Stem cell therapy for ALS

Table of Contents

• What is ALS disease?
• What causes ALS disease?
• ALS disease symptoms
• ALS disease treatment
• ALS disease stem cell research
• Stem cell therapy in Mexico
• Stem cell therapy cost

What is ALS disease?

ALS is the most common adult-onset motor neuron disease. It is characterized by both upper and lower motor neuron degeneration and has a median survival of 2–4 years.(1) ALS (amyotrophic lateral sclerosis) also known as Lou Gehrig’s Disease, is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. A-myo-trophic comes from the Greek language. "A" means no. "Myo" refers to muscle, and "Trophic" means nourishment – "No muscle nourishment." When a muscle has no nourishment, it "atrophies" or wastes away. "Lateral" identifies the areas in a person's spinal cord where portions of the nerve cells that signal and control the muscles are located. As this area degenerates, it leads to scarring or hardening ("sclerosis") in the region. 

Amyotrophic Lateral Sclerosis (ALS) is the most common neuromuscular disease worldwide for an incidence of 2-3 cases per 100,000 general population, and a prevalence around four to six per 100,000. It targets motor neurons (MNs) in the primary motor cortex, brainstem, and spinal cord leading to muscle atrophy, paralysis and death due to respiratory failure within 2-5 years. In most cases ALS is sporadic but a clear family history is present in approximately 10% of ALS patients. Mutations in more than 25 different genes are known to occur in 68% of familial and about 10% of sporadic ALS. ALS is a multifactorial disease and many pathogenetic mechanisms influence the onset and progression of the disease including failure of axonal transport, oxidative stress, mitochondrial dysfunction and glutamate-mediated excitotoxicity. (9)

What causes ALS disease?

The causes of the vast majority of ALS cases are still unknown. Investigators theorize that some individuals may be genetically predisposed to developing the disease but do so only after coming into contact with an environmental trigger. The interaction of genetics and environment may hold clues as to why some individuals develop ALS.

Although the majority of ALS cases are sporadic, meaning there is no family history of the disease, about 10 percent of cases are familial, meaning the disease runs in the family. A common misconception is that only familial ALS is "genetic." Actually, both familial and sporadic ALS can stem from genetic causes, and some people who have a diagnosis of sporadic ALS may carry ALS-causing genetic mutations that can be passed on to offspring. (3) Researchers continue to study possible causes for ALS. Most theories center on a complex interaction between genetic and environmental factors. (4)

Projected increase in amyotrophic lateral sclerosis from 2015 to 2040 (2016)

According to a research article published in nature.com (https://www.nature.com/articles/ncomms12408), the number of ALS cases across the globe will increase from 222,801 in 2015 to 376,674 in 2040, representing an increase of 69%. This increase is predominantly due to ageing of the population, particularly among developing nations. This projection is likely an underestimate due to improving healthcare and economic conditions. (5)

 

ALS Disease Symptoms

ALS Disease Treatment

Unfortunately, there currently is no known treatment to cure ALS. Most mass-available treatments focus on controlling the symptoms, functioning as a palliative and superficial solution in order to keep a manageable quality of life. Stem cell therapy not only focuses on treating the symptoms but on actually slowing down the disease’s progression, stopping its advance and reversing the damage done to tissue and organs. Regenerative medicine works in 3 stages:

1. Slow Down
2. Stop
3. Regenerate

Other complementary therapies recommend to ALS patients (6)

Physical and occupational therapy

Physical therapy and special equipment can enhance an individual’s independence and safety throughout the course of ALS. Gentle, low-impact aerobic exercise such as walking, swimming, and stationary bicycling can strengthen unaffected muscles and range of motion and stretching exercises can help prevent painful spasticity and shortening (contracture) of muscles.

Communications support

People with ALS who have difficulty speaking may benefit from working with a speech therapist, who can teach adaptive strategies to speak louder and more clearly. As ALS progresses, speech therapists can help people maintain the ability to communicate.

