Promises and Dangers of Stem Cell Therapies | Daniel Kota | TEDxBrookings

Summary

The speaker, a Brazilian scientist, discusses the complexities and potential dangers of stem cell treatments. He explains the spectrum of stem cells, from embryonic to adult, highlighting the risks of embryonic stem cells turning into cancer. He emphasizes the benefits of mesenchymal stem cells (MSCs) that can heal without differentiating. Despite the FDA's strict regulations, unapproved stem cell treatments are proliferating, leading to cases of harm. The speaker calls for scientists to communicate more effectively about stem cells to prevent such disasters.

Takeaways

• 🌐 Stem cells are becoming more prevalent in clinics, but not all treatments are necessarily safe or effective.
• 🧬 Stem cells exist across a spectrum, from embryonic to adult stem cells, each with different capabilities and risks.
• 🚀 The differentiation potential of stem cells is high, but it also poses the greatest risk, such as turning into cancer.
• 🔬 Scientists are working to understand the conditions that guide stem cells to become useful without causing harm.
• 🧪 Adult stem cells, particularly mesenchymal stem cells (MSCs), can treat diseases without differentiating, using various molecular mechanisms.
• 🏥 The FDA has not approved many stem cell treatments, indicating that the field is still largely experimental.
• 📈 There's a surge of clinics offering unregulated stem cell treatments, which can lead to serious complications.
• 👩‍⚕️ Some stem cell treatments are being offered without proper clinical trials, posing significant risks to patients.
• 📊 Public understanding of stem cells is often influenced more by media and less by actual scientific sources.
• 🌟 Scientists have a responsibility to communicate the realities of stem cell research to the public to prevent misuse and harm.

Q & A

What is the current situation with stem cell treatments according to the speaker?

The speaker indicates that there is a critical point in the history of stem cells where a massive number of treatments are available, but their regulation is becoming overwhelming, with some treatments falling through the cracks.

What does the speaker think about the public's understanding of science, especially on social media?

The speaker believes that people tend to use science as a winning argument on social media without truly understanding it, and that the public's interest in science is often superficial.

What is the range of stem cells according to the spectrum mentioned by the speaker?

The range of stem cells includes embryonic stem cells, postnatal adult stem cells, and induced pluripotent stem cells (iPS cells).

Why does the speaker say that embryonic stem cells carry the greatest risk?

Embryonic stem cells have the greatest differentiation potential, which also means they have the highest risk of going astray and turning into cancer.

What is the role of mesenchymal stem cells (MSCs) in disease treatment as described by the speaker?

Mesenchymal stem cells can treat and improve many disease models without needing to differentiate into anything. They do this by employing various molecular mechanisms such as genetic transfer, mitochondrial transfer, and secretion of anti-inflammatory proteins and growth factors.

How do adult stem cells differ from embryonic stem cells in terms of differentiation capacity?

Adult stem cells have a limited differentiation capacity as they have already decided to become a certain type of cell or are on the path to becoming one.

What is the significance of the discovery that stem cells can be found in fat tissue?

The discovery that stem cells can be found in fat tissue opens up the possibility of combining liposuction procedures with stem cell treatments, creating a perfect environment for the resurgence of unregulated stem cell treatments.

Why does the speaker believe that the FDA has not approved many stem cell treatments?

The FDA has not approved many stem cell treatments because they are very strict about safety, and stem cells are not like drugs that can be manufactured identically; they vary and are difficult to control.

What are two horror stories shared by the speaker about unregulated stem cell treatments?

One story involves a woman who received a stem cell facelift and ended up with bone growing in her face around her eyes, requiring surgical removal. The second story is about three patients with macular degeneration who had stem cells injected into their eyes, leading to disastrous outcomes.

What does the speaker suggest as the most reliable source of information about stem cells?

The speaker suggests that scientists are the most reliable source of information about stem cells, but it's scary because people often learn about scientific discoveries through non-scientific sources like comic books and sitcoms.

What is the speaker's view on how scientists should approach public communication about stem cells?

The speaker believes that scientists should take themselves less seriously, get out of their heads, and reach out to inform people about stem cells to prevent disasters and ensure that good treatments make it to the public.

Outlines

00:00

🧬 Stem Cells: The Current State and Challenges

The speaker begins by addressing the audience as a scientist and humorously discusses the public's curiosity about stem cells. They note the difficulty in answering questions about stem cell research succinctly. The speaker then shares their personal journey from Brazil to the United States, where they have been involved in stem cell research for the past decade. They highlight the current state of stem cell treatments, emphasizing the sheer number of treatments available and the regulatory challenges faced by agencies like the FDA. The speaker explains the spectrum of stem cells, from embryonic to adult stem cells, and introduces induced pluripotent stem cells (iPS cells). They discuss the potential and risks associated with embryonic stem cells and iPS cells, like the possibility of turning into cancer if not properly controlled.

