At the present moment following diseases / conditions are dealt with by Mediescapes India specific to our Indian collaborations*:

1. Critical limb ischemia / ischemic ulcer of the leg, foot especially in
   diabetic patients untreatable with conventional treatments such as bypass
   surgery

2. Ischemic heart diseases and cardiomyopathy untreatable with
   conventional treatments such as angioplasty, stents or bypass surgery

3. Spinal cord injury and neurological trauma where the patient has no
    conventional treatment available and left paraplegic

4. Cirrhosis of Liver

5. Oral Submucal Fibrosis

* In India as per the ICMR guidelines the stem cell aplication is done as an experimental therapy and the guidelines are availabe at: http://www.icmr.nic.in/stem_cell/stem_cell_guidelines.pdf

For diseases which are not mentioned above you may send an email with complete details of the patient. A latest discharge summary would be ideal. This would be put forth to our team of physicians and we shall revert **.

1. Alzheimer's disease
2. Parkinson's disease
3. Ischemic stroke
4. Autism
5. Cerebral palsy
6. Sensory Neural hearing loss
7. Motor Neuron Disease (ALS)

** We also reserve the right to refer few selected cases to our partners in China for their further feedbacks.

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Current status of Stem Cell Treatment in India - For Heart Disease

Adult stem cell treatment has been found to be useful for Advanced Coronary artery disease and heart Muscle damage after Myocardial Infarction (heart attack). The stem cells are Injected either into the coronary arteries via a special catheter or directly into the Heart muscle. In very high risk cases it can be injected in a Peripheral vein. Many studies have shown 20-40 % improvement in the Pumping capacity (Ejection fraction) and circulation status of the Heart using Stem cell therapy. The procedure is entirely painless.

Recent Clinical trials - like The "BOOST TRIAL" and "REPAIR - MI" have confirmed the value of Adult Stem cells in the treatment of Heart patients having Low Ejection fraction or advanced Coronary artery disease.
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Current status of Stem Cell Treatment in India - For Spinal Cord Injuries

Stem cells have found use in Patients with Muscular or Bladder paralysis after Spinal Cord Injury. In patients with paraplegia. This therapy is of maximum use in patients 1-2 years after Spinal cord injury. It could also be potentially of use for patients with other neurological diseases of the spinal cord. In the future the therapy may be useful for patients with Brain Damage also. Stem cell Injected directly into the Spinal fluid or around the spinal cord, at the site of injury has been found to improve nerve function. The Injection procedure is done under local anesthesia and is painless.
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Current status of Stem Cell Treatment in India - For Liver Failure

Stem cells have shown to be of value in patients with reduced liver function and cirrhosis with Liver fibrosis. Direct injection into the hepatic artery has also shown good clinical improvement in many patients.

This is a major medical breakthrough as Acute Liver failure has no definitive therapy and patients will not be able to survive the long wait for a Liver transplantation
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Current status of Stem Cell Treatment in India - For Cancer

Natural Killer cells (NK cells) which can be purified from the peripheral blood is found to be beneficial even in late cases of cancers like - Melanoma, Liver, pancreatic, lung and Gastric cancers. This treatment is called "Autologous Immune Enhancement therapy" (AIET).
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What is a clinical trial?

A clinical trial is a scientific study of potential new treatments or medications for a particular disease or condition. It is used to evaluate possible treatments that have potential effects against the disease/condition. Scientists may test whether a treatment is simply effective and safe, or if one treatment is more effective than another. Of course, how well a drug is tolerated is also a focus. A clinical trial involving human subjects is part of the long and careful process in the evaluation of a treatment candidate. If a new treatment or medication is proven effective AND safe, it may become approved for use in a specific population.

What is the benefit for clinical trial participants?

By participating in a clinical trial, a person helps to provide valuable information about his or her disease and possible treatment options. Participants may find the research to be beneficial to themselves, though this is not always the case. A trial may use a placebo (an inactive substance that helps determine a potential treatment’s safety and effectiveness when compared to an active drug or treatment) for some of those involved, or the therapy in question might work for only certain participants and not others. There is also a chance that a patient might experience an adverse event or side effect from the use of the drug

What are stem cells?

Stem cells are unspecialized cells that have two important characteristics that distinguish them from other cells in the body. First, they can replenish their numbers for long periods through cell division. Second, after receiving certain chemical signals, they can differentiate, or transform into specialized cells with specific functions, such as a heart cell or nerve cell.

Stem cells can be classified by the extent to which they can differentiate into different cell types:

- Totipotent stem cells can differentiate into any cell type in the body plus the placenta, which nourishes the embryo. A fertilized egg is a type of totipotent stem cell. Cells produced in the first few divisions of the fertilized egg are also totipotent.

- Pluripotent stem cells are descendants of the totipotent stem cells of the embryo. These cells, which develop about four days after fertilization, can differentiate into any cell type, except for totipotent stem cells and the cells of the placenta.

- Multipotent stem cells are descendents of pluripotent stem cells and antecedents of specialized cells in particular tissues. For example, hematopoietic stem cells, which are found primarily in the bone marrow, give rise to all of the cells found in the blood, including red blood cells, white blood cells, and platelets. Another example is neural stem cells, which can differentiate into nerve cells and neural support cells called glia.

- Progenitor cells (or unipotent stem cells) can produce only one cell type. For example, erythroid progenitor cells differentiate into only red blood cells.

At the end of the long chain of cell divisions are "terminally differentiated" cells, such as a liver cell or lung cell, which are permanently committed to specific functions. These cells stay committed to their functions for the life of the organism or until a tumor develops. In the case of a tumor, the cells dedifferentiate, or return to a less mature state.

Research is now being conducted on both adult and embryonic stem cells to determine the characteristics and potential of both to cure disease.

