The Sunday Telegraph

Can stem cells save Michael Schumacher?

The Formula One legend is said to be undergoing radical new treatment in Paris. Victoria Lambert reports

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The news that Formula One legend Michael Schumacher was moved to a hospital in Paris last week for pioneering stem cell therapy has provoked a fever of hope and speculatio­n among fans that his condition could be improved.

After suffering devastatin­g head injuries in a ski accident almost six years ago, Schumacher was placed in a coma for six months and has been receiving treatment at his home in Switzerlan­d. He has not been seen in public since the accident.

His privacy is closely guarded and, while it is understood he cannot walk or stand, and, according to former Ferrari manager, Jean Todt, he may still have trouble communicat­ing, nothing has been confirmed officially.

No wonder then that fans have been so excited to hear Schumacher is now under the care of worldrenow­ned cardiac surgeon Philippe Menasché, described as a “pioneer in cell surgery” at the GeorgesPom­pidou hospital in Paris.

Stem cells are cells that can differenti­ate – or change – into other types of cell, opening the possibilit­y of replacing damaged cells with healthy ones. Scientists have been looking into their use since the Sixties, most successful­ly so far in cases of cancers of the blood or bone marrow. More than 26,000 patients are treated with blood stem cells in Europe each year.

And since the Eighties, skin stem cells have been used to grow skin grafts for patients with lifethreat­ening burns; most recently, a new stem cell-based treatment to repair damage to the cornea (the surface of the eye) after an injury like a chemical burn, has received conditiona­l approval in Europe.

But their flexibilit­y offers hope for lots of illnesses and conditions including heart disease, MS and macular degenerati­on – and clinical trials are progressin­g in all these areas. Chronic spinal cord injury is being researched with some

promise, thanks to the Christophe­r & Dana Reeve Foundation, set up after actor Christophe­r Reeve was paralysed in a riding accident.

Crucially, for cases such as Schumacher, stem cells are also being explored for neurodegen­erative diseases like Parkinson’s and Alzheimer’s – and traumatic brain injuries like the one he suffered in a skiing accident in December 2013.

Head injuries are difficult to treat as brain damage cannot be undone and each case is different. Asked for comment by The Daily Telegraph, the hospital responded that they could neither confirm nor deny the presence of Schumacher.

However, if he is under the care of Mr Menasché it is likely he will have had stem cells delivered by an IV to the area of the body where it is felt they could work best – whether that is his head or heart.

In a recent interview online, Mr Menasché explained that stem cell treatment for cardiac conditions – his particular area of expertise – is in its infancy. “Nobody really knows how stem cells are working,” he said.

“They do not permanentl­y transplant into the myocardium ardium [the muscular tissue of the heart] – after a couple of days or weeks, they just disappear. Stem cells are cells which can differenti­ate – or change – into other types of cell, opening the possibilit­y of replacing damaged cells with healthy ones. Scientists have been looking into their use since the Sixties “But you still may have a functional benefit as during their transient stay in the heart,” he explains in the Future Tech podcast, “as the cells release molecules into the tissue. The hypothesis is that the repair comes from the heart itself, stimulated by these molecules.” Should the stem cells have been intended for Schumacher’s brain injury, research suggests that the treatment has potential. A University of Plymouth study published in the journal Cell Reports in June found that neural stem cells could be used to “wake up” and produce new neurons (nerve cells) and surroundin­g glial cells in the brain.

The research is in its infancy, says lead author Dr Claudia Barros, from the Institute of Translatio­nal and Stratified Medicine at the University of Plymouth, who acknowledg­es there is still a long way to go until such findings can be translated into human treatments.

“We are working to expand our findings, to bring us closer to the day when human neural stem cells can be controlled and efficientl­y used to facilitate brain damage repair, or even prevent brain cancer growth that is fuelled by stemlike cells,” she says.

A Chinese study published last month in the journal Frontiers in Cellular Neuroscien­ce examined the current state of progress into the effects of stem cell therapy on traumatic brain injury. But the researcher­s from Zhejiang University, Hangzhou warned much more work was needed: “Although a large number of basic studies have confirmed that stem cells have good effect in the craniocere­bral injury,” they said, “the safety of stem cells, the route of injection, the time of injection and the specific mechanism are all factors that affect the clinical applicatio­n of stem cells, and are the important research point in the future study.”

In the UK, some applicatio­ns of stem cell medicine are already available privately, although tightly controlled by the Human Tissue Authority – and not in the brain.

Simon Checkley, CEO at the Regenerati­ve Clinic in Brighton, explains: “It is possible to get stem cells from sources outside your body, like the umbilical cord or Wharton’s jelly j [the vitreous humour in the eyeball], but in the UK we can only take stem cells from our own bodies.

“It is possible to get them donated, but it is safer to use your own.”

In some countries, stem cells can then be manipulate­d in a laboratory but that is illegal in the UK, says Checkley. “There is a concern with cultured stem cells which have been bred in a Petri dish that they may keep proliferat­ing after you transplant them into a body. That, having triggered their growth, you can’t stop it and no one knows what might happen.”

At the Regenerati­ve Clinic, stem cells are taken from adipose fat, where they are plentiful, and then injected back into the area to be treated – mostly arthritic joints.

“We are seeing fantastic results,” Checkley says, “with reduced pain and improved mobility for 80 per cent of patients.” He is considerin­g a clinical trial which could see the treatment pass through the National Institute for Health and Care Excellence (NICE) and become available on the NHS.

The therapy is still only four years old, he emphasises. “We have treated 1,000 patients so far and around the world, it’s about 40,000. We need longer-term studies.”

This type of stem cell treatment is also offered in the UK for postmenopa­use vaginal atrophy and stress incontinen­ce, Checkley says, plus the genital skin condition lichen sclerosis. In all these cases, he says, the mechanism is the same: the stem cells are not replicatin­g dead or dying cells but acting as signalling devices, alerting the body that this is an area where healing is needed.

For stem cells to work in more complex conditions, they would need to be manipulate­d, Checkley says. In cases of brain injury or disease, that would mean altering stem cells so that they could be targeted more precisely. But he believes the role would be similar: “The idea is they would go to the area of greatest damage and signal the body to regrow tissue there.”

Cost would be a huge factor, he points out. A treatment for arthritis costs about £6,000 at the Regenerati­ve Clinic but an IV-led treatment for brain injury with manipulate­d stem cells could cost up to £50,000. But then what price recovery from a traumatic brain injury? Full recovery thanks to stem cells would be a prize beyond value.

‘Stem cells go to the area of damage and signal the body to regrow tissue’

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 ??  ?? Stem cell pioneers: the GeorgesPom­pidou hospital in Paris
Stem cell pioneers: the GeorgesPom­pidou hospital in Paris
 ??  ?? New hope: Michael Schumacher has not ot been seen in public since his skiing iing accident in 2013
New hope: Michael Schumacher has not ot been seen in public since his skiing iing accident in 2013

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