05:02

💉 Mesenchymal Stem Cells: The Multi-Tasking Heroes

The speaker delves into the discovery of mesenchymal stem cells (MSCs), which have shown promising results in treating various diseases without needing to differentiate into other cell types. They explain how these adult stem cells employ a variety of molecular mechanisms, such as genetic transfer and secretion of proteins, to modulate the body's systems towards healing. The speaker humorously compares these cells to responsible adults, contrasting them with hypothetical 'teenage stem cells' that would be less effective. They also discuss the prevalence of MSCs in various organs, including adipose tissue, and the potential for combining liposuction with stem cell treatments. The speaker raises concerns about the lack of FDA-approved stem cell treatments, except for specific bone restoration and cancer cases, and the rise of unregulated clinics offering unapproved treatments.

10:04

👁️‍🗨️ The Dangers of Unregulated Stem Cell Treatments

The speaker shares two cautionary tales of unregulated stem cell treatments gone wrong. The first involves a woman who received stem cell injections for a facelift, which resulted in the formation of bone in her face, requiring surgical removal. The second story is about three elderly patients with macular degeneration who were injected with stem cells directly into their eyes, leading to disastrous outcomes. The speaker criticizes the physician in the second case for falsely advertising the procedure as legitimate by starting an FDA clinical trial. The speaker emphasizes the importance of scientists being the most reliable source of information on stem cells and the need for better public education to prevent such tragedies. They also touch on the irony that people often learn about scientific discoveries through non-scientific sources like comic books and sitcoms, suggesting that scientists need to do a better job of communicating their findings to the public.

Keywords

💡Stem Cells

Stem cells are undifferentiated cells that have the unique ability to develop into specialized cells. They are a central theme in the video, as they hold great potential for treating various diseases and conditions. The speaker discusses different types of stem cells, such as embryonic stem cells and induced pluripotent stem cells (iPS cells), and their potential applications and risks.

💡Differentiation Potential

Differentiation potential refers to the ability of stem cells to develop into different types of cells. The video emphasizes that embryonic stem cells have the greatest differentiation potential, which is both a strength and a risk, as it can lead to the development of cancer if not properly controlled.

💡Mesenchymal Stem Cells (MSCs)

Mesenchymal Stem Cells, or MSCs, are a subset of adult stem cells that have shown promising results in treating diseases without needing to differentiate into other cell types. They achieve this by employing various molecular mechanisms to modulate the body's systems towards healing, as mentioned in the script when discussing their role in the stem cell revolution.

💡Induced Pluripotent Stem Cells (iPS Cells)

iPS cells are adult cells that have been genetically reprogrammed to behave like embryonic stem cells. They represent a significant advancement in stem cell research, as they can potentially be used to generate any type of cell needed for therapy without the ethical concerns associated with embryonic stem cells.

💡Regulatory Agencies

Regulatory agencies like the FDA in the US are responsible for ensuring the safety and efficacy of medical treatments, including stem cell therapies. The video discusses the challenges these agencies face in regulating the overwhelming number of stem cell treatments and the potential for unsafe treatments to slip through the cracks.

💡Stem Cell Treatments

Stem cell treatments involve the use of stem cells to repair or replace damaged cells or tissues. The video highlights the promise of these treatments but also the need for caution, as not all treatments have been approved by regulatory agencies and some can lead to serious complications.

💡Paradigm Shift

A paradigm shift refers to a fundamental change in approach or underlying assumptions. In the context of the video, the discovery that MSCs can treat diseases without differentiating represents a paradigm shift in stem cell research, changing the way scientists think about the potential uses of stem cells.

💡Adipose Tissue

Adipose tissue, or fat tissue, is mentioned as a source of stem cells. The video suggests that stem cell treatments could be combined with liposuction procedures to provide a readily available source of stem cells for therapy, highlighting the potential for innovative approaches to treatment.

💡Snake Oil

Snake oil, in the context of the video, refers to unproven or fraudulent medical treatments. The speaker warns about the rise of stem cell treatments being offered without proper scientific backing, likening them to snake oil and emphasizing the need for skepticism and regulation.

💡Scientific Literacy

Scientific literacy is the ability to understand and use scientific knowledge. The video argues for the importance of scientists communicating their findings to the public to prevent misunderstandings and misuse of stem cell technology, highlighting the role of scientific literacy in public health.

💡Clinical Trials

Clinical trials are research studies that involve human participants and are designed to evaluate the safety and efficacy of medical interventions. The video discusses the importance of clinical trials in assessing stem cell treatments and the need for caution when treatments have not undergone this rigorous testing process.

Highlights

Stem cells are coming to clinics but may not always be beneficial.

