1
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W Sandoval AG, Traktuev DO, March KL. Development of a student-driven undergraduate program in regenerative medicine. Regen Med 2022; 17:755-765. [PMID: 35924471 DOI: 10.2217/rme-2022-0069] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
As it begins to enter the clinic, regenerative medicine has the potential to revolutionize healthcare. Although there exists a growing need for individuals well-versed in the practice of regenerative medicine, few undergraduate institutions offer opportunities to learn about the topic. This article highlights the conception of two novel undergraduate courses in regenerative medicine developed through collaboration between students and faculty at our University to fill this void in the undergraduate curriculum. Lectures from scientists, healthcare professionals, regulatory experts and biotechnology leaders introduced students to regenerative medicine research and the translational process, and a certificate program incorporating relevant coursework and research experience is in development. This pipeline will guide promising undergraduate students to the field of regenerative medicine.
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Affiliation(s)
- Aaron Gabriel W Sandoval
- University of Florida Center for Regenerative Medicine, Gainesville, FL 32610, USA.,Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, CB2 0AW, UK.,Faculty of Life Sciences & Medicine, King's College London, London, SE1 1UL, UK
| | - Dmitry O Traktuev
- University of Florida Center for Regenerative Medicine, Gainesville, FL 32610, USA.,Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA
| | - Keith L March
- University of Florida Center for Regenerative Medicine, Gainesville, FL 32610, USA.,Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA
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2
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Lyons S, Salgaonkar S, Flaherty GT. International stem cell tourism: a critical literature review and evidence-based recommendations. Int Health 2021; 14:132-141. [PMID: 34415026 PMCID: PMC8890798 DOI: 10.1093/inthealth/ihab050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/21/2021] [Accepted: 07/27/2021] [Indexed: 01/08/2023] Open
Abstract
Stem cell tourism is an emerging area of medical tourism activity. Frustrated by the slow translation of stem cell research into clinical practice, patients with debilitating conditions often seek therapeutic options that are not appropriately regulated. This review summarises recent developments in the field of stem cell tourism and provides clinicians with the information necessary to provide basic pretravel health advice to stem cell tourists. PubMed and Scopus databases were consulted for relevant publications, using combinations of the terms 'stem cell', 'tourism', 'regenerative medicine', 'international', 'travel medicine' and 'environmental health'. The leading countries in the international stem cell tourism market are the USA, China, India, Thailand and Mexico. As the majority of clinics offering stem cell therapies are based in low- and-middle-income countries, stem cell tourists place themselves at risk of receiving an unproven treatment, coupled with the risk of travel-related illnesses. These clinics do not generally provide even basic travel health information on their websites. In addition to often being ineffective, stem cell therapies are associated with complications such as infection, rejection and tumorigenesis. Physicians, researchers, regulatory bodies, advocacy groups and medical educators are encouraged to work together to improve patient and physician education and address current legislative deficiencies.
