Parkinson’s disease is widely known as a neurological condition that causes motor symptoms. Typically, patients with Parkinson’s disease have pill-rolling tremor, cogwheel rigidity, and a shuffling gait. However, about half of all patients with Parkinson’s disease also have psychiatric symptoms such as anxiety and depression. It can be challenging for patients and caregivers to deal with Parkinson’s disease, but if anxiety and depression are also present, it can make matters worse. When psychiatric symptoms occur, they can make Parkinson’s disease more difficult to treat, increase the burden on caregivers, and greatly reduce quality-of-life for patients.
One of the things that make psychiatric symptoms so difficult to treat in patients with Parkinson’s disease is that doctors have limited treatment options. The antidepressants that they would normally use to treat depression and anxiety can make motor symptoms of Parkinson’s disease worse. People with Parkinson’s disease often struggle with sleep disturbances, and typical antidepressants can make sleep problems worse, too. Not surprisingly, many patients with Parkinson’s disease suffer from depression and anxiety and never find adequate treatment.
Physicians recently reported their experience with a patient with Parkinson’s disease who they treated with hyperbaric oxygen. The man had struggled with Parkinson’s disease for 1.5 years and had slipped into a severe depression. He had lost interest in pleasurable activities, was only sleeping about 2 to 3 hours each night, unintentionally lost over 40 pounds, and was having thoughts of suicide. He also had significant anxiety issues that made his life very difficult. Regular drug and psychotherapy treatments for anxiety and depression did not work for this man, so physicians were left with few options.
The man with Parkinson’s disease, severe depression, and anxiety underwent 30 days of hyperbaric oxygen treatments. He inhaled pure oxygen in a hyperbaric chamber for 40 minutes per session at 2 atm of pressure. In as little as four days of hyperbaric oxygen treatment, the man was sleeping better and longer than he did before treatment. His mood has also improved.
After 30 days of hyperbaric oxygen treatments, the man was able to sleep for 8 to 10 hours a night. Not only did his psychiatric symptoms improve, but his Parkinson’s disease symptoms also improved. While he still had Parkinson’s disease symptoms after hyperbaric oxygen treatment, the symptoms had improved substantially.
When physicians followed up one month after treatment had ended, the patient was still sleeping through the night, his mood was good, and he did not need assistance with his activities of daily living.
It is important to remember that this is a case study, the results of a single patient. Nevertheless, the improvements in both Parkinson’s disease and severe symptoms of anxiety and depression are incredibly impressive. For this man, at least, hyperbaric oxygen therapy had a substantial positive effect in his life where other treatments had failed.
Patients can also combine Hyperbaric Oxygen Therapy with Regenerative Medicine. Regenerative Medicine is an alternative option to help manage the symptoms of Parkinson’s Disease. The stem cells have the potential to replicate and repair numerous cells of the body, including those damaged by Parkinson’s. These advancements in the treatment of Parkinson’s Disease work to fully regenerate missing or damaged tissue that the body would not ordinarily regrow.
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Reference: Xu, Jin-Jin et al. (2018). Hyperbaric oxygen treatment for Parkinson’s disease with severe depression and anxiety. Medicine. 2018 Mar; 97(9): e0029.
Cartilage plays several important roles in the way joints move and function. Joint cartilage provides lubrication, acts as a shock absorber, and helps the joint move smoothly. Joint cartilage is comprised of two substances chondrocytes (i.e. cartilage cells) and extracellular matrix (proteins such as hyaluronic acid, collagen, fibronectin, etc.).
Many conditions can lead to joint cartilage defects. In young people, the most common cause of the joint cartilage defect is an injury. For instance, a football player suffers a hard contact that injures the joint. Another example is a gymnast who repeatedly places substantial impact forces on the knee and other joints of the lower body, resulting in damage. In older people, the most common cause of joint cartilage defects is Osteoarthritis. Over time, the joint cartilage breaks down in the cartilage loses its ability to lubricate, absorb shock, and support the smooth movement of the joint. This leads to stiffness, pain, and “trick” joints, among other symptoms.
Orthopedic surgeons, rheumatologists, and other physicians have attempted to treat these conditions by injecting the damaged joint with one of the two main components of joint cartilage: extracellular matrix. Physicians inject hyaluronic acid (and sometimes related extracellular matrix proteins) to help replace and restore damaged joints. This approach can be helpful for some patients, but it is certainly not a cure.
