Millions of Europeans are affected by stress urinary incontinence (SUI) which can have a devastating effect on quality of life. Between 20% and 50% of women are affected by the condition, which can result from damage to bladder-closing muscles during childbirth, men too can suffer from SUI, particularly those who have undergone surgery for prostate cancer

Once muscle fibers in the bladder's sphincter have been damaged, the muscle may not recover the strength and flexibility needed to close the bladder. Current treatments offer some short-term relief to the symptoms of SUI, but there is no effective cure.

Now, researchers are trying a new kind of therapy that aims to fix the sphincter by implanting stem cells taken from the patients' leg muscles. Before injecting them into the sphincter, millions of these cells must be produced in the lab.

"We take a biopsy from a leg muscle that is not used very often," explains Dr. Deana Mohr, University Hospital Zurich and the University of Zurich, Switzerland. "Stem cells are then isolated and expanded before being injected into the patient's bladder sphincter."

Severe

The study initially focuses on patients with mild SUI but could eventually be used in people with severe forms of the condition. "Patients with more severe diseases or who have undergone surgery may have suffered serious damage to their muscle," said Dr. Mohr. "They would need a larger volume of new tissue, so we want to show the effectiveness of treating milder cases first before moving to patients with severe SUI."

"The stem cells are stimulated by electromagnetic pulses and start rebuilding the sphincter muscle," said Dr. Mohr. "They identify areas where muscle fibers are missing or damaged and begin to fuse into muscle fibers where they are needed."

Each patient is treated with their cells, making the process quite time-consuming. The cells are developed in a special laboratory that meets strict standards and can take three to four weeks for each patient.

Pace

Using a patient's cells as a therapy reduces the risk that implanted tissue would be rejected. However, the slow pace of producing these personalized therapies is currently a major technical challenge.

Researchers on a project called SCIENCE are testing whether donated stem cells from adipose tissue in the abdomen could be used to reverse heart disease. These cells have the potential to form new blood vessels and heart muscle. While it takes several weeks to grow enough cells to implant in each patient, these donor stem cell lines are a promising new source of replacement heart tissue.

Initial

An initial study of 60 patients with coronary artery disease and heart failure has shown improved cardiac pump function and improved quality of life after stem cell therapy. These patients' hearts are now pumping more efficiently, resulting in fewer hospitalizations.

While the current larger trial is still ongoing, the team hopes to apply to the European Medicines Agency for a license to market the therapy through a spin-off company—Cell2Cure ApS. The consortium already has a patent on their technology but will need data on successfully treated patients if they are to convince regulators to approve it.

If the heart failure therapy proves successful, it could be adapted for patients with other serious conditions. "Potentially, the same stem cell lines that we have produced could be tested in arthritis, disc degeneration in the back, Crohn's disease and multiple sclerosis," said Prof. Kastrup. "It may also help reduce the rejection of organ transplantation."