Can others benefit as Gordie Howe did?

When hockey great Gordie Howe had a stroke in 2014, he was flown to Mexico for stem cell therapy. His family reported impressive results in his speech, mobility and vigor.

A stroke as a condition where the brain is temporarily deprived of oxygen. The nerve cells become impaired, leading to weakness, speech disturbance and even coma.

This is obviously a devastating condition — and it is not practical for the typical patient from the United States to travel to Mexico or some other country where stem cells are more widely available.

You may have heard about the controversy regarding embryonic stem cells, and of course they are not even available nor legal in the United States. But what about other sources of stem cells?

Our own bone marrow is a rich source of stem cells, and in the past several years we’ve discovered that our fat tissue is even better by a factor of 500.

There hasn’t been a lot of research in humans with stem cells from bone marrow or fat for the treatment of stroke. But studies done on animals look promising.

An inherent issue is the difficulty of harvesting these stem cells from a stroke patient. It can be difficult, and very dangerous, to sedate a person who’s had a stroke to get the stem cells out through bone marrow or liposuction.

There are certainly many government regulations to overcome when using stem cells – and the government cannot regulate progress in medicine.

Another source of stem cells is the umbilical cord blood which, unlike embryonic stem cells, serves no other purpose. It will never develop into a baby so lacks the significant controversy that surrounds embryonic stem cells.

There are many other advantages to umbilical stem cells: they are taken out of a blood bank and are available immediately; they are much younger than other forms of stem cells; and they are more pluripotent, meaning they have more potential to transform into other cells that need help. Furthermore, transplanting stem cells from the umbilical cord to another person seems to be widely tolerated with very little tissue reactivity.

In a study published July 30, 2016 out of China, researchers at the First Hospital of Hebei Medical University evaluated the use of umbilical cord stem cells in 22 patients who had had a brain stroke.

Of the 22, half received a placebo and the other half was given umbilical stem cells intravenously.

Researchers used the National Institutes of Health Stroke Scale (NIHSS), which goes from 0 (no stroke symptoms), 1 to 4 (minor stroke), 5 to 15 (moderate stroke), and 16-42 (more severe stroke).

The average stroke scale prior to treatment was about 14 (moderate) of the 22 patients. Over six months, the individuals treated with stem cells went down to a stroke scale of 3, while those treated with placebo went down to about 7.

In other words, the individuals treated with a single dose of stem cells went from a moderate to a minor stroke score. Those treated with a placebo went from a moderate to a moderate.

Researchers also used other measurements such as a mini mental state examination, emotional rating scores and other tests of depression and emotional suffering. In all cases, there were improvements in the patients treated with umbilical cord stem cells versus those who received a placebo.

Although this is pretty much the first-of-its-kind study, it gives us some promising information. First, it demonstrated that there were no adverse events in the patients with moderate strokes when treated with umbilical cord stem cells. It also showed us that umbilical cord stem cells, even as a single treatment, substantially improve long-term recovery.

We use stem cells for various conditions. Most common is the treatment of arthritis in patients who have deformed joints (most often the knee followed by the hip and shoulder) but do not want to undergo surgery.

Other conditions treated with stem cells include multiple sclerosis and other autoimmune diseases, emphysema and asthma, heart failure and kidney failure. While the results are not entirely consistent, there’s a very clear trend showing that the majority of patients receive notable benefits that improve their quality of life.

The more minor conditions such as arthritis show the most dramatic benefit.

Individuals with the most serious conditions have more subtle benefits – so this Chinese study is very promising news indeed.

“Mr. Hockey” died in June 2016 at age 88 but his legacy lives on with “The Gordie Howe Initiative,” research that is studying the effectiveness of mesenchymal stem cells derived from bone marrow donated by a healthy adult volunteer.

Stay tuned!

Dr. Charles Mok

(Source: American Journal of Translational Research, 2016;8(7):3241-3250)