The ethical controversy regarding regenerative medicine (stem cell therapy) revolves around how the cells are curated. While I believe in ethical procurement, the controversy has escalated to the point of hampering this very important, lifesaving research. I support the conduct of medical trials and their potential. In my opinion, it is a “wholistic” approach for advancing conventional Western medicine.
The veterinary schools of Tufts University in Massachusetts and University of California (UC) at Davis are two institutions spearheading exciting research into regenerative medicine (i.e. stem cell therapy) to repair, limit or manage several inflammatory conditions in dogs, cats and horses.
In particular, both schools are currently in the midst of two trials concerning inflammatory bowel diseases (IBD) in dogs which are using stem cells. The UC Davis study has taken a more general approach and has sought dogs that have chronic, idiopathic diarrhea that traditional therapies have failed to control.
The Tufts University study is more specific. It is looking into the treatment of IBD and concurrent protein-losing enteropathy in dogs.
Both studies are using mesenchymal stem cells (MSCs), which are traditionally found in the bone marrow but can also be found in umbilical cords, cord blood, peripheral blood, fallopian tube, and fetal liver and lung. UC Davis is using fat-derived (adipose) MSCs whereas Tufts has opted for umbilical cord cells. Neither study has released preliminary findings – but I would love to have preliminary reports!
IBS or IBD?
Let’s step back a second and remind ourselves about the difference between Irritable Bowel Syndrome (IBS) and IBD. The symptoms can be similar and include – but are not limited to – stomach cramps, bloating, gas, and diarrhea. Vomiting may also occur. Importantly, IBD causes inflammation that damages the gastrointestinal lining and its functions that can cause ulcers and a “leaky gut”. IBD can be caused by underlying genetic predisposition that runs in human and animal families when encountering a variety of environmental challenges. It is widely known that food sensitivities aggravate the condition.
On the other hand, some medical professionals say IBS does not cause inflammation, is not as severe, but is a functional disorder. This means that the digestive system looks normal after examination but is not working properly. Personally, I believe that this distinction is moot, and that IBS is due to an inflammation most of the time. Diarrhea, abdominal pain, cramps and constipation are all symptoms of IBS, as well as IBD.
My questions remain: what is causing the symptoms, if not inflammation? Could they simply not be detected by the diagnostic tests we currently have available?
It is important to point out that any dog can have IBD. However, research has shown that the following breeds typically suffer from certain types of IBD.
Boxers – Histiocytic ulcerative colitis. This is a severe form of IBD and it causes ulcers in the lining of the colon.
Basenjis, German Shepherds, Chinese Shar-Peis – Lymphocytic-plasmacytic enteritis. Lymphocytes and plasmacytes are inflammatory cells and are responsible for the body’s immune response. They infiltrate the stomach and/or small intestine causing diffuse mucosal inflammation.
Rottweilers – Eosinophilic gastroenteritis. Eosinophils are also inflammatory cells but are white blood cells.
Irish Setters, Soft Coated Wheaten Terriers, and Samoyeds – Gluten -sensitive enteropathy. This is often known as Celiac Disease in humans. One of the components is that the Zonulin protein – which is found in glutens – pokes holes in the gastrointestinal lining causing a “leaky gut” so that all sorts of bacteria and other matter to freely enter the digestive tract.
Wheat-sensitive enteropathy is a heritable trait in Irish Setters. Gluten foods cause immunological reactions which lead to atrophy of the intestinal villi of the inflamed small intestine. This, in turn, results in diarrhea and weight loss due to malabsorption of fluid, electrolytes, and dietary nutrients.
Even though chronic or intermittent diarrhea and intermittent vomiting are the most common symptoms of this food sensitivity, there have been few studies of the prevalence of this condition in animals being presented to veterinarians with chronic diarrhea or vomiting or other common bowel symptoms. The result was often either no diagnosis or a missed diagnosis of their immunologic food sensitivity or intolerance.
Soft Coated Wheaten Terriers (SCWTs) – This breed also has protein-losing enteropathy (PLE), which is an abnormal loss of protein from the bowel. Normal functioning intestines cause ingested proteins to be reabsorbed into the blood to allow for the production of more protein. This is not the case for people and pets that suffer from PLE; they simply excrete the protein from the leaky gut. SCWTs can also suffer from protein-losing nephropathy (kidney dysfunction), where excessive amounts of protein are lost in the urine.
