By Surapol Issaragrisil, M.D., F.R.C.P, F.A.C.P., F.R.C.P.A., F.R.C.Path and Pakpoom Kheolamai, M.D., Ph.D.

Advances in stem cell biology have led to the hope that stem cells can be used for the treatment of degenerative disorders. However, pluripotent stem cells, both human embryonic stem cells and induced pluripotent stem cells, are being investigated and no clinical trials using pluripotent stem cells have been reported. Adult stem cells, especially hematopoietic stem cells, have been used for transplant in various hematological disorders for many years. At present, there are several clinical trials using adult stem cells to treat several diseases other than hematological disorders, including heart diseases, neurological disorders and diabetes mellitus. Although there are many claims that stem cells of one tissue can transdifferentiate to become cells of any other tissues into which they are transplanted, there is no scientific basis to date to support such transdifferentiation. However, adult stem cell therapy is being practiced in several private and governmental hospitals. In Thailand, attempts to control inappropriate use of stem cell therapy are being made. The Thai Medical Council first announced a regulation for stem cell therapy on November 23, 2009. The regulation does not apply to hematopoietic stem cell transplantation, a well-established therapy for hematological disorders. Physicians must submit evidence for approval if they wish a stem cell therapy to be considered a standard procedure. All clinical research involving stem cell therapy must be approved by the Thai Medical Council. This regulation is a big step in promoting the appropriate application of stem cells for therapeutic use.