Traumatic brain injury (TBI) encompasses a wide range of injuries, neurological problems, and outcomes. On one end of the spectrum is a concussion, which can be mild and short lasting. At the other end of the spectrum, traumatic brain injury can be lethal or leave patients with chronic mental and physical problems. Despite this range of severities, traumatic brain injury is one of the leading causes of disability in the United States, affecting over 13 million people. People who suffer from chronic symptoms related to traumatic brain injury may struggle with chronic seizures, memory problems, concentration problems, agitation, among others. TBI can have profoundly worsened a person’s quality of life and overall well-being.
Unfortunately, little can be done to treat traumatic brain injury directly. Aside from treating symptoms, the main treatment for TBI is to have the patient to rest and avoid stimulation in an effort to give the brain time to heal. Patients can regain some function through intensive work with physical, occupational, speech, and recreational therapist. However, the brain’s ability to heal itself is limited compared to other tissues of the body. In short, the brain has very little capacity to make new brain cells after we are born. So once TBI has occurred, patients either need to depend on other healthy areas of the brain or simply adapt to their circumstances.
Fortunately, researchers are finding ways to improve on nature through hyperbaric oxygen therapy. Drs. Shandley, Wolf and other hyperbaric medicine researchers recruited a group of 28 military veterans who sustained a traumatic brain injury in Iraq or Afghanistan. These individuals had ongoing cognitive problems as a result of their brain injuries. Researchers placed some study participants in 2.4 atm avoid hundred percent oxygen, while the others simply underwent a placebo experience at basically normal pressure and oxygen levels. The two groups underwent 30 exposures each and took a cognitive test before and after these treatments.
Hyperbaric oxygen therapy increased the number of stem cells in the blood of patients with TBI. In other words, hyperbaric oxygen treatment was able to move stem cells from the bone marrow and perhaps other tissues into the bloodstream. At the same time, those treated with hyperbaric oxygen performed better on tests of cognition including ImPACT, BrainCheckers, and PCL-M test. Moreover, no adverse effects of treatment were observed. Taken together, these results suggest 30 sessions of hyperbaric oxygen treatment at 2.4 atm was able to increase stem cells in the blood and improve cognition in US warfighters who suffered traumatic brain injury during combat. These results are encouraging news for the millions of veterans and nonveterans who sustained a traumatic brain injury every year.
Reference: Shandley, S. et al. (2017). Increased circulating stem cells and better cognitive performance in traumatic brain injury subjects following hyperbaric oxygen therapy. Undersea & Hyperbaric Medical Society. 2017 May-Jun;44(3):257-269.
Duchenne muscular dystrophy is a degenerative condition that is hereditary caused by mutations to a gene called dystrophin. The condition affects both skeletal and cardiac muscles, impairing physical mobility and leading to weakened heart and respiratory functioning. Current treatments for Duchenne muscular dystrophy aim to control the symptoms of the condition and enhance the quality of life, but there is no known cure.
Given the need for effective therapies in Duchenne muscular dystrophy and the success of stem cells in treating other degenerative conditions, research has begun to focus on how cell therapies may be able to help Duchenne muscular dystrophy patients. Mesenchymal stem cells have been considered as an approach to this form of therapy.
Much of the research to date has emphasized autologous sources of stem cells that come from the patient themselves – such as from bone marrow or adipose tissues. However, a recent study, published in Biomaterials, investigated the impact of allogeneic mesenchymal stem cells – which comes from someone other than the patient – on Duchenne muscular dystrophy. Specifically, the researchers looked at the therapeutic effects of placenta-derived mesenchymal stem cells.
The scientists found that using placenta-derived mesenchymal stem cells may be able to reduce the amount of scarring and thickening of the connective tissue of the cardiac muscles and diaphragm in Duchenne muscular dystrophy while also minimizing inflammation. These promising findings demonstrate the potential to use stem cells to reverse the pathology of Duchenne muscular dystrophy and not just to address the symptoms. Future research will help to determine if regenerative therapy could have a meaningful impact on the course of this condition.
Reference: Bier et al. 2018. Placenta-derived mesenchymal stromal cells and their exosomes exert therapeutic effects in Duchenne muscular dystrophy. Biomaterials, 174, 67-78.
Four out of five people with multiple sclerosis experience muscle spasticity. Muscle spasticity causes increased muscle tone, uncontrollable muscle contractions, and spasms. Like severe muscle cramps, muscle spasticity can be quite painful and is one of the most troubling symptoms of multiple sclerosis. Despite being so common and so troublesome, multiple sclerosis patients with muscle spasticity have few effective treatments options. In many cases, the muscle spasticity continues even after treatment with drugs such as baclofen or tizanidine. Not only are these drugs largely ineffective, in many cases they cause substantial side effects.
