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Post Info TOPIC: Stem cells in the regeneration of ocular tissue.


Executive

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Date: Sat Feb 14 11:50 AM, 2009
Stem cells in the regeneration of ocular tissue.
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Hi,

The following is an article by Prof. Massimo Lombardi. It concerns his use of stem cells in the regeneration of ocular tissue. He has began to make retrobulbar injections with autologous stem cells since last February 2008.

I know very little about this branch of his treatments and include it here solely for your interest (Prof. Lombardi corrected my Keratoconus with his Mini ARK procedure some years ago now).

The original presentation contained a lot of images, too many to upload here, I will try and host them on another server at a later date.

Hari Navarro.

The New Frontiers of Ophthalmology:

“REGENERATIVE MEDICINE”, A TREATMENT ABLE TO REGENERATE OCULAR TISSUES USING AUTOLOGOUS STEM CELLS"
By: Massimo Lombardi & Patrizia Belilli

Generalities
Stem cells can be classified as:
TOTIPOTENT
PLURIPOTENT
MULTIPOTENT
UNIPOTENT


As regards TOTIPOTENT stem cells, each individual stem cell has the ability to develop into a full-fledged living body, e.g. the zygote and the blastomere (embryo’s first cells).

PLURIPOTENT stem cells maintain their proliferation abilities on a lifelong basis and are divided asymmetrically, since one of the two sister cells continues to be a stem cell whereas the other one starts differentiating. In mammals, pluripotent stem cells are present in the embryo node of the blastocyst during re-plantation of the uterus, as well as in embryos and fetuses during development and in adults, albeit limited to some regions of their body.

TOTIPOTENT stem cells differ from PLURIPOTENT stem cells since the latter cannot generate a full-fledged living body, but can specialise in cells able to generate a single organ or apparatus, since they come from one of the three germinative layers.

MULTIPOTENT stem cells can specialise only in some types of related cells, for example blood elements, such as red blood cells, white blood cells and blood platelets. MULTIPOTENT stem cells are also present in the nervous system of adults, as in the retina, which is one of the differentiations of the central nervous system.

Finally, UNIPOTENT stem cells can generate only a specific type of cell.
Depending on their origin, stem cells can also be classified as: ADULT, that is coming from the bone marrow of adults, or EMBRYO, when taken from the umbilical cord:
Adult stem cells are non-specialised cells of a specific tissue and are mainly Totipotent. They are currently used for the treatment of several pathologies.
Embryo stem cells are obtained through culture of the internal cells of a blastocyst (which is present only in embryos).
Research on embryo stem cells is still taking its first steps, especially owing to impediments of an ethical kind. As a matter of fact, to obtain a cell line from these cells, it is necessary to destroy a blastocyst, that is an embryo which has not grown beyond 150 cells.
Such an embryo is considered by many to be a potential human being, whose destruction would be equivalent to killing an already conceived human being.

Blood left on the placenta and on the umbilical cord is also a source of adult haemopoietic stem cells. Since 1988, these cells have been used to treat Gunther disease, Hunter syndrome, acute lymphocytic leukemia and many other paediatric pathologies.
Blood is collected from the umbilical cord – during spontaneous labour or C-section alike – by taking a sample from the umbilical vein (in a sterile closed circuit); then, the volume and the number of white blood cells are calculated, which must not be below 60 ml and 800 millions respectively.
It must be considered that this blood is not analysed directly given the potential presence of infectious agents; in fact, serologic tests are carried out on the parturient during labour and six months after cord donation. However, HLA typing is performed to verify if the donee is compatible with the donor’s tissue. HLA typing results are published on global databases, accessible by Transplant Centres authorised to search for compatible tissues for their patients. Blood taken from the umbilical cord is deprived of red blood cells and then cryopreserved for future use at a temperature ranging from -130° to -196° C. Before transplantation, blood is thawed out, and once all cryoprotective agents have been filtered, it is administered to the patient intravenously.
Prior to authorisation from the relevant Authorities, it is also possible to take blood from the placenta and send it abroad for cryopreservation in private laboratories.
This type of treatment, whereby stem cells are taken from a donor, is commonly referred to as heterologous (or “allogenic”).
Conversely, when stem cells are taken from the very same patients on whom they are going to be used, as we normally do in our medical practice, we refer to an “autologous” treatment.
As ophthalmologists, we are using autologous stem cells to treat ocular diseases.

