Francisco Ruiz-Navarro
Abstract
After reviewing several current clinical guidelines, we found that less than 1% of all clinical disease recommendations in clinical guidelines are supported by a level 1A of evidence (a systematic review of the homogeneous RCT, according to the Oxford Centre of Evidence). In reviewing the scientific evidence for stem cell treatment, we found that several stem cell therapies are based on the same, if not stronger, scientific evidence than current medical treatment. This means that accepted treatments and stem cell treatments have almost the same level of evidence. Although both are far from A-level, it is apparently sufficient for many clinicians and regulators to maintain a reluctant stance toward stem cell therapies, but not towards other types of treatment. We propose that not only level 1A evidence should be accepted as a treatment, especially in cases where there are no options for patients in addition to experimental treatments. In this debate, the need for ecrEC or blind trials arises, particularly because CCS therapies are a procedure rather than drugs and conducting clinical studies with "surgical placebos" is ethically controversial. There are analyses that describe how series of observational studies have found results similar to those obtained from RCTs, which means that a number of cohort or case-control studies would provide sufficient valuable information to provide treatments to clinical practice, although we plan to wait for a better conception of the RCT to confirm the results, if possible. We reviewed the most relevant literature on the use of stem cells to treat several neurological disorders. This review of the literature will provide key information on how stem cell interventions were performed with analysis of the level of evidence they provide. Based on the information gathered, we then compared the scientific evidence underlying current treatment guidelines with the scientific evidence on the stem cell publications currently available. As a result of this investigation and analysis, we conclude with a series of recommendations for the use of stem cells in clinical settings. They are able to divide and renew themselves for long periods of time. Unlike muscle cells, blood cells or nerve cells, which do not normally reproduce, stem cells can replicate several times. A stem cell starter population that proliferates for many months in the laboratory can produce millions of cells. Today, donated organs and tissues are often used to replace those that are sick or destroyed. Unfortunately, the number of people in need of a transplant far exceeds the number of organs available for transplantation. Pleuropotent stem cells offer the possibility of a renewable source of replacement cells and tissues to treat a myriad of diseases, diseases and disabilities, including Parkinson's and Alzheimer's disease, spinal cord injuries, stroke, cerebral palsy, Battens disease, amyotrophic lateral sclerosis, vision restoration and other neurodegenerative diseases. Many common neurological disorders, such as Parkinson's disease, stroke and multiple sclerosis, are caused by the loss of neurons and glial cells. In recent years, neurons and glials have been successfully generated from cultured stem cells, fuelling efforts to develop stem cell-based transplant therapies for human patients. More recently, efforts have been extended to stimulate formation and prevent the death of neurons and glial cells produced by endogenous stem cells in the adult central nervous system.