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Your Friday Dose of Woo: There’s no woo like stem cell woo

It’s time for a change of pace on Your Friday Dose of Woo.

I’m getting the feeling that you my readers may have gotten tired of the theme I’ve been doing the last three weeks. I can relate somewhat but I think it served a purpose (other than giving me free rein to indulge in a lot of bathroom humor, that is). First, I subjected you to a rather disgusting foray into the bowels (if you’ll excuse the term) of colon cleansing, complete with links to some truly disgusting websites where people not only enthusiastically discuss their poop, but take pictures and post them on the web. Next, I moved on to “liver cleanses,” complete with somewhat less disgusting pictures but with a fine lesson about how it is probably the liver flushes themselves that cause the various “stones” that come out in the feces. Finally, I discussed the altie obsession with “cleansing” toxins out of the blood, primarily using chelation, but also by other means. Of course, I’ve blogged extensively about chelation therapy before, both here and in my old blog, mainly because of its role in autism quackery and the death of a five year old boy. I thought about continuing the theme (after all, there’s still the lymphatic system to be cleansed, but decided against it.

That’s because there’s one form of woo that’s perhaps more annoying and more seductive than any other form, and that’s woo that masquerades as actual science. And what promising scientific breakthrough seems to promise the most new therapies and new cures for a variety of human diseases? I think you know the answer. Certainly Shelley does.

Yes, I’m talking about stem cell therapy. There’s definitely no woo like stem cell woo.

And, as the article referenced in Retrospectacle points out, stem cell woo has become big business in other countries with–shall we say?–more lax attitudes towards medical research and whether the therapies they are using actually do what is claimed for them, coupled with an equally lax attitude towards abortion, countries like Russia, the Dominican Republic, and Barbados. One of the favorite topics of altie woo happens to be “regeneration” and “antiaging.” Yes, it’s not just the woos who are looking to cheat time, but they come up with such bizarre “antiaging” therapies to do it. It should not be surprising that in many dubious clinics stem cells have devolved from promising science into woo. They’re in the news. They’re controversial. They’re a hot area of research, with several states, including California and New Jersey, vying to become national or even world centers for research and South Korea making a name for itself as a stem cell-friendly venue for biotech. In theory at least, stem cells do have great potential to treat a variety of diseases, such as Parkinson’s disease, cancer, and a wide variety of degenerative diseases. In the more far-out scenarios, if the totipotential nature of embryonic stem cells can be mastered, they could even be used to generate replacement organs for use in organ failure without the need for transplant and the attendant risk of rejection and need for lifelong immunosuppressive therapy. And, yes, perhaps they may even have utility in letting us indulge our vanity and ward off the effects of aging. Given this hype and the known potential regenerative potential of stem cells, it’s not surprising that stem cells have rapidly found a happy and prominent place in the armamentarium of antiaging woo, regardless of the fact that, for most applications, there is no evidence that stem cells do what they claim and no assurance that what is being injected is even really composed of actual stem cells. That is the woo, as are the claims for near miraculous results by dubious clinics offering what they claim to be stem cell therapy.

But, Orac, you say. Isn’t woo usually composed of magical thinking base on no evidence? Didn’t you yourself even say so? Well, yes, I did. The fact that someday stem cells may provide treatments for diseases for which we currrently don’t have particularly good treatments does not mean that their use by these dubious clinics today does not come constitute woo. If you don’t believe me, get a load of this magical thinking:

Although she is just 32, with skin like eggshell and a waterfall of ice-blond hair, Antonina Babosiuk recently found herself noticing certain changes: a roughening of the skin on her face, for instance, and a waning of her ability to shake off jet lag. As vice president of an international jewelry company, Babosiuk follows a brisk schedule, logging regular flights to Hong Kong to buy pearls and to Kyrgyzstan, where she inspects rings and bracelets produced at the company’s 400-person factory. Fearing that the long days were taking their toll on her appearance, Babosiuk secured an appointment at Beauty Plaza, a high-end Moscow spa, where she received an injection of stem cells that had been extracted from her own fat and multiplied in a petri dish. The treatment, which cost her roughly $20,000, has become increasingly popular among wealthy Muscovites as a kind of cure-all – one with a reputation for boosting energy and generally restoring the youthful vibrance lost with age. There have also been scattered reports of remarkable effects, from a superhuman ability to go without sleep to white hair that abruptly returns to its original black.

Woo.

Babosiuk experienced nothing so dramatic, but one or two months after her visit to Beauty Plaza, she noticed that her hair was more lustrous and that her skin had become softer. “It looks more fresh,” she explains. She was so satisfied that she persuaded her husband, a 42-year-old Russian businessman, to have the injections as well. “Stem cells are like vitamins,” Babosiuk says cheerfully. “That’s why I come in here. If I don’t make something for my health, I will look 40 tomorrow.”

