Chinese Scientists Using Stem Cells to Treat Coronavirus Patients

By Pat Anson, PNN Editor

As scientists around the world scramble to develop vaccines, therapeutic treatments and diagnostic tests for the coronavirus, Chinese doctors are having some initial success using stem cells to treat — and possibly cure — coronavirus infections.

Dr. Dongcheng Wu, who runs a stem cell lab in Wuhan, China – the epicenter of the COVID-19 outbreak – says he has successfully treated nine critically ill patients hospitalized with coronavirus pneumonia.

The patients had acute lung inflammation and serious breathing problems when they volunteered for experimental injections of Mesenchymal stem cells (MSCs) derived from human umbilical cords. All nine reportedly recovered within days.

“This treatment could potentially save thousands upon thousands of lives, so naturally we are very happy with these results,” Wu told the Daily Mail. 'Yes, it is a cure, but it is still very early in the process and we still have work to do.”

Wu is the chief science officer for Blue Horizon International (BHI), a New York-based foundation that supports research in stem cell therapy and cellular regenerative medicine.

BHI is currently recruiting 48 coronavirus patients in China for a placebo-controlled study of MSC injections.

In studies on mice, researchers found that MSC cells migrated to the lungs, where they significantly reduced inflammation and repaired damaged tissue.

BLUE HORIZON INTERNATIONAL

“So we thought what the heck, let's give it a shot. We gave nine patients, who were in hospital with severe, acute pulmonary dysfunction, we gave them core blood stem cells via IV and 100 percent of them got better, so of course we were astounded,” Dr. Brian Mehling, co-founder of BHI, told the Daily Mail.

The BHI study is not the first to use stem cells to treat coronavirus patients. According to the South China Morning Post, over a dozen clinical trials are underway in China using stem cells as a treatment for COVID-19.

Last month, a 65-year old woman infected with coronavirus was fighting for her life in an intensive care unit when she was injected with stem cells. Within days, her vital signs returned to normal, she began walking again, and tested negative for the COVID-19 virus.

Like Dr. Wu’s patients, the woman received MSC cells derived from the umbilical cords of newborn babies.

“Although only one case was shown here, it could be very important and inspire similar clinical practices in treating critically ill COVID-19 patients,” researchers reported in ChinaXiv, a Chinese website that publishes studies that have not yet been peer-reviewed.

Stem Cells ‘Could Cure’ Coronavirus Patients

Another new study, published in the journal Aging and Disease, found that MSCs given to seven coronavirus patients in Beijing “could cure or significantly improve” their symptoms.

“The pulmonary function and symptoms of these seven patients were significantly improved in 2 days after MSC transplantation. Among them, two common and one severe patient were recovered and discharged in 10 days after treatment,” researchers reported. “Thus, the intravenous transplantation of MSCs was safe and effective for treatment in patients with COVID-19 pneumonia, especially for the patients in critically severe condition.”

A Beijing doctor, who asked not to be identified, said there was growing discussion in the Chinese medical community about stem cells as a treatment for coronavirus.

“The stem cell industry may have some vested interest to promote their technology in this crisis, but if it really works, it should be made available to more patients,” she told the Morning Post.

Chinese stem cell researchers appear to be far ahead of their counterparts in the United States, where stem cell therapy remains controversial and there are more regulatory hurdles. Virtually all of the coronavirus stem cell studies listed in a U.S. database of clinical trials are being conducted in China.

Texas-based Celltex Therapeutics recently asked the Food and Drug Administration for permission to conduct a clinical study in the U.S. on the safety and efficacy of MSCs as a treatment for coronavirus.

Are You at Higher Risk for Coronavirus?

By Dr. Lynn Webster, PNN Columnist

Over 67,000 people have contracted the new coronavirus, now officially referred to as COVID-19. Many of those who died — over 1,500 people to date — were already in poor health.

