A woman has become the first person in the world to be given an entirely laboratory-engineered organ in a landmark operation that could change the face of transplant surgery. Skip related content
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Own stem cells save woman's lung

Claudia Castillo's own stem cells were used to create an artificial airway which replaced the bronchus to her left lung which had collapsed after she suffered a serious tuberculosis infection.

The 30-year-old Columbian-born mother-of-two is also believed to be the first transplant patient not to need powerful drugs to subdue the immune system.

Even though she received no immunosuppressive drugs, so far doctors have seen no hint of Ms Castillo's immune system rejecting the transplant.

Researchers from the UK, Italy and Spain worked together to grow tissue from Ms Castillo's own bone marrow stem cells, use them to fashion a new bronchus - a branch of the trachea or windpipe - and carry out the transplant operation.

Without the pioneering operation in June, Ms Castillo's lung would have been removed by surgeons.

The scientists believe in years to come the same approach will be used to create engineered replacements for other damaged organs, such as the bowel, bladder or reproductive tract.

In five years' time they hope to begin clinical trials in which laboratory-made voice boxes are implanted into patients with cancer of the larynx.

Professor Martin Birchall, a British member of the team from the University of Bristol, said: "What we're seeing today is just the beginning. This is the first time a tissue-engineered whole organ has been transplanted into a patient. I reckon in 20 years' time it will be the commonest operation surgeons will be doing. I think it will completely transform the way we think about surgery, health and disease."

Prof Birchall admitted that the decision to turn to tissue engineering to help Ms Castillo was a "leap of faith". The same procedure had only been attempted on pigs before, but had looked highly promising.

MacKenna Roberts
Progress Educational Trust
14 October 2008

The UK's High Court has ruled that it may have been unlawful for a widow to have removed her dead husband's sperm. Despite UK law requiring valid written consent for the storage and use of sperm, the 42-year-old widow obtained emergency Court permission to have sperm collected from her 31-year-old husband's body hours after he unexpectedly died from complications with a routine operation to remove his appendix in June 2007. She now seeks authorisation to undergo IVF abroad using his sperm. Giving the judgment, Mr Justice Charles said: 'I am not satisfied it is possible to lawfully remove sperm from a dead person who has not given effective advanced consent'. 

The mother-of-one pleaded that the couple had wanted another child, discussed their desire with family and friends and had sought information regarding IVF together. She explained that they had not thought to have him provide written permission because they had not feared that the minor surgery would be fatal. While the attempt to construct retrospective consent with evidence of his intentions holds little legal weight in light of the clear statutory provisions, her lawyer also argued that disposal of his sperm would contravene her human right to establish a family (protected under article 8 of the European Convention on Human Rights, enshrined in UK law by the Human Rights Act 1998). Because fresh sperm will lose viability over time, the Court authorised the emergency sample collection pending later legal resolution. Upon closer examination at the hearing, Mr Justice Charles questioned the decision. 

The final decision now resides with the Human Fertilisation and Embryology Authority (HFEA), which regulates gamete storage and its use. If permission is denied, then the HFEA decision will likely be legally challenged as was done by Diane Blood in a similar case in 1997. HFEA chair, Lisa Jardine, commented that the organisation sympathises with these 'difficult' situations but 'must operate within the legislation'. 

This case, like the landmark Blood case, may turn on the statutory loophole that provides the HFEA discretionary powers to dispense with the consent requirements for the sperm to be exported - in accordance with an EU citizen's right to receive health treatment in another member state. 

Diane Blood ultimately won a protracted legal battle through the English Courts in 1997 and was able to conceive two sons using her late husband's sperm. The Bloods attempted to start a family but Stephen Blood contracted meningitis and lapsed into a coma - his sperm was collected shortly before he died in 1995. The HFEA refused Mrs Blood authorisation to use the sperm as she did not have written consent from her husband. The High Court upheld the authority's decision because the HFE Act does not provide discretionary powers to waive domestic consent requirements. The Court of Appeal agreed but also decided that the authority could have used a statutory discretion to allow the transport of Blood's sperm to Belgium for treatment.

In Blood's case, Lord Hoffman noted that the sperm's storage was unlawful without the requisite written consent. However, given the unprecedented circumstances, he realised it was necessary for the clinic to store the sperm first and decide the legality later. He commented that he did not foresee the Courts would consider the legality of exporting unlawfully stored sperm again. A decade later, posthumous sperm has unlawfully been stored pending resolution of new legal arguments and Mr Justice Charles has likewise declared the case a 'novelty' in the law. 

