「Stem cells act like micro-doctors」
J: How is the response to immuno-cell therapy as an option in actual treatment?
Yokoyama：It’s enough. It is very palpable. The owners who have had lymphocyte therapy are 100% satisfied. In addition, the introduction of this therapy has raised the bar for the staff themselves, and the pressure of being expected to perform at such a level has led them to feel and act that they must successfully raise the level of the therapy. I feel a good response, not only in terms of the treatment, but also in terms of raising the level of awareness of the hospital staff. Immunotherapy comes alive only when the three major therapies are properly understood and used.
J：How do you explain this to the owners?
Yokoyama：In the beginning, we would check with the owners to see if this was the type of treatment they wanted. Many of the cases were children in a terminal condition, wandering between life and death. The reason why they get cancer is either a weakening of immunity due to aging or the resulting cellular copying errors, and if that is the case, then it is still good to boost their immunity. They are convinced when I say that. Currently, we have data showing that such children who wandered between life and death are now recovering with lymphocyte therapy, so I show them this data and talk about it.
J: I would like to ask you about mesenchymal stem cells. You are using stem cells to treat internal medicine and immune-mediated diseases. I have the impression that you are working very energetically on this field, although there have been few other reports on the subject.
Yokoyama：Mesenchymal stem cells have been effective in various cases of immune-mediated polyarthritis, pancreatitis, hepatitis, dry eyes, corneal ulcers, uveitis, trauma, and more. In a case of polyarthritis, the patient had been using steroids for two years and his body was in a state of disarray and his CRP remained high. During that time, the patient had lulls and lapses, and was in a life-and-death situation many times. The owner was very happy to see that the C-reactive protein (CRP) levels had dropped and his condition had improved. To my surprise, we were able to continue the situation for three months without prescribing steroids to keep the patient in good health.
Then there is liver disease, but the response has been to control the severe elevation of liver enzymes. That is a difficult point, because in some cases, elevated liver enzymes do not indicate hepatitis. In many cases of other liver diseases, the rapid rise in liver enzymes is suppressed for a certain period of time after the administration of stem cells, even though steroids are not used, or CRP is maintained even though liver enzymes rise, and as a result, the quality of life of the patient improves. I think the mechanism is that the administered stem cells secrete various cytokines, which act like microdoctors, so to speak, to suppress inflammation, melt liver fibers, and promote blood vessel regeneration. In other words, rather than fat stem cells regenerating hepatocytes, the theory of “cell therapy” with fat stem cells is more plausible.
Yokoyama：If we think theoretically about the principle of stem cells working, I honestly think it would be tough in chronic diseases, because inflammation is gone. Acute renal failure or nephritis would be an indication for stem cell administration. In the case of chronic renal failure, I use stem cell therapy to improve quality of life rather than to cure the disease. I think that traumatic injuries and acute illnesses are the most promising cases where stem cells can be effective. The various cytokines produced by stem cells play the biggest role first, and there are zero stem cells that differentiate into organ cells at the destination. Currently, trans-differentiation of stem cells (differentiation beyond the germline. There are now many reports of mesenchymal stem cells, which are usually considered to be mesodermal in nature), and I do not think that this in itself should be denied. J-ARM’s system has been able to secure the number of cells each time and has been able to increase the number of cells each time with evidence. We can use the exact same materials. Anyone with a facility can perform this type of treatment. For clinicians like us, this is the most important thing.