This month's ask the Doctor questions have been answered by Dr. Angy Etou of the XCell-Center at the Institute of Regenerative Medicine in the Eduardus Hospital in Cologne, Germany.

Biography and Background, Dr. Angy Etou -

Dr. Angy Etou is a (German) board certified neurosurgeon at the XCell-Center, Institute of Regenerative Medicine, Eduardus Hospital in Cologne, Germany.

Her experience dates back to 1974. She is a member of the European Society of Pediatric Neurosurgery, Deutsche Gesellschaft f?r Neurochirurgie, and the International Stereotactic Radiosurgery Society.

In her most recent work prior to the Xcell-Center, she performed neurosurgery at a private clinic Frankfurt City, operative therapy at Markus Hospital, Frankfurt Diakonie Clinic, and Interventional Spinal Procedures in collaboration with the University of Frankfurt Radiology Center.

She has served as vice-director of the Charite Berlin-Mitte and performed neurosurgery, pediatric neurosurgery, stereotactic neurosurgery and LINAC radiosurgery at Humboldt University in Berlin.

Questions and Answers -

1) When you re-insert the stem cells into your patient, do you include any type of human growth hormone (also known as secretagogue) or other types of growth factors?
  • We do not include any growth factors, growth hormones or any additional substances. We re-insert the pure stem cell concentrate.
2) How long do you think someone who has had stem cell treatment should wait before traveling to a foreign country or on a ship?
  • 2 days; We routinely treat foreign patients, who after e.g. lumbar puncture do fly back to their home countries two days after the treatment without any problems.
3) Do you know anything about the product GHP? It contains L-Lysine (1300mg), L-Arginine (1300mg), l-Ornithine (800mg), L-Glutamine (250mg), Glycine (500mf), L-Leucine (400 mg), L-Iso-Leucine (400mg), L-Valine (400mg). Is this something that could help a stem cell recipient, do you think?
  • No, I do not know. But according to the explanation of its contents, it is a mixture of several aminoacids, which as to my knowledge only under certain conditions might be of any value when taken orally.
4) I just don't understand much at all when it comes to taking cells out of my own body and then having a doctor do something to them in a lab and then put them back in me. How does this process help with my disease (diabetes) or any other disease for that matter. Do they trigger something to help me or just what does happen?
  • What does happen: We take out bone marrow, which normally produces blood cells and contains stem cells. These stem cells or progenitor cells are "designed" by the body for the repair of certain cells, but are not readily available to the different tissues or organs for renewal of specific cells in an adequate amount (except for the blood cell cycle) to fight disease.
  • What we do, is to bring these cells -without manipulating them- to where they are needed. The processes taking place at the site of lesion includes cytokine (=proteins, proteoids, aminoacids, which transfer particular messages to induce specific reactions) effects, metabolic and perfusion changes, and replacement of damaged cells. There are complex interactions, which are not yet fully understood and need to be studied further. But we do know that these various mechanisms of action are involved, and maybe some others that have not yet been discovered.
5) If someone has stem cell treatment and hasn't noticed any difference in their condition in 90 days, would you feel that they need to have it done again or is there still a chance that the treatment could help?
  • In the case of bone marrow stem cells, after 90 days; in some instances, there might be still no measurable effect. This does not mean that the treatment has been in vain. Even up to 6 months and beyond, positive results can materialize.
6) Other than counting the number of stem cells obtained, what is done to the marrow by the lab in the UK before it is returned to Cologne for injection?
  • The bone marrow collected and in the lab it is separated from blood components by centrifugation, i.e. concentrated. The number of stem cells is counted, their viability is tested and there is a check for infection.
7) What determines what diseases can be treated by your method? Are you constantly trying to develop new techniques to treat even more kinds of diseases or is there a limit to what can be treated?
  • The underlying mechanism of dysfunction does determine which diseases can be treated by stem cell therapy.
  • For the time being, we can treat diseases which are caused by a degeneration of cells, i.e. diabetes mellitus, caused by degeneration of "Langerhans" cells in the pancreas, neurodegenerative diseases like Parkinson, MS, ALS and many others such as diseases caused by cell damage, by traumatic or ischemic accidents like spinal cord injuries or cerebral stroke or joint degeneration (arthritis), e.g. in the knee joints.
  • We also treat optic neuropathies, i. e. degeneration of the optic nerves, be it hereditary or a sequel of other systemic disorders. We are working on optimizing application for optic neuropathies, i. e. retrobulbar, and perhaps application into the cerebro-spinal fluid space.
  • For spinal cord injuries and strokes, we are developing methods of local application or improving the accumulation of the stem cells at the site of the lesion. The field of cerebral "ischemia" includes conditions like "cerebral palsy" by malformation caused during the embryonal phase, asphyxia during or after delivery, or as a sequel of infective or vaccination complication in early childhood.
  • We are still in an exploratory stage as to dementias and we cannot treat some genetic defects.
  • We do not treat any cancer. For the latter much more research is necessary, to judge if there ever will be an indication for stem cells.
8) Do you feel that someone who has been told that they need a heart transplant or a lung transplant is too far gone to benefit from stem cell treatment or would it be something that they might want to try before submitting to the ultimate body invasion?
  • There is a chance for "heart patients" to undergo stem cell therapy, who otherwise have the only option of heart transplantation.
  • It is more complicated in the case of lung transplantation. Lung (transplant) patients who presented to our center so far, all had pulmonary fibrosis, a disease not yet fully understood. We cannot offer stem cell therapy for this condition yet but we are considering new treatment protocol and pretreatment requirements for pulmonary fibrosis and for other possible autoimmune diseases. Such conditions include e.g. sarcoidosis, rheumatoid arthritis or systemic lupus erythematodes. For the latter there are publications citing successful treatment by stem cells.
9) Do some diseases require more than one stem cell treatment? If so, which ones? How far apart would these be paced? Is there a reduced rate for boosters or would one expect to pay the same price as the initial treatment?
  • Some diseases like stroke, spinal cord injury, MS, cerebral palsy and others may need a repeated treatment. After 6 to 12 months, we consider repeat treatments after we?ve had time to observe the effects of the initial treatment. The cost of additional treatments is lower than the initial treatment.
10) What kind of follow up care do you advise? Are your doctors willing to stay in contact with patients or are patients pretty much on their own after treatment?
  • Patients are asked to complete follow up sheets which are returned by fax or e-mail. We also call our treated patients regularly to see how they are doing.
Background information - XCell Center at the Institute of Regenerative Medicine