Only recently, have researchers attempted to replace the other component of joint cartilage: chondrocytes. Specifically, researchers have focused their efforts on mesenchymal stem cells that have the ability to differentiate and become cartilage cells. Li and colleagues injected combinations of bone marrow-derived mesenchymal stem cells and hyaluronic acid into animals with experimental cartilage defects. They showed that hyaluronic acid injections alone modestly repaired the cartilage damage. However, when stem cells plus hyaluronic acid was injected, the joints were almost completely repaired. In other words, stem cells plus hyaluronic acid resulted in much greater improvement in joint cartilage damage than hyaluronic acid alone.
The authors of the study concluded that “bone marrow stem cells plus hyaluronic acid could be a better way to repair cartilage defects.” While additional work is needed, these results are extremely exciting for people who suffer from joint cartilage defects such as osteoarthritis. In the future, people who are candidates for hyaluronic acid injection treatments may instead receive a combination of hyaluronic acid plus stem cells and may enjoy an even greater benefit than hyaluronic acid treatment alone.
Reference: Li et al. (2018). Mesenchymal Stem Cells in Combination with Hyaluronic Acid for Articular Cartilage Defects. Scientific Reports. 2018; 8: 9900.
Most organs of the body recover from injury by generating new, healthy cells. Not every organ of the body has the same ability to form new cells, however. The skin is an example of an organ that has an amazing ability to regenerate. Liver and lung also have the ability to form new cells, but not as dramatically as skin. Kidney and heart have even less ability to repair and regenerate. On the opposite end of the spectrum from the skin is the brain, which has very little capacity to regenerate once it has been damaged or destroyed. All of these organ systems, especially those that are relatively unable to repair themselves, could theoretically benefit from stem cells.
Mesenchymal stem cells, also known as stromal cells, are multipotent stem cells derived from bone marrow, umbilical cord, placenta, or adipose (fat) tissue. These cells can become the cells that make up bone, cartilage, fat, heart, blood vessels, and even brain. Mesenchymal stem cells have shown a remarkable ability to help the body to produce new cells. Researchers are now realizing that the substances stem cells release may be more important than any new cells they may become. In other words, stem cells can directly become new healthy cells to a certain degree, but they can also release substances that dramatically increase the number of new, healthy cells.
Mesenchymal stromal stem cells release small packets called exosomes. These exosomes are filled with various substances that promote cell and tissue growth. Some of the most interesting and potentially useful substances are cytokines and micro RNA. Cytokines are the traffic cops of cellular repair, signaling certain events to take place while stopping others. Having the right cytokines in a particular area is critical for new tissue growth. The micro RNA released by stem cell exosomes is potentially even more exciting than cytokines. These tiny bits of RNA can directly affect how healthy and diseased cells behave. Micro RNA has a powerful ability to control the biological machinery inside of cells.
Exosomes exhibit a wide array of biological effects that promote the repair and growth of damaged and diseased organs. They promote the growth of skin cells and help wounds heal. Exosomes can reduce lung swelling and inflammation and even help the lung tissue heal itself (i.e. reduced pulmonary hypertension, decrease ventricular hypertrophy, and improve lung vascular remodeling). These small packets released by stem cells help prevent liver cells from dying (i.e. prevents apoptosis), promote liver cell regeneration, and slow down liver cirrhosis (i.e. fibrosis). Exosomes can also help protect the kidneys during acute injury and reduce the damage that occurs during a heart attack.
Several clinical trials are underway designed to allow these exciting developments to be used to treat patients. As the researchers state, “Extensive research and clinical trials are currently underway for the use of MSCs as regenerative agents in many diseases including spinal cord injury, multiple sclerosis, Alzheimer’s disease, liver cirrhosis and hepatitis, osteoarthritis, myocardial infarction, kidney disease, inflammatory bowel disease, diabetes mellitus, knee cartilage injuries, organ transplantation, and graft-versus-host disease.” We can reasonably expect that exosomes will be used to treat at least some of these conditions in the very near future.
Muscle health and strength is an important determinant of a person’s ability to function in daily life. One of the major determinants of healthy aging is how well people retain their muscle mass. The more that skeletal muscle declines, the more likely someone would not be able to care for themselves independently. Injury to muscles whether through trauma, burns, or toxins can greatly interfere with a person’s ability to perform activities of daily living. While muscle cells have a limited ability to regenerate themselves, quite often, patients never regain their former strength and level of function after serious injury.
Stem cells would seem to be ideally suited to help in this regard. Since stem cells have the potential to become muscle cells, one could imagine infusing stem cells into an area of muscle damage or injury to restore overall muscle function. While this makes sense intuitively, it may not be the case. Stem cells, for example, form new muscle cells, but they do not form cells that participate in muscle function. And yet, stem cells are able to help muscles regrow into functional skeletal muscles.