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Affiliation(s)
- Samantha Lyons
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Ireland.,Faculty of Health Sciences, University of Ottawa, Ontario, Canada
| | - Shival Salgaonkar
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Ireland
| | - Gerard T Flaherty
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Ireland.,School of Medicine, International Medical University, Kuala Lumpur, Malaysia
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3
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Richardson E, Akkas F, Master Z. Evaluating the FDA regenerative medicine framework: opportunities for stakeholders. Regen Med 2020; 15:1825-1832. [PMID: 32815780 DOI: 10.2217/rme-2020-0073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Elizabeth Richardson
- Director, Health Care Products Project, The Pew Charitable Trusts, 901 E Street, NW, Washington, DC 20004-2008, USA
| | - Farzana Akkas
- Senior Research Associate, Health Care Products Project, The Pew Charitable Trusts, 901 E Street, NW, Washington, DC 20004-2008, USA
| | - Zubin Master
- Associate Professor, Biomedical Ethics Research Program & Center for Regenerative Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
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4
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Julian K, Yuhasz N, Rai W, Salerno JA, Imitola J. Complications from “Stem Cell Tourism” in Neurology. Ann Neurol 2020; 88:661-668. [DOI: 10.1002/ana.25842] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 07/03/2020] [Accepted: 07/03/2020] [Indexed: 01/26/2023]
Affiliation(s)
- Katherine Julian
- Department of Neurology The Ohio State University Wexner Medical Center Columbus Ohio USA
- Laboratory for Neural Stem Cells and Functional Neurogenetics, Division of Multiple Sclerosis and Neuroimmunology, Department of Neurology UConn School of Medicine Farmington CT USA
| | - Nicholas Yuhasz
- Department of Neurology The Ohio State University Wexner Medical Center Columbus Ohio USA
| | - Widjan Rai
- Department of Neurology The Ohio State University Wexner Medical Center Columbus Ohio USA
| | - Jose A. Salerno
- Department of Neurology The Ohio State University Wexner Medical Center Columbus Ohio USA
- National Laboratory of Embryonic Stem Cells Universidad Federal Rio de Janeiro Brazil
| | - Jaime Imitola
- Department of Neurology The Ohio State University Wexner Medical Center Columbus Ohio USA
- Laboratory for Neural Stem Cells and Functional Neurogenetics, Division of Multiple Sclerosis and Neuroimmunology, Department of Neurology UConn School of Medicine Farmington CT USA
- UConn Health Comprehensive Multiple Sclerosis Center, Division of Multiple Sclerosis and Neuroimmunology, Department of Neurology UConn School of Medicine Farmington CT USA
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5
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Translating Basic Research into Safe and Effective Cell-based Treatments for Respiratory Diseases. Ann Am Thorac Soc 2020; 16:657-668. [PMID: 30917290 DOI: 10.1513/annalsats.201812-890cme] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Respiratory diseases, such as chronic obstructive pulmonary disease and pulmonary fibrosis, result in severely impaired quality of life and impose significant burdens on healthcare systems worldwide. Current disease management involves pharmacologic interventions, oxygen administration, reduction of infections, and lung transplantation in advanced disease stages. An increasing understanding of mechanisms of respiratory epithelial and pulmonary vascular endothelial maintenance and repair and the underlying stem/progenitor cell populations, including but not limited to airway basal cells and type II alveolar epithelial cells, has opened the possibility of cell replacement-based regenerative approaches for treatment of lung diseases. Further potential for personalized therapies, including in vitro drug screening, has been underscored by the recent derivation of various lung epithelial, endothelial, and immune cell types from human induced pluripotent stem cells. In parallel, immunomodulatory treatments using allogeneic or autologous mesenchymal stromal cells have shown a good safety profile in clinical investigations for acute inflammatory conditions, such as acute respiratory distress syndrome and septic shock. However, as yet, no cell-based therapy has been shown to be both safe and effective for any lung disease. Despite the investigational status of cell-based interventions for lung diseases, businesses that market unproven, unlicensed and potentially harmful cell-based interventions for respiratory diseases have proliferated in the United States and worldwide. The current status of various cell-based regenerative approaches for lung disease as well as the effect of the regulatory environment on clinical translation of such approaches are presented and critically discussed in this review.
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6
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Smith C, Martin-Lillie C, Higano JD, Turner L, Phu S, Arthurs J, Nelson TJ, Shapiro S, Master Z. Challenging misinformation and engaging patients: characterizing a regenerative medicine consult service. Regen Med 2020; 15:1427-1440. [PMID: 32319855 PMCID: PMC7466910 DOI: 10.2217/rme-2020-0018] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 03/19/2020] [Indexed: 02/06/2023] Open
Abstract
Aim: To address the unmet needs of patients interested in regenerative medicine, Mayo Clinic created a Regenerative Medicine Consult Service (RMCS). We describe the service and patient satisfaction. Materials & methods: We analyzed RMCS databases through retrospective chart analysis and performed qualitative interviews with patients. Results: The average patient was older to elderly and seeking information about regenerative options for their condition. Patients reported various conditions with osteoarthritis being most common. Over a third of consults included discussions about unproven interventions. About a third of patients received a clinical or research referral. Patients reported the RMCS as useful and the consultant as knowledgeable. Conclusion: An institutional RMCS can meet patients' informational needs and support the responsible translation of regenerative medicine.
