ABSTRACT
Background. The publicity around stem cell therapy has given many persons who have sustained a devastating injury such as spinal cord injury (SCI) the hope of achieving partial or full recovery from their injuries. Several phase I and II clinical trials are being conducted owing to positive results obtained in animal models. While safety during the trials has been demonstrated, clinical efficacy in the outcome of ethically approved trials is still lacking. Many persons affected by SCI are, however, desperate for a cure and are lured into undergoing stem cell therapy by marketing campaigns and information readily available on the internet. These people travel far and wide to undergo stem cell therapy, which has led to the term 'stem cell tourism'. Objectives. To compare the data from participants' self-report questionnaires before and after their stem cell therapy to determine if there were differences in their functional and neurological status, and to record details of the procedures. Method. Persons who sustained a SCI and who received apparent stem cell therapy in South Africa (SA) or elsewhere were recruited to participate in the present study. Volunteers who gave written informed consent were asked to complete a biographical questionnaire and validated self-report questionnaire (Spinal Cord Independence Measure version III (SCIM III)) before and after their stem cell therapy to determine if there were differences in their functional and neurological status. The results of the self-report questionnaires were compared with the published expected functional outcome of people with lesions at a similar level of SCI to the participants. The secondary aims of the study were to document details of the procedures and their locations, the sources of 'stem cells' and the cost. Results. There was no indication that the participants' functional outcomes, as measured by the self-reported SCIM III, were better than the expected level of functional ability in patients with similar injury levels. Likewise, the neurological motor recovery scored on the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) motor scores showed no improvement post stem cell therapy. Conclusion. This study highlights the need to curb the practice of offering unethical and non-evidence-based stem cell therapy for SCI. Ethical research and treatment is encouraged as well as an effective legal framework and education of health professionals, patients and their family members and caregivers, which will avoid unrealistic expectations, bogus therapies and the potential adverse effects of non-evidence-based 'stem cell therapies' offered by clinics via the internet
Subject(s)
Cells , Mesenchymal Stem Cells , South Africa , Spinal Cord InjuriesABSTRACT
Mesenchymal tumours of the gastrointestinal tract (GIT) are uncommon. Recent progress in the understanding of the biology and origin of these tumours has led to their reclassification. A new subclass designated Gastrointestinal Stromal Tumours (GIST) is diagnosed based on the presence of a mutational over expression of c-kit protein that is thought to be critical in the pathogenesis of these tumours.This newclass of tumoursmay form the majority of gastrointestinal mesenchymal tumours. Even though the diagnosis of GIST is mainly based on positive staining with CD117; a minority of tumours with histological characteristics of GIST are CD117 negative and are classified asCD117 negativeGIST. In this first reviewof mesenchymalGITtumours fromNigeria;we present 11 cases ofmesenchymal tumours of the gastrointestinal tract seen within a six-year period at our centre. Immunohistochemistry was performed on 7 of themin which histological appearances suggested GIST. Only two cases had all the criteria defined in the consensus conference on the diagnosis ofGIST. Our findings; albeit in a very small sample; contrastswith what obtains in developed countries in the proportion of GIT mesenchymal tumours that are truly GIST. This raises a question to be answered on the true nature and proportion of gastrointestinal strumal tumours among GITtumours inNigerian patients