Weekly reads: stem cells to gametes, no PRP benefit, WHO CRISPR, pubs

The paper of the week is from Science on making ovarian follicles and actual eggs from stem cells. It’s just in mice, but this line of work tends to stir people up. We’ll dive into that in a moment.

eggs from stem cells
Making eggs from stem cells in mice. “Reconstitution of follicle structures, including oocytes, entirely from mouse pluripotent stem cells. Illustrations on the left show a schematic overview of reconstitution of both FOSLCs and PGCLCs from mESCs. Oocytes in the reconstituted environment gave rise to offspring after fertilization. The right image represents fully grown cumulus-oocyte complexes derived from FOSLCs (red) and PGCLCs (blue).” Yoshino, et al. Science 2021, screenshot of part of FIg. 1.

But first some good news.

We’re up to 146 subscribers on our stem cell YouTube channel so I’m issuing a call to please subscribe toward our next goal of having 250 subscribers. Below is my latest video on an overview of the idea of stem cell therapy for Alzheimer’s disease.

The point of this YouTube channel is educational outreach. You might be surprised (or maybe not) at the vast sea of cruddy stem cell video content on YouTube. A big fraction of it is promotional for stem cell clinics. We need to change that reality. Even though Google has banned stem cell ads from its search results, YouTube (which is owned by Google) hosts a huge array of basically free stem cell ads as videos for clinics. It’s pretty awful.

Now onto our weekly reads. As always, there’s been a lot going on in the regenerative medicine and stem cell space in the past week or so.

Stem cell produced gametes

This area of research is not quite as new anymore, but it never seems to stop shocking some folks. What’s so unsettling? The idea that human reproduction might be successfully completed entirely using stem cells instead of the old fashioned way. The new paper is entitled, “Generation of ovarian follicles from mouse pluripotent stem cells.”

This kind of thing has been done before, but what seems unique this time is that all the components came from mouse ES cells.

Could it work in humans? What would be the ethical and societal implications? Proponents point toward possible fertility treatments, but I see more risk than possible benefit here. For one thing, if applied with a reproductive intent in humans, it would ease the use of heritable CRISPR gene editing, including some that might be misguided. Imagine the next He Jiankui, but he doesn’t need an IVF clinic or to allegedly forge approval documents for that. He just makes human embryos with stem cells. Yikes.

More reads on stem cells & regenerative medicine

7 thoughts on “Weekly reads: stem cells to gametes, no PRP benefit, WHO CRISPR, pubs”

  1. Paul, thank you for sharing the study on PRP.

    While any study may have shortcomings, there probably have been no better placebo-controlled double-blinded studies on PRP for Achilles tendonitis than this one. I guess there is a reason why PRP is generally not covered by insurance policies. It has not been adequately proven to provide benefit.

    This reminds me of a randomized, double blinded, placebo controlled meniscus surgery study of a few years ago that showed meniscus surgery to have no benefit over sham surgery. Here is ta link… https://pubmed.ncbi.nlm.nih.gov/28522452/

    If I hadn’t seen that study I probably would have decided to get that procedure done about 7 years ago when my knees were problematic. My knees are feeling pretty good right now and I’m in my early sixties, still playing basketball and tennis. I hope they stay that way but I’d bet
    I’d would be worse off if I had the surgery due to a greater risk of osteoarthritis, a condition I already had that could now be worse due to the removal of part of the meniscus.

    Keep posting useful information. Those who disagree have the opportunity to call you out on it. I know I have disagreed with some things you have written but I don’t mind a healthy debate.

  2. Paul,
    I do see and understand your purpose here to be a listing of articles.
    I do think you are in a unique position as an influencer to do great good here as we all try to find where these biologic therapies are clinically useful. You have absolutely hit the nail on the head with the problem with PRP definition and quantification. Again, I appreciate what you and Leigh T. have done to separate the most notorious bad actors out….it is getting harder to tell. With a little enforcement help from the FDA that will get easier. The recently formed Biologic Association, of which IOF is a member society, was formed by the largest orthopedic surgery groups in the country because these therapies have a place in orthopedics that will continue to grow. The Biologic Association is doing the clinical groundwork to make sure the patients we all care for can benefit in an evidence based way …hearing that evidence from respected clinical and basic science researchers with a vested interest in patient health and not personal gain. Best wishes!

  3. Totally agree with Dr. Buford. It is your responsibility as a “scientist” with a public forum to properly vet these seemly “high-level” of evidence articles.

  4. Dear Paul Knoepfler, PhD,
    I read your recent blog post supporting the opinion that PRP is of no benefit for achilles tendinopathy. While I realize that you do not treat orthopedic patients and that you are simply culling information from article titles and abstracts and in this case from another website….I still feel that there should be some professional responsibility when posting medical information on social media/blogs that may lead someone to seek care that is inappropriate or to not seek care that could help them. The article was published in JAMA by some PhD researchers in England who actually did not inject what we would commonly call PRP in orthopedics. They drew 9cc of blood and injected 3 cc of plasma that was not quantified or identified as PRP by any readily available hematology analyzer. In other words, they drew very little blood and did not run their product thru a machine that would have told them exactly what their PRP was…including the dose of platelets. For clinical papers that do not quantify the PRP, journals should not publish the article without significant bias disclaimers from the authors. As if that were not enough, the authors in this paper did not use any guidance at all to place the PRP into the tendinopathic region of the achilles. With this paper, we have a study with a nonstandard, unknown drug placed in an unknown location. The paper should be retracted or as most of us in this orthobiologic field are doing…simply discarded as not useful information. The problem is that JAMA, Medical Express, and now your blog have all presented this as a legitimate study with a legitimate conclusion….it is not. I can only hope that patients with achilles tendinopathy do find an experienced clinician who can give them all of their evidence based treatment options, which most certainly include PRP when done appropriately.
    I appreciate most of your efforts to educate the public and feel that in this case….there is some significant clarification necessary.
    Thanks
    Don Buford, MD, FAAOS, RMSK
    President, Interventional Orthobiologics Foundation.

    1. @Don,
      These Sunday posts are often lists of articles that I think people would find interesting. They are not reviews.
      I value your input on this and will try to find time to read that article and potentially update my short blurb on it. One would hope that JAMA would be very thorough in their reviews of such pieces, but apparently not always.

      It seems part of the challenge in the PRP arena more generally is that with hundreds of practitioners using “PRP”, likely made in dozens of ways, there are just too many definitions of PRP. In my brief review of the literature out there last year & earlier this year it was very difficult to wade through dozens of articles, often seeming to contradict each other, even including meta analyses.
      Paul

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