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Sunday, April 10, 2016

New Stem Cell Therapy for Septic Shock

"I thought when I got home I could walk it off, but it wasn't the case."
"When you look back at where I started and how sick I was, it's just a miracle. The hospital here was just amazing. The people are so, so helpful -- at all levels."
"If people come out of this like I have, it's amazing. It's something that's needed."
Charles Bernique, 73, Hawkesbury, Ontario
Ontario man Charles Bernique was injected with 30 million mesenchymal stem cells after developing sepsis, after which he was restored to full health. Sepsis can arise from infection from bacterium, viruses or fungus and is fatal in 20 to 40 per cent of cases.
Justin Tang / THE CANADIAN PRESS   Ontario man Charles Bernique was injected with 30 million mesenchymal stem cells after developing sepsis, after which he was restored to full health. Sepsis can arise from infection from bacterium, viruses or fungus and is fatal in 20 to 40 per cent of cases.
"We have very compelling pre-clinical data that this may work very well."
"We were incredibly impressed with the magnitude of the response in terms of being able to prevent inflammation, being able to reduce organ injury and improve survival in all animal models."
"[Stem cells] helped the body get rid of bacteria even though they were reducing inflammation. So, that was really interesting."
"We're working hard to start a larger trial next year, and it looks like things are falling into place for that. If those results were very definitive, within three to five years, there might be a compelling need to offer this therapy."
Dr. Duncan Stewart, executive vice-president, research, senior scientist, The Ottawa Hospital

"We can't make any claims about how [mesenchymal stem cells] are working in humans until we finish the trial. However, the results have been promising enough that we have received funding to start scaling up our stem cell production for a larger trial."
Jennifer Ganton, spokeswoman, The Ottawa Hospital
They are all speaking with hope and appreciation for a new technique pioneered at The Ottawa Hospital regarding a new experimental stem cell treatment for septic shock. The treatment remains in clinical trial mode, one that eventually will involve nine patients, and it represents a first in the world in the use of stem cell therapy in the treatment of septic shock. Which is an often-fatal infection that is identified out of intensive care units.

The condition itself can be initiated through a bacterial infection where eventually patients' organs become compromised as a result of their immune system reacting to fight the infection, and as a result the entire body becomes inflamed. The body's normal immune system reaction can place too heavy a burden on older people and on people with degraded immune systems, and no solution has yet been known to be effective in fighting the symptoms.

With over 100,000 cases of septic shock annually in Canada, this is an obviously serious problem with an infection that can produce a 20 to 40 percent mortality rate. Treatment costs for septic shock comes with the hefty sticker of $4-billion yearly. The use of stem cell therapy may point the way to that needed solution to septic shock. Stem cells are known as body "building blocks", growing in our bone marrow and most visceral organs, they are tiny, self-contained cell factories meant to develop into other cells which ultimately become what produces hearts, blood, bone and muscles.

The reconstructive properties of stem cells can be shared since medical science has developed a working method of harvesting and sharing these immature stem cells. Some types of stem cells have been used in the treatment of leukemia, bone-marrow deficiencies and aplastic anemia. But in The Ottawa Hospital's new experimental trials, this is the first time stem cells have been used to treat a dangerous and widespread infection which can have lethal consequences.

Donors responded to a request from the hospital's researchers to provide the raw material for the research. The donated material was cultivated and grown at a manufacturing centre for stem cells at the hospital. There have been early successes, most notably in the treatment given to Mr. Bernique, but to call the procedure a reliable and repeatable success is premature. Mr. Bernique appeared to respond positively to the stem cell treatment he was exposed to to help cure his condition. But the scientists cannot yet be certain whether it was the cells that made all the difference.

Mr. Bernique entered hospital last summer with what was initially diagnosed as extreme food poisoning. His esophagus had burst and a spreading infection was infiltrating his body. Initially treated for possible food poisoning, his treatment protocol was radically altered when it became evident that septic shock had set in, making him one of the first patients to receive the new stem cell treatment. He was placed in a coma to slow the infection trajectory and his wife agreed he would be a candidate in the stem cell trial.

The new treatment was called cellular immunotherapy for septic shock, (CISS), used alongside traditional treatment for the condition. An initial dose of 30 million mesenchymal stem cells was given him intravenously. That type of stem cell has properties modifying the immune system and promoting tissue healing. While some medical complications did arise from the septic shock, three months after the treatment Mr. Bernique recovered. He returned home and eventually began working part time.

It took six months from the initiation of the new treatment to return his life completely back to normal.

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