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Affiliation(s)
- Cambray Smith
- Biomedical Ethics Research Program, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
| | - Charlene Martin-Lillie
- Center for Regenerative Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
| | - Jennifer Dens Higano
- Mayo Clinic Alix School of Medicine, 200 First Street, SW, Rochester, MN 55905, USA
| | - Leigh Turner
- Center for Bioethics, School of Public Health & College of Pharmacy, University of Minnesota, N520 Boynton, 410 Church Street SE, Minneapolis, MN 55455, USA
| | - Sydney Phu
- School of History, Philosophy & Religion, Oregon State University, 322 Milam Hall, 2520 SW Campus Way, Corvallis, OR 97331, USA
| | - Jennifer Arthurs
- Center for Regenerative Medicine, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Timothy J Nelson
- Center for Regenerative Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
- Department of General Internal Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
| | - Shane Shapiro
- Center for Regenerative Medicine, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
- Department of Orthopedic Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Zubin Master
- Biomedical Ethics Research Program, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
- Center for Regenerative Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
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7
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Zarzeczny A, Tanner C, Barfoot J, Blackburn C, Couturier A, Munsie M. Contact us for more information: an analysis of public enquiries about stem cells. Regen Med 2019; 14:1137-1150. [DOI: 10.2217/rme-2019-0092] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aim: This study examines online enquiries received by two prominent stem cell science initiatives operating in different geographical jurisdictions. Materials & methods: Combined quantitative and qualitative analysis undertaken of internet-based queries (n = 1047) received by Stem Cells Australia and EuroStemCell from members of the public over a two-year period (May 2014–2016). Results: Findings reveal striking similarities between the two datasets and highlight the range of uncertainties, priorities and needs of those seeking information about stem cells online. Conclusion: Sustained and in-depth tailored guidance is needed to effectively meet the diverse stem cell-related information-based needs of communities internationally. Such efforts should be prioritized by regenerative medicine research initiatives and organizations, given the trust and hope diverse publics appear to place in these groups.
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Affiliation(s)
- Amy Zarzeczny
- Johnson Shoyama Graduate School of Public Policy, University of Regina, Regina, SK, S4S 0A2, Canada
| | - Claire Tanner
- Department of Anatomy & Neuroscience, Center for Stem Cell Systems, The University of Melbourne, Parkville, Victoria, Australia
| | - Jan Barfoot
- EuroStemCell, MRC Centre for Regenerative Medicine, University of Edinburgh, Edinburgh, EH16 4UU, UK
| | - Clare Blackburn
- EuroStemCell, MRC Centre for Regenerative Medicine, University of Edinburgh, Edinburgh, EH16 4UU, UK
| | - Anna Couturier
- EuroStemCell, MRC Centre for Regenerative Medicine, University of Edinburgh, Edinburgh, EH16 4UU, UK
| | - Megan Munsie
- Department of Anatomy & Neuroscience, Center for Stem Cell Systems, The University of Melbourne, Parkville, Victoria, Australia
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8
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Shaw MK, Babovič M, Monrouxe LV. Healthcare professionals', students', patients' and donors' perceptions of stem cell research and therapy: a systematic review protocol. BMJ Open 2019; 9:e025801. [PMID: 30798317 PMCID: PMC6398628 DOI: 10.1136/bmjopen-2018-025801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Stem cell research (SCR) and the biomedical potential of developing therapies are crucial topics in biomedicine. Like other biotechnologies, stem cells are context specific entities understood through local conceptualisations of culture, politics, nationhood, as well as their perceived therapeutic efficacy. There is a need to recognise how these developments are understood within the healthcare community and by those who may use them. This protocol describes a systematic literature review that aims to explore healthcare professionals', healthcare students', patients', and donors' perceptions of SCR and therapy (SCR/T) and the factors that influence their perceptions. METHODS AND ANALYSIS Following Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines a systematic review will be undertaken. Web of Science, Scopus, Medline+Journals @Ovid and Ariti Library will be systematically searched for studies on healthcare professionals', healthcare students', patients' and donors' perceptions of SCR and developing therapies. All articles will be screened by a researcher for inclusion and evaluation based on 12 criteria for evaluating qualitative research. At least 20% of articles will also be reviewed by a second researcher and any disagreement will be solved via consensus. Data extracted from the articles will be analysed using thematic synthesis enabling the identification of concepts across studies and the development of new theory. ETHICS AND DISSEMINATION As part of a larger research project, ethical approval has been provided by the Institutional Research Board (IRB) at Chang Gung Memorial Hospital. This review will be able to determine the impact that certain perceptions of SCR/T will have on the development of future medical knowledge and practice. The results of the study will be published in a peer-reviewed journal and disseminated at relevant conferences. PROSPERO REGISTRATION NUMBER CRD42018103627.
