Category Archives: Healthy Aging

Stem Cells Acting as “Little Doctors”

June 11, 2015

Stem Cells as “Little Doctors”

A stem cell can be defined as an undifferentiated cell of a multi-cellular organism that is capable of giving rise to indefinitely more cells of the same type and from which other kinds of cell arise by differentiation. They are mother cells that have the potential to become any type of cell in the body. One of the main characteristics of stem cells is their ability to self-renew or multiply while maintaining the potential to develop into other types of cells. They can become cells of the blood, heart, bones, skin, muscles, brain etc. There are different sources of stem cells but all types of stem cells have the same capacity to develop into multiple types of cells.

Commonly, stem cells come from two main sources:

  • Embryos formed during the blastocyst phase of embryological development (embryonic stem cells) and
  • Tissue (adult stem cells).

Since stem cells have remarkable potential to develop into many different cell types in the body during early life and growth, this unique characteristic that give them their very essence of internal repair systems. They are described as little doctors due to their microscopic sizes and their repair functions.

Therefore, we may ask ourselves, how then does this come about?

stem cells

What Are The Potential Uses Of Human Stem Cells?

There are many ways in which human stem cells can be used in research and the clinic. Studies of human embryonic stem cells will yield information about the complex events that occur during human development. A primary goal of this work is to identify how undifferentiated stem cells become the differentiated cells that form the tissues and organs. Scientists know that turning genes on and off is central to this process.

Some of the most serious medical conditions, such as cancer and birth defects, are due to abnormal cell division and differentiation. A more complete understanding of the genetic and molecular controls of these processes may yield information about how such diseases arise and suggest new strategies for therapy.

Human stem cells are currently being used to test new drugs. New medications are tested for safety on differentiated cells generated from human multicellular cell lines. Other kinds of cell lines have a long history of being used in this way. Cancer cell lines, for example, are used to screen potential anti-tumor drugs. The availability of multicellular stem cells would allow drug testing in a wider range of cell types. However, to screen drugs effectively, the conditions must be identical when comparing different drugs

Perhaps the most important potential application of human stem cells is the generation of cells and tissues that could be used for cell-based therapies. Today, donated organs and tissues are often used to replace ailing or destroyed tissue, but the need for transplantable tissues and organs far outweighs the available supply. Stem cells, directed to differentiate into specific cell types, offer the possibility of a renewable source of replacement cells and tissues to treat diseases including macular degeneration, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis, and rheumatoid arthritis.

A few small studies have also been carried out in humans, usually in patients who are undergoing open-heart surgery. Several of these have demonstrated that stem cells that are injected into the circulation or directly into the injured heart tissue appear to improve cardiac function and/or induce the formation of new capillaries.

Cardiovascular disease (CVD), which includes hypertension, coronary heart disease, stroke, and congestive heart failure are some of the heart diseases that can are under study by scientists to be treated using the stem cells replication idea.

In people who suffer from type 1 diabetes, the cells of the pancreas that normally produce insulin are destroyed by the patient’s own immune system. New studies indicate that it may be possible to direct the differentiation of human embryonic stem cells in cell culture to form insulin-producing cells that eventually could be used in transplantation therapy for persons with diabetes.

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Stem cells serve as internal repair systems to living organisms as they replenish through cell division essentially without limit as long as the person or animal is alive. This cause the damaged cells are disposed while news one is created.

The stem cells have also been found to be capable to treat eye defects. This has been one of the breakthroughs of using the stem cells as new medicine.

The following is a list of steps in successful cell-based treatments that scientists will have to learn to control to bring such treatments to the clinic. To be useful for transplant purposes, stem cells must be reproducibly made to:

  • Proliferate extensively and generate sufficient quantities of cells for making tissue.
  • Differentiate into the desired cell type(s).
  • Survive in the recipient after transplant.
  • Integrate into the surrounding tissue after transplant.
  • Function appropriately for the duration of the recipient’s life.
  • Avoid harming the recipient in any way.

Also, to avoid the problem of immune rejection, researchers are experimenting with different research strategies to generate tissues that will not be rejected.

