Stem Cell for Parkinson’s Diseases: An Emerging Landscape

Parkinson’s Treatment: A Changing Landscape in India

John Baumann, a popular motivational speaker from the US, stated: “Parkinson’s can be the wake-up call to transform yourself into a better person”.In India, Parkinson’s or any neurodegenerative disease fails to gain the spotlight, even though they are real troublemakers demanding immediate attention.  WHO reported more than 11 million individuals living with Parkinson’s globally. Meanwhile, India expects a neurological tsunami with an estimated 2.8 million cases of Parkinson’s projected by 2050. The biggest challenge is unawareness across the huge India population, leading to a larger proportion of Parkinson’s cases remaining undiagnosed. The irony remains in the fact that the global research landscape has advanced to stem cell therapy for parkinson’s that implies a regenerative approach. Through this blog, we aim to communicate the causes, risk factors, treatment options, and evolving landscape in future Parkinson’s Care.

Understanding Parkinson’s: Causes, Progression and Challenges

Parkinson’s often occurs due to neurodegeneration of dopaminergic neurons, leading to compromised motor and non-motor functions. It is often an age-associated disorder that progresses over time. The Common Symptoms Associated with Parkinson’s include:

• Tremor– indicated by rhythmic shaking of hands and legs
• Bradykinesia–  associated with slowed movement, resulting in difficulty performing daily life activities.
• Muscle rigidity– muscles turn stiff, making an individual feel tense and experience pain in movement
• Poor balance and posture– stopped posture and frequent loss of balance
• Change in Speech– slurred speech or difficulty in speaking
• Compromised automatic movement– difficulty in sudden shift or performing actions like blinking, smiling, moving arms, etc.

Diagnosis for Parkinson’s 

There is a lack of specific tests dedicated to Parkinson’s; thus, the diagnosis involves recording medical history and careful assessment of the signs and symptoms. The common diagnosis includes:

• Neurological and Physical Examination: Taking the medical history of the patient and performing a medical examination to assess memory, reflexes, or coordination. 
• Blood Test: often performed to rule out other conditions
• Imaging: MRI, PET scan, and Ultrasound to rule out other conditions
• Single-photon emission computerized tomography (SPECT) for the identification of the type of tremor.
• Genetic testing: Identifying any medical history of Parkinson’s in the family

Common Treatment for Parkinson’s Disease

The common treatment available for Parkinson’s helps manage its symptoms. This includes:

• Palliative Care: Medication prescribed for management of Parkinson’s helps in several symptom management including problems with walking, tremors, release of dopamine, etc. Some common medications include Carbidopa-levodopa, Inbrija, Duopa, dopamine agonists, monoamine oxidase B inhibitors, anticholinergics, etc. 
• Deep Brain Stimulation (DBS): The electrodes are connected to the brain that sends electric pulses in the brain. This is helpful against severe tremors.
• MRI-guided focused Ultrasound (MRgFUS) manages tremors in a non-invasive manner.

However, the major drawbacks with the above treatment options are their non-curative nature. Thus, the inclination towards Stem Cell Therapy for Parkinson’s is catching the attention of healthcare practitioners. 

Stem Cell Therapy for Parkinson’s: Scientific Basis

Stem cell therapy has widely caught the attention of the scientific community for its regenerative ability. Although stem cell therapy for Parkinson’s disease in India or globally isn’t FDA approved, recent clinical trials have reflected their promising potential in curing. Current research is focused on deciphering the best source of stem cells that can be used for Parkinson’s patients. The ultimate goal is to replace the lost neurons with new ones, hence restoring the original function.

Type of Stem Cells for Parkinson’s Disease

• Embryonic stem cells (ESCs): Stem cells derived from embryos at an early developmental stage that can differentiate into any cell type. However, using these cells has high ethical constraints, due to which it is limited to research.
• Adult Stem cells (ADCs): these are hematopoietic cells present in bone marrow or blood of the individuals. ADCs possess the ability to differentiate into more than 20 types of the body’s cell types. 
• Mesenchymal stem cells (MSCs): stromal cells that can be isolated from various tissues, including adipose fat tissues, bone and cartilage. MSCs can be isolated from umbilical cord blood as well. These cells, along with regenerative potential, have anti-inflammatory and antioxidant properties. 
• Induced pluripotent stem cells (iPSCs): These cells are developed from adult skin or blood and are reprogrammed for specific functions. However, reprogramming poses a greater risk of mutation or manipulation of the original property of the cells. 

How Do Stem Cells Treat Parkinson’s Disease?