Marijuana has long been known to exert a muscle relaxing (anti-spasmodic) effect. As medical marijuana is becoming legal in more jurisdictions, researchers are now carefully studying the effects of the substances within marijuana. One important example is a study conducted by Spanish researchers. In 2010, Spanish drug authorities approved the use of an oral spray that contains a combination of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), two active substances found in marijuana (Cannabis sativa). Spanish authorities approved the use of this drug for multiple sclerosis patients with moderate to severe muscle spasticity who did not benefit from other antispasmodic drugs.
Dr. Lorente Fernández and other Spanish researchers were interested in learning whether this combination of THC and CBD was able to help multiple sclerosis patients with severe muscle spasticity. The scientists found that the combination of substances found in medical marijuana was effective in 80% of patients they examined. What is striking about this finding is that every patient included in this study had failed to find relief from other medical treatments of spasticity. In other words, they had difficulty in treating muscle spasticity. When viewed in those terms, an 80% effectiveness rate is extremely impressive.
Some patients withdrew from treatment because they felt that THC/CBD did not help them within the first 30 days of starting treatment or some experienced dizziness or weakness.
Muscle spasticity is one of the most common, most troubling, and most difficult to treat symptoms of multiple sclerosis. While traditional medical treatments often fail, the substances in medical marijuana may offer hope. This study illustrates that 4 out of 5 multiple sclerosis patients with difficult to treat muscle spasticity achieved relief from a combination of THC and CBD, substances found in medical marijuana.
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Reference: Lorente Fernández et al. (2014). Clinical experiences with cannabinoids in spasticity management in multiple sclerosis. Neurologia. 2014 Jun;29(5):257-60.
Alzheimer’s disease is the most common form of dementia, and though its prevalence is growing, there are currently no medical interventions that are able to reverse or slow the disease. Most current therapies address the symptoms of Alzheimer’s disease rather than the underlying cause of the disease.
Stem cells appear to offer a promising opportunity for treating Alzheimer’s disease and other neurodegenerative disorders, and a recent review published in Current Alzheimer Research has covered research into the ways stem cells can be applied to these disorders. Specifically, the authors of the review discuss the stem cell sources that may offer the potential to treat neurodegenerative diseases and the mechanisms by which these stem cells may confer benefits to this set of patients.
According to data collected so far, stem cells may be both safe and effective in treating neurodegenerative disorders like Alzheimer’s disease, but the mechanism by which they produce benefits for those with these disorders is not entirely clear. There are some data that show that the replacement of degenerated tissue with new proliferative stem cells accounts for stem cell benefits in models of neurodegenerative disorders, while other data show that stem cells can lead to advantageous enhancements in the expression of synaptic proteins.
Evidence from other studies, however, suggest that stem cells help with neurodegenerative disease through the release of neurotrophic factors that lead to paracrine benefits. Additional studies point to modulation of the immune system as the way that stem cells may help those with neurodegenerative disorders.
Future research will help to elucidate the specific mechanisms by which stem cells can provide effective therapy for people with neurodegenerative disorders. It may be the case that a variety of stem cell types used in multiple ways can be helpful for neurodegenerative disease therapy, and research will help to delineate the different ways stem cells can be used and inform the therapies that are developed.
Reference: Bali, P, et al. (2017). Potential for stem cells therapy in Alzheimer’s disease: Do neurotrophic factors play a critical role? Current Alzheimer Research, 14(2), 208-220.
Alzheimer’s disease causes patients to have difficulty recalling memories and performing tasks. Alzheimer’s disease is progressive, which means it gets worse over time. Once Alzheimer’s disease begins, patients either stay the same or get worse. Most people notice symptoms getting worse over a period of 10 years. However, some people with Alzheimer’s disease will get worse very rapidly, over the course of a few years.
Because Alzheimer’s disease is discussed frequently in popular media, many people know that part of the disease process is the accumulation of abnormal proteins in the brain, namely beta-amyloid plaques and tau neurofibrillary tangles. One less well-known effect of Alzheimer’s disease is that it interferes with blood flow in the brain. This decreased blood flow is so common, in fact, that doctors can detect low brain activity using positron emission tomography (PET), which can help make the diagnosis of Alzheimer’s disease.