Following the Blood case, the Government held a review of the law. The 1998 report concluded that the 'written consent' requirement should remain. Coincidentally, on the same day last week, MPs in the lower house of Victoria, Australia passed a package of reproductive law reforms which included a controversial clause to allow women to conceive using their partner's posthumous gametes provided she has prior written consent.

2008

Approximately one in every 400 children suffers from Type 1 Diabetes . However, a team of scientists from the University of Florida recently discovered that blood from the umbilical cord might contain stem cells that can help defeat this debilitating disease.

Type 1 Diabetes is a condition where the body’s immune system attacks the pancreatic tissues, rendering them unable to synthesize insulin (a hormone that helps cells take in glucose). As a result, patients suffer from high blood sugar and a slew of other symptoms. One promising way to treat diabetes is to replenish or copy the damaged pancreatic tissue, and it is for this reason that Dr. Michael Haller and his team from the University of Florida’s College of Medicine looked to study the use of umbilical cord stem cells in diabetes. As Dr. Haller says, this could potentially “change the course of the natural history of the disease.”

Dr. Haller’s team attempted to tamper with the stem cells from cord blood so that they would produce insulin. However, finding children that were recently diagnosed was essential to the experiment, because their insulin needs were still minimal. Researchers then prepared 2-7 intravenous infusions of stem cells isolated from the patient’s umbilical cord blood (which had been banked at birth). After delivering the infusions to the diagnosed children, evaluations were conducted over two years to assess blood sugar levels and cell function.

It was found that the children required less medicinal insulin and also maintained better control of their blood sugar. Additionally, they had higher levels of regulatory immune cells in their blood, indicating that the procedure was successful. However, Dr. Haller explains that the findings were not a “cure-all.” Instead, the delivery of infusions should be regarded as a form of “immunotherapy” that will attempt to “protect what’s left of their insulin production for an extended period of time.”

Although stem cell research is currently a controversial topic in Washington, Dr. Haller claims that there was no real controversy related to cord blood. Instead, cord blood is essentially a “waste product,” but also a “precious resource” that is “increasingly seen as a potential area of study.” And although initially surprised with the number of children that had banked their cord blood, Dr. Haller was quick to point out that “not all have the means to do that.”

Dr. Haller’s research has the potential to change the lives of hundreds of thousands of families around the world and may, if successful, lead to new treatments for other forms of diabetes as well.

Reference:
American Diabetes Association.

8 October 2008

The number of women having successful in vitro fertilisation (IVF) treatment topped 10,000 for the first time in 2006, according to new figures released by the HFEA today. There were 10,242 births resulting in 12,596 babies in 2006, an increase of 13.1% on the number of births in 2005.

These figures have been published following an update to the HFEA´s interactive "Find a Clinic" guide (see www.hfea.gov.uk/guide).  Find a clinic provides patients with live birth rate information for clinics carrying out IVF and donor insemination (DI).

Live birth rates (the percentage of live births per treatment cycles started) also rose - 23.1% of treatments resulted in a live birth in 2006, up 1.5% for on the previous year.

In 1992, the full first yearafter the HFEA started collecting data, the live birth rate was 13%.

The number of patients and the number of treatments also increased. These latest figures show that 34,855 women were treated at UK clinics in 2006 - an increase of 6.8% on the previous year - and underwent 44,275 cycles of treatment.

Overall success rates increased in every age group. For women under 35 using their own fresh eggs, the live birth rate was 31% compared to 29.6% in 2005.

For women over 44 using their own fresh eggs, the rate increased from 0.8% in 2005 to 4% in 2006.

These latest figures show:
· IVF patient numbers up 6.8% (32,626 patients in 2005)
· IVF treatments up 5.6% (41,932 cycles in 2005)
· Births following IVF up 13.1% with 10,242 successful births resulting in 12,596 babies (in 2005 there were 9,058 births resulting in 11,262 babies)
· Overall rates of multiple birth - the biggest risk for mothers and babies after IVF - fell from 24% of births in 2005 to 22.7% in 2006.

Donor insemination treatments are down 28%, with 4,225 treatments carried out in 2006 compared to 5,865 in 2005.  Overall success rates for donor insemination are up slightly - 10.8% of treatments resulted in a live birth compared to 10.3% in 2005.

Find a Clinic includes details of every licensed fertility clinic in the UK -
the services offered, treatments carried out and numbers of children born. In addition to data for individual clinics, overall figures for the UK are also published so that patients can compare success rates for their age group and treatment type.