How could stem cells promote skeletal muscle regeneration without becoming functional skeletal muscle cells? The answer, as it turns out, is that stem cells produce molecules that strongly promote muscle regeneration and muscle function.
Stem cells release these molecules in tiny packets called exosomes. Exosomes are tiny spheres that “bubble out” of stem cells, in a manner of speaking. Exosomes have a cell membrane, like cells themselves, but are much smaller, and they do not have the ability to reproduce. Instead, exosomes are highly packed with proteins, DNA, messenger RNA, micro RNA, cytokines, and other factors.
Nakamura and co-researchers showed exosomes can help regenerate muscle. These researchers showed that by injecting exosomes harvested from stem cells (without any of the stem cells themselves), they could increase muscle growth and blood vessel growth. In short, these molecules accelerate the rate at which muscles regenerate.
While more research is needed, this work suggests that exosomes retrieved from mesenchymal stem cells could be used to help regrow functional muscle in patients with various forms of muscle injury.
Reference: Nakamura et al. (2015). Mesenchymal-stem-cell-derived exosomes accelerate skeletal muscle regeneration. FEBS Letters. 2015 May 8;589(11):1257-65.
Spinal cord injury can be one of the most devastating
injuries. Long neurons that extend from the brain down the spinal cord are
severed and scarred. In most cases, this damage can never be repaired. If
patients survive an injury to the spinal cord, they can be permanently
paralyzed. Researchers have attempted to use high-dose steroids and surgery to
preserve the spinal cord, but these approaches are either controversial or
Ideally, one would create an environment in which nerve
cells in the spinal cord could regrow and take up their old tasks of sensation
and movement. One of the most promising approaches to do just this is stem cell
To test this concept, researchers used
stem cells derived from human placenta-derived mesenchymal
stem cell tissue (not embryonic stem cells) to form neural stem cells in
the laboratory. These neural stem cells have the ability to become neuron-like
cells, similar to those found in the spinal cord. The researchers then used
these stem cells to treat rats that had experimental spinal cord injury. The
results were impressive.
Rats treated with neural stem cells regained the partial
ability to use their hindlimbs within one week after treatment. By three weeks
after treatment, injured rats had regained substantial use of their hindlimbs.
The researchers confirmed that this improvement was due to neuron growth by
using various specialized tests (e.g. electrophysiology, histopathology). Rats
that did not receive stem cells did not regain substantial use of their
hindlimbs at any point in the study.
This work is particularly exciting because it shows that
stem cells can restore movement to animals who were paralyzed after spinal cord
injury. Moreover, the researchers used human stem cells derived from placenta,
which suggests that this effect could be useful in human spinal cord injury
patients (perhaps even more so than in rats). While additional work is needed,
these results offer hope to those who may one day develop severe spinal cord
Zhi et al. (2014). Transplantation of placenta-derived
mesenchymal stem cell-induced neural stem cells to treat spinal cord injury.
Neural Regen Research, 9(24): 2197–2204.
Parkinson’s disease is a progressive neurodegenerative disorder that causes tremor,rigidity, changes in facial expression, and several other symptoms. Whilesufferers usually retain their full cognitive abilities and memory, they tendto be impacted in mood and some mental health conditions that emerge as part ofthe condition process.
Parkinson’s disease is caused by loss of brain cells in a specific region of the brain called the substantia nigra. The neurons in this area of the brain contain dopamine, and as those nerve cells die, the levels of dopamine in the brain decrease. Consequently, patients with Parkinson’s disease often take medications that improve or accentuate dopamine signaling in the brain. These drugs can be effective for a certain period of time, but eventually, the condition will overcome the ability of these drugs to improve dopamine signaling. There is no cure for Parkinson’s disease, but researchers hope stem cells may be the answer.
Since dopamine drugs have worked reasonably well to control the symptoms of Parkinson’s disease, researchers assumed that replacing dopamine cells in the brain would help treat Parkinson’s disease. In a way, it did. When people with Parkinson’s disease received transplants of stem cells intended to produce dopamine, some of them experienced dramatic improvements in motor function. However, patients still had several other symptoms of Parkinson’s disease such as fatigue, bowel problems, sexual problems, and mood disorders. Neuroscience researchers realized Parkinson’s is not just about a loss of dopamine. It turns out, that while stem cells can help restore dopamine in people with Parkinson’s disease, they also coulduse help with serotoninneuron regenerating.
As a result of this groundbreaking work, researchers are now planning and implementing experiments in which Parkinson’s disease patients will receive stem cell transplants containing both dopamine cells and seroton in cells. If effective, we will be one step closer to a new and powerful treatment for Parkinson’s disease.