The XCell-Center at the Institute of Regenerative Medicine in the Eduardus Hospital in Cologne brings together therapeutic use of autologous adult stem cells and medical research.
  • to make the therapeutic application of autologous adult stem cells available at the highest medical standard,
  • to expand existing knowledge on the effects of autologous adult stem cells through clinical studies, thus optimizing therapeutic use for a host of diseases
The XCell-Center treats patients with their own (Autologous) adult stem cells. In fact, the XCell-Center is the first private clinic worldwide to hold an official license for the entire stem cell therapy treatment process. In accordance with German tissue law and the German Medicines Act, the XCell-Center has a GMP (Good Manufacturing Practice) certificate for the extraction of bone marrow from the ilium, the production of peripheral blood stem cells, and the preparation and implantation of stem cells.

Patients with various degenerative diseases are treated using the highest medical standards. Our therapy focuses on the treatment of diabetes mellitus (types 1 and 2 as well as complications) and stroke. Further indications comprise neurological diseases; in particular spinal injuries, multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), Parkinson's and Alzheimer's disease as well as arthritis, heart diseases, and incontinence.

The XCell-Center also carries out research on the medical use of adult stem cells. Two phase II studies "SCIDIM" 1 and 2 (SCIDIM = Stem Cells In Diabetes Mellitus types 1 and 2), analyzing the effect of autologous adult stem cells in the treatment of diabetes mellitus, will start before the end of 2007. Another clinical study: "SCIS" (SCIS = Stem Cells In Stroke), analyzing stem cell therapies for patients with stroke is planned for 2008. Further studies to evaluate the treatment of urinary incontinence, erectile dysfunction and osteoarthritis are being developed.

Contact Information -

Jay D. Lenner Jr.

JD Lenner Jr. LLC
Houston, TX 77079
Tel: 1-866-680-8202
Fax: 1-713-583-9322

Patient Relations Manager for
XCell-Center GmbH
Custodisstrasse 3-17
50679 Cologne, Germany