「Since the last two years, the atmosphere has changed a bit.」
J：You have been giving lectures not only throughout Japan but also overseas, but do you feel that there has been any change in the surrounding reactions to regenerative medicine?
Kishigami：I guess since the last two years. The atmosphere has gradually changed. Perhaps it is partly thanks to iPS cells. I was surprised to learn that stem cells are so amazing.
J：Dr. Kishigami has been involved in many cases of spinal cord injuries as well as bone fractures through regenerative therapy. For example, he has treated a patient with a herniated disc who had little chance of recovery after conventional treatment by administering mesenchymal stem cells, and has enabled the patient to walk.
Kishigami:I am often told that the patient could have stood up even without the stem cells. Therefore, we dare to administer mesenchymal stem cells only to patients who still cannot stand up even one month after the onset of the disease. If it is one week after the onset of the disease, there is a possibility that the patient will recover walking without treatment, but it is unlikely that the patient will be immobile for a month and suddenly heal spontaneously. Veterinary doctors know that, you know.
The case of a grade IV toy poodle child was typical. This case was also a case where more than 2 months had passed since the onset of the disease. She was unable to stand on her hind legs and had a bedsore because she kept falling on her bottom. The family originally came to us because they felt sorry for the bedsore and heard that we could heal it. He never said he wanted his paralysis cured. I asked him, “We can heal the bedsore, but do you have to heal the paralysis?” I asked him, “What? I replied, “Yes, but not the paralysis! The family had given up on treating the paralysis. They had been told by those around them that it could not be cured. We decided to give it a try, and we administered stem cell therapy. The day after the treatment, he stood up and started walking. His family said, “What in the world happened? They said, “What in the world happened? However, stem cell therapy is not effective in all cases. It has been found that it is better to culture the cells and administer them at an early stage after the onset of disease. Data are also showing that it depends on the grade of injury.
J：You are doing a lot of other treatments with stem cells, but other than herniated discs, what other diseases can we hope for?
Kishigami：Brain. An infarction of the central nervous system. This is promising. Perhaps the mechanism behind this is the possibility that the administered stem cells will create blood vessels near the infarction site. In the case of a Maltese who had a cerebellar infarction that caused his center of gravity to go haywire and he fell flat on his back, his condition rapidly improved after the administration of subcutaneous fat-derived stem cells. This is also supported by data from MRI images showing a reduction in the infarct area.
Then there is kidney failure, which is also interesting. Just today, there was a cat with mesenchymal stem cells injected for renal failure, and the family member said, “Doctor, it’s not working very well. I looked at the BUN and CRE values, and it was true that they were not getting much better. However, the child had been a polyuricurist and had been passing clear urine, but she said, “And she hasn’t been drinking water lately. (Laughs.) “Wait a minute. That’s why it’s working,” he said. “Well, his pee is darker and less and less, doctor. What do you think? It’s working! It’s working!
J：So the decrease in that pee is one of the important indicators.
Kishigami：That’s right. He said, “That’s where we start.” As was the case with the cat case I did before, we are seeing more and more cases where dehydration is disappearing and there is no longer a need for intravenous infusions. I gave three intravenous infusions of adipose tissue-derived stem cells to a 13-year-old cat with typical polydipsia and polyuria and chronic renal failure. The cat belonged to my wife’s brother. After the administration, his BUN level went from 90 to 65 or so, not much better as far as numbers go. But his face changed drastically. He used to stay still and groom his hair, but he started to eat a lot. My brother was also surprised, saying, “His face looks like a different cat. Of course, the renal values such as creatinine and BUN are important. However, I also feel that patients should look at themselves more than the numbers.
J：So there are signs of symptomatic improvement, although it is difficult to be reflected in numerical values. Nowadays, it is also practical to administer iohexol to measure GFR (glomerular filtration rate) and to measure cystatin C levels in plasma. I think those things are also useful tools to measure renal function after administration of mesenchymal stem cells.