Stem cell medical tourism and unproven stem cell interventions are a growing concern for many patients. According to a research by the Boston University School of Medicine, an increasing number of clinics worldwide are offering baseless and scientifically unproven expensive stem cell-based therapies - which are usually ineffective - to desperate patients.

The recent study revealed questionable marketing practices and dubious claims from 417 websites advertising stem cell-based therapies. It was thought that stem cell tourism offered online was predominantly from countries in Southeast Asia, Russia and Eastern Europe.

“In the early days of this under-regulated industry, clinics were typically located in developing economies, where weak laws or lax enforcement enabled these businesses to operate with relative impunity,” said senior author Professor John Rasko from the University of Sydney.

Gap between expert and public perception of stem cell therapy

"Remarkably, an increasing number of these clinics now operate within the United States. It is imperative that scientific and medical societies, as well as professional respiratory disease and critical care communities speak out forcefully against stem cell tourism," according to Leartis Ikonomou, PhD, assistant professor of Molecular and Translational Medicine at BUSM and member of the Center for Regenerative Medicine.

Ikonomou, a lead member of the American Thoracic Society's Stem Cell Working Group, also said that the general public perceive stem cell-based therapies differently as they are motivated by hope or are desperate for a cure, whereas health experts and stem cell researchers evaluate therapies based on evidences of safety and efficacy.

However, compared to stem cell researchers and health experts, the general public perceive stem cell-based therapies differently, according to Ikonomou, a lead member of the American Thoracic Society's Stem Cell Working Group. Whereas experts evaluate therapies based on evidence of safety and efficacy, patients are motivated by hope or are desperate for a cure.

Stem cells are self-renewing cells that can differentiate into various specialised cell types such as blood cells and skin cells. In regenerative medicine, stem cells can be used to repair and replace damaged tissues in the body. They can also be used to treat numerous diseases, such as cancer, autism, heart disease, and Alzheimer's. However, stem-cell research is still in a very early stage and few human trials have taken place.

Increasingly, stem cell medical tourism has become more popular, probably due to growing evidence that stem cells can be used to cure many age-related diseases and delay ageing, such as the PRP therapy, which extracts platelet rich plasma for facial rejuvenation, making patients look younger.

Popularity on the rise in Asia, but to what end?

In 2007, around 25,000 Malaysians -with hopes that advances in stem cell research will break new frontiers that would keep them young forever - have registered to have their stem cells stored five years after stem cell storage was introduced in Malaysia. Other Southeast Asian countries, such as Singapore, Thailand, Indonesia and the Philippines, are paving the way for stem cell research and therapy, according to Rasko’s study.

Ikonomou and colleagues suggest several reasons the rise in stem cell medical tourism: aggressive and unscrupulous advertisement of unproven stem cell therapies, overly hyped portrayal of stem cell therapy in mainstream media, bias selection of patient testimonials to suggest benefit, and the reluctance of experts to speak-out against stem cell medical tourism due to fears of litigation and political backlash.

Nevertheless, regulating these therapies can be a challenge. To tackle the problem of unregulated therapies in stem cell medical tourism, Ikonomou suggests that all parties including patients, doctors and scientists should be continuously educated through international collaboration and engagement.

The US Food and Drug Administration (FDA) have also warned consumers to be cautious about stem cell claims, and urged them to “to learn all they can about the regulations covering any stem cell-based product they are considering”.

According to the International Medical Travel Journal, stem cell therapy can be categorised in three ways, based on the degree of regulation and scientific support: first, are clinically proven stem cell treatments that have undergone rigorous clinical trials in accredited institutions backed by a huge budget; second is non-approved stem cell treatment in reputable centres offered by qualified health professionals, where the patient is fully informed of the lack of scientific support and its related risks; and lastly, fraudulent stem cell treatments where clinics are not licensed or regulated, and the promotional claims for the therapy’s safety and efficacy are exaggerated, and have little or no scientific backing.

Currently, FDA has only approved the use of stem cells for leukaemia treatment - commonly known as bone marrow transplants - and some bone, skin and corneal diseases or injuries, according to the International Society for Stem Cell Research. Other stem cell treatments are still at very experimental stages.

Heart muscle cells grown from stem cells aid in predicting drug-related heart damage

Besides the ever growing focus on stem cells for treatments, researchers at the Stanford University School of Medicine have utilised the nature of stem cells to predict the reaction of a patient's heart to a drug.

Heart muscle cells were made from induced pluripotent stem cells, which mimic the expression patterns of key genes in the donor's native heart tissue to be used as a proxy to predict any drug-related heart damage before administering the drug to the patient.

The research validates the use of these stem-cell-generated heart muscle cells to test the potential cardiotoxicity of certain drugs and also to devise new therapies for conditions such as cardiomyopathy. This could increase the safety profile of many medications, the researchers say.

"30% of drugs in clinical trials are eventually withdrawn due to safety concerns, which often involve adverse cardiac effects," said Joseph Wu, MD, PhD, director of Stanford's Cardiovascular Institute and professor of cardiovascular medicine and of radiology. "This study shows that these cells serve as a functional readout to predict how a patient's heart might respond to particular drug treatments and identify those who should avoid certain treatments." MIMS


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