Over 40,000 stem cells transplants are performed worldwide each year, providing recovery from ones-fatal diseases. Experts believe that such transplants will be the answer for many of today's incurable diseases.

Stem cells are primitive immature cells which have the ability to self-replicate and differentiate into any formed blood elements: white cells., red cells and platelets. This allows them to act as a repair system for the body, replenishing other cells as long as the organism is alive.

Blood stem cells can be collected from the bone marrow or bloodstream of:

++ Compatible family member or an unrelated donor.
++ An identical twin
++ Patient's own cells previously collected and suitably stored

What are the sources of stem cells?

There are three sources of stem cells:

- Embryonic stem cells (ESCs) are derived from 4- to 5-day-old embryos. At this stage, the embryos are spherical and are known as blastocysts. Each blastocyst consists of 50 to 150 cells and includes three structures: an outer layer of cells, a fluid-filled cavity, and a group of about 30 pluripotent cells at one end of the cavity. This latter group of cells, called the inner cell mass, form all the cells of the body.

ESC cultures are created in the laboratory by transferring the inner cell mass from a blastocyst into a specially treated plastic culture dish. The cells divide and, after several days, begin to crowd the culture dish. When this happens, the cells are removed and plated into several fresh culture dishes. This process is repeated many times, eventually yielding millions of ESCs. If, after six months, the cells keep dividing without differentiating, are still pluripotent, and are genetically normal, they are referred to as an ESC line.

The blastocysts used for creating ESC lines are derived from eggs that were fertilized in in vitro fertilization clinics but never implanted in a woman’s uterus. The resulting embryos were frozen and later donated for research purposes with the informed consent of the donors. Currently, there are over 400,000 unused frozen embryos in U.S. fertility clinics.

Because ESCs are pluripotent and relatively easy to grow in cell culture, they are attractive candidates for use in stem cell therapies. However, just injecting ESCs into a site of injury would probably result in a tumor growing in that spot. ESCs must first be directed to differentiate into the desired cells, such as heart muscle cells, blood cells, or nerve cells. To control ESC differentiation in cell cultures, scientists try different techniques, such as changing the chemical composition of the culture medium, altering the surface of the culture dish, or inserting specific genes into the cells.

One possible drawback to using differentiated ESC lines in stem cell therapies is that ESCs from one person might illicit an immune response when placed into another person, because the proteins on the ESC surfaces might be viewed as foreign by the recipient’s immune system. However, this is far from certain. ESC derivatives have been transplanted between species (for example, pigs to rats) without being rejected, so the possibility exists that ESC derivatives from one person might be safely transplanted into another person. Studies investigating this have yet to be done.

- Adult stem cells are undifferentiated cells that are found in small numbers in most adult tissues. However, they are also found in children and can be extracted from umbilical cord blood. A more accurate phrase is “somatic stem cells,” although this phrase has yet to be generally adopted.

The primary roles of adult stem cells in the body are to maintain and repair the tissues in which they are found. They are usually thought of as multipotent cells, giving rise to a closely related family of cells within the tissue. An example is hematopoietic stem cells, which form all the various cells in the blood.

Recent evidence, however, indicates that some adult stem cell types may be pluripotent, or at least able to differentiate into multiple cell types. For example, hematopoietic stem cells can differentiate into neurons, glia, skeletal muscle cells, heart muscle cells, and liver cells. Whether they actually do this ordinarily within the body is unknown.

Blood from the placenta and umbilical cord that are left over after birth is a rich source of hematopoietic stem cells. These so-called umbilical cord stem cells have been shown to be able to differentiate into bone cells and neurons, as well as the cells lining the inside of blood vessels.

A potential advantage of using adult stem cells from a patient is that the patient’s own cells could be expanded in culture, treated to differentiate into the desired cells, and then reintroduced into the patient. The use of the patient’s own cells would eliminate any possibility that they might be rejected by the immune system. Disadvantages of using adult stem cells are that they are rare in mature tissues and it is more difficult to expand their numbers in cell culture, compared with ESCs

- Embryonic (or fetal) germ cells are pluripotent stem cells derived from so-called primordial germ cells, which are the cells that give rise to the gametes (sperm and eggs) in adults. Scientists obtain primordial germ cells from the area in a 5- to 9-week-old embryo/fetus destined to become either the testicles or the ovaries (the dividing line between embryo and fetus is the end of the 8th week). Like ESCs, the primordial germ cells are transferred into a specially treated plastic culture dish, where they form germ cell colonies.

Less research has been performed using embryonic germ (EG) cells than ESCs, mostly because the embryos used for deriving EG cells are deliberately aborted, while the blastocysts used for deriving ESCs are produced through in vitro fertilization in a fertility clinic. EG cells are also difficult to maintain in cell culture because they have a tendency to differentiate spontaneously.

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CURING THE ONES INCURABLE

Dramatic breakthroughs in the field of Haematology and stem cell transplant offer new hope in treating conditions where conventional therapies have proven to be ineffective. These include life-threatening blood disorders such as multiple myeloma, chronic lymphatic leukaemia and Thalassaemia Major, which cannot be cured using conventional therapies such as chemotherapy and radiotherapy.

With allogeneic stem cell transplant (using stem cells from compatible family member or an unrelated donor), cure rates for some of these previously "incurable" disorders are as high as 90%.

Leukaemia, for example, makes up about 40% of paediatric cancers and was ones extremely difficult to cure. Yet, with stem cell transplant, some of South East Asia's leading hospitals enjoys an 80% cure rate for lymphoblatic leukaemia, comparable to leading paediatric cancer centres in USA and Europe. stem cell transplantation also allows for higher doses of chemotherapy then usual resulting in higher success rates.