Stem Cell Cures: Hype vs. Reality
I was watching a reality TV show with my wife the other night and a woman with severe Lyme disease said that she had undergone a stem cell treatment! I couldn’t come up with a mechanism for why that would work, but knowing the outfit that offered the treatment, I wasn’t surprised that they were preying on these patients. Then this cool graph appeared on Twitter which instantly quantified my angst about stem cells and the perception that they can potentially cure everything.
How All of the Hype Around Stem Cell Cures Began
First, any new technology that has big promise generates hype. While much of the scientific community doesn’t like physicians using stem cells to treat patients at this point in “history”, they’re the ones responsible for the initial hype. In hopes of increasing funding for embryonic stem cell research, they launched an expensive and carefully crafted campaign to build public interest. This lead to the “peak of inflated expectations” that we find ourselves in right now, which allows clinics like the one above to offer treatments that make little common sense.
The bacterial spirochete that causes chronic Lyme disease is likely also in the stem cells from this patient’s fat, so giving an IV fat stem cell treatment back to the patient only serves to further spread the bacteria to far flung areas. So whatever small anti-inflammatory effect the IV stem cells may garner, it is likely to be cancelled out by making the disease worse! And as of today’s date, not a single publication exists in the US National library of Medicine on this topic.
We’re still near the top of that peak of inflated expectations with hundreds of doctors a month being poorly trained in weekend courses on how to give patients basic stem cell treatments. These doctors really have no idea how stem cells work or how to correctly use them to maximize outcome and they know even less of what they’re capable of, other than treating them like magic pixie dust. So before we hit the “Trough of Disillusionment”, expect to see physicians selling stem cell treatments for just about every known human disease, regardless of whether it makes sense.
Reality Will Set In
About 3-5 years from now, we will hit that trough and hopefully this will be physician driven. Good doctors will wake up like a new years eve hangover and say, “What the heck was I thinking?”. Hopefully for their sake, it will be more like, “What happens in Vegas stays in Vegas” than the opposite. Stem cells will lose their luster as reputable physicians will have seen that they don’t cure everything. Then the tough work will begin of figuring out where stem cells really excel, where they’re useful, and what, like that morning after, was poor judgement.
After those several years, will come the “Plateau of Productivity”, where physician use of stem cells will pick up again, with a refocused and realistic effort to use these cells for what they can help and to maximize their effects. This will be the “Golden Age”, where a combination of autologous stem cells, mass produced products, and other new biologics will allow some really startling advancements to occur.
All of this Has Happened Before…
How can I predict it will all happen this way? I’ve lived it. When we first began using stem cells to treat orthopedic conditions a decade ago, we treated them like magic pixie dust as well, thinking they could cure everything. After a few years, reality set in. For a few treatments we went back to the drawing board to successfully re-engineer them, while for others we had to realize the limitations of the technology. Finally, a few years ago, we got to that “Plateau of Productivity” where we understood that the next phase would be all about maximizing the effects of treatments. As an example, this lead to our knee micro environment study where we’re looking at 25 growth factors and cytokines in the joint to predict which type of environments promote or hamper stem cell growth. At the same time, doctors just beginning to use stem cells are still treating them like magic fairy dust.
The upshot? At the end of the day, it’s painful to see things like a woman with Lyme disease being scammed. It’s also painful to see physicians advertising that they can cure any number of diseases that stem cells will likely never be able to tackle. Having said that, it’s also a bit interesting personally to go from pioneer and the only doctor in the U.S. doing this type of work on the bleeding edge, to the guy who is the experienced voice of reason!