To summarize, stem cells offer exciting promise for future therapies. For more information about this topic and others visit www.awaremednetwork.com. Dr Dalal. Akoury is an expert in integrative medicine. While at it, visit http://www.integrativeaddiction2015.com for information about the integrative addiction conference 2015 that she be holding, the conference will provide information on holistic approaches to issues of addiction and how to deal with patients of addiction.

Stem Cells Acting as “Little Doctors”

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Clinical Trials For Heart Failure

June 6, 2015

What’s Heart Failure?

Heart failure is an intricate clinical condition of symptoms and signs that suggest malfunction of the heart. This is often caused by structural and or functional defects of the heart. A good number of patients have heart failures as a result of left ventricular systolic dysfunction (LVSD).

“More often than not, LVSD is associated with reduced left ventricular blood ejection fraction. Some patients have heart failure as a result of a preserved ejection fraction (HFPEF). Whereas the most popular cause of heart failure in the United States (US) is coronary artery disease, many patients have had a myocardial infarction,” Owan TE, Hodge D.O., Herges R.M, et al. (2006).

Heart failure and or related diseases often increase steadily with age, a typical age at first diagnosis being at 76 years. Prevalence of heart failure is even expected to rise in the near future as a result of an increased ageing population. Improved survival of people with heart disease and more effective treatments of the same are more reasons for such increased prevalence.

“Heart failure has a poor prognosis: 30–40% of persons diagnosed with the condition die within a year, after which the mortality rate is less than 10% for every succeeding year. However, there has been better prognosis in the past 10 years. The 6-month mortality rate further decreased from 26% in 1995 to 14% in 2005 and even further now,” Petersen S, Rayner M, and Wolstenholme J. (2002).

“Heart failure accounts for over a million inpatient bed-days 2% of all NHS inpatient bed-days in the US and 5% of all emergency medical admissions to hospital. The admissions because of the heart condition are even projected to rise by 50% over the next two decades, largely as a result of the ageing population,” Hobbs FD, Roalfe AK, and Davis R.C., et al. (2007).

This article provides acceptable and standard practices on adults with heart failures, especially those with chronic heart failures. Such trials entail diagnosis, treatment, and rehabilitation.

Heart Failure

Clinical Trials For Heart Failure

Clinical trials as well as therapeutic care should take into account the patients’ needs and preferences. A patient with acute heart failure for instance should be able to make or rather should be given an opportunity to make an informed decision about his/her therapeutic care together with the healthcare professionals.

If the patient does not have the ability to make reliable decision about his/her the trials and or therapeutic care, the healthcare professional should follow established guidelines set by the Department of Health on consent and the professional code of practice as set out in the Mental Capacity Act.

Also important is good communication between the patient and the professional. These may be in different forms but a recommended practice involves a written document that suits the patient’s unique clinic diagnosis and can also act as evidence. Clinical trials and therapeutic care given and information communicated to the patients should be appropriate to the latter’s medical history and culture.

Such information should be accessible to people with special needs such as physical, sensory, learning disabilities, and or to those who neither speak nor read English. Family members, guardians and or care-takers should also have an opportunity to contribute in the decisions about the trials and care.

“During clinical examinations, it is important to refer patients with supposed heart failures and or previous myocardial infarction (MI) urgently to have transthoracic Doppler 2D echocardiography and specialist assessment within 2 weeks,” Owan TE, Hodge D.O., Herges R.M, et al. (2006).

“Clinical trials on treatment should measure serum natriuretic peptides (B-type natriuretic peptide [BNP] or N-terminal pro-B type natriuretic peptide [NTproBNP]) in patients with suspected heart failure without previous MI. Because very high levels of serum natriuretic peptides carry a poor prognosis, refer patients with suspected heart failure and a BNP level above 400 pg/ml (116 pmol/litre) or an NTproBNP level above 2000 pg/ml (236 pmol/litre) urgently, to have the 2D echocardiography and assessment within 2 weeks,” Owan TE, Hodge D.O., Herges R.M, et al. (2006).

Heart Failure

Trials on treatment involve offering both angiotensin-converting enzyme (ACE) inhibitors and beta-blockers licensed for heart failure to all patients with heart failure due to left ventricular systolic dysfunction. It is also advisable to use clinical judgments when deciding which drug to use first.