Find a Clinic, the HFEA´s Guide to Infertility and the HFEA´s website combine to provide patients with a great deal of information to help them make informed decisions about what treatments are available, what help is available and what clinics can offer them.

· There were more than 1.2 million views of the HFEA Find a Clinic website - www.hfea.gov.uk/guide - with each visitor looking at 14 pages on average, showing that patients are doing thorough searches across a number of clinics.

· 70% of patients say that the interactive Find a Clinic information is either very useful or useful

Professor Lisa Jardine, Chair of the HFEA said:
"In the year that we celebrated the thirtieth anniversary of the birth of the world´s first IVF baby, these latest figures show just how far we´ve come. IVF is now commonplace, with the number of treatment cycles and births rising yet again.

"A key function of the HFEA is to be an information resource, helping to guide people through their treatment journeys and giving them the information they need to feel properly informed about the choices they are making. We are currently at the start of a consultation process that will look closely at how we might further improve the information that we publish to best capture the performance of clinics. A more sophisticated analysis of national data would be valuable to patients, clinics and the NHS.

"However, the number of donor insemination cycles and births continues to fall. While more couples are able to take advantage of techniques such as ICSI, for those patients whose treatment requires donor sperm, this is of great concern. The HFEA is supportive of clinics that are actively recruiting donors and we welcome the BFS Working Party proposals to introduce a national system for donor recruitment."

· Further national statistics and background notes are provided in "Facts and Figures 2006 - fertility problems and treatment." (See link) It includes data on the number of multiple births, regional data and the age of women coming forward for treatment.  Information and data for specific clinics can be found here: www.hfea.gov.uk/guide

http://www.hfea.gov.uk/en/1635.html

Charlotte Maden
Progress Educational Trust
06 October 2008

Scientists at the University of Oxford, UK, believe they have identified the way in which embryos implant in the uterus, providing essential information which may be used in the future for infertility treatments and offering hope to thousands of infertile couples.

Implantation of an embryo to the lining of the mother's uterus is an essential process that takes place at an early stage of development. The embryo initially attaches and forms a contact with the uterus lining, which triggers a cascade of signals in both the embryo and the uterus. This allows cells from the embryo to start moving across into the uterus, finding blood vessels in the mother and eventually forming the placenta.

Problems in the implantation process can lead to loss of potential pregnancies, even in couples trying to conceive without infertility problems. Current estimates suggest that infertility affects one in seven couples in the UK, with around 32,000 couples seeking infertility treatment each year. It is thought that a significant number of these patients could be infertile as a result of implantation problems.

The team of scientists, led by Professor Helen Mardon from the Nuffield Department of Obstetrics and Gynaecology at Oxford, along with Professor Anne J Ridley at King's College, London, added embryos to a layer of cells from uterus lining in a culture dish to mimic events in the womb. They were then able to video embryos implanting themselves in the cell layer, allowing the scientists to dissect the molecular processes involved. Their findings were published in the journal Proceedings of the National Academy of Sciences.

Their investigation led them identify two proteins that are essential players in the implantation process. They are from the Rho GTPase family of proteins, and ensure that cells in a particular part of the uterus lining move out of the way of the 'invading' embryonic cells.

Professor Mardon said: 'We have shown that two proteins, called Rac1 and RhoA, control the invasion. The first stimulates cells in the womb lining to move and allow the embryo to invade and implant properly while the second inhibits this. We believe this controlled balance of the two proteins is critical for successful implantation of the embryo. If the balance of Rho GTPases is altered, the cells of the womb lining don't migrate and the embryo doesn't implant'.

The findings bring new hope to people with infertility issues. The new information will help the understanding of how this process works, and therefore aid 'the development of drugs to help embryos implant properly', said Prof Mardon.

LifeNews.com Note: The three authors write for the Family Research Council.

As the reader will see from our prior publication, "Adult Stem Cell Success Stories - 2006," [1] adult stem cell research had an impressive track record as of 2006-over 1100 FDA approved clinical trials in the United States for 72 different illnesses and disabilities.

2007 has seen further advances in adult stem cell research and therapy. Currently, peer-reviewed studies have documented over 1400 FDA approved trials[2] for 73 different conditions in humans where patient health has been improved through adult stem cell therapy.[3]

Adult stem cells are found throughout the human body from birth onward, in placentas, and in umbilical cord blood. Unlike embryonic stem cell research, no embryos are destroyed in retrieving them.