Although the benefits of Beauty Plaza’s injections are still hearsay, the idea that stem cells could serve as a wonder drug for aging faces is spreading, driven by a combination of new research and a growing demand for nonsurgical alternatives to the traditional face-lift.

Can you say confirmation bias? Sure, I knew you could. Of course the “benefits” of Beauty Plaza are hearsay, probably because they are nonexistent. And paying $20,000 a pop for these injections is strong motivation to look for any sign that reinforces one’s belief that the treatment is working. After all, one wouldn’t want to be forced to admit one is paying so much money for a worthless treatment that probably doesn’t even contain any actual adult stem cells, would one? (I’m also sure that her “fresher” skin and “more lustrous” hair have nothing at all to do with any of the other beauty treatments she is no doubt getting from the Beauty Plaza.) Besides, stem cells are not easy to isolate, purify, and expand. To successfully cultivate them requires a great deal of expertise, and these cells are easily contaminated with fibroblasts, immune cells, and other non-stem cells. I know, as I’ve been looking into cultivating endothelial progenitor cells (a type of vascular stem cell) as part of my research.

Still don’t believe this is woo? Well, then, check out this quote from another of these dubious clinics, the Institute of Regenerative Medicine:

“We inject the cells taken from the liver tissue of human foetuses directly into the vein in the back of your hand,” explains the well-spoken English consultant Jenny, who gives telephone consultations to potential patients.

“The results are incredible. You’ll feel and look different after a month because these cells help the body to regenerate itself. The effects last for approximately a year before it needs to be “topped up.”

Despite criticism from Church leaders and religious groups on the Island, Barnett Suskind, chief executive of IRM, is unapologetic about the treatment he carries out. ‘It is the most natural form of healing there is – in ten years, everyone will be doing this,’ he says. ‘You think better, sleep better, and look better. Your quality of life improves and your libido certainly improves.’

Ah, yes, “natural” healing. Let’s see. IRM takes livers out of human fetuses, probably trypsinizes them to dissolve the connective tissue and leave just the cells, does all sorts of manipulations on them in order to isolate the stem cells, grows the cells until you have enough, and then injects this concoction into its clients’ veins. Apparently Mr. Suskind has a different definition of “natural” than I do. And, of course, it allegedly helps the libido.

Of course, although using stem cells as a sophisticated beauty aid or “surgery-less” plastic surgery seems to be among the most common of the woo uses of stem cells, that’s not all they claim. Look at the list of diseases, for example, claimed by another one of the clinics listed in the article, the Medra Clinic:

The fetal stem cell searches out, detects and then attempts to repair any damage or deficit discovered, as well as releases growth factors, which stimulate the body’s own repair mechanisms. . . .

A partial list of diseases includes:

Alzheimer’s, Anemia, Autism, Brain damage, Cancer, Cerebral Palsy, Chronic Fatigue Syndrome, Depression, Diabetes, Diverticulitis, Epilepsy, Impotence, Immune Suppression, Leukemia, Multiple Sclerosis, Parkinson’s, Rheumatoid Arthritis, Sickle Cell Anemia, Spinal Cord Injury, Stroke, Systemic Lupus Erythematosus and Ulcerative Colitis. . . .

Rarely has a single treatment modality offered so much promise to those suffering from some of mankind’s worst afflictions.

Another successful use of Fetal Stem Cells is in the field of anti-aging (rejuvenation/longevity.)

A large number of patients have been treated with Fetal Stem Cell Therapy, with by current standards, remarkable physical and psychological improvements.

Gee, sound familiar? I’ve presented a similar list for chelation therapy, and you can see similar pitches on a number of altie websites. Of course, if you peruse some of these sites, it becomes clear that, to these stem cell purveyors, stem cell therapy is nothing more than the latest in a long line of Fountains of Youth promising to turn back the clock and eliminate all the diseases of aging. As I mentioned before, stem cells do indeed have the potential to treat quite a few diseases and potentially even regenerate some organs, but little of this potential has yet been realized, and it could take years, if not decades, to determine what stem cells can and cannot do. At present, stem cells are only routinely outside the auspices of a clinical trial in bone marrow transplantation to treat hematopoietic malignancies. However, there have been reports of possible utility in spinal cord injury (in mice and a couple of human reports), repairing heart muscle damaged by heart attacks (mice and humans), but wide applicability is probably a fairly long way off and potential complications are at this time mostly unknown. For one thing, stem cells tend to aggregate around sites of injury, making it impossible (at least now) to control where intravenous injections of such cells end up:

“An intravenous injection of cells – euch,” says Evan Snyder, the director of the Stem Cells and Regeneration Program at the Burnham Institute in La Jolla, Calif. One problem, Snyder notes, is that you can’t control where cells go once you put them in the bloodstream. Given the propensity of stem cells to aggregate around a site of injury, moreover, there’s no reason the injected cells couldn’t all end up migrating to a cut on your finger. At $35,000 a shot, that would amount to an extraordinarily expensive Band-Aid.