We had been waiting for 25 years before using stem cells for the treatment of ocular diseases and we rose to the challenge with great anticipation. The first treatment ever in the history of Ophthalmology was carried out at the beginning of February 2008.
By an “actual” treatment with Autologous Stem Cells we mean a treatment whereby ocular tissues can be regenerated, with the exception of the corneal epithelium, since this was already abundantly reproduced in several centres, including the Bank of Corneas in Mestre.
It must be reinforced that the corneal-conjunctival epithelium is a type of tissue, which more than any others is spontaneously regenerated with no need of culture further to solution of continuity, burns, etc..

Treatment with autologous adult stem cells:
Adult stem cells are taken from the bone marrow, and more specifically from the right or left iliac spine of the iliac bone in a local anaesthesia.
Adult stem cells are not specialised and reproduce daily to generate some specific cells: for example, 200 billion red blood cells are generated every day by haemopoietic stem cells, mainly in the spleen and in the bone marrow.
These “Totipotent” stems cells can generate almost any type of differentiated adult cells, including hepatic, neural, muscular, renal, follicular cells, retinal photo-receptors, etc..
By the way, stem cells useful for the regeneration of the central nervous system, the brain and the bone marrow are apparently present in blood vessels, retina, digestive epithelium, liver, brain and dental pulp.
The treatment with “autologous cells” is totally rejection-free, and there is no risk to contract illnesses, unlike grafts from a donor (heterologous grafts), which notwithstanding controls, may imply a certain degree of risk.
The conservation of cells is helpful in treating several pathologies, including lymphomas, leukemia and someone suggest to have had success on some cases of cancer.
One of the most promising applications of stem cells concerns degenerative or chronic diseases, which affect millions of patients.
There are several fields of application for grafts using “autologous stem cells”, because in theory almost every pathology, excluding hereditary birth diseases, could represent a possible indication of treatment. The question was debated at length in oncology, and therefore the Center has made the political decision to exclude, at least for the time being, oncological cases which had been already diagnosed.

“Regenerative Medicine” needs a different approach compared to pharmacology. In fact, we are not talking about drugs and the action of cells is not only physical-anatomical but first and foremost “bio-energetic”.
And strangely enough, this type of information is not provided at all over the six-year medical degree course and following postgraduate studies.
It is quite odd that the so-called “Official medicine” has never considered a key element, that is the difference between a human being and a cadaver, since unlike the latter, the former has the ability to move and to pulse according to existing bio-rhythms, thereby showing that the true difference between the two is a “Bio-energy quantum”.
Hence, we rely on autologous stem cells as being able to “re-energise” or “bio-energise” tissues on which they are implanted and subsequently, reproduce dead or damaged cells, recanalise or reconstruct vessels, “nervous fibers”, retinal photo-receptors, muscular fibers, etc..

Expectations of doctors and patients alike are positively great in this regard. And today we are starting to see the first results, at last.

Despite the above-mentioned great expectations, however, this treatment is usually misunderstood because people tend to consider it from the standpoint of the so-called “Modern” medicine, whereby a missing mass (of cells) (because they are dead, infected or anyway inactive) is replaced by cells biologically performing a specific “mass action”. This has proven to be inaccurate, since the action of these cells is instead the following:

   1.“Bio-resonance”: re-activation of stem cells, which are already present in the target organ and in the entire body

Therefore, no ponderal principle is enforced

   2. Selective and elective replacement of dead or damaged cells
   3. “Bio-energisation” of the target organ and the entire body

Actually, we still don’t know for sure if and when these cells are activated.
We assume that the general bio-energetic conditions of the patient play a key role in the ability of removing dead or damaged cells from the target tissue. This means that the “quantum” of bio-energy, which can be measured using “Amsat” and “Reflexograph” devices, is essential to make these cells perform the biological and bio-energetic role we expect.