Offer only beta-blockers licensed for heart failure to all patients with the heart condition due to left ventricular systolic dysfunction, including: adults and those patients with other vascular diseases, erectile dysfunction, diabetes mellitus, interstitial pulmonary disease, and or chronic obstructive pulmonary disease (COPD) without reversibility.

Professionals are also advised to seek specialist guidance to offer one of the following alternatives if the patient fails to respond to treatment despite optimum therapy with an ACE inhibitor and a beta-blocker. They may include: an aldosterone antagonist licensed to handle heart failure patients and an angiotensin II receptor antagonist (ARB) licensed for heart failure.

Clinical trials about rehabilitation should involve a supervised exercise-based rehabilitation program designed for patients with heart failure in groups. While at it, it is advisable to ensure the patient is stable and does not have a condition or device that would immaturely conclude the rehabilitation program.

During the program, you could also include a psychological and or educational component. The program may be incorporated within an existing exercise-based or other cardiac rehabilitation program.

“It should be noted patients with chronic heart failure require monitoring. This monitoring should include; a clinical assessment of functional capacity, fluid status, cardiac rhythm, nutritional status, cognitive status and a review of medication; including need for changes and possible side effects, serum urea, electrolytes, and creatinine. Also, when a patient is admitted to hospital because of heart failure, the professional should seek advice on their management plan from a specialist in heart failure,” Petersen S, Rayner M, and Wolstenholme J. (2002).

Lastly, patients with this kind of heart condition should generally be discharged from hospital only when their clinical condition is stable and the management plan is optimized. The timing should take into account patient and career wishes, and the level of community care and support.

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Dr. Dalal Akoury, M.D., M.P.H. is a family physician with a wealth of knowledge and years of experience in integrative medicine. She will highly be of assistance.

Also, don’t miss an opportunity to learn and interact with professionals during this year’s Integrative Addiction Conference 2015. For more information, visit http://www.integrativeaddiction2015.com. The conference will also deliver unique approaches to telling symptoms of addiction and how to assist patients of addiction.

Clinical Trials For Heart Failure

 

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Fetal Cells: Enhanced Efficiency And Effectiveness For Wound Healing.

June 4, 2015

Fetal Cells: Enhanced Efficiency And Effectiveness For Wound Healing

“Extensive burns and full thickness skin wounds can be devastating to patients, even when treated. There are an estimated 500,000 burns treated in the United States each year. The overall mortality rate for burn injury was 4.9 % between 1998 and 2007 and medical costs for burn treatments approach $2 billion per year,” Owan TE, Hodge D.O., Herges R.M, et al. (2006).

These statistics could as well be over 11 million injuries per year as claimed by some medical reports. Other than burns, full-thickness chronic wounds also claims a large number of patients and despite technological development of therapeutic approaches, healing rates remain way below 50 % of success.

Patients with the non-healing chronic wounds are as well estimated at about 7 million per year in the US alone. Yearly costs on the other hand continue to rise, the figure is currently approaching $25 billion. Patient survival is reportedly inversely proportional to the amount of time required to recover from such a chronic wound and to stabilize.

wound-healing

Those with severe burns of between or more than 15–20 % total their body surface area are also likely to go into shock without rapid treatment. In addition, without sufficient and or rapid fluid resuscitation, patient conditions deteriorate and mortality rates increase steeply.

Inadequate therapeutic programs often result in long-term patient complications including open wounds, prominent scars, prolonged pain, high temperature sensitivity, loss of feeling to touch and or itching.

Patients who suffer from such burns and or chronic wounds benefit from prompt treatments that result in appropriate closure and or protection of the wounds. Burn patients in particular, who receive delayed treatments, are usually subject to prolonged therapeutic care that has long-term negative physiological side effects.

Recent medical advancements have been made to handle wound healing; however, the generally accepted and practiced treatment approach still remains an autologous split-thickness skin graft. This involves extracting a piece of skin with the goal of removing stem cells from a minor surgical site on the patient’s body, stretching the skin, and re-applying the graft on the burn or chronic wound.