Treatments with adult stem cells continue to be so impressive and continually increasing that we have decided to publish a yearly update each fall/winter. (Note: There have been no successful treatment trials in human beings using embryonic stem cells.)

Unlike embryonic stem cells and the recently discovered (and ethical) "induced pluripotent stem cells" ("iPS cells")[4], adult stem cells do not create tumors.[5]

Below we summarize some of the developments in adult stem cell research and treatments since our 2006 paper.

Heart Tissue Regeneration

Doug Rice of Otis Orchards, Washington, was diagnosed with congestive heart failure eight years ago. Diabetes prevented him from receiving a heart transplant.

Facing the possibility that he would suffer fatal heart failure, Rice flew to Thailand to receive an experimental adult stem cell therapy through the company TheraVitae. Stem cells were isolated from Rice's blood in a lab in Israel and differentiated into angiogenic cell precursors, and transferred back into Rice's heart.

So far, TheraVitae has treated over 100 patients, 80 of whom have seen improvement, with the remainder holding steady. In Rice's case, the results were immediate, with his heart increasing to 41 percent efficiency from 11 percent before the procedure. According to Rice, "I've been around a lot of people with bad hearts. I know if they looked at [adult stem cell therapy], it might save their lives. I firmly believe it saved mine."[6]

Osiris Therapeutics is another company that has begun using adult stem cells to treat heart patients. Their "easy to administer" adult stem cell treatments have been given to recent heart attack victims, who have seen their hearts pump blood 25 percent more efficiently on average, when tested at both three and six months intervals following the procedure.

The procedure is done intravenously, thus raising the possibility it could be widely and easily used at local hospitals. Marc Penn, director of the Bakken Heart Brain Institute at the Cleveland Clinic, says of the new therapy, "It's very exciting, perhaps a sea-changing trial for the field ... offering the chance of an off-the-shelf-product."[7]

Bodo-Eckehard Strauer is the director of the cardiology department at D|sseldorf University Hospital, and has used bone marrow stem cells to treat over 300 heart patients. In September, 2007, Dr. Strauer used adult stem cells on a patient "on the verge of dying" following a severe heart attack. Following seven weeks in intensive care, he received a transplant of his own bone marrow adult stem cells from Dr. Strauer, and his condition improved. This seems to be the first time that cardiogenic shock has been treated by adult stem cells. Dr. Strauer calls it a "global innovation."[8]

Type 1 Diabetes

Jaider Furlan Abbud is one of 13 patients who were the first to be successfully treated with adult stem cells for Type 1 Diabetes. Dr. Abbud and the other patients participated in a clinical trial led by researchers from Northwestern University and Brazil. Dr. Abbud became insulin-free after receiving treatment which included an adult stem cell transplant using his own blood stem cells.[9]

Bone Cancer

Carol Franz has survived two bouts of multiple myeloma-a cancer of the bone marrow- because of adult stem cell transplants. In 2003, when Franz first was diagnosed with the disease, the only way to keep the cancer from destroying her bone structure was to undertake five months of aggressive chemotherapy.

Following this, Franz had some of her blood removed, and her adult stem cells were isolated. Next Franz was given additional chemotherapy treatment. Then her adult stem cells were transplanted back to her withered bones, which regenerated.

Three years later Franz was again diagnosed with multiple myeloma, and again was treated with her adult stem cells. To this day she is healthy and cancer free.[10]

Nerve Regeneration

Dr. Paul Kingham of the United Kingdom Centre for Tissue Regeneration in Manchester and his team announced in October that they were able to transform isolated adult stem cells from human fat tissue into nerve cells. They expect to isolate more such stem cells and use them to create artificial nerves. According to Dr. Kingham, "The differentiated stem cells have great potential for future clinical use, initially for treatment of patients with traumatic injuries of nerves in the arms and the legs."[11]

Liver Cancer

Scientists at the University of D|sseldorf have successfully taken bone marrow stem cells from liver cancer patients and used them to regrow liver cells in their patients. Two years after the procedure, six of the eight patients have healthy livers.[12]

Neurological Disease

At the University of California, Irvine, scientists used adult stem cells in restoring the memory of mice. Lead researcher, Mathew Blurton-Jones, said of the finding, "This is one of the first reports that you can take a stem cell transplantation approach and restore memory ... There is a lot of awareness that stem cells might be useful in treating diseases that cause loss of motor function, but this study shows that they might benefit memory in stroke or traumatic brain injury, and potentially, Alzheimer's disease."[13]

