How well informed are the doctors today about the cellular therapy? Is it time consuming? Where does cellular therapy stand in the Indian Healthcare system today?
For more than four decades, medical fraternity has knowledge about stem cell science and its potential therapeutic applications. However, earlier, clinicians were commonly aware of hematopoietic stem cell therapy, but were relatively uninformed about the advantages of mesenchymal stem cells. This could be attributed to the medical course syllabus which initially did not include topics specifically on cellular therapy.
Early works on cell based therapy were reported in blood related conditions (leukaemia, bleeding disorders etc.) in the form of bone marrow transplant. In this form of therapy, stem cells capable of forming blood cells (red, white blood cells, platelets) are transplanted to restore/replenish tissues destroyed by chemotherapy and/or radiation therapy. More recently, research on stem cells has shown that these cells possess varied properties related to organ and tissue regeneration. Medical science is now analyzing the mechanics of utilizing the power of these dynamic molecules in treatment of various chronic and previously untreatable conditions. Breakthroughs are being made in the field of regenerative medicine, gene therapy, nanotechnology etc. With recent advances, doctors are aware of the possibility of manipulating these cells to grow specific tissues or repair the damage to organs caused by diseases. Continuing medical education programs conducted routinely enable medical professionals to stay abreast with current research in order to aid in transition of the technology from bench to bed-side.
Despite the technological advances that medical science is witnessing, it is not possible at present to predict the exact time when cellular therapy and regenerative medicine will replace existing forms of pharmacological and surgical treatments. Nonetheless, there is increasing awareness amongst clinicians who now more receptive to and are advising cell based therapy as an effective therapeutic modality for treatment of diseases.
Which are the diseases that can be treated through cellular therapy? What are the latest advancements?
Cellular therapy and regenerative medicine focuses on eliminating the root cause of the problem by use of cells (cytokines, chemokines etc.), growth factors from one’s own body. Orthopedic conditions such as avascular necrosis, osteoarthritis, autoimmune conditions such as rheumatoid arthritis, ankylosing spondylitis, neurological conditions such as cerebral palsy, stroke etc., as well as diabetes, liver, genitourinary disorders, dermatological conditions and many more can achieve benefits from cellular therapy. This form of therapy can be further explored in management of organ failure, to overcome rejection following organ transplants, developmental defects, cancer immunotherapy etc.
Research advances pertaining to introducing products with cell and scaffold based technology through tissue engineering are underway. Bioactive scaffolds that are capable of supporting activation and differentiation of host stem cells at the required site are being developed. In the future it will be possible to use human native sites as micro-niche/micro-environment for potentiation of the human body’s site-specific response.
Technologically, advances have been made over the years in both diagnostic and therapeutic approaches. Molecular imaging technology (optical imaging, positron emission tomography etc.) has simplified research on disease mechanism and treatment evaluation related to cell based therapy. Several new technologies are being introduced that simplify the process of isolation and characterization of cells. One such example is the Prodigy technology which completely automates the procedure of cell manufacturing from start to finish, thus enabling standardization and GMP compliance. In addition, detection and identification of specific cell populations is now possible through gene labeling techniques. Similarly, advances in microscopy have enabled study of cell behavior with respect to their surroundings.
What is the scope of cellular therapy in the country?
India is a nation with increasing population demands. Our country is seeing an alarmingly rapid rise in occurrence of diseases and conventional treatment modalities are gradually losing potential to cure affected individuals. Being a developing economy, the application and opportunity of cellular therapy and regenerative medicine is different when compared to other countries. A number game exists between diseases (such as cancer, lifestyle related, autoimmune conditions etc.) and finances in our country. The aim of cellular therapy is to enable a diseased person to use his own body cells for treatment thereby addressing the issue of extreme financial burden as seen with conventional treatment modalities. This will drastically benefit our patients and country and will also propagate India towards becoming the leader in cellular therapy and regenerative medicine.