In December 2017, we were in Ethiopia and were conducting an OPD and Surgical camp. A patient whose name is Robert met us. He was suffering from muscular dystrophy. He was in his 40’s. He was a good businessman with dreams of expanding his business both vertically and horizontally.
However, he was worried about his deteriorating muscle strength and reached the point where he was not able to hold a pen in his hand. A man with a sharp mind and kind heart was having a serious realization that he is going to become a liability for his family and organization.
One of the renowned neurosurgeons who was traveling with us for the camp consulted Robert and informed him that nothing substantial can be done.
Businessmen came in the camp with tons of hope from us but were returning with shaken confidence and utter helplessness. While describing his experience of consultation, he was having fewer words and more tears which were coming uncontrollably. He requested us to do anything and everything possible in the medical sciences for his deteriorating health.
This Pushed MedicoExperts to look for alternative treatments and therapies for Muscular dystrophy. Our research suggested that Stem cell therapy can give results, but the small world of stem cell researchers and practitioners is very confusing as many of the patients are seeing the results but at the same time few could see partial results, and more worrisome few were deprived of seeing any results.
The challenge was to decode this mystery and how to ensure sustained and predictable results. We decided to have a thorough deep dive into the subject and met researchers, practitioners of stem cell therapy in five countries. We also met patients who have taken the therapy to understand their approach and more importantly results, which were obviously positive, okay-ok types, and no results.
We correlated the practitioner’s perspective and approach with the patient’s expectations and results and started guiding Robert for the treatment.
Today, Robert is back in action and has already expanded his business by 50% since when we first met. He is happily living with his family full of confidence and dreams for himself and his family. He walks normally and is able to do all his normal activities.
He also knows that he will be required to repeat the therapy in 7 to 10 years.
Before we move further, let’s first understand what muscular dystrophy is.
Muscular dystrophy (MD) is a neuromuscular disorder that constantly damages healthy muscles making them weak and wasted. A disease is a form of congenital abnormality due to the wrong expression of faulty genes. Muscles and membranes need many different proteins to be strong and function properly and these proteins are supplied to our body from the food we eat but some of them are synthesized by our own body such as Dystrophin.
This information regarding the production as well as the amount of protein is being passed on, by our own genetic makeup. Due to gene mutation, wrong information is passed from one generation to another generation due to which these important proteins are not produced or produced in very low quantities. Without these proteins, muscles lose their structural and functional integrity slowly which may affect the overall normal functioning of the body.
Types of Muscular Dystrophy
Depending upon the impaired gene, the site where the gene is located, and the progression of symptoms muscular dystrophies are divided into various types. Major forms of Muscular Dystrophy:
- Duchenne Muscular Dystrophy: This is the most common form of muscular dystrophy which affects boys. The symptoms are usually observed during 2-3 years of age. The child becomes wheelchair-bound at the age of 12 years and dies of respiratory failure by his early 20’s. This involves the weakness of major involuntary muscles such as the heart, lungs, etc.
- Emery Dreifuss Muscular Dystrophy: This is a very rare form of MD, typically observed in late childhood to early teens. Symptoms are the same such as wasting of muscles, weakness, joint deformities with slow progression. In severe cases, sudden death may occur due to cardiac arrest.
- Limb-girdle Muscular Dystrophy: This is a type of muscular dystrophy, that affects both boys and girls, usually occurring in late childhood to middle age. The symptoms include muscle atrophy in shoulders, upper arms, around the thighs and the hips
- Myotonic Muscular Dystrophy: This is a type of Muscular Dystrophy, in which muscle relaxation can cause a problem occurring especially in teens. Some other problems such as muscle weakness, wasting, cataracts, and heart problems are commonly observed.
- Facioscapulohumeral Muscular Dystrophy: This type of Muscular Dystrophy occurs in both men and women but is predominant in men. The symptoms may include sleeping with their eyes slightly open, an inability to squeeze their eyes tightly, and an inability to bring their lips together.
What causes Muscular Dystrophy
Due to genetic defects, the proteins that are formed by the genes are either absent or less functional. The group of proteins that are affected in different muscular dystrophies is called Dystrophin Sarcoglycan Complex (DGC). DGC is important to maintain the structure of the cell wall of the muscle cell called Myocyte.
Muscle degeneration occurs due to the bad structure of the cell wall of the myocyte (muscle cell) even with day-to-day muscle activity.
This uncontrolled degeneration leads to rapid muscle death and weakness which ultimately leads to muscular dystrophy. Uncontrolled muscle death is the primary cause of muscle weakness. Due to continuous muscle degeneration, there is a chronic inflammation that damages muscles even more.
