Hockey legend’s recovery highlights adult stem-cell advances

Daily News Article   —   Posted on March 3, 2015

Gordie-Howe
(by Marlene Harris-Taylor, The Toledo Blade) – Hockey legend Gordie Howe’s star power is raising awareness in the United States and Canada about advances in adult stem-cell therapies as he continues what is being called a “miraculous” recovery from a massive stroke.

Those closest to him, including his son, Toledo, Ohio radiologist Dr. Murray Howe, are convinced the former Detroit Red Wings player would have died if he had not traveled to a medical clinic in Tijuana, Mexico, for an experimental stem-cell treatment not yet available in the United States.

After a debilitating stroke on Oct. 26, Mr. Howe, 86, had a few weeks of slight recovery, but then his health “went downhill” quickly, said Dr. Howe, director of sports medicine imaging for ProMedica Toledo Hospital. The family had started preparing for his funeral. But that all turned around after he had the adult stem-cell treatment on Dec. 8.

“If you saw him now, you wouldn’t know he had a stroke,” Dr. Howe said.

“It’s been wonderful. Every day I would say he’s a little bit better, and there are little hints of improvement. Certainly in the first month, every day his strength, coordination, and balance were better. He has been eating like a horse. He had lost 20 pounds, and now he has gained back 25 pounds, so he is pretty close to his playing weight now,” Dr. Howe said.

In describing his father’s treatment and recovery in the last three months, Dr. Howe does not hesitate to use words such as unbelievable, astonishing, and amazing.

Eight hours after Mr. Howe received what is called a lumbar puncture, where stem cells were injected in the spinal fluid of his lower back by an anesthesiologist, he went from being bedridden and only mumbling short sentences to speaking clearly and walking with assistance, Dr. Howe said.

On the second day at the clinic, he received an IV infusion of a different type of adult stem-cell treatment.

When he returned to his home in Lubbock, Texas, on Dec. 10, Mr. Howe’s recovery from the stroke continued at an rapid rate, his son said.

“His vocabulary had dropped down. If you showed him pictures — the speech therapists when they were testing him, he could name about one of 10 items. After his stem-cell treatments, he was able to identify 80 percent of the pictures. The speech therapist was just floored,” Dr. Howe said.

“In 28 years of medicine, I have never seen a response, a recovery, from a stroke in such a rapid time frame and such an impressive response to me that is nothing short of miraculous,” he added.

He was doing so well the family accepted an invitation for Mr. Howe to attend a dinner in his honor on Feb. 6 in his hometown of Saskatoon, Sask.

Mr. Howe played 25 seasons with the Red Wings from 1946 to 1971 and played for the Houston Aeros and the New England Whalers of the World Hockey Association from 1973 to 1979. He finished his final season in 1980 at the age of 51 with the Hartford Whalers in the organization’s first season in the NHL.

He won four Stanley Cup championships, six Hart Trophies as the NHL’s most valuable player, and six Art Ross Trophies as the NHL’s leading scorer.

At the event in Canada, Mr. Howe shared the stage with other hockey greats Wayne Gretzky and Bobby Hull. Video of the event, provided by the family, shows Mr. Howe standing under his own power for several seconds as the audience gave him a standing ovation.

“He walked on stage. He goes under his own power, but he is almost 87, and a fall risk, so I just made sure he didn’t trip,” Dr. Howe said.

The lumbar injection Mr. Howe received has not been approved for use in the United States by the Food and Drug Administration (FDA) partly because the clinical trial process is longer and more cautious in the United States than in some other countries, said Dr. Paula Grisanti, chairman of the National Stem Cell Foundation based in Louisville.

Each new drug or therapy must go through a phase one, phase two, and phase three trial, which can take several years and, depending on the drug, can cost millions of dollars.

Between 4,000 and 5,000 clinical trials dealing with different stem-cell drugs on the FDA website clinicaltrials.gov are in varying stages of completion in the United States and Europe, she said.

“There is a fine line we walk between regulating therapy enough to protect patients but not regulating so much to inhibit innovation,” Dr. Grisanti said. …

The IV infusion of stem cells that Mr. Howe received on the second day of treatment has been approved for use in the United States, but now patients must wait six months after a stroke to start them, Dr. Howe said.

“They are being conservative and want to see how you recover on your own in the first six months, and after that, we can attribute any improvement you have to the stem cells,” he said.

Dr. Howe does not fault the FDA for being cautious or for having regulations, but he said the result is that U.S. and Canadian doctors are at a disadvantage because other countries such as Russia have been using adult stem cells to treat a variety of illnesses for more than 20 years.

Dr. Gristani estimates it will be at least five years before the stem-cell injection used on Mr. Howe will be through all the clinical trials in the United States. Then insurance companies will have to approve their use before they become widely available, which will likely add several more years to the process.

Because some of the treatments used on Mr. Howe are still in clinical trials here, Dr. Gristani said his recovery is being greeted with skepticism by some in the scientific community.

Most of the for-profit companies use cells manufactured from fat tissue. They take the cells from liposuction and grow them by the millions in a petri dish and manipulate them to make them more robust. They then inject them into the patient to fix the problem, Dr. Gristani said.

Some scientists, she said, are saying, “You are harvesting fat cells and injecting them, but you don’t know how long it will last because there is no clinical trial with the requirement for data collection, and how do you know, and are you protecting patients? ”

Dr. Gristani said some private companies are “leapfrogging” over the U.S. clinical trial process and offering patients treatment in other countries, such as the California-based Stemedica Cell Technologies Inc., which reached out to Mr. Howe’s family and offered him free, no-strings-attached treatment to repair the damage from his stroke.