Stem cells are unspecialized cells in the body that majorly bear two specific characteristics. They have the capacity to replicate themselves indefinitely and have the ability to replace and or repair nearly all body tissues as directed.

Stem cells extracted from the amniotic fluid, (AFS) are reportedly a very rich cell source for use in regenerative therapy due to their high proliferation capacity, immune-modulatory activity and multipotency.

AFS also have the capacity to modulate inflammatory responses and secrete therapeutic cytokines. Because of these characteristics, AFS cells have been explored for treatments in wound healing and skin regeneration among similar therapeutic care.

These attempts have over time been backed by relevant scientific studies that increasingly indicate AFS cells are effective in accelerating healing of skin in embryonic environments and more recently in treating wounds in adults. More scientific evidence also points to the fact delivered cells are often temporary, that is, do not permanently integrate into final skin tissue.

Instead, they hide a portfolio of effective growth factors very vital to the skin regeneration and angiogenesis, suggesting a trophic ability of enhancing skin and or wound healing.

These initial pieces of scientific studies suggest delivery of AFS cells have the potential to be an effective cell treatment for enabling wound healing and should be considered for clinical trials and use in treating skin wounds in patients.

While this treatment indicates the ability to yield a reasonably good therapeutic outcome, if the wound is extensive, the number and size of donor sites may be limited, making autographs difficult to use in cases that require rapid and or aggressive measures to save the wounded patient’s life.

Alternatively, allografts may be used but the option suffers a critical need of immuno-suppressive drugs so as to prevent body immune rejection of the graft. This limitation has thus caused the creation of noncellular dermal substitutes, which most often comprises a polymeric scaffold.

They include skin regeneration template and Biobrane among others. Even though such polymeric scaffolds result in improved wound healing, they are costly to produce and more often result in relatively poor temporary outcomes.

Recent developments in tissue engineering have also led to more complex biological skin parallels that may yield more suitable alternative wound care options for patients. These include: cellularized graft-like products such as dermagraft, Apligraf (Organogenesis), and TransCyte, (Advanced BioHealing) among others.

The products are commonly polymer scaffold patches that are planted with human fibroblasts and cultured in vitro prior to their application. Unfortunately, these grafts are also expensive to produce, and as allografts, can suffer from the same immunological setbacks mentioned earlier.

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This topic can go on and on. It is actually very interesting but it would not be possible to include everything in one article. However more information can be found at www.awaremednetwork.com. Dr. Dalal Akoury M.D., M.P.H., who is also a family physician and has many years of experience in integrative medicine will be of great assistance.

Also, do not miss an opportunity to learn and interact with various professionals during this year’s Integrative Addiction. For more information about the upcoming conference, visit http://www.integrativeaddiction2015.com. The conference will also deliver unique approaches to telling symptoms of addiction and how to assist patients of addiction.

Fetal Cells: Enhanced Efficiency And Effectiveness For Wound Healing.

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EPCs Role in Cardiovascular Diseases

June 4, 2015

Endothelial Progenitor Cells Role in Cardiovascular Diseases

EPCsCurrently, regenerative medicine is on focus with hopes that it can be used in treatment of cardiovascular diseases. The circulating endothelial progenitor cells have been shown to possess an ability to form mature endothelial cells that can be useful in the process of vascular repair as well as neoangiogenesis. In preclinical studies, it has been shown that the circulating endothelial progenitor cells (EPCs) have the potency for cardiovascular regeneration. With this said, it is god to admit that there is still a lot needed to be done in this area to show the effectiveness of the regenerative activities of these EPCs. Here we look at how the EPCs relate to cardiovascular diseases.

Endothelial Progenitor Cells are biomarkers of cardiovascular diseases

Just like other stem cells the circulating endothelial progenitor cells have the ability to proliferate, migrate, and differentiate into mature endothelial cells. First discovered from the human peripheral blood, the EPCs were shown to incorporate into sites of physiological or pathological neovascularization. Ever since the EPCs were discovered, a lot has improved in the understanding of the blood vessel formation. There is a growing body of evidence that EPCs helps in providing postnatal vasculogenesis mechanism for neovascularization and vascular remodeling.