Between 2002 and 2012, researchers tested 244 treatments for Alzheimer’s disease, and only one medication was approved by the FDA. After all this time, there is still no cure for Alzheimer’s disease. In fact, the drugs used to treat Alzheimer’s disease are mostly ineffective. At best, they slow the progression of the disease for several months to a few years.
This lack of success has prompted several research groups to focus on other treatments for Alzheimer’s disease. One experimental treatment for Alzheimer’s disease is hyperbaric oxygen therapy. In hyperbaric oxygen therapy, patients rest in a specialized chamber while they experience oxygen at a slightly higher pressure than they would in the outside world.
Researchers wanted to determine whether hyperbaric oxygen therapy could improve the symptoms of Alzheimer’s disease, but also whether they could see those brain changes using PET. To do this, Drs. Harch and Fogarty enrolled a woman with rapidly deteriorating Alzheimer’s disease in their clinical study. She was exhibiting the characteristic signs of Alzheimer’s disease and reduced brain activity and blood flow in her brain. They treated her with a series of hyperbaric oxygen therapy treatments (1.15 atmospheres, 40 minutes, 5 days per week over 66 days).
After 21 treatments, the woman had increased energy, her mood was better, she was better able to perform activities of daily living, and she was actually performing crossword puzzles. After 40 hyperbaric oxygen treatments, she had better memory and concentration, she was sleeping better, her appetite had improved, she was able to hold conversations and able to use a computer.
Interestingly, when the researchers performed follow-up PET study after hyperbaric oxygen therapy, blood flow and brain activity improved as much as 38% compared to the PET study before treatment.
Additional clinical studies with larger groups of Alzheimer’s disease patients are needed to determine how effective hyperbaric oxygen therapy is, what pressure to use, and how many treatments are needed, etc. Nonetheless, the impressive changes reported in this case study are promising, and should spark additional clinical research.
Contact a Stemedix Care Coordinator for more information on Regenerative Medince Therapy combined with Hyperbaric Oxygen Therapy (HBOT) for Alzheimer’s Disease.
Reference: Harch et al. (2019). Hyperbaric oxygen therapy for Alzheimer’s dementia with positron emission tomography imaging: a case report. Medical Gas Research. 2019 Jan 9;8(4):181-184.
Much of the initial excitement surrounding stem cells was that they have the potential to become other types of cells. Add cardiac stem cells to a heart damaged by a heart attack, for example, and perhaps those stem cells will become new heart cells and restore heart function. While this does occur—stem cells differentiated mature into adult cells—a fascinating and potentially more exciting use of stem cells is for what they secrete rather than what they become.
Over the past few years, researchers have become increasingly interested in the beneficial substances that stem cells secrete. Researchers refer to the collection of substances that stem cell secretes as its secretome. Stem cell researchers grow various kinds of stem cells in the laboratory and then measure the substances that the stem cells secrete to identify its secretome.
Dr. Hsieh and coauthors discovered that stem cells taken from human umbilical cord secrete an astounding number of helpful molecules. The scientists collected mesenchymal stem cells from Wharton’s jelly (which is a substance found in the human umbilical cord that is normally thrown away as medical waste). They then compared those mesenchymal stem cells with stem cells taken from bone marrow. The researchers found that the umbilical cord mesenchymal stem cells produced molecules that help protect nerve cells, helps nerve cells grow, and help blood vessels grow. The effects were much greater than from cells taken from bone marrow.
One interesting result from their scientific study was the effect of umbilical cord mesenchymal stem cells on injured nerve cells. The researchers deprived brain cells of sugar and oxygen to mimic what the cells would experience during a stroke. The substances secreted by stem cells protected the nerve cells during this harsh treatment. This effect was much stronger in the umbilical cord stem cells compared to the bone marrow stem cells.
Another interesting result from this research was that umbilical cord mesenchymal stem cells helped blood vessel cells organize and form new blood vessels (“tubes”). This could be very important for establishing blood flow to damaged tissue from burns, frostbite, heart attack, or stroke.
These results show that mesenchymal stem cells taken from umbilical cord tissue (Wharton’s jelly) have a unique secretome, which is more potent than similar cells taken from bone marrow. This research is particularly important for patients who have suffered an ischemic stroke or heart attack, as it may provide a clue for a way to treat these conditions in the future.
Reference: Hsieh et al. (2013). Mesenchymal Stem Cells from Human Umbilical Cord Express Preferentially Secreted Factors Related to Neuroprotection, Neurogenesis, and Angiogenesis. PLOS One.2013; 8(8): e72604.