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Affiliation(s)
- Malissa Kay Shaw
- Chang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital Taoyuan Branch, Taoyuan, Taiwan
| | - Mojca Babovič
- Chang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital Taoyuan Branch, Taoyuan, Taiwan
| | - Lynn Valerie Monrouxe
- Chang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital Taoyuan Branch, Taoyuan, Taiwan
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9
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Abstract
The stem cell and regenerative medicine arena has become increasingly complicated in recent years with thousands of people involved. There are as many as a dozen or more main groups of stakeholders, who together may be viewed as one ecosystem that is now rapidly evolving. The nature of the ecosystem and its evolution have major implications for not just those within it, but also for medicine and society at large. Here, I describe this ecosystem and its evolution, as well as the negative impacts within the ecosystem of a constellation of hundreds of unproven for-profit clinics and related businesses. Finally, I propose approaches for how to positively influence and drive the future of the global stem cell ecosystem.
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Affiliation(s)
- Paul S Knoepfler
- Department of Cell Biology & Human Anatomy, University of California, Davis, 1 Shields Ave, Davis, CA 95616, USA
- Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children Northern California, Sacramento, CA 95817, USA
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10
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Toraldo DM, Toraldo S, Conte L. The Clinical Use of Stem Cell Research in Chronic Obstructive Pulmonary Disease: A Critical Analysis of Current Policies. J Clin Med Res 2018; 10:671-678. [PMID: 30116436 PMCID: PMC6089575 DOI: 10.14740/jocmr3484w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 06/27/2018] [Indexed: 02/06/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a disorder affecting more than 200 million people around the world, resulting in three million deaths per year. COPD is characterized by the loss of lung tissue and airway remodelling, with chronic inflammation of the airways and progressive destruction of lung parenchyma. The use of stem cells may lead to regenerative processes that address biological damage. However, this approach raises ethical issues that need to be considered in clinical trials using stem cell therapy, such as informed consent, patient recruitment and harm minimization, as well as the inherent uncertainty of these medical procedures on human beings. Indeed, up to now, these experiments have been performed in preclinical studies using animal models, with few studies involving humans. Additional efforts should be made to assess this promising procedure.
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Affiliation(s)
| | - Sara Toraldo
- Faculty of Economics, Catholic University of the Sacred Heart, Piacenza, Italy
| | - Luana Conte
- Interdisciplinary Laboratory of Applied Research in Medicine (DReAM), University of the Salento, in the "V. Fazzi" Hospital, Italy.,Department of Biological and Environmental Sciences and Technologies, University of the Salento, Lecce, Italy
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11
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Datta S. An endogenous explanation of growth: direct-to-consumer stem cell therapies in PR China, India and the USA. Regen Med 2018; 13:559-579. [PMID: 30129871 DOI: 10.2217/rme-2017-0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The recent expansion of direct-to-consumer stem cell therapies (DSCTs) across nations where medical malpractice laws are the strongest globally challenges the causal assumption that low regulatory standards in developing countries bolster DSCTs. Drawing on firm-level data of existing biopharmaceuticals, approved stem cell therapies (SCTs) and DSCT clinics across the USA, PR China and India, this paper provides an innovation studies perspective of the ways in which the paradigmatic shift in fundamental knowledge production - from in vitro to in vivo stem cells - is transforming SCT discovery and delivery. It argues that the endogenous and inherent disruptive attributes of SCTs, rather than exogenous conditions like regulations, provide a substantive explanation for the recent expansion of DSCTs and urges regulatory adaptation to endogenous imperatives for effective governance of SCTs.
