मंगलवार, 10 दिसंबर 2013

कलम कोशाएं (स्टेम सेल्स )और मधुमेह

कलम कोशाएं (स्टेम सेल्स )और मधुमेह 

कलम कोशाओं को मास्टर सेल्स कहा समझा जाता है। जिनसे आप 

शरीर 

का कोई भी अंग तैयार कर सकतें हैं। इन्हें  एम्ब्रियो से जबकि उसकी उम्र 

दो तीन दिन ही होती है प्राप्त किया जा सकता है। यानी गर्भ धारण के बाद 

जब कोशा विभाजन की प्रक्रिया चंद विभाजनों की ही साक्षी बनी हों तब। 

इस समय  तमाम कोषाएं यकसां होती हैं। इन्हें अभेदित 

(undifferentiated cells )कहा  जाता है। इसके बाद तो सबको एक 

सॉफ्ट 


वेअर मिल जाता है सबके रोल तय हो जाते हैं किसे  क्या करना आगे 

चलके। शरीर के किन अवयवों का निर्माण करना है।इस स्थिति में 

कोशाओं को भेदित या diffrentiated cells कहा जाता है। 

हमारे दौर की तमाम ला -इलाज़,दुस्साध्य बीमारियों को साधने का साधन 

समझा जाता है ,इन जादुई कोशाओं को। लेकिन ये तमाम प्रयास अभी 

व्यावसायिक आज़माइशों की बाट जोह रहे हैं। कई मुल्कों में तो कलम 

कोशा शोध को ही प्रतिबंधित किया हुआ है। कोई सरकारी इमदाद इस 

शोध को नहीं मिलती है। तर्क है ईश्वर  का काम कोई साइंसदान लेब में 

कैसे कर सकता है। 

इलाज़ भी अभी नियय कायदे कानूनों की धुंध में हैं। ऐसे में मुम्बई के कई 

धुरन्धर शोधकर्ता ,रिजेनरेटिव मेडिसन के माहिर बा -कायदा यह इलाज़ 

मुहैया करवा रहे हैं। जबकि यह चिकित्सा की पद्धति अभी खुद शैशव 

अवस्था में है। 

ऐसे में हमें खुद समझ में  नहीं आता इस स्थिति पर क्या टिपण्णी करें। 

जबकि दिल्ली के नतीज़ों की तरह अनिर्णीत है यह कलम कोशिका 

प्रोद्योगिकी और इससे उद्भूत पुनर -सृजन -चिकित्सा। केज़रीवाल 

साहब  की तरह करिश्माई ज़रूर लगती है यह अभिनव री -जेनरेशनल 

मेडिसन। 


हाँ एक बात हम  निश्चय पूर्वक जानते हैं।अनेक चरणों में आजमाइशें 

होती 

हैं ऐसी चिकित्सा पद्धतियों की। जो  स्वयं सेवी आज़माइशों के लिए खुद 

को प्रस्तुत करते हैं  उनके लिए नियमावली है जिसका कड़ाई से पालन 

होता है। सब्जेक्ट्स को पैसा भी मिलता है। 

सैर सपाटे के लिए अमरीका पहुंचे हमारे जैसे लोग सब्जेक्ट नहीं बन 

सकते।बहर -सूरत पढ़िए इस रिपोर्ट को जानिये माहिरों की राय इस विषय 

में :   

I feel like a college girl


By Jyoti Shelar, Mumbai Mirror | Dec 10, 2013, 12.00 AM IST

An accounts professor gambled with stem cell therapy to battle diabetes. But experts say it's too soon to sing halleluiah.

Miserable' is the word Poonam Jaggi uses to describe how she felt a year ago. After the 50-year-old accounts professor at Grant Road's Akbar Peerbhoy College was diagnosed with Type 1 diabetes in 2007, she began experiencing the usual symptoms associated with the metabolic disorder in which the pancreas fail to produce insulin, a crucial hormone that removes excess glucose from the blood. 

Over time, she was battling hairfall and failing vision, the latter, a result of glucose absorption in the lens of the eye leading to shape change and vision deterioration. Eventually, she suffered from peripheral neuropathy, a nerve disease common among diabetics that makes it tough for them to walk or stand for longer than five minutes. 

Diabetes made sure the Thane resident gave up three of her favourite indulgences - teaching, driving and writing. 

"I was unable to do anything at all," remembers Jaggi, whose sugar levels fluctuated between 350 and 450. It's not as if she hadn't made efforts to alter her lifestyle. She had scaled down her weight from 89 kg to 78 kg and took regular insulin jabs of 30 units in addition to three tablets a day to facilitate insulin production. 

Stem the problem 

Her 23-year-old son, while spending hours researching treatments online, stumbled on stem cell therapy - a controversial and under-researched form of regenerative medicine that claims to offer miraculous results. 

To put it simply, stem cells are the body's raw materials - cells from which all other cells with specialised functions are generated. They are found in various tissues of the human body - brain, bone marrow, blood vessels, skeletal muscles, skin and liver - and even embryos that are three to five days old. These cells can be 'activated' into becoming specific cells that can then be used to regenerate and repair diseased or damaged tissue in humans. 

Within weeks of her first session in October 2012 at Navi Mumbai-based Dr Mahajan Trauma Centre, Jaggi began noticing a change. 

She spotted fresh hair growth, her vision improved gradually, and she discontinued wearing the spectacles she had been given by the optometrist in 2006. 

