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Stem Cell Treatment A Potential Lifeline

Panama has become a hemispheric leader in research into stem cells and their therapeutic applications. The nerve center of this medical revolution is the Ciudad del Saber (City of Knowledge), a complex near the Panamanian capital dedicated to the acquisition of knowledge.

By: Juan Abelardo Carles Rosas
Photos: Carlos Eduardo Gómez, Courtesy MediStem de Panamá

Last September, Ryan Benton, a 28-year-old man suffering from Duchenne muscular dystrophy, became the first U.S. citizen to receive mesenchymal stem cell therapy in the United States. The life expectancy of those suffering from this disease is generally no more than twenty-five years, but this native Kansan has been receiving treatment in Panama for six years. Two Texans have also been receiving treatment in this Central American country: a football coach with multiple sclerosis and an odontologist who injured his knee during a dance competition.

The brain drain used to go the other way, but a series of national and international factors has made Panama a hemispheric leader in research into stem cells and their therapeutic applications. The nerve center of this revolution is the Ciudad del Saber (City of Knowledge), a complex near the Panamanian capital dedicated to the acquisition of knowledge through the work of a network of innovative companies, international organizations, and development associations, working in conjunction with academic and research institutions. Among the latter is MediStem, a research and development company responsible for helping Benton and many other patients around the world.

Nearly half of the approximately 16,000-square-foot facility is occupied by entities researching and processing stem cells. Before entering, we are required to exchange our clothing for sterilized gear and rub our arms and faces with disinfectant gel. Once inside, we witness the arrival of a batch of umbilical cords donated by mothers shortly after giving birth. Each cord will be cleaned and analyzed to determine the quality and quantity of stem cells present in the tissues.

“Seven of every ten samples are rejected,” explains Rodolfo Fernández, a MediStem researcher. “We have worked with adult stem cells extracted from fatty tissue or bone marrow, but we have seen that umbilical cord stem cells are more robust, producing the trophic factors we use in our research and treatments.” “Trophic factors” are understood as a set of protein substances secreted by stem cells that regulate the relationship between an organism and its own tissues. The effect of these factors relieves, for example, the autoimmune inflammatory processes responsible for illnesses like autism, rheumatoid arthritis, and multiple sclerosis.

The earliest research was done years ago with embryonic cells, but this raised questions among the public as to the ethics of the technology. “I do not know of any treatment in which embryonic cells are useful. The cells are programmed to become babies, to develop organs and tissues. You cannot leave an embryonic cell in a batch of stem cells, since that could result in a keratoma (formation of hard, keratinous tissue that could interfere with an organism’s normal functioning). Adult stem cells enter the organism, complete their tasks, mature, and then are discarded by the body in three or four months,” notes Neil Riordan, a U.S. physician and a key member of the team researching stem cells in Panama.

Riordan has lived in Panama for four years and has been involved with MediStem Panamá since 2007. Another MediStem researcher, Dr. Jorge Paz Rodríguez, remembers a visit to Riordan’s research complex in Costa Rica that year. “We were excited about what was being done there; it was amazing. We returned to Panama and began knocking on the doors of all the government offices; we knew this was something worth fighting for.” At that time, Panama had a 2004 law that prohibited cloning, but left open the possibility of a different type of cell research.

This broad definition allowed Fernández, Paz Rodríguez, and other doctors to research stem cells legally and ethically. “Today, Panama has the first comprehensive laws for research, practical application, and therapeutic treatment with adult stem cells rather than embryonic stem cells,” explains Fernández. “This makes it possible to regulate the establishment of laboratories, production processes, and studies of medical applications, all in accordance with protocols and under the supervision of the Panama Bioethics Committee. Patients can be sure that they are being treated with standardized and safe processes that have been shown to be effective for many medical conditions,” adds Paz Rodríguez.

In keeping with this framework, studies are being developed in Panama for nine specific medical conditions, including osteoarthritis, spinal cord lesions, asthma, and autism. We learn of a case of spinal cord lesions involving a Puerto Rican teenager whose T5 vertebra was shattered by a stray bullet. “When he came to Panama between July and August of this year, the boy could not feel anything or move; he did not even notice when he urinated,” comments Dr. Riordan as we watch a recent video —sent by the boy’s mother— of the patient exercising his legs with a weight machine. “I have no doubt this young man will walk again,” states the doctor.

As for Ryan, the young man from Kansas, Riordan believes that Ryan can have a normal life if he receives treatment every three, or at most, six months, so arrangements were made with the U.S. Food and Drug Administration (FDA) for him to receive treatment in his own country. “There is a clinic in the United States with which we can associate in order to offer the therapy. Our aim is to have the patients receive doses of stem cells, just like diabetics receive injections of insulin. The illness is not cured, but it is controlled, giving patients a better quality of life.”

Additionally, study protocols, which have already been approved by the National Bioethics Committee and Health authorities in Panama, have been filed with the National Center for Biotechnology Information of the National Institutes of Health (NIH), also in the United States, and assigned a registration number, so the international scientific community can follow the research. “We have been treating patients under established protocols for years, but now we are taking this to another level, since all the data collected in the studies can be presented at medical conferences: we have information in black and white that confirms the incredible stories of our patients,” explains Paz Rodríguez.

We can only imagine the undiscovered possibilities of medical treatment offered by the fledging research into adult stem cells. The sky is the limit for MediStem Panamá researchers. “We have all the facilities for ongoing research here. We have continued doing research, since we want to venture into applications for treating other diseases,” emphasizes Fernández. Beyond the illnesses that can be treated with this type of therapy, there is also the matter of its cost and accessibility. It is not cheap to produce something new, but as study protocols are approved and results become known, it will be easier for insurance to cover the therapies, and factories can establish production processes that reduce the cost. One way or another, stem cell therapy is here to stay.

 

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