Fears about the virus spreading led to more than 30 million people being quarantined in the coastal province of Zhejiang, China — which is more than 500 miles away from the epicenter of the virus in Wuhan, China. As I write this, the U.S. and 25 other countries have a confirmed diagnosis of coronavirus

It is clear that COVID-19 qualifies as an epidemic and some experts predict it could become a pandemic (a pandemic is the global spread of a virus, while an epidemic is contained in a particular region, such as China.)

The people with increased risk for experiencing severe symptoms, and possibly dying of COVID-19, are seniors and those with chronic illness. Of course, many people in chronic pain are part of both risk groups. The mortality rate of COVID-19 has been reported to be about two percent.

People with chronic pain may be more susceptible to viruses in general, because chronic pain can change the way our immune systems work. McGill University researchers found that chronic pain changes the DNA in T-cells, a type of white blood cell essential for immunity. Researchers were surprised by the number of genes affected by chronic pain, and hope their findings will lead to new treatments.

Preventing Infections

According to the Centers for Disease Control and Prevention, symptoms of COVID-19 are similar to those of other viruses: fever, coughing, and shortness of breath. Symptoms may be mild or severe, and sometimes deadly.  

Most troubling is that the virus causes respiratory difficulties that can lead to pneumonia — and antibiotics are worthless against viral pneumonia.

In severe cases, COVID-19 can also cause organ failure. A full recovery, according to The Guardian, “will depend on the strength of their immune system."

One of the most effective methods to reduce illness and mortality from viruses is to develop and use a vaccine. Vaccines prevent an estimated two to three million deaths worldwide every year, according to WHO. 

Developing new vaccines used to take at least a decade. However, thanks to recent medical advancements, it may be possible to develop a vaccine that can prevent COVID-19 in a matter of months.  

World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus has called COVID-19 "a very grave threat." However, Ghebreyesus stresses that while we wait for a vaccine to be developed, we are not defenseless. The CDC recommends following the usual advice about protecting yourself from viruses: stay away from people who are sick; wash your hands and avoid touching your eyes, nose, or mouth with unwashed hands; and clean and disinfect objects that you touch. 

Since chronic pain can compromise the immune system, pain patients should follow the best available advice to protect themselves from exposure to COVID-19. The potential of infection is a serious issue that should not be dismissed, particularly for people with chronic pain and illness. 

Feeding on Ignorance 

One of the most significant threats to the spread of disease is social rather than medical: the dissemination of rumors and false information, such as conspiracy theories by anti-vaxxers. Even intelligent people with otherwise good reputations, such as Robert Kennedy, Jr., are promulgating nonsense about vaccines through social media to millions of people. These efforts must be discredited and stopped.  

According to a recent Gallup poll, the pharmaceutical industry is regarded more negatively by Americans than any other industry. There are well-known reasons why the public has a dim view of Big Pharma, but it’s the only industry that can prevent the deaths of an untold number of people during pandemics. In this situation, we need to cheer them on. 

Immunization is important to stop the spread of viruses. But first, the vaccines must be developed. Once they are available, people with chronic pain should discuss the potential benefits and risks of immunization with their physicians.  

President Trump recently said the coronavirus may disappear by April. This is a dangerous statement. In the United States, most viruses wane in the summer, but not always and they usually reappear by fall. Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases, points out that some respiratory viruses may exist year-round in other parts of the world.  

There is never a good time to disregard science. But if there were, the start of a new pandemic surely would not be it.   

Lynn R. Webster, MD, is a vice president of scientific affairs for PRA Health Sciences and consults with the pharmaceutical industry. He is author of the award-winning book, “The Painful Truth,” and co-producer of the documentary, “It Hurts Until You Die.” You can find Lynn on Twitter: @LynnRWebsterMD.

Opinions expressed are those of the author alone and do not reflect the views or policy of PRA Health Sciences.

Valley Fever Spreading in U.S. Southwest

By Barbara Feder Ostrov and Harriet Blair Rowan, California Healthline

Valley fever cases are on the rise in California and across the arid Southwest, and scientists point to climate change and population shifts as possible reasons.

California public health officials documented 7,768 reports of confirmed, suspected and probable new cases of the fungal disease as of Nov. 30, 2019, up 12% from 6,929 in the first 11 months of 2018.

