Any sufficiently advanced technology is indistinguishable from magic, Arthur C. Clarke once wrote. So it is with stem cells and their almost miraculous potential to save our lives. Stem cells are so tiny that it would take a million of them clustered together to form a pin head. Yet as their name denotes all other cells ’stem’ from them. They can divide and multiply rapidly into cells that give rise to the brain, the heart, the spine, the limbs, the muscles, the skin and everything else that constitutes the human body. Once the body is fully grown they lie dormant in the marrow of your bones, in the cavities in your eye, under the nose, in your stomach and even in your skin waiting for the signal to transform into whichever tissue or organ that is needed. They are the body’s hidden biological repair system – the super mechanics with a warehouse stacked with everything you need to make your body new again.
A decade ago, not many knew how to harness their almost magical capability to heal the body. Now researchers are unlocking the mysteries these nanosized cells store and are ushering in a revolution in the treatment of a range of debilitating diseases. In Delhi, at the All India Institute of Medical Sciences (AIIMS), a steady stream of patients comes in for treatment of dilated cardiomyopathy, a condition in which the heart becomes weakened and enlarged. It cannot pump blood efficiently and one of its symptoms is a rapid pulse – twice the normal.
Till now, short of having a heart transplant, it was among the most difficult cardiac disorders to treat. But for such patients there is new hope with AIIMS setting up a cardiovascular stem cell group that has begun, probably for the first time in the world, clinical trials to see whether the stem cells extracted from the bone marrow of patients, known as adult stem cells, could improve the heart’s performance. The results are encouraging but Balram Bhargava, professor of cardiology and a co-principal investigator, says: “It’s not magic yet. Still, in a field that has little options for patients, this is a definite improvement.”
Eye disorders
By 24, Abhishek Sharma, who was afflicted with allergic conjunctivitis, had lost his vision in both eyes. “I couldn’t recognise a person if he sat in front of me.” He couldn’t find a job or a bride. He approached the L.V. Prasad Eye Institute and his vision was restored within weeks. Now he is a call centre executive, married and has two children. He says: “For me it’s like a miracle.”
Status in India – Corneal regenerative procedures using stem cells are the most promising in India. The L.V. Prasad Institute has treated over 700 cases with much success. The Drugs Controller has approved of such therapy for widespread use. AIIMS is also conducting a major multi-centre trial to look at the role of stem cells in repairing tissue damaged during acute heart attacks. In many such cases, even bypass surgery doesn’t seem to improve the functioning of the heart. Among the earliest beneficiaries of the wonders of such stem cell treatment is S. Kabilan, a former chief secretary of Assam.
Four years ago he suffered a heart attack and underwent bypass surgery at AIIMS. When he heard about the new stem cell treatment which could regenerate damaged tissue, he readily consented to having it done. Since then the functioning of his heart has been regularly monitored and the ejection fraction–the amount of blood pumped out of a ventricle with each heartbeat–has shown considerable improvement. Says Kabilan: “I feel fit as a fiddle and have never felt better in recent times.”
In Hyderabad, inside an operation theatre at the L.V. Prasad Eye Institute, Dr Virender Sangwan, a surgeon, is in the process of implanting cornea tissue grown from stem cells into the left eye of a middle-aged factory worker who had accidentally burnt it, leaving him blind in that eye.
Harvesting stem cells from the limbus, the region where the cornea touches the white of the eye, Sangwan and his team of specialists are confident of restoring the worker’s sight in a matter of weeks. That stems from the fact that in the past nine years they have treated over 700 such patients with remarkable success, possibly one of the largest such regenerative experiments anywhere in the world. Because of the work of the L.V. Prasad Eye Institute and others, the Drugs Controller of India has recently cleared Reliance Life Sciences to launch the first tautologous limbal stem cell therapy–the first time stem cell therapy has been officially cleared for widespread use in India.
For once, Indian scientists are not lagging behind in a key area of cutting edge research and are rubbing shoulders with the best of the business which includes countries such as the UK, Australia, China, Italy and Korea. “India now has a global presence in both basic and clinical research in stem cells. We are in the big league now, ” says D. Balasubramanian, L.V. Prasad’s director of research and till recently chairman of the apex government committee overseeing stem cells work in the country. In areas such as ocular, cardiovascular and neurological disorders, Stephen Minger, director of the Stem Cell Biology Laboratory at the Wolfson Centre for Age Related Diseases at King’s College London, acknowledges that the research being done in India is “world class and has exciting possibilities”.