--------------------------------------------------------------------------------

[1] For a comprehensive survey of adult stem cell research successes prior to 2007, please see Family Research Council's Insight paper "Adult Stem Cell Success Stories - 2006." Available at: http://www.frc.org/get.cfm?i=IS06H01

[2] See clinicaltrials.gov; searching with the term "stem cell". For discussion of stem cell search terms, see the online supplementary information for Prentice, D. A. and Tarne, G., "Adult versus Embryonic Stem Cells: Treatments," Science 316 (June 8, 2007): 1422-1423. Available at: http://stemcellresearch.org/facts/scienceletter.htm, or http://www.sciencemag.org/cgi/data/316/5830/1422b/DC1/2

[3] For the most recent list, see http://stemcellresearch.org/facts/treatments.htm and the peer-reviewed reference list at that site.

[4] In this procedure, one's own body cells are directly re-programmed to an embryonic-like stem cell state. Since this kind of embryonic stem cell, or iPS cell, was not derived through the destruction of a living embryo, their retrieval for research does not pose an ethical problem. Takahashi K., et al., "Induction of Pluripotent Stem Cells from Adult Human Fibroblasts by Defined Factors," Cell 131 (November 30, 2007): 861-872, published online November 20, 2007; Yu, J., et al., "Induced Pluripotent Stem Cell Lines Derived from Human Somatic Cells," Science published online November 20, 2007; Nakagawa, M., et al., "Generation of Induced Pluripotent Stem Cells without Myc from Mouse and Human Fibroblasts," Nature Biotechnology, published online November 30, 2007.

[5] The iPS cells, being an "embryonic-type" stem cell, have the same propensity to multiply out of control and produce tumors as do embryonic stem cells taken from embryos.

[6] Kevin Graman, "Lending Heartfelt Support: Stem Cell Recipient Spreads Message," The Spokesman-Review (June 19, 2007). Available at: http://www.spokesmanreview.com/local/story.asp?ID=195513

[7] Rob Waters, "Stem Cells Spotlighted in Baxter Heart Study: Treatment Believed to Reverse Heart Failure," Bloomberg News (July 16, 2007). Available at: http://www.chicagotribune.com/business/chi-mon_baxterjul16,1,1153370.story

[8] Brehm, M. and Strauer, B. E., "Reversal of Therapy-resistant Cardiogenic Shock after Intracoronary Transplantation of Adult Autologous Bone Marrow-derived Stem Cells," Dtsch Med Wochenschr 132 (September 2007):1944-1948,

[9] Voltarelli, J. C., et al., "Autologous Nonmyeloablative Hematopoietic Stem Cell Transplantation in Newly Diagnosed Type 1 Diabetes Mellitus," Journal of the American Medical Association 297 (April 11, 2007):1568-1576.

[10] See carolfranz.com; J. Mehta and S. Singhal, "High-dose Chemotherapy and Autologous Hematopoietic Stem Cell Transplantation in Myeloma Patients under the Age of 65 Years, Bone Marrow Transplant 40, 1101-1114, 2007; A. Aviles, et al., "Biological Modifiers as Cytoreductive Therapy before Stem Cell Transplant in Previously Untreated Patients with Multiple Myeloma," Annals of Oncology 16 (2005): 219-221.

[11] Roger Highfield, "'Bionic' Nerve to Repair Injured Limbs," The Telegraph (October 18, 2007).

[12] Celia Hall, "Stem Cell Treatment Saves Liver Cancer Patients," The Telegraph (March 27, 2007). Furst, G., et al., Portal Vein Embolization and Autologous CD133+ Bone Marrow Stem Cells for Liver Regeneration: Initial Experience," Radiology 243 (April 2007): 171-179, published online Feb 20, 2007.

[13] Steven Reinberg, "Stem Cells Restore Memory in Mice," HealthDay (October 31, 2007). Yamasaki, T. R., et al., "Neural Stem Cells Improve Memory in an Inducible Mouse Model of Neuronal Loss," The Journal of Neuroscience 27 (October 31, 2007): 11925-11933.

Lorna Stewart
Progress Educational Trust
06 October 2008

A study of 2000 men, conducted by Dr Anette Aggerholm and colleagues at Aarhus University Hospital in Denmark, has found no association between obesity and semen quality. The study, published in the journal Fertility and Sterility, involved taking blood and semen samples from all participants as well as recording lifestyle information, height and weight. In contrast, other recent studies (summarised in a literature review this month in Fertility and Sterility) have linked obesity with decreased fertility.