The increase is part of a recent trend in the nation’s Southwest dating to 2014, with outbreaks most prevalent in California and Arizona. Nationally, public health officials reported 14,364 confirmed cases of valley fever in 2017, more than six times the number reported in 1998, according to the U.S. Centers for Disease Control and Prevention.

Valley fever is caused by a Coccidioides fungus that lives in the soil of California’s Central Valley, Arizona and areas of other Southwestern states prone to desert-type conditions.

Animals and people can contract the infection by breathing in dust that contains the microscopic fungus spores. The infection is not transmitted from person to person.

Symptoms can include fatigue, cough, fever, headache, muscle aches or rash. While the majority of people infected experience mild flu-like symptoms or no symptoms at all, as many as 10% develop serious, sometimes long-term lung problems, including pneumonia.

‘I Am So Tired’

PNN columnist and iPain founder Barby Ingle – who lives in Arizona -- came down with valley fever last month. It was originally diagnosed as bacterial pneumonia, but when Barby’s fever, coughing, headache and joint pain persisted for weeks, her doctors ordered another round of tests.

“A CT scan was ordered that showed that it was actually valley fever pneumonia and that it had spread from the right lung to both lungs and lymph nodes,” Barby explained in an email. “I am told it will be up to a year of treatment and that they will do x-rays, CT scans and blood tests monthly, that there will be permanent scars on my lungs, and that it can turn to meningitis and/or can cause death if not treated.

“I am so tired. I feel like someone really big is sitting on my chest. I have learned that when breathing is compromised, the pain I deal with daily has becomes secondary. The brain concentrates on just breathing.”

BARBY INGLE

Barby has been on oxygen therapy since early November and recently started taking anti-fungal medication. Her immune system was already compromised by Reflex Sympathetic Dystrophy (RSD) and other chronic illnesses.  

“I asked my pulmonologist if I should move and she said if you go to another region, you will just get what they have there. It may not be valley fever, but every region has something like this that people with poor immune systems are more susceptible to,” said Barby. “She told me to ride with my car on recirculated air instead of outside fresh air setting. That is most likely where I was exposed.”   

About 200 Americans die from valley fever every year, according to the CDC. Researchers are working to develop a vaccine for both humans and animals.

Federal health officials say the infections likely are underreported because not every state requires public disease reporting for valley fever and because some infected people never develop symptoms or seek medical care.

Dr. Royce Johnson, a valley fever expert, recalls treating about 250 to 300 cases a year when he arrived in rural Kern County in the 1970s. As of Nov. 30 this year, Kern County — now a hot spot for the disease — reported more than 2,700 confirmed, suspected or probable cases, according to the California Department of Public Health.

“This is a major, major health problem, and it’s growing,” said Johnson, medical director of the Valley Fever Institute at Kern Medical in Bakersfield. “The extent of the endemic area is increasing, and the number of cases in the whole Southwest is going up.”

A University of California study examining the financial toll of valley fever on California estimated the direct and indirect lifetime costs of 2017 cases at about $700 million, when considering treatment expenses, lost productivity and mortality.

Researchers attribute the spike in cases to a number of factors. There’s more awareness of the disease because of media coverage and public health campaigns. California has earmarked $2 million for a public awareness campaign, and employers in regions of the state where workers are at higher risk for the disease will be required to educate them about the disease.

Population growth in the American Southwest, where the fungus is endemic, also plays a role, both because of the increased pool of patients and development that disturbs the soil. In Kern County, which reports the majority of California’s cases, the population has grown 65% since 1990.

But the most significant factor may prove to be climate change, which expands the ecosystems where the fungus can flourish. Using climate models, UC-Irvine researchers projected that by 2100 the expanse of areas with hot, dry conditions favored by the fungus could double and the number of valley fever cases could grow by 50%.

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. Additional content was added by PNN.

