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The Independent Weekly
December 4 - 10, 2009 spectrum
Peter Couche was always
active and full of life, then he
suddenly suffered a stroke that
would change his life forever. He
has not been able to walk, talk or
feed himself again.
His is a story of the acute
tragedy of stroke that afflicts one
Australian every 10 minutes and
may leave one person every 30
minutes with long-term disability,
robbing them of their independ-
Peter was only 41 when this hap-
pened 17 years ago. The perception
is that stroke is an old person s
disease, but today in Australia one
in five sufferers are under 55.
Peter s is a story I know only too
well as a neurologist and stroke
physician. The challenge facing
neurologists and neuroscientists in
the 21st century is how to repair the
brain after a stroke
Every week I read scientific
publications on the internet that
describe new breakthroughs in
stem cell technology or therapy.
Many of my patients now ask: "Is
stem cell therapy going to change
my outlook after a stroke has left me
Stem cells are the primitive
building blocks of life. They are
unique cells that have the potential
to generate all 210 different types of
cells that make up the human body.
It is important to know that not all
stem cells are the same.
There are three different types of
human stem cells. First, embryonic
stem cells are taken from an early
human embryo, which has the
broadest potential to make all 210
cells in the human body. Second,
induced pluripotent stem cells,
which were only made in 2007
when cells from human skin were
genetically reprogrammed to
produce stem cells that behave like
embryonic stem cells. This was a
remarkable genetic feat with great
therapeutic potential. Finally, there
are adult stem cells that are found
in many organs of the adult body
such as the bone marrow, umbilical
cord, skin and even teeth.
Adelaide University s stroke
research program, in collaboration
with the Queen Elizabeth Hospital,
is actively investigating the use of
stem cells from human teeth.
When young adults have
impacted wisdom teeth removed,
these are used to grow adult stem
cells. With better dental hygiene
many older adults still have good
teeth that could be used to easily
obtain stem cells for future therapy.
It is a major advantage if stem
cells come from your own tissue.
We have demonstrated these stem
cells can make nerve cells and
even cause nerves to redirect their
connections. Both of these qualities
are needed if stem cells are to help
repair the brain following a stroke.
This year we undertook a stroke
study in rats and found that when
human stem cells from teeth were
transplanted into the brain 24 hours
after a stroke the animals showed
less paralysis of their limbs.
We have seen a two-fold or
greater improvement in limb
mobility after stem cell therapy
in stroke rats. So are we ready for
human trials of stem cell therapy
In 2005 Peter paid up to $50,000
to travel to the Netherlands and
receive stem cell therapy. I have
a number of patients who see me
who have travelled to India and
China for stem cell therapy. Most
tell me, as Peter does, that they felt
better following the treatment.
Unfortunately, to date, I have not
seen dramatic improvement in
My view is that stem cell therapy
received for payment alone in non-
should be considered with caution.
An even more important issue
relates to the safety of these stem
This year a much-feared tragedy
was reported in medical journals
involving a child whose parents
paid for stem cell therapy in Russia.
Stem cells from a human fetal
brain were injected into the fluid
surrounding the young boy s brain
and spinal cord to treat a devastat-
ing neurological disease. Four years
later the boy developed tumours in
the brain and spinal cord that were
derived from the transplanted stem
Animal studies had previously
shown that embryonic stem cell
treatment into the brain results in
up to one in 10 animals developing a
brain tumour. This tragic case has
shown us this is a real risk.
So, which type of stem cell is
safe? Which type of stem cell is
the best to repair the brain? These
questions and many others remain
to be answered by scientists over
the next several years.
Peter and I regularly discuss the
rapid progress in stem cell research
and when he will be able to receive
stem cell therapy again. Recently,
while overseas, I learnt of a number
of pilot human clinical studies
using different types of stem cells to
treat neurological disease, includ-
To Peter and my patients who
await a change in their lives
following a stroke, I say: "Keep as
active as you can, remain positive
but be patient a little longer and do
not risk unsafe and untested treat-
ments." We are all travelling along
this unchartered road together and
generating hope is worthwhile.
■ Associate Professor Simon Koblar
is director of the stroke research
program of University of Adelaide
and The Queen Elizabeth Hospital.
A new state of mind
Associate Professor Simon Koblar with Peter Couche.
Photo: Randy Larcombe
Adelaide University's Simon Koblar has a message of hope and caution for stroke sufferers,
including Peter Couche, a successful stockbroker who suffered a brain-stem stroke 17 years ago.
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