The men who took part in the study ranged in age from 18 to 66 years old and nearly half were overweight. The researchers noted that levels of sex hormones were generally more decreased the more overweight a man was, and men who were moderately overweight had slightly lower sperm counts than men of average weight. However, obese men did not have lower sperm counts or sperm quality than men of an average weight. Dr Aggerholm concluded that, whilst there was a strong association between obesity and hormonal changes, there was no such association between obesity and semen quality.

Work published in the same journal in August this year by Dr Eric Pauli and his colleagues at Pennsylvania State University College of Medicine, US, also found that obese men had lower levels of sex hormones in their blood. The much smaller study of only 87 men found that the more obese a man was, the lower his levels of hormones essential for reproduction. Dr Pauli and colleagues did not assess semen quality but suggest that hormonal changes could act to decrease a man's fertility when acting in concert with dampened libido and increased risk of erectile dysfunction (both of which have been established by previous studies of obesity).

A literature review published this month, also in Fertility and Sterility and authored by Dr Hammoud and colleagues of University of Utah School of Medicine, US, concludes that there is now good evidence for a link between obesity and decreased fertility in males. They call for greater clinician awareness of the effects of obesity on fertility as well as studies into the reversibility of obesity-associated male infertility with weight loss.

ity To Regenerate Other Tissues

A collaborative study conducted by a group of Spanish scientists from the University of Granada and Leon has concluded that mononuclear blood cells derived from the human umbilical cord blood can be used to treat liver disease, such as hepatitis. The study results will be published in the upcoming issue of Cell Transplantation.

Luis G Fontana, lead scientist working at the Department of Biochemistry and Molecular Biology, University of Granada, and colleagues, introduced human umbilical cord blood cells (HUCBCs) through the hepatic portal vein of D-galactosamine-induced hepatitis mice models. The analysis of enzymatic activities of various liver enzymes, including alkaline phosphatase, alanine transaminase, lactate dehydrogenase and gamma-glutamyl-transferase, as well as monitoring of total and direct bilirubin levels, demonstrated a significant improvement in both histological damage and the hepatic function of the rats following cell transplantation.

In an earlier research, Xiuli Wang and coworkers (Blood, 2003) transplanted highly purified CD34⁺CD38^-CD7^- human hematopoietic stem cells obtained from umbilical cord and bone marrow, into immunodeficient mice, to evaluate the efficacy of the stem cell-based treatment strategy for liver disease. One month after the transplantation procedure, the mice models were induced with liver damage and hepatocyte proliferation by administering carbon tetrachloride (CCl₄). The researchers observed increased expression levels of human-specific albumin mRNA and protein in the serum of CCl₄-injured mice models, one month post liver damage. However, the scientists documented the lack of human albumin in mice that did not receive transplantation and in noninjured controls transplanted with the stem cell population. The study indicated the development of albumin-expressing hepatocyte-like cells in the liver of immunodeficient mice, suggesting the use of bone marrow and umbilical cord stem cells as an effective treatment strategy for liver diseases.

The term hepatic or liver disease denotes a broad range of conditions or disorders that affect the structure or proper functioning of the liver. There are diverse causes for liver diseases including viral infection, injury, genetic defects, and exposure to drug or toxic compounds. Nausea, vomiting, reduced appetite, jaundice, low-grade fever, muscle pain, and fatigue are some of the common symptoms associated with different types of liver diseases.

According to the 2007 report of the American Liver Foundation (ALF), one in ten US individuals are affected with liver diseases. Hepatitis, cirrhosis, hepatic carcinoma, alcohol-related liver diseases are some of the commonly occurring hepatic diseases. Liver transplantation is the only treatment modality for patients with end-stage liver diseases. As per ALF, the number of patients undergoing transplantation has increased rapidly in recent years, and currently around 17,000 Americans are awaiting surgical treatment. Stem cell therapy, using bone marrow or umbilical cord cells, could be an effective alternative for liver transplantation in treating irreversible liver dysfunction and also for managing other chronic hepatic diseases.

References

1. Scientists use stem cells from the umbilical cord to treat hepatic diseases. Press Release. University of Granada. Last accessed on July 9, 2008.

2. Wang X, Ge S, McNamara G, et al. Albumin expressing hepatocyte-like cells develop in the livers of immune-deficient mice transmitted with highly purified human hematopoietic stem cells. Blood. Online Publication. January 30, 2003.

