Stem cell could be used to repair damaged human organs

Stem-cell-therapy
Dr. David Ikudayisi is a United States (U.S.) Board Certified Internist with a strong passion for regenerative aesthetic and cosmetic medicine. Ikudayisi was born in Nigeria, where he studied medicine at the University of Ibadan, Oyo State. He won the sole Bureau for External Aids (BEA) scholarship in his state for that year to study medicine in Sechenov Moscow Medical Academy, Russia. After graduation, he went to the United States for further education. Ikudayisi is the Medical Director of Glory Wellness & Regenerative Centre, Ikeja, Lagos. Ikudayisi, in this interview with The Guardian, said he started this multi-specialty healthcare centre because of his comprehensive training, experience, strong interest and passion in regenerative, aesthetics and cosmetic medicine. The regenerative surgeon among other things said Adult Stem Cell Therapy (ASCT) was not for everyone. He said the procedure was expensive, regardless of where it is done and aims at regenerating and/or repairing the damaged tissue in the body which conventional treatment does not do. CHUKWUMA MUANYA writes.

What is the history of stem cell therapy in Nigeria?
First of all, it is very important to understand that there are two main types of stem cell – embryonic stem cells (ES) cells and adult stem cells. The former type involves using embryos as source of cells while the latter involves using cells harvested from an individual or adult. Other types, such as induced pluripotent stem cells (iPSCs), are produced in the lab by reprogramming adult cells to express embryonic stem cells characteristics.

The type of stem cell therapy that we are talking about here is the adult stem cell therapy that uses a patient’s own body fat or bone marrow as the source of stem cells, unlike the controversial Embryonic Stem Cells Therapy (ESCT). Stem cell therapy is under regenerative medicine, just like Platelet Rich Plasma (PRP) therapy.

PRP is blood plasma that has been enriched with platelets. Platelets contain healing properties, which can accelerate the healing of tendons and ligaments in the musculoskeletal system.

Regenerative medicine aims to restore normal function by repairing or replacing damaged or malfunctioning cells and tissues in patients who have lost tissue or organ function due to age, disease or congenital defects. With PRP therapy, the growth factors in the blood are what activate the healing process at a faster rate. And with adult stem cell therapy, the stem cells in Adult fat/bone marrow can differentiate into any tissue where they find themselves.

Adult Stem Cell Therapy (ASCT) or regenerative medicine it is not yet common in Nigeria but the Nigerian doctors are well aware of the use of bone marrow transplant for blood disease called leukemia, and in the past, PRP therapy has been used in at least one of our teaching hospital in Lagos, and some doctors in Nigeria are now using PRP therapy. Today, the benefits of PRP therapy is very popular amongst the orthopedics doctors in Nigeria, but there still stands the set back due to financial cost of supplies and equipment needed for the state of the art technology, and the affordability by the patients. As for the current Adult stem cell therapy, it is new in Nigeria, but not new in Europe, United States (U.S.) or India.

What diseases is it relevant for?
The applications of ASCT are enormous, and there is much more to be discovered. The basic way to understand who will benefit simply knows that if there is need for repair and/regenerate any part of the human tissue/organ, the ASCT with/without PRP therapy may be an option that will help. The exceptions are cancer treatments, as their treatments with stem cells are under investigations/research using tissue engineering.

To list some common treatable diseases, we can group them into local applications – multiple joint pain, back pain, meniscal tears, ligament tears, avascular necrosis of the hip joints, facet arthropathy, hair thinning, erectile dysfunction, female sexual dysfunction, female urinary incontinence, cosmetic/aesthetic applications (vampire facial, vampire facelift, vampire breast and nipple lift); and systemic applications – diabetes, hypertension, anti-aging (generalized treatment), chronic kidney disease, lupus, rheumatoid arthritis, plantar fasciitis, scleroderma, multiple sclerosis, congestive heart failure, heart attack (myocardial infarction), COPD (lung disease) and infertility, etc. As for the infertility treatment, cure has not been developed, so those that opt for stem cells are doing so increase their chances of becoming fertile or increase their chances of having successful In vitro fertilization (IVF).