Stem cells can induce curative function in Parkinson’s disease via various functions, including:

• Neuronal regeneration, repair, and replacement
• Dopamine restoration potential
• Immunomodulation and reduced inflammation
• Neuroprotective support for slowing disease progression

Clinical Trials for Stem Cell Therapy for Parkinson’s Disease 

The legitimation of stem cell therapy for Parkinson’s can be proven via stringent and successful clinical trials. Researchers are vigorously running clinical trials, and complete approval of any type of stem cell therapy for Parkinson’s is yet to be granted. Some of the recent clinical trial results include: 

Stem Cell Therapy	Clinical Trial Phase	Outcome
Bemdaneprocel (BRT-DA01) Dopamine Precursor Cell	Phase I	Safe, moved forward for Phase II trail
MSCs Infusion	Phase II	Safe and well tolerated
iPSCs: Autologous Dopamine-Producing Cell Transplants	Phase I/IIa	Under monitoring
Embryonic Stem Cell–Derived STEM-PD Cells	Phase I	Ongoing

However, it must be noted that there are more clinical trials desired to approve the safety and long-term efficacy of the stem cell therapy for Parkinson’s disease.

Status of Stem Cell Therapy for Parkinson’s in India

Though Stem Cell Treatment for Parkinson’s is not FDA approved, its promising potential has made it a preferable choice for many healthcare practitioners across the globe. 

MSCs are the most commonly used stem cells for Parkinson’s treatment in India. The stem cells used can be either autologous or allogenic. At the same time, some other approaches include exosome-based neuroregenerative therapies.  A healthcare practitioner focuses on a combination of treatment and undertakes multi-modal strategies for curing Parkinson’s 

What Should Patients Expect

Patients choosing stem cell therapy for Parkinson’s must be aware of the detailed process, such as: 

• Complete assessment of the patients, including thorough medical examination, family history, other health concerns, etc. It is important to determine whether the individual is eligible for the treatment.
• Customization of the stem cell treatment based on an individual’s needs. This includes determining the safety of the procedure, determining the type of stem cells, the isolation procedure, and the steps of the treatment process.
• Post-treatment rehabilitation and monitoring of the progress

Evidence-Based Outcomes of Stem Cell Therapy for Parkinson’s

Stem Cell Therapy for Parkinson’s has proven to be safe for most patients. The significant improvement in Parkinson’s treatment includes: 

• Improvements in tremors, constricted movements, and rigidity
• Reduction in medication dependency
• Enhanced cognitive and motor function
• Long-term neuroprotective potential

Safety Considerations & Risk Factors

Stem cell therapy has shown positive outcomes, yet there are certain short and long-term risks associated with this. This includes: 

• Short-term Risks: Localized Haemorrhage or Infection
• Long-term Risks: Teratoma formation, graft-induced dyskinesis, genetic instability, and immune rejection.

What Should be Kept in Mind?

Opt for treatment from a renowned clinic and an experienced neurologist or neurosurgeon in stem cell therapy.

Set up clear expectations related to the treatment procedure, the isolation process of stem cells, the duration, and the cost of the therapy

*NOTE: It must be noted that stem cells should be of superior quality. 

Advancells, Noida, is among the reputed manufacturers of stem cells, where all the safety guidelines are followed along with GMO certification.

Major Takeaways

• Stem cell therapy for Parkinson’s Disease in India is promising, but more rigorous research is required to ensure its long-term safety and efficacy.
• Determining the best source of stem cells and their long-term outcomes must be determined.
• Be aware that commercial clinics promote stem cell therapy as FDA-approved or 100% safe.

Parkinsons Patient Success Stories

FAQ’s:

Q- What are the common symptoms of Parkinson’s disease?

Parkinson’s is generally an age-associated progressive disease, and the common symptoms include tremors, shakiness, difficulty with speech, reaction, hand movement, etc. 

Q- What are the common Parkinson’s treatments in India?

Common Parkinson’s treatment includes medications, supportive care, and DBS. All the treatment focuses on management of the problem and does not have curative potential.

Q- Is stem cell therapy for Parkinson’s disease in India safe?

Stem cell therapy is safe when performed under expert supervision. Prior to opting for the treatment options, patients and their family members are recommended to discuss with their clinicians and take a clear overview of the treatment process.

Q- Is stem cell treatment for PSP in India the same as Parkinson’s disease?

PSP stands for progressive supranuclear palsy, which is often confused with Parkinson’s disease. Although various symptoms like tremors and problems with posture are similar in both cases, the disease pathophysiology of both differs, as in PSP, widespread areas of the brain are degenerated.  As both are neurodegenerative diseases, the stem cell therapy approach for both can be similar, but the exact strategy for treatment depends on the stage and severity.