These cells have also been shown to possess diverse physiological functions and helps in the recovery process of myocardial ischemia and infarction, limb ischemia, wound healing, atherosclerosis, endogenous endothelial repair, and tumor vascularization. Earlier clinical trials have proved that EPC therapy is safe and feasible for the treatment of cardiovascular diseases. Plus, the circulating EPCs are also considered as biomarkers for coronary and peripheral artery disease. In spite of the medicinal abilities of these EPCs, there is still a lot to be done in order for the mechanism by which these cells work can be fully understood and be applied.

Despite the haze that still clouds the mechanism with which the EPCs work, it has been shown that EPCs locating to damaged tissues and organs proceeding vascular regeneration do not only help in the formation of the neovasculature but also produce a variety of proangiogenic cytokines and growth factors thus promoting proliferation and migration of pre-existing Endothelial Cells and activating angiogenesis to contribute to vascular regeneration. it is suggested that the EPCs owes their ability to contribute to vascular regeneration to the presence of cytokines and other secreting pro-angiogenic factors in them such as VEGF, stroma derived factor (SDF)-1α, angiopoietin-1 (Ang-1), hepatic growth factor (HGF), insulin-like growth factor (IGF)-1, and eNOS/iNOS (inducible nitric oxide synthase). Thus, EPCs can mediate tissue-protective effects and contribute to neovascularization via direct vasculogenesis in ischemic tissues and indirect production of proangiogenic factors to pre-existing endothelial cells.

Research has shown that there are reduced numbers of EPCs in clinical conditions like diabetes mellitus, heart failure, chronic kidney disease and hypertension. In such conditions these EPCs also become impaired and malfunctioning. It has also been shown that the number of peripheral EPC is significantly reduced and their functions impaired in patients with established coronary artery disease and stroke. In contrast the number of EPCs has been found to be on the increase in patients with acute coronary syndrome such as acute myocardial infarction or unstable angina since they are mobilized from the bone marrow into the bloodstream.

The levels and migratory capacity of EPCs is also highly reduced in those suffering from hypertension with coronary artery disease. Besides, the concentration of circulating EPCs is considerably reduced in refractory hypertension as compared to healthy subjects. Imanishi T and his colleagues reported that EPC senescence is augmented in both experimental hypertensive rats and patients with essential hypertension, which may be related to telomerase inactivation. The team found that the hypertension-induced EPC senescence may affect the process of vascular remodeling.

Another researcher, Delva P in his research; Endothelial progenitor cells in patients with essential hypertension, reported that there was no alteration in the number or functional activity of EPCs in 36 patients with essential hypertension. Some research studies have also demonstrated that the numbers of EPCs are decreased in pulmonary hypertension while others that the number of EPCs are increased or remain normal in pulmonary hypertension. With these available literature that are somehow conflicting there isn’t a clear relationship between EPCs and hypertension

EPCs and Heart Failure

EPCsTo show the relationship between heart failure and the number of circulating EPCs, Valgimigli M and his counterparts tested the level of EPCs in patients suffering from heart failure and they discovered that EPC mobilization occurred in heart failure and showed a biphasic response, with elevation in early stages while depression in the advanced stages. The increased EPCs was shown as a replication of a functional bone marrow response to diffuse and severe endothelial damage during the early stages of heart failure but an additional and significant increase of tumor necrosis factor (TNF-α) counteracted and overwhelmed the elevation of EPC mobilization in advanced disease phases by exerting a possible suppressive effect on hemopoiesis.

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With the above findings, it is clear that there is a relationship between the EPCs and the cardiovascular diseases. For more information about bone marrow transplant and stem cell transplantation, visit www.awaremednetwork.com Dr. Dalal Akoury, a doctor with years of experience in integrative medicine will be able to help. Don’t hesitate to check on http://www.integrativeaddiction2015.com  and learn about the upcoming Integrative Addiction Conference 2015. The conference will dwell on unique approaches to telling symptoms of addiction and how to help addicts.

