Thursday, August 14, 2008

Big Pharma Should be Very Concerned...WBC's from the Patient Could Cure Serious Disease

Recent research on autologous WBC's has been nothing less than miraculous Two new articles are important.

The first potential break through is in cancer research. A researcher at Wake Forest is convinced that cancer is caused by white blood cell suppression. In other words, our WBC's fail to do their job of picking off the cancer cells that brew in our bodies every day. However, this researcher believes that by taking healthy WBC's from donors he can cure cancer (at least in mice). This has so upset the traditional oncologic research community that he has been unable to get grants for his work. As a result, he is asking patients to self-fund the first human trial.

The major development other involves rheumatoid arthritis. In this treatment, researchers from the U.K. take white blood cells, reprogram them using a chemical cocktail, then inject them into joints with rheumatoid arthritis. This has been effective in animals in curing the disease and early human trials are beginning now.

What's the upshot? If you can take someones cells and miniammly modify them or provide healthy cells from a donor and cure these horrible diseases, the big pharma business plan will be in disarray. Basically, these are blood banking or minimal culture treatments that combined, would eliminate hundreds of billions in cancer and RA treatment.

All this brings us back to an age of autologous biologics where the idea of using drugs and pharmaceutical cocktails to achieve results may be changed forever, or at least the playing field altered. Already we are seeing biologic approaches such as platelet rich plasma that are gaining popularity among interventional pain physicians and those who treat acute and sub acute sports injuries. In addition, autologous stem cell approaches are allowing the treatment of chronic joint diseases. All of this points in a direction where the future will have a myriad of hybrid treatment approaches. In the end, we may all be using bits and pieces of ourselves as therapy.

Monday, August 11, 2008

A recent investigation into how mechanical loading can turn MSC's toward bone even if they are given chemical signals to become fat, has broad implications for exercise programs. While we fret about calories or eating too much fat, their study suggests that MSC's can become fat cells simply by lack of physical activity. Clinically, we likely see this in many AVN patients who may have part of their disease pathogenesis in their low activity lifestyle. I've always thought that in many of these patients their MSC's would prefer to become fat over bone (hence the lesion-where weak fatty marrow tissue replaces strong bone). This would also have big implications for a host of disease states that are likely activity related and involve poor bone formation such as osteoporosis. We've all known for sometime that being more active is good for our health and our bones, but this new research helps us understand that at the earliest stages of adult stem cell development, activity gives our cells clues to either strengthen our bodies or make them weaker. For example, most animal studies of orthopedic healing would suggest that even in bone or cartilage injuries, more activity promotes better repair. While this can be a two edged sword (too much activity on an injured part can cause it to fail while not enough will reduce the strength of the repair), many cell based treatments now recognize that promoting activity as quickly after the procedure is key to a good recovery. In other words, keeping an animal off a cartilage lesion "to let it heal", in general promotes new cartilage that is not as strong or chemically complete as when an animal is allowed to do what it wants (meaning some limping while it hurts and then full activity when it feels able).

The take home message? We Americans have gotten used to low activity levels that not only promote obesity by reducing our caloric burn, but also increase the tendency of our stem cells to turn into fat when they should be bone (and likely muscle, cartilage, tendon, ligament, etc... )