UK survey reveals that three-quarters of infertile patients would consider treatment abroad

 MacKenna Roberts
Progress Educational Trust
27 July 2008

An overwhelming majority of infertility patients in the UK said they would contemplate travelling abroad for fertility treatment, according to the first comprehensive study on the strength and motivations behind the fertility tourism industry. Among the 339 infertile patients who responded to an online poll conducted by Infertility Network UK, 76 per cent stated they would be willing to seek fertility treatment outside the UK with 70 per cent citing their reasons would be to avoid higher costs and long wait-lists at UK clinics. Infertility Network UK performed the survey for this year's National Infertility Day on Saturday, 19 July 2008, when it announced its findings at a conference in central London. 

Other popular reasons provided by the patients for why they might prefer to receive fertility treatment abroad were high success rates (61 per cent) and the greater availability of donor eggs and sperm (54 per cent). The UK has suffered a decline in the number of egg and sperm donors since removing donor anonymity by law in 2005. The 24 per cent opposed to treatment in overseas clinics were commonly concerned about lower standards, lack of regulation and language-barrier difficulties.

Clare Brown, Chief Executive of Infertility Network UK, blames the current 'appalling' difficulties - such as 'postcode lottery' arbitrary provision - that infertile couples face in Britain in order to access fertility assistance: 'If the NHS funded three full cycles of treatment as recommended by NICE, many couples would not be forced to consider going abroad for treatment', she said. She warned that regulations can be totally different for foreign fertility clinics and it is 'absolutely vital' for individuals to do 'thorough research beforehand'.

Yet the study revealed an 88 per cent level of satisfaction from those who received treatment abroad, reportedly not only due to lower costs, shorter waiting-lists and successful pregnancy rates but also due to general staff attitude, atmosphere and state of the facilities. Clare Brown added that she hopes 'that clinics in the UK take into account the findings of this survey and learn from the good experiences many couples have had at clinics abroad'.

Among those who were dissatisfied, 47 per cent experienced problems due to language and communication difficulties and 37 per cent due to unregulated practice. Prime Minister Gordon Brown stated, 'The Government is working directly with Infertility Network UK, as well as experts in the NHS to ensure the needs of people with fertility problems are recognised and addressed'.

This Friday, 25 July, marks the birthday of Louise Brown, who was the world's first IVF-conceived child born in England. Thirty years onward, roughly 3.5 million IVF-assisted babies have been born worldwide, averaging at least 200,000 annually. However, infertile individuals in the UK are among the least likely in the developed world to receive IVF with one of the lowest annual IVF performance rates in Europe - under 700 per million Britons. In 2005 just 1.6 per cent of total births were assisted pregnancies compared with rates of 3-3.5 per cent in Scandinavia.

A special-focus Economist article attributed the low statistics to the lack of public funding available and the low-priority ascribed to infertility as a medical condition in the UK. Only nine out of the 152 local primary-care trusts provide the three recommended IVF cycles. In 2005, two-thirds of the IVF cycles performed in Britain were privately funded.

june 2008 

Neurological Disorders: A Focus On Cord Blood Stem Cells As A Potential Treatment Option

Main Category: Neurology / Neuroscience
Also Included In: Stem Cell Research
Article Date: 23 Jun 2008 - 2:00 PDT


Today there are more than 600 known disorders and conditions that affect the nervous system and for many of them treatment options are extremely limited. In addition to the physical and mental toll these conditions take on patients, their families and caregivers, they also have an enormous economic impact, resulting in hundreds of billions of dollars annually in medical expenses and lost productivity.(1)

Scientists are pursuing research to gain a better understanding of the human nervous system in order to find new breakthroughs. Stem cell therapy is one therapeutic option that is showing great promise. Due to the complexities involved in harvesting human neural cells, easily-accessible, alternative stem cells - like those found in umbilical cord blood - are being researched as potential sources for cellular therapies to treat neurological diseases.

A Closer Look at Cerebral Palsy

Cerebral palsy is a broad term that refers to a group of neurological disorders caused by an injury to the brain that affect body movement and muscle coordination.(2) An estimated two million children and adults have cerebral palsy in the United States, and an additional 10,000 babies and infants are diagnosed with the condition annually.(3)

There is currently no cure for cerebral palsy and no standard therapy that works for all patients. Since many of the brain damage-related incidents that cause cerebral palsy occur during pregnancy, prevention is often difficult - leading many researchers to believe regenerative stem cell therapies may offer a treatment option to regenerate nerve tissue and repair damage to the brain.