The Media’s Addiction to Opioids

By Roger Chriss, Columnist

A recent and very brief CDC report described 59 pneumonia deaths in Minnesota between 2006 and 2015 that involved opioids. The gist of the study was that “opioid users are at increased risk for pneumonia” and therefore the deaths should have been reported as opioid related overdoses, even though the autopsy reports list pneumonia as the cause of death.

Vox said the study suggests “the opioid epidemic may be even deadlier than we think,” while the Daily Mail warned it was “just the tip of the iceberg” and that “we may have grossly underestimated the scale of the opioid epidemic.”

JAMA Surgery also recently published a study, which found that about 6 percent of surgery patients continued to use opioids more than three months after their surgery.

U.S. News cited the study to proclaim that “Many Opioid Addictions Surface After Surgery,” while MedicalXpress said it was proof that someone could go “from opioid-free to long-term user, in one operation.”

Both the CDC report and the JAMA Surgery study were grossly misrepresented. Fear sells, and the opioid crisis has become a favorite source of fear-mongering in the media.

The CDC report is a one page, four-paragraph document released by the agency’s Epidemic intelligence Service (EIS). It never mentions the words “addiction” or “epidemic,” yet it leaps to one very big conclusion.

“The total burden of opioid-associated deaths was underestimated in Minnesota,” the report says. “The contributions of opioid toxicity, infectious disease, or their interactions to death are challenging to disentangle; understanding these interactions might inform future opioid-related mortality prevention efforts.”

The JAMA Surgery article is a retrospective study which found an association between post-operative use of opioid medications for pain management and patient history of smoking and alcohol use. The study looked at opioid abuse only as an exclusion criteria for the patient population; it was not a study about addiction in any form. The JAMA article concludes by saying that “new persistent opioid use represents a common but previously underappreciated surgical complication that warrants increased awareness.”

In other words, we have intriguing results that should be investigated further, with the ultimate goal of improving public health and welfare. Unfortunately, all that is lost in the alarmist media coverage that mischaracterizes the findings, over-interprets the data, and extrapolates consequences to reach what at best are highly premature conclusions.

In its coverage of the CDC report, CNN quoted EIS officer Victoria Hall, DVM, as saying that the Minnesota data represents “an iceberg of an epidemic.” 

Keep in mind that Hall is not an epidemiologist, an infectious disease specialist or an expert on icebergs. She is a veterinarian by training and a recent graduate of Mississippi State University's College of Veterinary Medicine. Hall has been working for the CDC less than a year, according to her LinkedIn profile.

In a CDC media briefing, Hall refers to only one specific case in Minnesota: a middle-aged man dying of pneumonia, who was on opioid therapy for chronic back pain. This case is not mentioned in the CDC EIS report. His death may be an important hint of a new facet of the opioid crisis, or it may be an anomalous outcome. More work is needed to figure out what is really going on. For now, it bears remembering that the plural of anecdote is not data.

VICTORIA HALL, DVM

Similarly, U.S. News reported on the JAMA Surgery article by stating that, “Some surgery patients prescribed opioids for post-operative pain relief may face a high risk for developing a long-term opioid addiction, new research warns.” This report also appeared on Philly.com  and on WebMD , spreading the misinformation about addiction risks, which were never even mentioned in the article.

In other words, there was a huge and speculative leap from the data in the CDC report about 59 opioid-related pneumonia deaths over a decade-long period all the way to a stealth epidemic sweeping the nation. And an equally large jump from an association between the duration of post-surgical opioid use and patient social history to a new source of opioid addiction.

The sensible response is to call for further research. For the CDC, this means collecting data from all 50 states about otherwise unexplained deaths and seeing if opioids are involved in any of them, then following up with analysis on possible under-reporting. For the world of surgery, this means performing prospective trials to see if the reported association holds up, and then investigating if such use increases the odds of a patient developing opioid use disorder.

For now, we just don’t have the data to figure out what is going on. And as Sherlock Holmes says: “It is a capital mistake to theorize before one has data.”

Roger Chriss suffers from Ehlers Danlos syndrome and is a proud member of the Ehlers-Danlos Society.

Roger is a technical consultant in Washington state, where he specializes in mathematics and research.

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.