Yorkshire Terriers – Lymphangiectasia is considered a chronic form of PLE. The medical community distinguishes the two because lymphangiectasia specifically results from dilations of the lymphatic vessels.
The Tufts University study researching protein-losing enteropathy with stem cell therapy treatments decided to exclude Boxers, Yorkshire Terriers and SCWTs.
IBD is diagnosed with an array of blood and urine tests and endoscopy with biopsy of the affected intestine may be warranted. In many cases, the diagnosis is presumptive based upon the clinical signs and routine lab tests, and can be treated as such without resorting to endoscopy or biopsy. Once the condition has been diagnosed, the medical community relies on corticosteroids and/or immunosuppressive drugs to treat the condition, along with gastrointestinal supplements to protect, soothe and heal the bowel. However, the long-term use of either of immune suppressive drugs can have severe long-term side effects. They are simply not cures.
The other treatment option is a food elimination trial. I once relied heavily on these trials for many years with my client’s pets. Today, however, I realized they could be doing more harm than good.
That’s why I developed the NutriScan Food Sensitivity & Intolerance Test, which tests the immune response of the antibodies IgA and IgM to 24 potentially offending foods. NutriScan testing is not a cure for IBD, but will help mitigate the pervasive degeneration of the gut lining by indicating to veterinarians what not to feed their patients, and to caregivers which food their pets should avoid.
At this time, the research community believes that stem cell therapy will also not cure IBD, but the hope is that the therapy will repair tissue, promote tissue regrowth, and limit inflammation. Realistically, FDA CVM approval is probably several to many years away. Nevertheless, once approved, I envision the fusion of stem cell therapy with NutriScan testing to strengthen the gut for sustaining long-term health.
“Canine Protein- Losing Nephropathies-Effect of Umbilical Cord Mesenchymal Stem Cells on 90 Day Survival.” Clinical Trials. Tufts University Cummings School of Veterinary Medicine, n.d. Web. 23 Apr. 2016. https://sites.tufts.edu/vetclinicaltrials/?qa_faqs=canine-protein-losing-nephropathies-effect-of-uc-mscs-on-90-day-survival.
Dodds, W. Jean, DVM. “Allergens Cause Inflammation: Are Corticosteroids the Long-term Solution?” Dr. Jean Dodds’ Pet Health Resource Blog. 3 Jan. 2016. Web. 23 Apr. 2016. https://www.hemopet.org/steroids-dog-inflammation/
“Dogs Clinical Trials.” UC Davis School of Veterinary Medicine, n.d. Web. 23 Apr. 2016. http://www.vetmed.ucdavis.edu/clinicaltrials/current_trials/by_species/dogs.cfm.
Hoskins, Johnny D., DVM. “Diagnosing IBD: Exclude Known Causes of Chronic Intestinal Disease.” Veterinary News. DVM360, 01 Nov. 2005. Web. 23 Apr. 2016. http://veterinarynews.dvm360.com/diagnosing-ibd-exclude-known-causes-chronic-intestinal-disease.
Hoskins, Johnny D., DVM. “News Top Headlines Recalls Market Trends Medical News Practice News Education News Regulatory News Equine News Association News Politics Law and Ethics Dvm360 Magazine ADVERTISEMENT Advances in Managing Inflammatory Bowel Disease.” Veterinary News. DVM360, 01 Oct. 2001. Web. http://veterinarynews.dvm360.com/advances-managing-inflammatory-bowel-disease.
“Inflammatory Bowel Disease in Small Animals.” Diseases of the Stomach and Intestines in Small Animals: Merck Veterinary Manual. Merck Manuals, n.d. Web. 23 Apr. 2016. http://www.merckvetmanual.com/mvm/digestive_system/diseases_of_the_stomach_and_intestines_in_small_animals/inflammatory_bowel_disease_in_small_animals.html.
“Intestinal Protein Loss in Dogs.” PetMD, n.d. Web. 23 Apr. 2016. http://www.petmd.com/dog/conditions/digestive/c_dg_protein_losing_enteropathy.
“What’s the Difference Between IBD and IBS?” WebMD, n.d. Web. 23 Apr. 2016. http://www.webmd.com/ibs/ibd-versus-ibs.