The public's interest in science often comes from social media discussions.

Stem cells exist within a large spectrum, from embryonic to adult stem cells.

Embryonic stem cells have the greatest differentiation potential but also the highest risk.

Adult stem cells, specifically mesenchymal stem cells (MSCs), can treat diseases without differentiating.

MSCs use molecular mechanisms like genetic transfer and secretion of proteins to promote healing.

Stem cells can be found in virtually every organ, including adipose tissue.

The FDA has not approved any stem cell treatments except for bone restoration and some cancer cases.

Stem cells are not like drugs; they can behave differently even when sourced from the same individual.

There is a resurgence of unregulated stem cell clinics offering unapproved treatments.

A woman developed bone in her face after receiving an unapproved stem cell facelift.

Patients with macular degeneration were blinded after receiving an unapproved stem cell injection into their eyes.

The public often learns about scientific discoveries through non-scientific sources like comic books and sitcoms.

Scientists need to communicate more effectively with the public about stem cell research.

Stem cells are coming, but it's crucial to ensure that safe and effective treatments are what reach the clinics.

Transcripts

I'm here to tell you that stem cells are

probably coming to a clinic near you but

that's not necessarily a good thing you

see whenever people find out I'm a

scientist do you usually ask me how's

this whole stem cell thing going and

I'll be honest with you I for the

longest time I had no idea how to answer

that question you see I'm from Brazil as

you can tell and and we and you and your

birds in Brazil when you tell people

you're scientists there's there's no

follow-up question there's only this

look on people's faces you know it's a

mixture of sorrow concerned a little bit

of disappointment you know it is really

the look of a father whose daughter just

brought a boyfriend home and it's going

of all the choices out there I mean

that's what you decided to go with and

and yes and so I stuck with science and

I was really fortunate to have the

opportunity to come to this great

country and for the past 10 years I have

immersed myself in stem-cell research

now that the but in here people are

really interested in science right but

like everything else nowadays the only

time people are really interested in

science is in social media discussions

isn't it in social media discussions

science seems to be such a winning

argument I mean if you drop a scientific

fact then you basically win the

discussion right which is basically why

we have discussions anyways I guess but

as a scientist that has always baffled

me okay because if there's one thing I

learned in science is that David premium

was right when he said the more we know

the less we know and the less we know

the more we think we know so quite

honestly what people want to know is

when can I go to the doctor get some of

it simply and it's fair and I think

there's only one way to describe the

current situation we find ourselves in

as it relates to stem cells and that is

to say we have reached a critical point

in the history of stem cells

a point that can only be described as

this what you see is a massive number of

different stem-cell treatments out there

and really the only thing between them

and us our regulatory agencies such as

the FDA in the US but the number of stem

cell treatments out there are getting so

overwhelming the some are just falling

through the cracks and the question then

is how did we get here and what does

that mean to you so the first thing we

have to understand is that stem cells

really exists within a relatively large

spectrum okay it starts with your

embryonic stem cells goes through your

postnatal adult stem cells all the way

to adult cells that we can now it

genetically reprogrammed to become

embryonic like stem cells we call those

induced pluripotent stem cells or iPS

cells now we knew from the beginning

that embryonic stem cells offer perhaps

the greatest differentiation potential

which is by the way what defines a stem

cell is a cell that can replicate and

giving the right cue it can

differentiate you to something else

hopefully something useful but we've

always known that great differentiation

potential also means the greatest risk

and it's a very simple concept to grasp

right we tell our kids I tell my kids

they can be anything they want when they

grow up

all right don't you accept the chances

of my son become a professional

basketball player probably really slim

right but I don't tell them them but we

also know that there are very specific

conditions environmental factors the

half should be present just for a kid to

become a functional contributing member

of our society and more often that we

like to admit those conditions are not

met they're not in place and a lot of

the kids end up going straight

unfortunately when it comes to embryonic

stem cells in IPS cells going astray

really means turning into cancer and

that's the last thing we wanted now as I

speak and I say in an upset a lot of

scientists by oversimplifying something

very complex there are many scientists

working precisely on deciphering those

conditions and in the future it's quite

possible that the choice between using

neck stem cell in IPS cell we would come

down to a moral choice but with that

link said I have to tell you that both

embryonic stem cells and iPS cells

represent a very small fraction of all

the stem cells out there what makes the

bulk of them are really adult stem cells

in going in we knew that adult stem

cells have limited differentiation

capacity after all they already decided

to be something or on the road to become

something but then ten years ago

something happened that can only be

described as a paradigm shift these

cells are better a subset of these cells

we call the mesenchymal stem cells or

MSC's for short we're able to treat and

improve a lot of experimental models of

disease from heart attack type 1

diabetes neurological diseases without

ever needing to differentiate into

anything and after 10 years of research