Nutritional support

Nutritionists can teach individuals and caregivers how to plan and prepare small meals throughout the day that provide enough calories, fiber, and fluid and how to avoid foods that are difficult to swallow. People may begin using suction devices to remove excess fluids or saliva and prevent choking.

Breathing support

As the muscles responsible for breathing start to weaken, people may experience shortness of breath during physical activity and difficulty breathing at night or when lying down. Noninvasive ventilation (NIV) refers to breathing support that is usually delivered through a mask over the nose and/or mouth. Initially, NIV may only be necessary at night but may eventually be used full time. NIV improves the quality of life and prolongs survival for many people with ALS.Because the muscles that control breathing become weak, individuals with ALS may also have trouble generating a strong cough. There are several techniques to help people increase forceful coughing, including mechanical cough assistive devices. 

ALS disease stem cell research

Published scientific studies have continuously found that neurotrophic growth factors (NTFs) extend the survival of motor neurons in amyotrophic lateral sclerosis (ALS) and that the combined delivery of these neurotrophic factors has a strong synergistic effect. (7)

Stem cell treatment was found to be safe and well tolerated over the study follow-up period. Most of the adverse effects were mild and transient, not including any treatment-related serious adverse event. The rate of progression of the forced vital capacity and of the ALS Functional Rating Scale–Revised score in the IT (or IT+IM)–treated patients was reduced (from −5.1% to −1.2%/month percentage predicted forced vital capacity, P < .04 and from −1.2 to 0.6 ALS Functional Rating Scale–Revised points/month, P = .052) during the 6 months following MSC-NTF cell transplantation vs the pretreatment period. (7)

While stem cells are unable to directly replace diseased motor neurons, transplanted stem cells secrete neurotrophic factors and differentiate into supportive cells, such as astrocytes and microglia, generating a neuroprotective milieu that can slow degeneration of motor neurons. (8)

It is fundamental to consider that chronic inflammation plays an important role in ALS. The most important therapeutic potential of SCs relies on their ability to regulate inflammation and to empower resident cells to facilitate tissue repair through endogenous stem cell activation or environment modulation. (9)

Motor neurons can be generated in vitro from stem cells of various sources including embryonic stem cells (ESCs), induced pluripotent stem cells (iPS) and neural stem cells (NSCs) [10 – 11]

Stem cell therapy in Mexico

Is stem cell therapy safe and legal in Mexico?

An important question our patients ask before coming to our clinics is: Is stem cell therapy safe? We also understand that, perhaps, the real question is: Is stem cell therapy legal in Mexico? Yes and of course! In Giostar Mexico, we ask for each applicant to submit a health history form, from which our medical directors personally evaluate the viability of each applicant. This means that stem cell therapy may not be for everyone. Important: we currently do not treat macular degeneration and patients with cancer.

Stem cell therapy is thoroughly regulated by the Mexican FDA-equivalent: COFEPRIS. Due to advanced legislation, Mexico enjoys sufficient regulatory framework to offer applications otherwise unavailable in countries such as the US or Canada, for example: local direct applications (hands for arthritis, shoulder pain, knee pain), lumbar and cervical applications, all which have proven better results for patients, than just receiving stem cell therapy intravenously.

Stem cell therapy cost

Stem cell therapy cost for ALS, on average in Giostar Mexico, starts at $8,500.00 USD for one application (half-treatment). Pricing highly depends on the personalized protocol that the Medical Director determines based on each patient's condition. What may this include?