Endothelial Progenitor Cells Role in Cardiovascular Diseases

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Allogeneic Stem Cells For Neurodegenerative Diseases

June 4, 2015

Allogeneic Stem Cells Role in Neurodegenerative Diseases

stem cellThe stem cells are the precursors of all cells in the body. They are very essential for formation of new tissues and healing of damaged tissues as a result of diseases or even accidents. The stem cells are available in adequate quantities in the bone marrow and in the adipose tissues as well. They have the ability to turn into the red blood cells, platelets or even the white blood cells. They can also form the muscles cells, the bones and even cartilage and hence help in keeping your body healthy. naturally you should be having the healthy amounts of these stem cells, unfortunately due to diseases and accidents that may result in bone marrow destruction and damage you may have too little of these essential stem cells and so you will need a stem cell transplant. In most cases the stem cell transplant is done through an IV, supplementing the little stem cells you have left and hence enabling the body to work right.

When the stem cells are harvested from the same person, the transplant is termed as autologous stem cell transplant. the autologous stem cell transplant is the most popular as the cells are harvested from the patient’s own body and this rules out any chance of the transplant being rejected or causing any pathological reactions that may warranty serious medical attention. however there are cases when the stem cells can’t be sourced from the patient’s own body and this will dictate that the stem cells be sourced from a different person who is not genetically identical to the patient; this is termed as allogeneic stem cell transplant. For safety of any recipient in allogeneic stem cell transplant, it is important to match closely the immune system markers to reduce chances of any reaction that may inhibit the healing process.

Stem cells and neurodegenerative diseases

Neurodegenerative diseases are numerous and each has distinctive effects on the patient but all are caused as a result of neurodegeneration. Neurodegeneration refers to the damage of the nerves in that are essential for transmission of messages within the nervous system. When the nerve cells are destroyed and deformed, they lose their original structure they will begin to malfunction. In most cases this damage is done gradually but at the end of it all the patient will suffer from cognitive disabilities such as memory loss and poor decision making. There are numerous neurodegenerative diseases, however basing on their debilitating effects, just a few have been known and are being currently focused on. Some of the famous neurogenerative diseases includes; Huntington disease, Parkinson’s disease and Alzheimer’s disease. Apart from these diseases listed above there are others that have not been in the medical literature and are less publicized, this doesn’t mean that they are not worth the mention. They are.

The greatest danger of all neurodegenerative diseases is that they lead to progressive brain damage and neurodegeneration. The major three diseases may show different features and effects but they progress in similar manner at the cell level. take Parkinson’s disease for example, it affects the basal ganglia of the brain, depleting it of dopamine hence causing stiffness, rigidity and tremors in the major muscles of the body which are distinctive features of the disease.

In Alzheimer’s disease, it is characterized by deposits of minute protein plaques that damages different brain parts thereby leading to gradual memory loss while Huntington’s disease is known to corrupt the genetic make-up affecting muscles of the body thereby resulting in motor restriction and eventual death.

Allogeneic stem cells transplant

Allogeneic stem cellsThe cell is harvested from the bone marrow of a suitable donor by use of a needle. This maybe done repeatedly to draw the sufficient amounts needed for the transplant. After harvesting the cells from the marrow the blood is passed through a machine that separates the stem cells from the blood leaving the rest of the blood flowing back into the donor through the needle into the donors arm. The harvested stem cells can then be transplanted into the patient through a central venous catheter that is inserted into the patient’s chest. The stem cells flow through the catheter into the patient’s blood and into the bone marrow where they will give rise to other stem cells between one to three weeks.

After transplant the stem cells will begin to work in repairing and replacing the worn out tissues caused by various degenerative diseases. All this is made possible since they can form any cell in the body and help restore the normal body functions.

The neurodegenerative diseases have very debilitating effects; the inception of stem cell therapy seems to be a light at the end of the tunnel for those suffering from these diseases. Anyway you need to be updated on how well you can regain your health and vitality back even after suffering from these diseases.

conference

Get in contact with Dr. Dalal Akoury an experienced doctor in integrative medicine at www.awaremednetwork.com as well as http://www.integrativeaddiction2015.com and learn more about the upcoming Integrative Addiction Conference 2015. The conference will focus on the unique approaches to identifying symptoms of addiction and how to help addicts.

Allogeneic Stem Cells Role in Neurodegenerative Diseases

 

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