Proposed Study Hopes to Bring Life to Patients with Critical Brain Injuries

In Brief

Bioquark Inc. is planning a study that involves delivering stem cells into the brain in an effort to grow novel neurons in brain-dead patients. The ethics of the experiment are being questioned.

Nothing is as certain as death. Yet humans absorb arrive up with ways to push it further and further. The heart stops beating? conclude CPR. The lungs fail? consume a mechanical ventilator. These techniques absorb saved the lives of millions. There is a point of no return, however: when the brain dies.

One company, Philadelphia-based Bioquark Inc., thinks it may be possible to push back on even that final step. Bioquark plans to launch a study to consume stem cells and a slew of other therapies to bring a glimmer of life back to the dead brains of newly deceased patients.

The opinion led to hundreds of chilling headlines and has met serious backlash from scientists and ethicists alike. While Bioquark’s proposed study may trigger ethical and practical concerns, experts conclude say advances in stem cell research and medical technologies mean someday brain injury could be reversible. perhaps, possibly (and that’s a astronomical perhaps, possibly) brain death won’t be the stay of life.

“I agree stem cell technology in the neurosciences has tremendous potential, but we absorb to study it in a way that makes sense,” said Dr. Diana Greene-Chandos, assistant professor of neurosurgery and neurology at Ohio State University Wexner Medical Center. What doesn’t design sense, she says, is to apply stem cell research in complex human brains — very damaged ones — before animal studies absorb gotten far enough.

That’s why Bioquark’s proposed study, slated to lift site in South America sometime this year, has caused such uproar in the science community. The team plans to manage therapies to 20 brain-dead subjects with the hope of stirring up electrical activity in the brain. The opinion is to deliver stem cells to the brain and coax them to grow into novel brain cells, or neurons, with the attend of a nurturing peptide cocktail, electrical nerve stimulation, and laser therapy.

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“We are employing this [combined] approach, using tools that by themselves absorb been employed extensively, but never in such an integrated process,” said Bioquark CEO Ira Pastor.

One critique is that such a study could give erroneous hope to families who may absorb a poor understanding of the severity and irreversibility of brain death, and confuse it with coma or vegetative state. “There are a lot of gray areas in medicine. And we should every single hold an open intellect. But we need to design certain we are not misguiding our patients,” said Dr. Neha Dangayach, attending physician in the neurosurgical intensive care Unit at novel York’s Mount Sinai Hospital.

Pastor’s response to the criticism? The public is catching up to the opinion of brain death. He’s also clarified that full resurrection is not the company’s intended goal — at least not yet. “We are not claiming the ability to erase death. We are working on a very small window, a gray zone between reversible coma and death,” he said.

Ethics aside, critics say there are practical problems with the procedure. There is inadequate evidence behind Bioquark’s approach, they argue, and the way the study is planned does not sound realistic.

When the brain dies, inflammation and swelling run amok, the connections between neurons disintegrate, arteries collapse, and blood flow shuts down. “Once someone is brain-dead, you can hold them on the ventilator but it’s very tough to hold the organs from shutting down and the heart beating for more than a few days,” said neurologist Richard Senelick. “Nature is going to run its course.”

So, many scientists say Bioquark’s study may be a quixotic quest — on par with cryogenic brain preservation and head transplants. They may sound fine in theory but are so impractical that they absorb exiguous chance of success. Nevertheless, experts agree the quest does raise serious questions that deserve answers. Just what would it lift to save a brain? Perhaps resurrecting dead brains is not in the realm of opportunity…but what is?

Brain Death and the Cell ‘Suicide Switch’

There is an immense reward in pursuing brain regeneration. whether it pans out, it could potentially save the lives of those who are injured in an accident or, more commonly, suffer extreme brain damage following a cardiac arrest or stroke. Every year in the United States, approximately 350,000 people experience an out-of-hospital cardiac arrest, according to the American Heart organization. Only approximately 10 percent survive with fine neurologic function. Another 130,000 people die of stroke annually.

