The Jakarta Post
The possibility that stem-cell therapy could help to treat various diseases has prompted scientists and doctors to broaden their research into the technology.
Although there is no policy that governs stem-cell research ' triggering controversy over research that uses embryonic stem cells ' many countries have developed their own policies on stem-cell research for therapeutic purposes, including Singapore ' which is considered Asia's stem-cell center, as well as Japan and India ' the UK, the US and Switzerland.
Stem-cell therapy has become popular among some people wishing to improve their health as a single cell has the ability to naturally replicate or re-grow damaged cells in the body.
In Indonesia, the Stem Cell and Cancer Institute ( SCI ), established in Jakarta by medicine producer Kalbe Farma in 2006, is currently conducting thorough research into stem-cell therapies, including cell therapy for regenerative medicine and anti-aging treatments, as well as genetically modified stem cells for cancer treatment.
SCI director Sandy Qlintang said the team would start its pre-clinical trial for allogeneic stem cells for treatment of osteoarthritis sometime this year.
There are three types of stem cells: autologous ' stem cells that come from the patient's own body; allogeneic ' stem cells that come from another person; and xenogeneic ' stem cells that come from animals, which has been banned around the world.
Sandy said he and his team would start testing their stem cells on animals during the pre-clinical assessment using good laboratory practice ( GLP ) standards, a step toward having the product approved for entry into the international market.
'Pre-clinical trials can take around two years, while clinical testing ' where the cell will be tested on humans ' can take around five to six years as it must go through several phases to measure the safety and the effective dosage,' he said.
'We're targeting to launch it in 2022 or 2023.'
Sandy said that once it had been tested ( and proven ) safe for use, the stem cells would be put in a vial and frozen in liquid nitrogen. They would then be unfrozen right before being injected into a patient.
Meanwhile, on research on stem-cell therapy for treating cancer, Sandy said that his team was still in the 'proof of concept' stage, aiming to verify its real effectiveness.
Apart from SCI, the University of Indonesia ( UI ) School of Medicine has also been conducting extensive research on stem cells since 2009. In some research activities, they have worked together with SCI.
Ratna Sitompul, the school's dean, said they were applying stem-cell therapy to around 50 patients in Cipto Mangunkusumo Hospital ( RSCM ).
'The stem-cell therapy that we apply to patients is still limited to a research service. And not all diseases can be treated using stem cells,' she said.
For example, Ratna said, they had used the therapy for a patient suffering from a spinal disorder and managed to record a relatively fast recovery period.
Other illnesses that can be treated by stem-cell therapy include diabetes, osteoarthritis, heart disease, Parkinson's disease, cerebral palsy, epilepsy, asthma and lung disease.
Ratna said that at RSCM, they still practiced autologous stem-cell therapy with cells from the patient's peripheral blood, as they were easier to get samples of compared to bone marrow stem cells. Brain tissue, skeletal muscle cells, heart cells and fat tissue are among several other potential sources of stem cells.
She said that despite the benefits, stem cell therapy was categorized as an expensive treatment. 'To isolate the stem cell and inject it into patients requires sophisticated equipment and skillful human resources. If we don't go through the process carefully, it may be harmful,' she said.
According to Regulation No. 32/2014 issued by the Health Ministry, there are 11 hospitals that are authorized to offer stem cell therapy.
They are Sanglah Hospital in Bali, Hasan Sadikin Hospital in Bandung, Fatmawati Hospital, Jantung Harapan Kita Hospital, Kanker Dharmais Hospital and Persahabatan Hospital in Jakarta, Dr. Sardjito Hospital in Yogyakarta, Dr. M. Djamil Hospital in Padang, West Sumatra, and Dr. Kariadi Hospital in Semarang. RSCM and Soetomo Hospital in Surabaya are designated 'supervisory' hospitals for stem-cell treatment.
Sandy said patients should be cautious if offered stem-cell therapy from hospitals not on the authorized list. 'Patients should also ask about the sources of the stem cells, especially if they offer allogeneic stem-cell therapy, in order to avoid malpractice. They should also ask about the cell's characteristics and the total dosage they will be given.'