I can tell you that the way they

accomplish such features is by simply

going at it it's by simply doing

everything itself can possibly do in

fact that's why we still call them adult

stem cells because you do find them at

various ages but can you imagine if they

were teenager stem cells I mean first of

all they wouldn't like to go there

because it would be boring right and

they were gay and they would get there

and they wouldn't do anything it just

being titled that the whole disease

would just treat itself because they

were there I mean nothing will get it

right but as responsible adults

themselves they go to work and they

employ a plethora of different molecular

mechanisms things like genetic transfer

transfer of mitochondria secretion of

anti inflammatory proteins secretion of

growth factors that combine we modulate

key systems in our body

so I'm talking about your vascular

system your immune system and even other

stem cells are have in your body and

they modulate them towards healing as

simple as that

and I challenge you to think about any

disease or condition and I can guarantee

you you would benefit from either one if

not all of these interactions and that's

what's causing the stem cell revolution

we see today but that's not all

something else happened it turns out we

discovered we can find these cells

virtually in every organ in your body

including your adipose tissue your fat

tissue so what I'm telling you is that

you could have a stem-cell treatment at

the same time you have liposculpture the

future in a country like the US where

the number of lipo sculptures or lipo

aspirated procedures reaches almost

300,000 cases a year you combine it with

a relatively simple method to isolate

those stem cells then you create a

perfect environment for the resurgence

of dr. Stanley and I'm not saying dr.

Stanley had in bad intentions on this

heart in fact I think we should have

fallen this whole snake oil thing but

the fact is that in the u.s.

particularly the FDA has not yet

approved a single stem cell treatment

apart from stem cell for bone

restoration in some cancer cases all the

other stem cell treatments are not yet

approved by the FDA and their taste is

really strict actually it's the

strictest regulatory agency in the world

but I do tend to lean towards safety as

well because that's what we live really

talking about and there are hundreds of

clinical trials which are really dead

their trials studies assessing safety

and advocacy in a very limited number of

patients and I think it's it's quite

simple to understand why someone would

be concerned about those cells cells are

not drugs

I could manufacture drug here send out

to Brazil and they would manufacture the

exact same drug but I cannot guarantee

that my stem cell in your stem cells

will act and behave the same everything

else should be a little bit different

and what's worse if I can get your stem

cells I start growing them and I give

something to my colleague down the hall

a few weeks later and when we come back

and compare them they they might be

different and the last thing is

we know they do a lot of things but we

don't know quite how to control them

okay and what's really rare

dr. stainless are popping up everywhere

in the country and with them come the

horror stories and I'll share two of

them with you today first one is a

middle-aged woman woman who saw an

advertisement for facelift in stem cells

facelift in stem cells now I know a few

scientists who work with stem cells none

of which work with facelift but this

physician in particular decided was a

good idea to inject stem cells in this

patients face around her eyes and a few

weeks later she woke up and every time

she blinked she heard a click and you

could think that's cool for a second to

start freaking out and it turns out that

stem cells in her face decided to turn

into bone so she needed to have them

surgically removed and granted this

happened 10 I'm more than 10 years ago

the second story is really recent it

happened this year there were three

older patients who suffer from

degenerative disease of the eye macular

degeneration and they also saw the

advertisement for stem cells and the

physician in that case decided well

let's go step further and inject these

cells inside our eyes directly into

their eyes and few weeks later or in

life and what's worse about this case is

that the physician he had the trouble to

go to the FDA and start a clinical trial

so he could falsely advertise that his

procedures were somehow legit and so we

have really come to a point in history

in which the most reliable source of

information when it comes to stem cells

are really scientists and that's very

scary Otto ADA there was a survey done

in Florida and they in which they asked

people how do you first hear about

scientific discoveries and out of 13

different possibilities scientists

ranked number 9 which means more people

learn about science scientific

discoveries by the way done by

scientists through comic books sitcoms

and

that's how people hear about the

scientific discoveries and I think

that's largely fog of scientists

ourselves we are largely faultless

you know being from Brazil I think the

biggest difference between Americas in

Brazilians are Americans tend to think

they tend to take themselves a little

bit too seriously and I think it's

because you guys don't have enough

problems you don't right in Brazil

there's so many issues so many problems

because we and we we can't afford to

make ourselves another one we wouldn't

get out of bed but here people tend to

think ourselves a little just I'm not

saying we shouldn't take what you do

seriously because I think we do and we

must well we shouldn't take ourselves

too seriously and scientists fall from

the same disgrace and what we really

need I think is science and as

scientists we need to get out of our

heads a little bit and reach out and

inform people about stem cells because

quite frankly a simple message could

have prevented those disasters and a

simple message will most likely prevent

future ones because stem cells are

coming we just have to make sure the

good ones make it thank

you