Moving into the Clinic: Cord Blood as Experimental Treatment

In vitro studies have shown cord blood stem cells are able to differentiate into neural cell types.(4,5,6) In animal models, research has demonstrated convincing evidence that cord blood stem cells injected intravenously migrate to the brain (passing the blood-brain barrier) and improve neurological function and promote healing.(7,8,9) The results from such studies lead many researchers to suggest that infusion of cord blood stem cells could alleviate damage to the brain tissue, reduce muscle tightness, and improve gait and mobility-related symptoms in humans.(7,8,9)

This research also lends support for the pioneering clinical work at Duke University, focused on evaluating the impact of autologous cord blood infusions in children diagnosed with cerebral palsy. Dr. Joanne Kurtzberg, a professor of pediatrics and pathology and director of Duke's Pediatric Blood and Marrow Transplant Program, is infusing the child's cord blood stem cells back into the body in an effort to facilitate repair of brain tissue damaged by perinatal hypoxic (oxygen-deprived) events. To date, more than 20 children have participated in the experimental treatment.

Beyond Cerebral Palsy: Cord Blood and Other Neurological Disorders

The promising advances being made in cerebral palsy may soon benefit patients with other neurological diseases as well. In animal models of spinal cord injury, cord blood stem cells have been shown to reduce the size of injury, promote neural tissue growth and improve motor function, leading researchers to believe that cord blood stem cells may prove to be a useful therapeutic strategy to repair injured spinal cords.(10,11,12,13) In fact, a case study published in 2005 showed that a 37-year-old spinal cord injury patient who received a transplant of cord blood stem cells directly into the injured site showed improved sensory perception and movement in the hips and thighs within 41 days of treatment. CT and MRI results also showed regeneration of the spinal cord at the injured site.(14)

Regenerative Medicine: A New Frontier

Regenerative medicine, using stem cells to repair or replace damaged tissue, is an area of study in which cord blood stem cells hold great promise. Current estimates indicate that approximately 1 in 3 Americans could benefit from regenerative medicine.(15) Other recently published data indicate that as many as 1 in 217 people will undergo a traditional stem cell transplant in their lifetime. When accounting for future stem cell applications, like emerging regenerative medicine therapies, the researchers estimated the odds of needing a stem cell transplant will be 1 in 102 persons.(16)

For use in regenerative therapies, current scientific use suggests that access to autologous (one's own) stem cells offers better treatment options for patients. Because younger patient populations are more likely to have access to their own cord blood, this therapeutic advancement may hold the greatest hope among children. Cord blood will continue to be evaluated for cerebral palsy and other neurological disorders in the future as more individuals have access to their preserved, autologous cord blood.

Evelyn Harvey
Progress Educational Trust
27 May 2008

A legal fight by a UK woman to have a child using sperm taken from her husband after his death is underway. The case highlights the need for regulatory clarity on the issue, which first came to prominence in 1995 when Diane Blood won the right to conceive using sperm from her comatose spouse. 

Doctors were allowed to harvest the sperm as the unnamed 42-year old woman and her husband, from Twickenham. London, had just begun fertility treatment, a judge ruled. However, the Human Fertilisation and Embryology Authority (HFEA) are questioning the legality of the sperm extraction process. The law currently requires the man's written consent, although a gynaecologist has confirmed that the couple were seeking fertility treatment before the man's death. 'Had the husband had the opportunity to give consent in writing, it is clear from the overwhelming evidence that he would have done so', said David Josiah-Lake, the solicitor representing the woman.   

In Diane Blood's case, she was eventually permitted to undergo treatment abroad when the HFEA lifted its ban on the export of human gametes. She now has two children. She supports the current applicant, saying: 'If the couple were engaged on a joint venture to have a child and there is evidence from a conversation that the deceased would have wished the surviving partner to continue with that notwithstanding his death, then I see no need for that consent to be in writing. I cannot imagine life without my children. They bring joy to a great many people including my late husband's family'.    

Vincent Cable, the widow's local Liberal Democrat MP, submitted an amendment to the Human Fertilisation and Embryology Bill, currently passing through parliament, which would allow the use of sperm in such cases in the UK, removing complications surrounding cross-border fertility treatments. He additionally proposed that a consultant's confirmation of the deceased's intention to have children should be sufficient evidence of consent.   

'This amendment is quite narrowly drawn but would deal with a small number of specific cases where it is a woman's right to have a child by her partner. In this case the couple were already embarking on fertility treatment and it was clear her husband had it in mind to support her having a child in this way, so she could have a stronger case than Mrs Blood', said Cable.  

The widow hopes that the HFEA will allow her to use her late husband's sperm to conceive a brother or sister for their only daughter. The HFEA said that they could not comment on the case as it was before court.