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Last time, in Russia appeared several publications about Rudolf
Virchow and his teaching on cellular pathology [1-3]. Apparently, the
purpose was popularization of the idea of cellular pathology in connection
with cell therapies and the stem cells (SC) that have become popular in
the former Soviet Union. Unfortunately, not all methods applied here in
the practice are founded in the evidence-based international research: the
theme is cluttered with numerous publications of questionable reliability,
some of them probably aimed at an official registration of certain methods
and products for obtaining permissions for their practical use. In
scientific literature, a gap can be noticed between the supposed healing
properties of SC associated with their capability to migrate to and
engraft into injured tissue, which is still largely under scrutiny [4];
and lack of clear morphological evidence thereof for some organs and
tissues. For a pathologist, it is quite difficult to imagine, how the SC
or their progeny migrate to the places, where they are supposed to be
needed, and engraft into pre-existing structures, e.g. in cartilage,
myocardium or in nervous tissue. The benefit from the cell therapy is
corroborated in many studies where clinical or functional improvement had
been reported [e.g., 5]. At the same time, there is a gap between
advertising and a more fundamental part of scientific literature: the
former speaks about rejuvenation of tissues etc., and the latter explains
sometimes questionable therapeutic effects by paracrine or
immunomodulating mechanisms via secretion of cytokines and growth factors
[4,6]. Note that a stem cell is an undifferentiated cell, whose biological
purpose is procreation with a multi-lineage differentiation of the
progeny. Therefore, a specific paracrine function can hardly be awaited
from a SC as compared to more differentiated cells. Allogenic
transplantation of the stem cells, whatever is understood under it, is an
inoculation of foreign protein, which can cause immune reactions.
Moreover, stem cells are often implanted by means of surgical or
angiographic procedures associated with a risk of adverse events. In its
turn, implantation of autologous stem cells is sometimes nothing else but
autotransfusion of certain fractions of the patient's own blood, which was
used e.g. in haematology also in the past, but today it is named cell
therapy. It should be noted in conclusion that the problem with the cell
therapy in the former Soviet Union is that some researchers are influenced
by commercial interests. The result is a large quantity of publications,
while it is difficult to determine, which ones can be relied on. In
practice, cases similar to that described by Dyer [7], probably happen
here as well, but they are not reported in literature.
References:
1. Stochik AM, Paltsev MA, Zatravkin SN. [From the history of the
19th century pathology. Rudolf Virchow and his view of disease] [Article
in Russian] Arkh Patol 2009; 71(5): 11-16.
2. Paltsev MA, Severin ES, Ivanov AA. [Anatomical pathology and
molecular diagnosis] [Article in Russian] Arkh Patol 2006; 68(4): 3-7.
3. Anichkov NM, Perov IuL. [Rudolf Virchow: the 150th anniversary of
the cellular pathology teaching] [Article in Russian] Arkh Patol 2009;
71(1): 3-8.
4. Kollar K, Cook MM, Atkinson K, Brooke G. Molecular mechanisms
involved in mesenchymal stem cell migration to the site of acute
myocardial infarction. Int J Cell Biol 2009; 2009: 904682.
5. Kirillov AM, Fatkhudinov TKh, Dyachkov AV, Koroteev AV, Goldshtein
DV, Bochkov NP. Transplantation of allogenic cells in the therapy of
patients with dilated cardiomyopathy. Bull Exp Biol Med 2007; 144: 635-
639.
6. Joggerst SJ, Hatzopoulos AK. Stem cell therapy for cardiac repair:
benefits and barriers. Expert Rev Mol Med 2009; 11: e20.
7. Dyer C. Stem cell therapy doctor exploited desperate patients, GMC
finds. BMJ. 2010 Sep 13;341:c5001. doi: 10.1136/bmj.c5001.
Stem cells and cell therapy: a view from Russia
Last time, in Russia appeared several publications about Rudolf
Virchow and his teaching on cellular pathology [1-3]. Apparently, the
purpose was popularization of the idea of cellular pathology in connection
with cell therapies and the stem cells (SC) that have become popular in
the former Soviet Union. Unfortunately, not all methods applied here in
the practice are founded in the evidence-based international research: the
theme is cluttered with numerous publications of questionable reliability,
some of them probably aimed at an official registration of certain methods
and products for obtaining permissions for their practical use. In
scientific literature, a gap can be noticed between the supposed healing
properties of SC associated with their capability to migrate to and
engraft into injured tissue, which is still largely under scrutiny [4];
and lack of clear morphological evidence thereof for some organs and
tissues. For a pathologist, it is quite difficult to imagine, how the SC
or their progeny migrate to the places, where they are supposed to be
needed, and engraft into pre-existing structures, e.g. in cartilage,
myocardium or in nervous tissue. The benefit from the cell therapy is
corroborated in many studies where clinical or functional improvement had
been reported [e.g., 5]. At the same time, there is a gap between
advertising and a more fundamental part of scientific literature: the
former speaks about rejuvenation of tissues etc., and the latter explains
sometimes questionable therapeutic effects by paracrine or
immunomodulating mechanisms via secretion of cytokines and growth factors
[4,6]. Note that a stem cell is an undifferentiated cell, whose biological
purpose is procreation with a multi-lineage differentiation of the
progeny. Therefore, a specific paracrine function can hardly be awaited
from a SC as compared to more differentiated cells. Allogenic
transplantation of the stem cells, whatever is understood under it, is an
inoculation of foreign protein, which can cause immune reactions.
Moreover, stem cells are often implanted by means of surgical or
angiographic procedures associated with a risk of adverse events. In its
turn, implantation of autologous stem cells is sometimes nothing else but
autotransfusion of certain fractions of the patient's own blood, which was
used e.g. in haematology also in the past, but today it is named cell
therapy. It should be noted in conclusion that the problem with the cell
therapy in the former Soviet Union is that some researchers are influenced
by commercial interests. The result is a large quantity of publications,
while it is difficult to determine, which ones can be relied on. In
practice, cases similar to that described by Dyer [7], probably happen
here as well, but they are not reported in literature.
References:
1. Stochik AM, Paltsev MA, Zatravkin SN. [From the history of the
19th century pathology. Rudolf Virchow and his view of disease] [Article
in Russian] Arkh Patol 2009; 71(5): 11-16.
2. Paltsev MA, Severin ES, Ivanov AA. [Anatomical pathology and
molecular diagnosis] [Article in Russian] Arkh Patol 2006; 68(4): 3-7.
3. Anichkov NM, Perov IuL. [Rudolf Virchow: the 150th anniversary of
the cellular pathology teaching] [Article in Russian] Arkh Patol 2009;
71(1): 3-8.
4. Kollar K, Cook MM, Atkinson K, Brooke G. Molecular mechanisms
involved in mesenchymal stem cell migration to the site of acute
myocardial infarction. Int J Cell Biol 2009; 2009: 904682.
5. Kirillov AM, Fatkhudinov TKh, Dyachkov AV, Koroteev AV, Goldshtein
DV, Bochkov NP. Transplantation of allogenic cells in the therapy of
patients with dilated cardiomyopathy. Bull Exp Biol Med 2007; 144: 635-
639.
6. Joggerst SJ, Hatzopoulos AK. Stem cell therapy for cardiac repair:
benefits and barriers. Expert Rev Mol Med 2009; 11: e20.
7. Dyer C. Stem cell therapy doctor exploited desperate patients, GMC
finds. BMJ. 2010 Sep 13;341:c5001. doi: 10.1136/bmj.c5001.
Competing interests: No competing interests