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Affiliation(s)
- Saheli Datta
- King's College London, Global Health & Social Medicine Strand, London WC2R 2LS, UK
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12
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Horner C, Tenenbaum E, Sipp D, Master Z. Can civil lawsuits stem the tide of direct-to-consumer marketing of unproven stem cell interventions. NPJ Regen Med 2018; 3:5. [PMID: 29479481 PMCID: PMC5818472 DOI: 10.1038/s41536-018-0043-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 01/19/2018] [Accepted: 01/22/2018] [Indexed: 11/11/2022] Open
Abstract
The sale of unproven stem cell interventions (SCIs) by commercial entities has proliferated in highly developed countries, most notably in the USA. Yet, there have been few criminal prosecutions and regulatory enforcement actions against providers who have violated laws and best practice standards due to the lack of resources and legal ambiguity. While the stem cell research community has invested much in protecting patients and preventing the growth of this industry, some patients are seeking remedies under civil law to hold stem cell clinics responsible for fraudulent practices. Several patients have filed lawsuits against providers demanding compensation for physical injuries caused by unproven treatments and financial losses due to fraud and false advertising. Lawsuits can be used as a tool not only to compensate plaintiffs but also to achieve positive public health and policy outcomes. In this paper, we explore the value of a public health litigation strategy as a countermeasure against the exploitative practices of the unproven SCI industry by analyzing stem cell lawsuits and comparing them with other major public health litigation efforts. We argue that stem cell lawsuits complement other approaches to reining in unsafe practices. In particular, stem cell lawsuits could intensify publicity and raise awareness of the harms of unproven treatments, set legal precedent, reshape the media narrative from one focused on the right to try or practice to one highlighting the need for adequate safety and efficacy standards, and encourage authorities to turn their attention to policy reform and enforcement.
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Affiliation(s)
- Claire Horner
- 1Baylor College of Medicine, One Baylor Plaza, Suite 310D, Houston, TX 77030 USA
| | - Evelyn Tenenbaum
- 2Albany Law School, 80 New Scotland Avenue, Albany, NY 12208-3494 USA.,3Alden March Bioethics Institute, Albany Medical College, 47 New Scotland Avenue, MC 153, Albany, NY 12208-3478 USA
| | - Douglas Sipp
- 4RIKEN Center for Developmental Biology, 2-2-3 Minatojima, Minamimachi Chuo-ku, Kobe, Japan.,5Department of Physiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan.,Keio University Global Research Institute, 2-15-45, Mita, Minato-ku, Tokyo 108-8345 Japan.,RIKEN Center for Advanced Intelligence Project, Nihonbashi 1-chome Mitsui Building, 15th floor, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027 Japan
| | - Zubin Master
- 8Biomedical Ethics Research Program, Mayo Clinic, 200 First Street SW, Rochester, NY 55905 USA
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13
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Jiang L, Dong BH. Fraudsters operate and officialdom turns a blind eye: a proposal for controlling stem cell therapy in China. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2016; 19:403-410. [PMID: 26906907 DOI: 10.1007/s11019-016-9692-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Stem cell tourism-the flow of patients from home countries to destination countries to obtain stem cell treatment-is a growing business in China. Many concerns have been raised regarding fraudsters that operate unsafe stem cell therapies and an officialdom that turns a blind eye to the questionable technology. The Chinese regulatory approach to stem cell research is based on Guidelines and Administrative Measures, rather than legislation, and may have no binding force on certain institutions, such as military hospitals. There is no liability and traceability system and no visible set of penalties for non-compliance in the stem cell legal framework. In addition to the lack of safety and efficacy systems in the regulations, no specific expert authority has been established to monitor stem cell therapy to date. Recognizing the global nature of stem cell tourism, this article argues that resolving stem cell tourism issues may require not only the Chinese government but also an international mechanism for transparency and ethical oversight. A stringent set of international regulations that govern stem cell therapies can encourage China to improve stem cell regulation and enforcement to fulfill its obligations. Through an international consensus, a minimum standard for clinical stem cell research and a central enforcement system will be provided. As a result, rogue clinics that conduct unauthorized stem cell therapies can be penalized, and countries that are reluctant to implement the reconciled regulations should be sanctioned.
