A few days ago I was watching ESPN before the Miami Heat game started. I heard a disturbing story concerning one of my favorite sports. This story concerned a lawsuit filed by two thousand former NFL players against the NFL. In the suit the players stated that the NFL intentionally hid the the effects and dangers of concussions on the players. The NFL obviously denied the claim. One can see both sides of the argument. I do not intend to take sides or do finger pointing but wish to give a possible solution to the problem. There are s 1800 pounds of force in a head on collision. Do I think football is a violent sport ? Yes I do; I happened to break my leg twice playing it. Football is the reigning king of sports in America. I am not sure if a much safer way can be found to play football. If the rules are changed dramatically we will get a game much like the pro bowl. The pro bowl is constantly a ratings disaster neither players nor fans like it. Yet very few injuries occur in the pro bowl because the rules and mine set are different. The injuries we see in football are usually less severe than we our seeing in the battlefield in Afghanistan. The NFL is actively looking for methods to mitigate the effects of head injuries as are the United States military forces. Right now the US military seems way ahead in their research in treating head injuries.
You might ask yourself what does this have to do with stem cells? Well the answer is plenty. When a player or solider suffers a head injury cells in the brain area are injured or outright destroyed. Until the last few years there was very little that could be done for these injuries. One of the reasons for this is that it is difficult for medicines to cross the blood- brain barrier. This is a natural protection device that the body employes to prevent damage to vital brain tissue. Stem cells have no problem crossing this barrier. The problem is that is that there are not enough of them to repair the injuries. This is where stem cell science comes into play.
The treatment of concussions with stem cell therapy will occur on two fronts. First we would probably give a large bolus of intra venous stem cells ( most likely harvested from either fat or bone marrow) some of which would cross the blood brain barrier ( many of them would be caught in lung tissue). Secondly, large numbers of hematopoeitic stem cells would need to be stimulated and released by the bone marrow. This stimulation can occur by using various compounds that are known to significantly increase marrow stem cell output. This could be accomplished by using some of the oral cytokines (growth factors) we are now starting to use. Supplements will certainly be important. Another important agent is GCSF (granulocyte colony stimulating factor). GCSF is used many times to speed recovery after patients receive chemotherapy. It will dramatically increase stem cell output. My friend and colleague Dr. Maharaj has been using GCSF to treat a variety of neurological conditions including Parkinson’s disease with good results. There is no reason to believe this would not work with concussions.
In addition to treating players with medicines, growth factors, and supplements that increase stem cell bone marrow output we can make use of some other modalities which also increase stem cell output. One such modality is hyperbaric oxygen. Another modality is Photonic laser therapy as is being developed by Immuno-Genic Corporation and IMI Healing Technologies. What these therapeutic measures have in common is that they will increase Nitric Oxide production. Nitric Oxide is a very potent stimulator of bone marrow stem cell output. Remember many of these injuries are a numbers game so if we increase the number of stem cells the greater the chance of repair. The US military is currently working on these techniques. There is no reason why the NFL can not adopt these techniques. Quite simply when a player suffers a concussion, treatment should be started the next day and continued for a few weeks. It is quite likely that the player could be taken off injury list after a week or two while still continuing treatment. Further treatment could be given a the end of the season. Hopefully, this may be a pathway for a very difficult problem.
Thanks Dr.P
