic diseases? Specifically are they tested for HIV and hepatitis?
- 4. How are the cells prepared/manufactured?
- 5. How many patients have been treated with these cells?
- 6. How have these patients done? What kind of follow-up is practiced/required?
- 7. Are there any toxicity/adverse reactions associated with the therapy?
2. On the positive side, what excites you the most about the stem cell field today?
I think the stem cell field has enormous potential particularly in the emerging fields of cellular therapies and regenerative medicine. I think that development of this field will take 10-20 years and that it will take this long to see stem cells used in routine medical care. I think it will be necessary to develop third party, ‘off the shelf’ products to fully realize the potential of cellular therapies.
3. Where do you think the field will be in 5 years? 10 years?
In 5 years, I think we will be conducting early phase trials in some disease at the proof of concept stage. I also think we’ll see major advances in immunotherapies, e.g. tumor and antiviral vaccines, cells to enhance immune reconstitution. In 10 years I think we’ll have evidence from these trials to justify further development of specific cell therapies for specific diseases. My best guess is that we’ll first see cells used to treat patients with stroke, ischemic heart disease, newborn and fetal brain injury and traumatic brain injury.