Interview with Arnold Caplan, Part 3: challenges & opportunities for clinical use of MSCs

I recently had a phone interview with Dr. Arnold Caplan, the founder of the MSC field. You can read parts 1 and 2 of the interview here and here.

Today’s post, part 3, is focused on clinical use of MSCs.

I want to start off today’s post with a wonderful quote from Caplan:

“All MSCs are good if no one screwed them up!”

This statement by Caplan was in response in part to my asking about how different clinics handle MSCs is such dramatically different ways and how many of them somehow claim that their MSCs are unique. The latter claim, said Caplan, is in part a situation where businesses are looking to claim patent and IP rights.

The critical challenge, in my mind, is that some clinics (particularly those lacking training and expertise, but still jumping on the stem cell bandwagon) do indeed screw up the MSCs.

In our discussion of this challenge, Caplan said to me, “Don’t say that all medical tourism is bad”. Admittedly on my blog I have a habit of raising concerns about medical tourism and I don’t always differentiate between one type and another. They all worry me.

Caplan said that he does sometimes recommend that patients in certain situations go abroad for treatments that are not available in the US. He cited the example of recommending an MS patient go to a specific facility in Panama that Caplan says has the same level of quality as US hospitals, but is allowed to perform procedures with MSCs that are not permitted here in the US currently.

When asked if he himself would receive an MSC treatment from a non-FDA approved clinic if he was in that kind of health situation himself, Caplan responded (accurately) that it was a loaded question. Perhaps it was a bit unfair of me to ask since frankly I am not sure how I would answer it myself if I found myself in that kind of situation. But I am more skeptical about such treatments than Caplan.

I also asked Caplan about oversight and how we should handle clinics that are non-compliant here in the US and that lack expertise. I also mentioned ICMS as an example of an effort by the industry at self-regulation of a sort, albeit clearly imperfect. Caplan responded that he didn’t think that was the solution, “ICMS uses a hands-off process”.

He continued, “What we really need is for people in the stem cell field to do inspections of the clinics, but of course some will not allow that.” Indeed, it seems that some non-compliant clinics in the US will do what they can to avoid any kind of inspection.

Caplan said that he was very supportive of the FDA. He has some ideas and also a new proposal about stem cell regulation that will be the topic of the 4th and last post in this series.

5 thoughts on “Interview with Arnold Caplan, Part 3: challenges & opportunities for clinical use of MSCs


  1. In the article you state, “Caplan said that he does sometimes recommend that patients in certain situations go abroad for treatments that are not available in the US. He cited the example of recommending an MS patient go to a specific facility in Panama that Caplan says has the same level of quality as US hospitals”….What specific clinic is he referring to? Can you please tell us its name?


  2. Once again impressed by this Dr. Caplan. Specifically, the quote:

    “All MSCs are good if no one screwed them up!”

    The success of MSC therapy has been limited by poor homing efficiency.
    I wonder what he would think of utilizing nanotechnology in order to enhance these cells, and to improve their natural characteristics. Granted, sounds like he is more concerned about the derivation above all, just an interesting avenue being studied at this time.

    I will cite the Karp lab(MIT, BWH) in their sialyl lewis polymer construct that enables MSCs to exhibit a robust rolling response in inflamed tissue.(enabling systemic delivery through engineered cell homing). Also, and in the same lab, they were able to bind iron oxide to MSC in order to track the cells(MRI?)

    Just thinking that the derivation may not be the only problem, but when administered systemically these cells tend to get entrapped in the cardiovascular organs. If there are organizations that can produce low passage MSCs and utilize nanotechnology for maximum efficiency, aren’t we talking about one of the most promising treatments in history? My point is that it may take the collaboration of many different types of organizations in order to “screw up” these cells in order to get them to get them what we want them to do, as it appears they aren’t able to without chemical modification. Thanks.


  3. Alan-

    Re: Utilizing nanotechnology in order to enhance MSCs

    Perhaps as a vehicle for targeted drug delivery? (see below) …

    (Journal of Controlled Release, March 2013)

    Mesenchymal stem cells as delivery vehicle of porphyrin loaded nanoparticles: Effective photoinduced in vitro killing of osteosarcoma

    see: http://www.sciencedirect.com/science/article/pii/S0168365913001557

    Abstract

    Mesenchymal stem cells (MSC) have the unique ability to home and engraft in tumor stroma. These features render them potentially a very useful tool as targeted delivery vehicles which can deliver therapeutic drugs to the tumor stroma. In the present study, we investigate whether fluorescent core-shell PMMA nanoparticles (FNPs) post-loaded with a photosensitizer, namely meso-tetrakis (4-sulfonatophenyl) porphyrin (TPPS) and uploaded by MSC could trigger osteosarcoma (OS) cell death in vitro upon specific photoactivation. In co-culture studies we demonstrate using laser confocal microscopy and time lapse imaging, that only after laser irradiation MSC loaded with photosensitizer-coated fluorescent NPs (TPPS@FNPs) undergo cell death and release reactive oxygen species (ROS) which are sufficient to trigger cell death of all OS cells in the culture. These results encourage further studies aimed at proving the efficacy of this novel tri-component system for PDT applications.


    • Dave,

      Thanks for the note. Drug delivery is def something to consider IMO, thats also possible with things like platelets…that are already responding to injury and may also be able to be imaged with something like iron oxide. Although they are able to home, when administered systemically it appears that tend to get caught in the organs at a fairly alarming rate, so that could be the underlining issue.

      so really this could potentially offer an efficient, less invasive approach, and perhaps safer employment of the cells.

      this slex lewis polymer, theoretically, would give the MSCs the ability to carry P-Selectin..which would enable scientists to engineer the MSCs in a way that will target specific tissues and cells instead of letting them roam somewhat aimlessly. The fact that they engraft and migrate, from my understanding, is an unefficient process.

      just something I think is worth mentioning as scientists continue developing potential therapies using the cells.

  4. Pingback: Interview with Arnold Caplan, Part 4: the FDA and the Future | Knoepfler Lab Stem Cell Blog

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