The second session, in February 2013, she claims, made her skin - left dry and pale by diabetes - softer and smoother. The fact that the pain in her limbs has reduced means she can drive around the city like before. 


But Jaggi's biggest relief is that she is almost off medication. The insulin jabs have been discontinued, and the medicine dosage is down to half because her sugar levels are within the normal 80-110 limit during fasting, and 140 post lunch. 

Jaggi, who admits, "I was so desperate to get well, I didn't bother checking on results with other patients who'd tried it," isn't alone. And that's odd since stem cell therapy is still in the clinical trial stage in India, with an estimated 4,000 trials currently underway. 

Dr Pravin Mahajan, a general surgeon researching regenerative medicine for five years, who treated Jaggi among 40 others suffering from arthritis, hair fall, facial scars, acne, muscular dystrophy and cerebral palsy, agrees that not all patients respond to the same degree. "The response depends on the state and immunity of the patient. But all my diabetes patients are now either off insulin or on reduced dosage," he says. 

Dr Geeta Jotwani, assistant director general (stem cell research) at the Indian Council of Medical Research (ICMR), argues that patients like Jaggi who show improvement are in fact, isolated cases. "For the few who show improvement, there are lakhs who don't," she says, adding that it's important that doctors follow up with their patients for at least five years after conducting the procedure to examine longevity of results and side effects. Most of Dr Mahajan's patients, for instance, have been receiving treatment only over the last two years. 


Forty-seven-year-old Panvel resident Vishnu Gawli is one of them. The private detective, who is third in his family to suffer chronic diabetes, was bed-ridden after he suffered a minor heart attack in June 2012, followed by a paralytic attack in October the same year. "I had given up work and was unable to even make it to the bathroom on my own," says Gawli, whose blood sugar would fluctuate between 250 and 300. 


Within a week of meeting Dr Mahajan this June, he says, he was able to gradually move his limbs, and cut down on medicines. "I simply follow a nutritious diet and exercise regularly," he says. 


Word of caution 

A speedy recovery like Gawli's, caution experts, could be a placebo effect. Andheri-based diabetologist Dr Rajiv Kovil warns that blood sugar level is not the only parameter to take into account while examining the therapy's success. "What's wanted is a thorough study, undertaken with a larger sample size and a longer follow up," he adds. 

In fact, no research has been conducted into the side-effects of stem cell therapy, experts rue. Dr Jotwani says the formation of a tumour on account of excess cell generation is a likelihood. Additionally, there is no clarity on whether there's a chance of relapse. Doctors don't report such patients neither do patients step forward to bring it to the expert's notice. 


Different strokes 

Experts are also divided on method of treatment. While Dr Mahajan extracts stem cells from the patient's own bone marrow, Dr Altaf Patel, a Mumbai Central-based physician sources stem cells from a healthy donor's umbilical cord. Dr Patel, who has treated 20 odd diabetics over two years has a reason for his approach. "If a patient's own stem cells had the ability to repair, wouldn't they perform the function while in the body? I believe, reintroducing 'ineffective' cells is pointless. Which is where, the donor comes in." 

While methods may vary, what doesn't is the money involved. 

"Globally, between 40 per cent and 60 per cent healthcare and pharmaceutical companies are investing in research and development of stem cells," said Shailesh Gadre, MD of Stemade, India's only dental stem cell bank which offers extraction, processing and storage of cells harvested from dental pulp. 

The treatment itself is expensive. While Jaggi paid Rs 2.5 lakh for two sessions, Gawli shelled out Rs 1.6 lakh for one session that lasted no longer than a day. 


Ideally, argue industry observers, neither should have had to pay considering all stem cell therapy is at trial stage in the country. At present, only Bone Marrow Transplantation - in use since 1968 to treat blood and bone marrow diseases, blood cancers, and immune disorders - is an approved form of stem cell therapy. 

All others can be only conducted as clinical trials only after approval from the Drug Controller General of India (DGCI), and for free after the patient signs a consent form. "What is going on across the country is simply not acceptable," says Dr Jotwani. 

The therapy also falls in the legally grey area, as ICMR is still in the process of drafting regulations for it. The only guideline currently available is that any institution or individual using human stem cells should be registered under the National Apex Committee for the Stem Cell Research and Therapy (NAC-SCRT). 

But for patients like Jaggi, who says she feels as young as she did in college, the therapy has, for now at least, granted a fresh shot at life. "My colleagues and students are yet to digest the transformation," she smiles. 



HOW IT'S DONE 


A wide bore needle is used to extract 200ml of bone marrow, while another 200ml of adipose (fat tissue) is extracted from the same area along with 100cc of peripheral blood for platelet rich plasma (PRP). The bone marrow and adipose tissue are then sent for culture where stem cells are segregated and then 'activated'. Around 300-400 million of these cells are then transplanted into the patient through an IV. 

Dr Mahajan says stem cells trigger a few reactions after entering the body, which results in reduced blood sugar levels. 

First, they release chemicals and growth hormones responsible for creating new capillary and blood vessels. They also activate residential stem cells in other body organs. They then trigger an epigenetic reaction, which means that cells which are not typically hormone producing ones start secreting hormones. 

The stem cells then get differentiated into islet cells (which work together to regulate blood sugar), beta cells (that sense sugar in the blood and release the necessary amount of insulin to maintain normal blood sugar levels) and hormone cells. 

"Eventually, insulin resistance is reduced in patients and glucose breakdown begins," explains Dr Mahajan.


I feel like a college girl

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नई पोस्ट : कोरे ख़त आते रहे