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Affiliation(s)
- Li Jiang
- Kenneth Wang School of Law, Soochow University, Shi Zi Jie 1 Hao, Suzhou, 215006, China.
| | - Bing He Dong
- Kenneth Wang School of Law, Soochow University, Shi Zi Jie 1 Hao, Suzhou, 215006, China
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14
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Boltze J, Arnold A, Walczak P, Jolkkonen J, Cui L, Wagner DC. The Dark Side of the Force - Constraints and Complications of Cell Therapies for Stroke. Front Neurol 2015; 6:155. [PMID: 26257702 PMCID: PMC4507146 DOI: 10.3389/fneur.2015.00155] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 06/23/2015] [Indexed: 12/16/2022] Open
Abstract
Cell therapies are increasingly recognized as a promising option to augment the limited therapeutic arsenal available to fight ischemic stroke. During the last two decades, cumulating preclinical evidence has indicated a substantial efficacy for most cell treatment paradigms and first clinical trials are currently underway to assess safety and feasibility in patients. However, the strong and still unmet demand for novel stroke treatment options and exciting findings reported from experimental studies may have drawn our attention away from potential side effects related to cell therapies and the ways by which they are commonly applied. This review summarizes common and less frequent adverse events that have been discovered in preclinical and clinical investigations assessing cell therapies for stroke. Such adverse events range from immunological and neoplastic complications over seizures to cell clotting and cell-induced embolism. It also describes potential complications of clinically applicable administration procedures, detrimental interactions between therapeutic cells, and the pathophysiological environment that they are placed into, as well as problems related to cell manufacturing. Virtually each therapeutic intervention comes at a certain risk for complications. Side effects do therefore not generally compromise the value of cell treatments for stroke, but underestimating such complications might severely limit therapeutic safety and efficacy of cell treatment protocols currently under development. On the other hand, a better understanding will provide opportunities to further improve existing therapeutic strategies and might help to define those circumstances, under which an optimal effect can be realized. Hence, the review eventually discusses strategies and recommendations allowing us to prevent or at least balance potential complications in order to ensure the maximum therapeutic benefit at minimum risk for stroke patients.
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Affiliation(s)
- Johannes Boltze
- Department of Cell Therapy, Fraunhofer-Institute for Cell Therapy and Immunology , Leipzig , Germany ; Translational Center for Regenerative Medicine, University of Leipzig , Leipzig , Germany
| | - Antje Arnold
- Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine , Baltimore, MD , USA ; Institute for Cell Engineering, Johns Hopkins University , Baltimore, MD , USA
| | - Piotr Walczak
- Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine , Baltimore, MD , USA ; Institute for Cell Engineering, Johns Hopkins University , Baltimore, MD , USA
| | - Jukka Jolkkonen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland , Kuopio , Finland
| | - Lili Cui
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland , Kuopio , Finland
| | - Daniel-Christoph Wagner
- Department of Cell Therapy, Fraunhofer-Institute for Cell Therapy and Immunology , Leipzig , Germany
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15
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Master Z, Robertson K, Frederick D, Rachul C, Caulfield T. Stem cell tourism and public education: the missing elements. Cell Stem Cell 2015; 15:267-270. [PMID: 25192461 DOI: 10.1016/j.stem.2014.08.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Stem cell tourism describes the Internet-based industry where in patients receive unproven stem cell interventions. To better inform the public, several organizations provide educational material on stem cell therapies and tourism; however, an assessment of the currently available resources reveals a lack of comprehensive information, suggesting that further efforts are needed.