Dr. Howe said he is aware of the critics who distrust the process. He was skeptical himself when first approached by Stemedica because he wasn’t aware of the treatment.

“Some have said, ‘Oh, it’s a placebo effect.’ Well, that doesn’t make sense because my dad, because of his short-term memory [problem], he doesn’t remember he had a stroke. He doesn’t remember he had a treatment. He has no idea. All he knows is he is doing great and doing what he likes to do,” Dr. Howe said. …..

He added: “You can take a negative perspective and say, well, these guys just did this for the publicity, but look at it from the opposite way. They had a lot to lose. If my dad had went there and died or got no response after dragging Gordie Howe across the country when he’s on his death bed – I mean, to me I was really impressed by that confidence.”

Dr. Howe said the company has extended another offer for his father to go back to the same clinic in June for an additional treatment that could possibly help with some of the underlying brain injuries that he suffers from playing hockey for 32 years – many of them without a helmet.

The results of the clinical trial in which Mr. Howe participated, involving about 30 to 50 patients in Mexico, will be officially published in mid-2016, Mr. McGuigan said.

Reprinted here for educational purposes only. May not be reproduced on other websites without permission from the Toledo Blade. Visit the website at toledoblade.com. 


Questions

1. What is the result of experimental adult stem-cell therapy that 86 year-old hockey legend Gordie Howe had in Tijuana, Mexico after a debilitating stroke, according to his son, radiologist Dr. Murray Howe?

2. How does Dr. Howe describe his father’s overall recovery after the adult stem-cell therapy?

3. Describe the treatment Gordie Howe received.

4. How quick was Mr. Howe’s initial recovery the first day of treatment?

5. Overall, what benefits did Mr. Howe receive from the experimental adult stem-cell treatment?

6. Why is Mr. Howe’s stem-cell treatment not yet approved in the U.S.? (Still in the experimental phase?)

7. How does Dr. Howe defend the stem-cell company (Stemedia) that treated Mr. Howe?

CHALLENGE QUESTION: What is Gordie Howe’s nickname?


Background

A stem cell is essentially a “blank” cell, capable of becoming another more differentiated cell type in the body, such as a skin cell, a muscle cell, or a nerve cell. Microscopic in size, stem cells are big news in medical and science circles because they can be used to replace or even heal damaged tissues and cells in the body. They can serve as a built-in repair system for the human body, replenishing other cells as long as a person is still alive.

There are two main stem cell types:  embryonic stem cells and adult stem cells (i.e., somatic stem cells).

Adult stem cells are a “natural” solution. They naturally exist in our bodies, and they provide a natural repair mechanism for many tissues of our bodies. They belong in the microenvironment of an adult body, while embryonic stem cells belong in the microenvironment of the early embryo, not in an adult body, where they tend to cause tumors and immune system reactions.

The primary role of adult stem cells in humans is to maintain and repair the tissue in which they are found. While we call them adult stem cells, they are more accurately called somatic (from the Greek word soma = body) because they come virtually any body tissue, not only in adults but children and babies as well.

The stem cell issue is filled with questions, confusion, and controversy about science, cures and the best ways to find those cures. Often ignored in the discussion is one glaring, indisputable fact: certain kinds of stem cells – called adult stem cells – are already helping people with cures and treatments, with the real promise and hope that more can be done. If one hears in the news about stem cells helping people, you can be sure that it is the result of adult stem cells, as that is the only type of stem cell helping people today.

Background on Adult Stem Cells vs. Embryonic Stem Cells:
(from PBS, a Newshour Extra report on the Stem Cell Research Debate)

Stem cells are universal cells that have the ability to develop into specialized types of tissues that can then be used throughout the body to treat diseases or injuries. Stem Cell Research is a topic embroiled in much controversy. Scientists are hopeful that one day stem cells will be used to grow new organs such as kidneys or spinal cords as well as different types of tissues such as nerves, muscles, and blood vessels. The controversy sparked by the use of stem cells and research in this area comes from the fact that…these cells are taken from embryos that are just days old. As a result of this, the embryo, which is a developing human life, is destroyed. Many people feel it is immoral and unethical to destroy embryos for the sake of science. To further the debate, while these cells are easily cultured, replicate quickly, and have a relatively long life, embryonic stem cells have not yet been successfully used to provide any kind of therapy for humans and pose risks such as tumor growth and rejection by the body.

On the other side of the issue is the use of adult stem cells for research. Adult stem cells are available from a variety of sources including blood from the umbilical cord, the placenta, bone marrow, and even human fat. ….they may have some limitations in the type of tissues they are able to form. For many years, adult stem cells have been used to provide a number of different therapies to people with a relatively high rate of success. Recent research has shown that adult stem cells taken from one area of the body are able to regenerate and form tissues of a different kind. In addition to the proven therapies and research, the use of adult stem cells from a patient’s own body decreases the risk of rejection because the cells are not seen as foreign invaders.

All in all, many scientists believe that the use of adult stem cells should be the primary focus of stem cell research based on past success, lower chances of patient rejection, and the idea that adult stem cell research does not spark the moral, ethical, and political debate seen so frequently when the use of embryonic stem cells is considered. (from a 2008 report)