What diseases have you been able to treat with it here?
The patients that have been treated at the medical centre or hospital where I practice have the following diseases or indications: local applications – multiple joint pain, back pain, meniscal tears, ligament tears, hair thinning, erectile dysfunction, female sexual dysfunction, urinary incontinence, cosmetic/aesthetic applications (vampire facial, vampire facelift, vampire breast and nipple lift); and systemic applications – diabetes, hypertension, anti-ageing (generalized treatment), plantar fasciitis, COPD (lung disease).

Do you have living witnesses to the benefits of this procedure who can talk to the press?
Yes. Some already in Nigeria while with some flew to US, but many in US.

Who regulates the practice in Nigeria?
The Medical and Dental Council of Nigeria (MDCN) regulates all practices of medicine in Nigeria. ASCT and PRP therapy are under regenerative medicine. Although ASCT may be relatively new, PRP therapy is not new and it is already common among some doctors in Nigeria. Any doctor to the best of my knowledge is not practicing embryonic stem cell in Nigeria, and that is not my line of practice anyway. And I am not aware of any research going on by the Nigerian government or hospital about induced pluripotent stem cells (iPSCs) therapy, again to the best of my knowledge since I do not 100 per cent or fully live in Nigeria.

Are there side effects or consequences?
The type of stem cell treatment we are talking about is autologous, that is taken from the same patient that it is given back to. Therefore, there is no risk of rejection of the transplant. The risk of infection is very minimal almost to none if the harvesting and transplant is done under sterile condition for ASCT or at least aseptic condition for PRP therapy.

What have been the challenges in introducing the procedure?
ASCT is relative new in Nigeria, and even to some educated citizens. Unfortunately unlike in US, most Nigerians do not believe in preventative medicine. They only go to doctors when it is already too late or at the extreme final stage of their condition. I do not blame them because the main reason of delaying seeking health care is the associated financial cost. I hope and pray that one day, we will all get to that level of health care that is available in developed countries.

We are just trying to create awareness of regenerative medicine in Nigeria, part of which is a relatively new field in Medicine. Nigerians are already travelling to Indian to get the procedures done like ASCT. It will be great if many doctors in US, United Kingdom (U.K.) and other advanced countries, who practice regenerative medicine in those countries, will consider bringing their practice home to Nigeria for some Nigerians to also benefit. I am not asking them to do Pro bono because I understand the cost implication of my request, but at least, let us start from somewhere someday sometime. Nigeria too can become medical tourist centre in Africa because of regenerative medicine. There is a future for Nigeria in the medical world, for example, open heart surgery was performed in 2015 at Babcock University, there are a couple of world class Intensive Care Unit (ICU) that I am personally aware of.

Why should anybody opt for stem cell therapy? I mean does it have any advantage over conventional treatments?
ASCT is not for everyone. It is expensive all over the world, regardless of where it is done. ASCT aims at regenerating and/or repairing the damaged tissue in the body which conventional treatments does not do. There is limited life span of surgical and other procedures; there is limitation of surgery for spinal problems. For example, not everyone with bad knee joint wants to go for knee surgery, if it is treatable by another means, and especially patients want to use their own body to heal themselves. Effect of conventional treatments does not last as long as the effect of ASCT or PRP therapy in conditions/diseases where regenerative medicine is currently applicable and effective. Not everyone wants to take pain medication on daily bases if they can afford not to do so. There are situations where conventional medicine has no suitable answers, for example, no one time or single dose medication for hair thinning, no medication regenerate kidney cells to prevent them from deteriorating, no medication for female sexual dysfunction affecting married couples, no medication reverses the symptoms of multiple sclerosis as of today, just to mention few.

What is the cost implication?
Due to its relative newness, it is expensive all over the world. And it is expected to be more affordable in future.

Where can it be procured?
There are centers in Nigeria where patients can be treated without having to travel abroad, like in Lagos and Abuja. David Ikudayisi is of Glory Wellness and Regenerative Centre.



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