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Affiliation(s)
- Zubin Master
- Alden March Bioethics Institute, Albany Medical College, 47 New Scotland Avenue, MC 153, Albany, NY 12208-3478, USA; Health Law Institute, Law Centre, University of Alberta, 89 Avenue and 111 Street, Edmonton, AB T6G, Canada
| | - Kelsey Robertson
- Health Law Institute, Law Centre, University of Alberta, 89 Avenue and 111 Street, Edmonton, AB T6G, Canada
| | - Daniel Frederick
- School of Public Health, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY 12222, USA
| | - Christen Rachul
- School of Linguistics and Language Studies, PA 236, Carleton University, Ottawa, ON, K1S 5B6, Canada
| | - Timothy Caulfield
- Health Law Institute, Law Centre, University of Alberta, 89 Avenue and 111 Street, Edmonton, AB T6G, Canada.
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16
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Lowenthal J, Sugarman J. Ethics and policy issues for stem cell research and pulmonary medicine. Chest 2015; 147:824-834. [PMID: 25732448 DOI: 10.1378/chest.14-1696] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Stem cell research and related initiatives in regenerative medicine, cell-based therapy, and tissue engineering have generated considerable scientific and public interest. Researchers are applying stem cell technologies to chest medicine in a variety of ways: using stem cells as models for drug discovery, testing stem cell-based therapies for conditions as diverse as COPD and cystic fibrosis, and producing functional lung and tracheal tissue for physiologic modeling and potential transplantation. Although significant scientific obstacles remain, it is likely that stem cell-based regenerative medicine will have a significant clinical impact in chest medicine. However, stem cell research has also generated substantial controversy, posing a variety of ethical and regulatory challenges for research and clinical practice. Some of the most prominent ethical questions related to the use of stem cell technologies in chest medicine include (1) implications for donors, (2) scientific prerequisites for clinical testing and use, (3) stem cell tourism, (4) innovation and clinical use of emerging stem cell-based interventions, (5) responsible translation of stem cell-based therapies to clinical use, and (6) appropriate and equitable access to emerging therapies. Having a sense of these issues should help to put emerging scientific advances into appropriate context and to ensure the responsible clinical translation of promising therapeutics.
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Affiliation(s)
- Justin Lowenthal
- School of Medicine, Medical Scientist Training Program, Johns Hopkins University, Baltimore, MD
| | - Jeremy Sugarman
- Berman Institute of Bioethics, Department of Medicine, Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD.
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Scott CT. The case for stem cell counselors. Stem Cell Reports 2014; 4:1-6. [PMID: 25483110 PMCID: PMC4297874 DOI: 10.1016/j.stemcr.2014.10.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 10/30/2014] [Accepted: 10/31/2014] [Indexed: 12/14/2022] Open
Abstract
In this article, Scott describes how a new counseling profession could support clinical sites and patients enrolling in stem cell clinical trials. A possible model is proposed, along with a curriculum that would provide counselors with the tools to address challenges facing the clinical stem cell field. Finally, a candidate recruitment and clinical site interface scheme is offered.
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Stuart MJ, Pattavilakom A. Clinically relevant aspects of stem cell technologies: current state of play. ANZ J Surg 2014; 85:615-9. [PMID: 25267417 DOI: 10.1111/ans.12864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2014] [Indexed: 01/22/2023]
Abstract
The emergence of stem cell technologies and their potential applications in regenerative medicine have generated immense interest by both the lay public and clinicians. Unproven and unregulated cell-based therapies are commercially available both in Australia and internationally, and reports of patient uptake (stem cell tourism) and associated morbidity are increasingly frequent. Clinicians in all fields will require an enhanced understanding of the basic science principles and current state of play in regenerative medicine in order to effectively counsel patients regarding these therapies in the setting of both commercial ventures and clinical trials. This review aims to concisely highlight the key clinically pertinent features of these trials and briefly discuss the specific therapeutic potential, mechanism of action and risks associated with these variables.
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Affiliation(s)
- Michael J Stuart
- Department of Neurosurgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia
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19
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McMahon DS. The global industry for unproven stem cell interventions and stem cell tourism. Tissue Eng Regen Med 2014. [DOI: 10.1007/s13770-013-1116-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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