Along with muscles of the body, the muscles of cell walls are also affected which affects the blood supply to the muscles causing more damage. As DCG is also present in various non-muscular tissue like nerves, kidneys, spleen, and Schwann cells so muscular dystrophies may also show some neurological symptoms.
Symptoms of muscular dystrophy
Muscular Dystrophy cannot be diagnosed early in its progression since some people have the normal pattern of development during the first few years of their life.
Slowly and gradually they start facing problems such as climbing stairs, walking on their toes, getting up from the sitting position, etc.
Mostly a child with MD often develops enlarged calf muscles due to fat replacements.
Some of the important muscular dystrophy symptoms are:
Conventional Treatments for Muscular Dystrophy
Prior to the use and development of stem cell therapy, the conventional treatment approaches for muscular dystrophy were aimed at providing mobility and aid in strengthening the muscles of the heart and lungs.
The previously available treatment options included physical therapy, occupational therapy, medication, and surgery. Depending on the extent of difficulty faced by the patient, treatment plans are made to help manage the trouble in swallowing, breathing, walking, and hand movements and also to slow the deterioration of muscle tissues.
The doctor may prescribe certain medications to help with the condition.
Through medication, the doctor aims to delay the progression of the condition and also strengthen the muscles.
In cases where there is probable heart damage, heart medication is also recommended.
Low-impact workouts like stretching, walking, etc. will help maintain muscle movement and improve overall health.
Under the careful supervision and guidance of a doctor, the patient can also do some exercises to retain range-of-motion of the muscles which otherwise is affected by muscular dystrophy.
These exercises will help in keeping the muscles and joints flexible.
Several types of therapy and assistive devices can improve the quality and sometimes the length of life in people who have muscular dystrophy.
Braces and mobility aid will help provide support to the weak muscles and also provide self-dependency.
The braces will also help in keeping the muscles and tendons flexible and stretched, thereby reducing contracture progression.
Surgery may be required to correct the spinal curvature or contractures which could lead to trouble in breathing.
In cases where the heart function may be affected, surgery to implant a pacemaker or other cardiac devices is done.
Advanced Treatment Options for Muscular Dystrophy in India
Recent research has proven that stem cells have the potential to regenerate and repair damaged muscle cells. Stem cell therapy is one of the effective treatments for MD as it provides cells that can both deliver functional muscle proteins and replenish the stem pool. Transplanted cells have myogenic potential i.e. the cells can divide into a mature myocyte and then can repair and regenerate muscle fibers. Pre-clinical evidence ensures that stem cell therapy can restore dystrophin protein which leads to the formation of muscle fibers that are resistant to easy damage and degeneration.
Stem cells are known to have a tangible approach in the treatment of MD. These cells by their natural property can regenerate affected muscles by inducing myogenesis and provide a decent symptomatic relief. As the expected deterioration of patients of MD is about 20% every year, an improvement in the percentage of deterioration after Stem Cell therapy is proven and observed by most doctors. Stem cell therapy can halt the growth of the disease which can prevent further complications of the disorder.
To know more about stem cell therapy.
HBOT mobilizes human bone marrow stem cells that can assist in muscle cell regeneration. Based on these results, it is recommended that HBOT in patients with MD improves symptoms and facilitates the functions of stem cells.
It is used as an alternative therapy to improve the intake and oxygen use of the body and to activate the immune system. Ozone therapy is one of the most potent ways to flood your body with additional oxygen drastically and quickly.
Not only does ozone itself have incredible healing capabilities but this fact has also been well documented for centuries. Combined with stem cell therapy, ozone therapy yields successful outcomes
The stem cell researchers and practitioners are able to enhance the results by clubbing the stem cell therapy with HBOT or/and Ozone therapy. The right combination can only be determined after a thorough examination of the patient.
Moreover, Stem cell therapy together with advanced hyperbaric oxygen therapy (HBOT) technology has turned into the highest possible blend of benefited muscular dystrophy treatment.
Procedure for stem cell therapy for Muscular dystrophy
Stem cell therapy is a simple and completely safe procedure that requires only injections and no surgery is involved. In Stem cell procedure, Adult stem cells are taken from the bone marrow of the patient and injected back into the patient after processing them in a specialized stem cell laboratory.
The procedure involves 3 steps.
Step1: Bone Marrow Aspiration:
In this process, a needle is inserted into the hip bone to extract the bone marrow. This is done under local anesthesia so that the patient does not experience pain.
