In recent months, due to a major success achieved in the area of biotechnology by Geron Corporation, general public has become aware of the fact that future achievements of medicine will be dramatically related to the transplantation of tissues based on special cells of human embryo. These cells are called Stem Cells since all the other more special kinds of cells descend from them like branches descend from a tree stem. The print media provided numerous forecasts and prospects of stem cells application for medical purposes.

In addition to forecasts however there is also exists certain clinical experience of stem cells application for treatment of numerous diseases and conditions of the human organism.

Popular newspaper Mirror Weekly presented in its issue of January 23, 1999 an interview given by Dr. A. SMIKODUB, President of the "EmCell" Embryonic Tissues Center, Head of Cell Therapy Clinic of the National Medical University and of the "EmCell" Embryonic Tissues Center and Dr. A. KARPENKO, General Director of the "EmCell" Embryonic Tissues Center; this interview was initiated by publications related to the work carried out by Geron Corporation.

Herein is a part of this interview, dealing with the experience gained in the course of treatment using Embryo Stem Cell Transplantation method, carried out at the specialized Cell Therapy Clinic of the National Medical University. Their experts have gained 10-years experience with almost 1,000 transplantations of Stem Embryo Cells under a program of scientific research aimed at treatment of diabetes mellitus, cancer, AIDS, diseases of blood, intestine and joints, diseases and traumas related to the nervous system etc.

R. - What's your opinion on the time required to put these forecasts (related to applications of Human Embryonic Stem Cells, described in Geron's publications) into practice?

A. Karpenko: - Both commentators of this biotechnological achievement and its authors are very cautious when speaking about the time of introducing this method in the practical medicine. They are speaking of about ten or more years. At the same time, rather substantial experience has been accumulated internationally in the area of the human embryo stem cells application in the transplantation cell therapy.

As early as in 1991, the Ministry of Public Health of Ukraine issued methodical recommendations on the application of embryonic cell suspensions, and in 1994 the Cell Therapy Clinic was opened in Kyiv in order to continue and develop research and clinical application of Embryonic Stem Cell Transplantation.

R. - If, as you are saying, cell therapy is being developed in Ukraine, why is this fact almost unknown?

A. Smikodub: - Yes, transplantation cell therapy is actively coming into being in Ukraine. In Kyiv, our work is carried out at 14 prominent research institutions of the Ministry of Public Health and Academy of Medical Science of Ukraine, such as Institutes for Oncology, Endocrinology, Infectious Diseases, Pediatrics; Hematology Centers for Children and Adults, Center for Proctology, and the Central Army Hospital. Published in the Proceedings of the Ukrainian Congress of Therapeutists, that took place in the fall of 1998, were seven papers by the experts of our Clinic; these papers address the use of cell therapy methods in treatment of diabetes mellitus, blood diseases, cancer, AIDS, and other severe diseases. Our papers had been presented at international congresses that took place in Italy, Japan, USA, Switzerland, UAE.

The Cell Therapy Clinic of the National Medical University and EmCell Embryonic Tissues Center constitute the only specialized medical institution dealing with development and practical application of the Embryonic Stem Cell Transplantation for a wide range of diseases and conditions. Therefore, experts are aware of our activities.

Another matter is that we do not advertise our work. The features of our method do not permit us to provide medical aid to a great number of patients. In addition, selection of patients considerably depends upon the directions of scientific research. Postgraduates of the National Medical University carry out researches at the Cell Therapy Clinic. Generally, such work is being carried out jointly with prominent research institutes of Ukraine. Such arrangement ensures accumulation of joint experience in the area of cell therapy by our experts and workers of the above institutions.

We are doing our best to publish work results both in Ukraine and internationally, to make presentations of these results at conferences and congresses. Some of our achievements have been protected by patents. Three months ago we were granted the USA Letters of Patent for treatment of AIDS by Embryonic Stem Cell Therapy method. We also have some European patents as well as positive resolutions on our patent applications in Russia.