Worse, these cells could result in tumors:

Among others, Dr. Amit Patel, of the University of Pittsburgh Medical Center, worries about darker possibilities. Because there’s no way to control where the stem cells go once they’re injected, they may end up causing more problems than they cure. Mice bred to have stomach ulcers, for instance, were shown to have a higher incidence of cancer formation at the site of the sores, because stem cells aggregate at those lesions. Adding more stem cells might increase that risk. Likewise, Patel points out, a patient could have a small, undetected tumor growing in the liver or a lung, in which case the injection of stem cells might actually accelerate the cancer.

“Even when I do direct injections to the heart, the majority of the cells don’t stay there,” Patel says. “Once the cells are in your bloodstream, who knows where they’re going to land.”

Indeed, one Russian tycoon, after receiving a fetal stem cell injection at the Beauty Plaza in Moscow, developed pea-sized tumors all over his face and legs, and one shouldn’t forget that cancer stem cells represent a hot area of research right now as both a major mechanism behind the pathogenesis of cancer and as potential targets for therapy. All of the above shows is that you have sound science, which is the careful testing and weighing the risks against the potential benefits, and then you have the hype, which makes pie-in-the-sky claims for its therapy with no concern for for the risks. Even if some of the claims turn out to be partially true, as of today we can’t say that they are true.

Of course, some of you may still not be convinced that stem cell therapy in the hands of dubious clinic operators has reached the level of woo. Perhaps this next example will convince you. This example could only come from the U.S., where there are such strict restrictions on stem cell research and therapies that human stem cell woo would be very difficult, if not impossible, to pull off (the main reason so many of these clinics are in nations with more lax regulations). I bring you The Frozen in Time™ Stem Cell Facial:

The latest beauty treatment to hit Manhattan’s spa scene has, according to the owner, already drawn a host of customers from the UK and Europe as well as wealthy New Yorkers. The facial involves an exfoliation and steam. The face is then covered in a moisturiser composed of cells harvested from the embryonic fluid of pregnant cows. The result according to Nabi’s owner Ivy Cho is ‘ biological supremacy over ageing skin’.

The spa claims that introducing live stem cells from cows helps your skin cells – which may be damaged by ‘ environmental factors’ – restore and replicate themselves, creating healthier, stronger, more youthful-looking skin.

‘The treatment is originally from France and has become popular with premium customers,’ says a consultant at the spa who claims the cows are not hurt in any way during the process.

‘We pat the liquid onto the face rather than rubbing it in, which breaks up the cells. It takes just an hour, but immediately afterwards your skin will feel hydrated, firmer and tighter, with a flawless glow. After six days your skin becomes radiant.’

And straight from the company’s website:

By introducing live stem cells that are genetically flawless to the human skin, our dry, mature, older cells begin to restore themselves and replicate generations of healthier, stronger, more youthful looking skin. This clinically proven, FDA approved treatment grows new skin and renews skin that is compromised through environmental factors, sun damage, stress, etc. It is also ideal for sunburns, post-laser, post chemical peels, and post surgery to regenerate healthy looking skin.

All this for just $250. What a bargain. I’ll have to remember to check it out the next time I’m in Manhattan, as I’ve always wanted to have cells derived from cow amnionic fluid spread on my face. I’m just not so sure about the FDA-approved part. Did the FDA really approve a treatment involving slathering bovine “stem cells” on people’s faces?How do we know that these are stem cells? Will the company provide the antigenic profile that demonstrates that they are, in fact, stem cells? How do we even know the cells are still alive, particularly since they’ve apparently been frozen, a process that, if not properly done with appropriate cryopreservants, will kill the cells? Come to think of it, if the FDA really did approve this spa’s formula, that’s a pretty good indication to me that, whatever else may be in the concoction, it’s almost certainly not living stem cells. As Dr. Richard Granstein, Chair of dermatology at New York Presbyterian/Weill Cornell, put it:

“These cells are dead. They come from a cow. And you’re rubbing them onto the surface of the skin, where they could never seep in,” says Granstein. “It’s just not going to happen.”

Of course, woos don’t inquire too fast. Personally, in this particular case, I’m torn between decrying the utter (and amusingly laughable) ludicrous woo of this treatment and enjoying sitting back and watching affluent and gullible New Yorkers (and those who can afford to travel to New York for the treatment) waste their money in homage to P.T. Barnum’s famous dictum, all to slather pumices derived from frozen cells harvested from the nether regions of cows. Either way, though, the magical thinking that leads to anyone believing that dead “stem cells” from cow amniotic fluid can do anything other than make a rather disgusting facial cream when applied to the face definitely constitutes woo.

As Shelley asks, “With frauds in Korea, cosmetic clinics in the Caribbean, and vetoes at home, does stem cell therapy (legitimate, medically-necessary therapy) ever stand a chance???”

I certainly hope so.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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