Step 2: Stem Cell Separation:
The bone marrow which is taken in step 1 from the patient is sent to the Stem cell laboratory, where the stem cells are separated from the remaining cells of the bone marrow by the density gradient method.
Step 3: Stem Cell Injection:
A lumbar puncture is done using a very thin needle through the L4-L5 space of the spine, after giving local anesthetic and the stem cells are injected into the cerebrospinal fluid.
Prerequisites for Muscular dystrophy treatment
Minimum age: 2 years onwards
Hemoglobin: 10 gms onwards
What are the expected outcomes of stem cell therapy for Muscular dystrophy in India?
It has been found that 90% of individuals with Muscular dystrophy have shown clinical improvements and outcomes in the following areas:
Cost of Muscular Dystrophy Treatment in India
India is one of the most cost-effective and result-oriented destinations to choose to undergo stem cell therapy. With the availability of state-of-the-art hospitals, the best stem cell experts, and excellent infrastructure which is at par with international standards, you also get affordability and trustworthiness. The stem cell therapy for muscular dystrophy treatment in India is based on the patient’s requirements and medical condition.
The cost of stem cell therapy in India starts from USD 2000 per cycle, depending on the patient’s current condition, treating doctor, and suggested treatment protocol. A stay of 12-15 days in the country is required for the entire treatment, and in some cases, the stay may be extended to 45 days as well.
Depending on the protocol of the chosen specialist stem cell therapy will be clubbed with the latest and advanced therapies like ozone therapy HBOT, stimulations, and many more for better results. The cost of Hyperbaric Oxygen Therapy (HBOT) ranges between 50 – 90 USD per session. Each session lasts for about 60-90 minutes for 25-30 days, every day.
Successful stem cell treatment for muscular dystrophy aims to restore and slow down muscle wasting which occurs in muscular dystrophy. Our research and years of successful treatment of muscular dystrophy in India have resulted in patients showing significant improvement.
Over 90% of patients with muscular dystrophy have shown improvement in muscle strength, mobility, improved hand function, increase in stamina, and also improved balance and limb strength.
Our patients have exhibited notable improvements in multiple ways that demonstrate the advantages of cell therapy in India for muscular dystrophy.
The strength and tone of the muscles improve after stem cell therapy as a result of new muscle fibers which consequently help reduce symptoms and improve the condition.
Frequently Asked Questions and patient concerns:
1. What is Muscular Dystrophy?
Muscular dystrophy (MD) is an umbrella term for more than 30 genetic diseases that cause progressive weakness and degeneration of the muscles used in the movement.
2. When does a doctor suspect Duchenne Dystrophy (DMD)?
DMD is suspected when children present with walking difficulties usually around the age of 2 or 3 years.
3. Is Muscular Dystrophy always inherited?
Although most muscular dystrophy is genetic, about one-third of the families of DMD patients have no prior history of the disease. This is because DMD may occur as a result of a spontaneous genetic mutation.
4. Is Muscular Dystrophy only development in infancy?
Babies, teens, or adults can face muscular problems at any phase of their development as this is caused due to muscular weakness. About 1 in every 3,500 boys worldwide is born with the most common form of the disease, Duchenne Muscular Dystrophy (DMD)
5. Do all forms of Muscular Dystrophy begin in childhood?
Some forms of Muscular Dystrophy appear in infancy or childhood, while others may not appear until middle age or later. Each of the dystrophies causes progressive skeletal muscle deterioration and weakness, but the severity and life expectancy vary.
6. Why does Duchenne Muscular Dystrophy (DMD) affect mostly boys?
Duchenne muscular dystrophy (DMD) is caused by a mutation on the X or male sex chromosome, so it mostly affects boys. However, girls and women who carry the defective gene may show some milder symptoms.
7. Can Duchenne Muscular Dystrophy (DMD) be prevented?
Duchenne muscular dystrophy (DMD) is a genetic disorder. There are no tests to detect DMD in a child before birth. However, genetic counseling helps in the identification of at-risk families.
8. What is the efficacy and longevity of the stem cell treatment for Muscular Dystrophy?
Muscular Dystrophy is a neuromuscular disorder that constantly damages healthy muscles making them weak and wasted. The stem cell therapy and subsequent physiotherapy will be able to provide strength to the muscle and you would soon start living a normal life within a few months.
However, due to the nature of the disease, there is a high probability that you will start losing muscle strength once again after a few years of treatment. This recurrence may happen from 5 to 10 years. In such a case you may need to repeat the therapy.