- Would you please describe in more detail what and how you are treating.

A. Smikodub: From the standpoint of the scope of diseases we are treating, our Clinic is unique. We are treating various pathologies: to make sure of this, you only have to take a look at the register of our patients. As of today, we have carried out about 1,000 cell transplantations ( we started wide-scale clinical practice in 1994, when in compliance with an order issued by the Kyiv Health Administration our Clinic was established). As you may see, there are all kinds of diagnoses: hypoplastic and hemolitic anemias, leukoses, tumor processes of various localization, cirrhosis, diabetes mellitus, Crohn's disease, ischemic heart disease, nonspecific ulcerative colitis, multiple sclerosis and Parkinson's disease, AIDS...

As a physician with 25-year practice, I can state that now there are no medicines which could provide the effects like those observed as a result of application of cell suspensions. In our clinical practice, we have had numerous cases of so-called curing hopeless patients. We possess unique systemic observations in cases of lymphomas and lymphosarcomas. Some patients who were supposed to die, stayed alive. In some of them, we even managed to restore work capacity. Our first female patient who suffered from AIDS and was dying at the emergency care department in 1993 is still alive today, and passes regular (once a year) examinations. We have some very promising results in the treatment of patients with Alzheimer's disease against which the most advanced pharmaceuticals are useless. In the course of treating such patients we have noted restoration of numerous specific brain functions. We have also managed to achieve perfect results in treatment of diabetes. In patients with initially revealed diabetes, the dose of insulin was reduced down to 70-50 %; there are cases where we had to cancel administration of insulin. A very important fact consists in that in all cases of application of cell suspensions, considerable improvement of patients' condition was noted.

- So you mean that the miracles described in American press are possible and can be now proven by the practice available in Ukraine?

A. Smikodub: Generally, scientific community does not approve any miracles; therefore we are cautious about such statements. But the fact that Embryonic Stem Cell Transplantation has extended the borders of things possible in medicine is indisputable. Cell therapy cannot make a giant out of a dwarf, it rather ensures achievement of realistic goals by delaying wasting away, compensating injuries, restoring the ability to carry out active work, improving quality of life and making it full-fledged. Health-improvement, curative and prophylactic effects of Embryonic Stem Cell Transplantation in numerous diseases and conditions are beyond any methods existing in modern medicine.

Here, it is very important to understand the existence of several kinds of treatment using embryonic cell suspensions. In some cases they are used without the goal to ensure survival and reproduction of administered cells. Such cases include e.g. stimulation of operative wound healing, application of animal material. Here, we do not mean real transplantation; positive effects are achieved through the stimulation provided by administered biologically active substances.

The most promising way of application of cell suspensions comprises Embryonic Cell Therapy and its variation, Embryo Stem Cell Therapy. Cell suspensions are prepared from the embryonic cadaverous material having 6 to 16 weeks of gestation. Since such cells are very young, they do not have complete antigen properties, and therefore can be engrafted in the recipient's organism and differentiated into cells which this organism lacks. We are dealing with completely young cells. The material for such cell suspension is provided by legal abortions carried out at early stages in specialized medical institutions.

- What is your opinion on the way followed by the Geron experts? Is it capable of ensuring large-scale development of cell therapy?

A. Smikodub: Embryonic Stem Cell Transplantation Therapy is too effective not to be developed. I would not dare to predict if ideology followed by Geron will be successful. I think that the existing restricted scope of Embryonic Stem Cell Transplantation Therapy application is caused primarily by its initial development phase as a novel scientific area of activity.

We are planning to expand the application of Embryonic Stem Cell Transplantation and to keep on developing its theoretical clinical foundations. Any leadership in science is very seldom long-lasting. Of course, we are happy to be the leaders in some areas. We will keep on trying to develop and patent new methods of treating numerous diseases with the use of Embryonic Stem Cell Transplantation Therapy.

Mirror Weekly ("Zerkalo Nedely"), 1999, No.3 (224), January 23, 1999, p.13 Mirror Weekly 1999