For some years now in our Centre, we have been using Bio-electronic and “Homotoxicologic” Medicine to treat the different hypoergic states of the patient, thereby increasing the “quantum” of vital energy present in the patient himself/herself. The aim is to treat - using only this new Medicine – different pathologies in regard to which “Traditional Medicine” was not able to give a positive answer. With our work, we aim to provide evidence about what can be done in Ophthalmology using Autologous Stem Cells.
Clinical case: A.T., 45-year-old woman.
We hereby present the clinical case of a patient, who came to see us in March 2007 for a wet maculopathy affecting both eyes, with l.e. » r.e.
She reported she underwent PRK in 2001 (refractive and aberrometric treatment) for a modest myopia.

In October 2005, further to an examination, she was diagnosed with maculopathy of the l.e. (left eye) and subsequently underwent 8 sessions of “photo-dynamic therapy”, with the tragic outcome of having her left-eye visus reduced from 8/10 to finger count at 10 cm.

When we first saw her on March 5th, 2007 we observed the following clinical picture:
- anterior segment of the eyeball:
 R.E.: v.n. 5/10 corrected with (-1.5 -0.5)9/10
 L.E: central scotoma, insecure finger count at 10 cm
Intra-ocular segment: oo pressure (both eyes):11 mmHg
posterior segment of the eyeball:
oo: diffused choroidosis
R.E.: modest paramacular epitheliopathy
L.E.: disc-shaped sero-haemorragic macular degeneration with bleeding at the posterior pole
- visual field:
(image missing)

The patient underwent a “Homotoxicologic-organotherapeutic” and “bio-electronic” therapy for 3 months (approx. 10 retrobulbar each eye injections) prior to treatment with autologous stem cells.

Once completed the above-said therapeutic cycle, a vision test was taken on June 25th 2007, which gave the following results:
(image missing)

Treatment with autologous stem cells was performed on April 25th 2008. The patient was administered approx. 4 ml of stem cells in one deep retrobulbar injection.
(image missing)


Picture 1: post-treatment ultrasound on May 23rd, 2008
(image missing)

On June 25th, 2008, a check-up of the visual field gave the following result, which can be clearly and easily compared with the previous one:
(Images missing)

Argument
The visual field has significantly improved both in terms of peripheral vision and specific Macula-Threshold test.
This was followed by a visus improvement of the right eye with a -1.5 -0.5 correction (110°) 10/10 and of the left eye with a -1.5 -1.5 correction (170°) 1/50 wide.
The Macula-Threshold test is particularly important as regards photosensibility indexes directly related to the “bio-energetic index” of retinal photo-receptors, since it shows two things:

   1. when the numeric value was reduced compared to average, there is no doubt that a damaged photo-receptor was replaced or the stem cells present on retinal tissue were re-activated through “Bio-resonance”.
   2. when the value was below 28-30, at the level of the visual field, the photo-receptor involved was probably “Bio-energised” through “Bio-resonance”, thereby increasing its absolute sensibility levels.

In addition to this positive outcome, we must also report of the early positive results recorded in patients affected by pigmentary retinopathy. These results will be published later on, once we have reached a significant number of cases.

Conclusions

Over the last few years, a new era of Medicine has begun: “Regenerative Medicine”. We are putting all our efforts in this new frontier with pride and satisfaction, as we already did with other breakthroughs in Ophthalmology in the past (see Refractive Surgery, Conservative Surgery in Keratoconus, etc.) and we are now starting to reap the fruit of this work.
Day after day we have been perfecting both the preparatory stage and the stem cell treatment itself. Therefore, we will soon get back to this issue with new articles and updates on ongoing treatments and results.


-- Edited by QuintriX at 15:06, 2009-02-18

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Executive

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Date: Mon Feb 16 6:08 PM, 2009
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A great leap for Mankind ! its just some really fantastic news !

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