To appreciate the challenge of saving the brain, first gawk at what it takes to cancel it. It was long thought that death occurs when the heart stops. Now we know that death actually happens in the brain—and not in one single moment, but several steps. A patient lying in a coma in an intensive care unit may appear peaceful, but findings from biochemical studies paint a much different scene in his brain: fireworks at the cellular level.

When neurons encounter a traumatic event, like lack of blood flow after cardiac arrest, they disappear into a frenzy. Some cells die during the initial blackout. Others struggle to outlive in the complex cascade of secondary injury mechanisms, triggered by the stress of being deprived of oxygen. Neurotransmitters spill out of neurons in high concentrations. Free radicals pile up, burning holes in brain cell membranes. The pierced cells respond to the attack by producing more inflammation, damaging other cells.

Eventually, the stress response triggers apoptosis, or the process of programmed cell death. In other words, the cell’s “suicide switch” gets turned on. The cells die one by one until the brain ceases to function.

That’s brain death: the total and irreversible loss of function of the brain. Doctors determine brain death by checking whether the patient’s pupils react to light, whether he responds to pain, and whether his body tries to breathe or has retained any other vital function of the brainstem, the fragment most resilient to injury.

“We absorb strict tests, because it’s a very serious question—the question of distinguishing life from death,” Dangayach said.

For brain damage at a much smaller scale, however, the situation could be manageable. Cutting-edge therapies are focused on this opportunity.

More Neurons in a Pill?

Stem cells absorb brought an exciting potential opportunity to the grim area of treating brain injury. Currently, there’s no FDA-approved stem cell-based therapy for brain problems, and experts propose staying absent from any clinic that offers such therapies. But that doesn’t stop researchers from being excited approximately the possibilities. Unlike in other parts of the body, cells lost in the brain are gone forever. Could stem cells replace them?

“That’s a unprejudiced thing to question,” neurologist Dr. Ariane Lewis of novel York University said. Lewis is a strong critic of Bioquark’s approach, saying that the study “borders on quackery,” but she thinks stem cell research is promising for stroke recovery. “We absorb exiguous evidence right now, and this is not a commonly employed therapy, but it’s a research question.”

Two regions in the adult brain contain stem cells that can give rise to novel neurons, suggesting the brain has a built-in capacity to repair itself. Some of these cells can migrate long distances and reach the injury site.

In some injuries, the brain produces biological factors that stimulate stem cells. Researchers are working to identify those factors — with the aim of someday translating the findings into novel drugs to boost a patient’s own stem cells.

“whether we can identify factors that stimulate these cells we could directly repair [the brain],” said Dr. Steven Kernie, chief of pediatric critical care medicine at novel York Presbyterian Hospital, who is working on this research.

Other teams absorb been working on turning different types of brain cells into neurons. A team at Penn State University developed a cocktail of molecules that can convert glial cells, a type of brain cell, into functioning neurons in mice. The cocktail of molecules could be packaged into drug pills, the researchers said, perhaps one day taken by patients to regenerate neurons.

Another option: transplant novel neurons into the brain. In a 2016 study, scientists successfully transplanted young neurons into damaged brains of mice. A real-life injury in the human brain is a much messier situation than a clear-prick lesion made in the lab. But eventually, such advances may translate into techniques to repair stroke damage.

For diseases like Parkinson’s, in which a specific population of neurons is lost—as opposed to widespread indiscriminate damage — there absorb been several clinical trials with many more slated. Scientists in Australia are using brain cells of pigs as a substitute for lost neurons. Later this year, a Chinese clinical trial will implant young neurons derived from human embryonic stem cells into brains of Parkinson’s patients. And five more groups are planning similar trials over the next two years, Nature reported.

Approaches taken in Parkinson’s trials may be the most biologically plausible, Kernie said. whether these trials are successful, they may pave the way for more widespread application of stem cells for treating brain diseases. “It’s not proven yet that it will work, but it’s something that’s on the horizon.”

“These Scientists absorb a procedure To Cheat Death. Will It Work?” was originally published by NBC Universal Media, LLC on June 29, 2017 by Bahar Gholipour. Copyright 2017 NBC Universal Media, LLC. every single rights reserved.

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