Take your vitamins with your stem cells

Naples, Italy -

Since the majority of chronic human diseases are associated with multifactorial causes and multifactorial mechanisms, the ability of a monotherapeutic intervention to evoke long term benefit seems, at least theoretically, not realistic. The field of therapeutic angiogenesis has often been critized for the utilization of only single angiogeneic approaches clinically, while in preclinical models it is obvious that utilization of several approaches together often yields synergy.

The same critism can be said of the field of stem cell therapeutics. How many clinical trials utilize combination approaches to induce therapeutic responses? To my knowledge, none.

In a recent paper (de Nigris et al. Therapeutic effects of concurrent autologous bone marrow cell infusion and metabolic intervention in ischemia-induced angiogenesis in the hypercholesterolemic mouse hindlimb.Int J Cardiol. 2007 Apr 25;117(2):238-43. Epub 2006 Jul 27) intravenous stem cell therapy was compared to control, and to intravenous stem cells together with nutritional modification.

It was demonstrated in a hypercholesterolemic mouse model that ischemia can be more effectively overcome in the hind limb by combining intravenous bone marrow stem cell administration with nutritional intervention as opposed to either treatment alone. The nutritional intervention consisted of 1.0% vitamin E added to the chow, 0.05% vitamin C and 6% l-arginine added to the drinking water.

This study is very impoortant and its implications should be considered in the development of clinical trials. In other words, lets say that we are giving stem cells for the treatment of myocardial ischemia. The ischemia is cause by atherosclerosis, which is caused, in part by various free radicals and low grade inflammation. Now even if in a perfect world the injected stem cells make new blood vessels and the myocardial ischemia subsides, will it not come back again just the same way that it originally got there?