• Transportation from hotel-clinic, clinic-hotel and airport-hotel as well as hotel-airport (mainly for our Clinics in Playa del Carmen and Guadalajara; our Clinic in Los Algodones, due to its proximity to the US-Mexico border crossing, we pick up patients on the border or at Yuma Airport and take them to our clinic or their hotel)
• Lodging (available in our Clinic in Algodones) in Hotel Hacienda or Hotel Cielito Lindo
• Oxygen Therapy
• Body preparation – Nutritional IV Therapy
• 1 - 10 billion exosomes (volume depends on Doctor's personal evaluation of each patient)
• 1 - 4 stem cell vials (35 - 140 million stem cells) - IV (Intravenous) and Local applications
• Laboratory protocol by Dr. Anand (activation of the stem cells in order to direct them towards the affected tissue or organ)
• Medical Consultation
• Dietitian Follow up post-therapy
• Preferential discount for future reinforcements/applications
• Laboratory exams the previous day before the first application

Financial Option for Stem Cell Therapy

Giostar Mexico is continuously looking to provide our patients with resources and options to receive stem cell therapy at the best stem cell clinics in Mexico. We are happy to announce that, through United Medical Credit, our patients (exclusive for US citizens) may now receive up to $25,000.00 USD in credit for their treatment (note: price for therapy varies depending on the condition to be treated and a number of stem cells [vials] included). Patients can ask for the maximum amount of the credit or ask for a percentage based on the price of the therapy.

Stem cell therapy for ALS in the best stem cell clinic in Mexico is a viable option for patients interested in regenerative medicine, which focuses on treating the condition itself, not just the symptoms that come with it. Giostar Mexico is here for you. Are you reading to begin?

For more information regarding stem cell therapy for ALS, available dates and further details, feel free to contact us at 619-866-6000.

Stem cell therapy is a procedure in the regenerative medicine field. Regenerative medicine's ultimate goal is that our 

What stem cell therapy does in your body is slowing down or stopping the suffered deterioration and it can even regenerate tissue. That is why we ask patients to fill out a health form, so our medical staff may first identify if stem cell therapy is actually an option for them and the medical team knows the specifics of your health condition.

References

1. del Aguila, M. A., Longstreth, W. T. Jr, McGuire, V., Koepsell, T. D. & van Belle, G. Prognosis in amyotrophic lateral sclerosis: a population-based study. Neurology 60, 813–819 (2003).
2. ALS Association: https://www.als.org/understanding-als/what-is-als
3. Muscular Dystrophy Association: https://www.mda.org/disease/amyotrophic-lateral-sclerosis#what-causes-als
4. Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/amyotrophic-lateral-sclerosis/symptoms-causes/syc-20354022
5. Arthur, K., Calvo, A., Price, T. et al. Projected increase in amyotrophic lateral sclerosis from 2015 to 2040. Nat Commun 7, 12408 (2016). https://doi.org/10.1038/ncomms12408
6. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Amyotrophic-Lateral-Sclerosis-ALS-Fact-Sheet#treatment
7. Petrou P, Gothelf Y, Argov Z, et al. Safety and Clinical Effects of Mesenchymal Stem Cells Secreting Neurotrophic Factor Transplantation in Patients With Amyotrophic Lateral Sclerosis: Results of Phase 1/2 and 2a Clinical Trials. JAMA Neurol. 2016;73(3):337–344. doi:10.1001/jamaneurol.2015.4321
8. Goutman, S., Savelieff, M., Sakowski, S., Feldman, E. Stem cell treatments for amyotrophic lateral sclerosis: a critical overview of early phase trials. Expert Opinion on Investigational Drugs, Volumen 28, 2019, Issue 6. Pages 525-543. Published online: 12 Jun 2019.
9. Letizia Mazzini, Angelo Vescovi, Roberto Cantello, Maurizio Gelati & Alessandro Vercelli (2015): Stem cells therapy for ALS, Expert Opinion on Biological Therapy, DOI: 10.1517/14712598.2016.1116516
10. Lee H, Shamy GA, Elkabetz Y et al.Directed differentiation and transplantation of human embryonic stem cell-derived motoneurons. Stem Cells 2007; 25: 1931–1939
11. Dimos JT, Rodolfa KT, Niakan KK et al.Induced pluripotent stem cells generated from patients with ALS can be differentiated into motor neurons. Science 2008; 321: 1218–122.** The demonstration that pluripotent stem cells can be directly generated from fibroblast cultures of ALS patients and differentiated into MNs.