Texas Governor Receives Experimental Stem Cell Transplant

Presidential Candidate Submits to Experimental Procedure to Relieve Back Pain

On July 1 Perry tweeted that he had had nerve decompression and spinal fusion to treat recurring pain from an old back injury, noting that the procedure had been successful "as advertised." What the Texas governor did not reveal was that he had also received an infusion of stem cells, a procedure that is extremely expensive (no word on whether the health insurance offered to Texas state employees paid for it) and not approved by the FDA. The efficacy of the procedure is questionable.

A Disastrous History of Stem Cell Experiments

Stem cells are known as "pluripotent," having the ability to morph into any kind of tissue. The most obvious source of stem cells is aborted human embryos, which in their early stages are tiny balls of stem cells not yet differentiated into different kinds of tissues. The use of this kind of stem cells in medical treatment is, as all observers of the American political scene know, anathema to almost all Republican and some Democratic politicians.

Injecting back pain and brain injury patients with embryonic stem cells, however, is nothing new. In the 1990's, several Australian neurosurgeons cultivated stem cells and injected them directly into the brains and spinal cords of patients who had had brain or spinal cord injuries or Parkinson's disease. The results were disastrous.

The patients' brains grew new brain cells. They also grew new muscle cells, eye cells, bone cells,  thyroid cells, and cancer cells, resulting in a slow and painful death of the transplant recipient. After these early catastrophes, both the understanding of stem cells and the techniques for using stem cells were vastly improved.

Perry Receives Adult Stem Cells

Most notably, researchers have learned how to work with adult stem cells, stem cells made in small quantities even in adults. Made in bone, adult stem cells have the capacity to mature into blood cells, bone cells, muscle cells, cartilage, or fat. Some researchers have been able to further manipulate the differentiation, or maturing process, of adult stem cells to produce beta-cells that make insulin (from skin cells) and even nerves.

From an ethical standpoint, adult stems are desirable because they are not "harvested" from human embryos. The patient provides his own stem cells from blood or fat to be cultured in the lab to create a large enough number to be reinjected for medical treatment. The stem cells then transform themselves into the desired tissue that needs repair, or more often, they don't.

The most common form of stem cell transplant is a bone marrow transplant, performed with the idea of enabling the body to make more blood cells. While we don't have all the details, Governor Perry's stem cell injection seems to have been intended to regenerate cartilage along the spine that will hold it in place. We don't know whether the procedure has been successful, or exactly how the stem cells were used (whether they were injected into the spinal column and could reach the brain, for instance), but the governor who just a few months ago was shooting coyotes on his morning job has more recently been seen wearing a back brace and orthopedic shoes.

The US Food and Drug Administration has been in litigation for several years over its authority to regulate stem cell transplantation. As a result, stem cell transplants and implants for bone marrow replacement and sickle anemia treatment can be publicly advertised, while stem cell transplants for other applications are not. It not unlawful to administer stem cells to repair hearts and brains and spines in the United States, but the procedures are not approved.

Texas governor Rick Perry is not inclined to let a little thing like FDA approval stand in the way of Texas becoming a center for adult stem cell therapy. Just three weeks after his own stem cell injections, Governor Perry wrote the Texas Board of Medical Examiners that he would like for Texas to become "a world leader in the research and use of adult stem cells", and that they should make rules for the use of stem cells accordingly. Even before Perry's procedure, he had approved a $5 million grant to the Texas A&M Health Science Center Institute for Regenerative Medicine and a $2.5 million grant to a Texas-based company known as America Stem Cell to further their efforts.

But do adult stem cell implants work?

For certain established procedures, the answer is "more often than not". Bone marrow transplants are stem cell transplants, preferable from a related donor who has compatible bone marrow tissue. The bone marrow enables the recipient's body to continue to make blood after irradiation to treat cancer or when there is a hereditary blood disease. The procedure is successful 70-90% of the time when the cells are received from a sibling and no cancer is involved. The procedure may only be successful about 25% of the time when cells come from an unrelated donor (which is only attempted when there is no medical need for radiation treatment.)

Umbilical cord blood contains the baby's own stem cells. It provides stem cells that are an exact match for the baby itself later in life (if the blood is frozen). These cells are a good match for a sibling, and sometimes a second child is conceived to save the first child's life. Procedures involving umbilical cord blood are usually successful.

Culturing adult stem cells to repair hearts and spines, however, can have unintended consequences.  Stem cells have to be placed on an artificial scaffold so they form not just the right tissue but the right tissue in the right size and shape.  Adult cells that have been deprogrammed to create stem cells and reprogrammed to provide the desired kind of tissue have been known to become cancerous. People have been known to travel around the world to Texas for stem implantation, spend $10,000 to $50,000 for an injection of their own stem cells, and get no benefits at all.

As a presidential candidate, Governor Perry will become a very visible "advertisement" for the success or failure of his procedure. Any seriously deleterious results of his treatment, however, may not be visible for several years.