Submitted by KaishiXYZ t3_zzlxv8 in explainlikeimfive
Comments
TheSaltySeagull1987 t1_j2cyi10 wrote
Isn't it more a case of funding (bang for buck) and necessity? Vaccines for COVID-19 were developed at light speed (really big bang) compared to the usual time it takes.
Rahf t1_j2d6v85 wrote
A lot of research springs out of discovery from individual scientists, or small teams. These can then form a company in order to keep developing this drug or treatment, but will need to acquire funds and then drive the clinical pipeline with at least three major clinical trials.
Most so-called candidates you find in active clinical trials are always presenting themselves as a more effective way to treat a certain illness, or a completely new treatment for an illness that doesn't have effective cures or management therapies at this moment--there are many.
Each clinical trial can by itself take months or years to complete. That's not counting the preparatory work before as well as the complementary work after they finish. And this is assuming the company or group of people involved are constantly able to raise millions upon millions of dollars in capital to pay for this.
The big pharmaceutical companies draw benefit from their financial muscle, administrative power, and absolute knowledge on regulatory demands. So their pipelines are more streamlined, yet still take years upon years.
The Covid vaccines were extraordinary circumstances. They are not good examples of the timelines involved, because nearly every resource available was availed to that research and approval. Which meant everything else that was next in line got bumped down or to the side, and thus delayed.
Why does it take all this time? Because we have placed high demands on treatment being safe and effective, or at least not immediately dangerous to the patient.
DMRexy t1_j2dgzkl wrote
People underestimate how much the research for COVID vaccines was streamlined. It didn't skip steps, but every step could happen immediately as soon as the previous was done. No waiting around for funding, no trying to convince anyone that it's a worthwhile project, no being sidelined because something else was more profitable. Just GO GO GO. Thousands and thousands of researchers worldwide with a singular focus.
It was pretty cool to see.
FenderMoon t1_j2dj4u7 wrote
Makes me wish we could have that sense of urgency about things more often. Usually we get so wound up with red tape that we drag things out for years before they ever even see the light of day.
DMRexy t1_j2dpxzv wrote
While I see where you're coming from, I kind of hope we never need that sense of urgency again haha
hsvsunshyn t1_j2e4lq6 wrote
Less red tape would be good, but there are still a lot of people who remember things like thalidomide. For regular things, the need for the process is critical. Often, research, funding, or various stages of trials and other testing is delayed because the benefits or results of previous stages/documentation did not clearly show what the approvers needed to see, or the information provided was suspect.
Note that some cases, such as approval for off-label uses for medicines that are already proven safe, work their way through the process much faster, since the main question is the efficacy; the question about safety was previously answered in earlier work/approvals.
For the COVID vaccines, saying that it was "streamlined" almost does not do it justice. If a step was completed at 8:00 PM on a Friday for anything else, the next step would not start until Monday at the earliest. For COVID, the people involved in the next step would be at the office at 7:30 PM, waiting for the previous step to be complete, and they would be prepared to work overnight, then hand off to the next step at 6:00 AM Saturday morning, and so on.
It is an unsustainable pace overall, but it worked for that single need.
TheSaltySeagull1987 t1_j2d8gj2 wrote
Thanks for your thorough answer. Puts things into perspective. 👍
Tounsk t1_j2d0lmu wrote
I can answer for PD but other neurodegenerative diseases are similar.
Unfortunately, for Parkinson's disease, stem cell treatments have not been very successful so far. Part of the reason is that the abnormal protein (alpha-synuclein) which causes the degeneration of neurons continues to spread, even in the grafted stem cells. In other words, we are not addressing the underlying reason for the degeneration.
Also, stem cells are meant to replace neurons in areas of the brain responsible for movement. We already have fairly good treatments for those symptoms (including levodopa). Parkinson's gets more challenging to treat when it starts to affect other parts of the brain and causes "non-motor symptoms". Stem cells would not help with those symptoms.
There are other adverse effects of stem cells like dyskinesia and the theoretical risk of cancer, etc.
It's still an area of active research so there is still hope. It may be an adjunct treatment to disease-modifying treatments in the future.
​
TL;DR: stem cells replace neurons but don't fix the underlying problem that causes the death of neurons
Says_Yer_Maw t1_j2doy7i wrote
Is there a similar treatment for restoration/replacement of neurons affected by MS (if we assumed that the progress of the MS could be halted)?
druppolo t1_j2dr23i wrote
Can you explain the cancer part? I recall that’s why it is way easier to use them on animals as the cancer risk is “less of a problem”.
I’m pretty curious, if you have the time, I thank you a lot.
[deleted] t1_j2citl3 wrote
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[deleted] t1_j2cnkrc wrote
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PD_31 t1_j2eh21s wrote
Treatments are more profitable than cures and there are a lot of companies earning a lot of money with people paying for life-long treatment instead of a one-time cure.
Iamwillingtolearn t1_j2ehwe5 wrote
Stem cell research is still a touchy ethical discussion. Regardless of the benefits and what one might believe, there is a lot of nuance to the discussion that can’t be simply reduced by common Reddit arguments for either side.
Further, in the United States at least, medical treatments have to undergo STRICT trials and testing, the most common process comes in 4 stages. Often times, it will take up to a decade or so before a treatment even hits the market. While it’s easy to laugh at the US and our medical system, we take what we put out very seriously.
[deleted] t1_j2e1qf9 wrote
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mrPandabot35 t1_j2ce5sj wrote
The ethics of harvesting the cells has been a pretty big issue. Someone started saying they come from aborted babies and that dude went with it. Stem cells could literally be harvested from the placenta and umbilical, some not so good cells from adults too. Here’s another thing: healthy people is not good for business in the pharmaceutical world. If you use something that’s too effective you won’t need to buy more of the less effective stuff.
Moskau50 t1_j2cgtu6 wrote
>healthy people is not good for business in the pharmaceutical world. If you use something that’s too effective you won’t need to buy more of the less effective stuff.
Speaking cynically, "healthy" people don't exist. The longer someone lives the more illnesses and medical issues they will have. A long-lived person is a long-term patient; being the person/company to cure a degenerative/"incurable" disease is a huge windfall in both money (at that point, you can name your price) and prestige. No company would sit on that information.
Speaking more rationally, it's not like curing these diseases would be a simple measure anyway. Even treating "normal" diseases is a massive effort. The amount of raw effort, resources, money, and capital investment needed to produce normal treatments isn't something to be casually dismissed. Pharma companies would be happy to "retire" a medication in exchange for a huge windfall payment from the cures in order to make room for other medications/processes that are in the pipeline.
mrPandabot35 t1_j2chwar wrote
Of course, people will eventually become I’ll with something, but what I’m thinking is that things like Crohn’s or some kind of organ/nerve damage could be better handled potentially decreasing the number of hospital visits, medication needs, and the domino effect that follows. Time lost from those visits decreasing quality of life. Meds taking their toll on the liver. Just because we can’t “fix” everything, we should do more than treat symptoms.
Moskau50 t1_j2cj5b8 wrote
If you have an idea for how to cure those diseases, I'm sure there are plenty of companies that would love to hear it.
Just saying "we should focus on this" isn't useful; current production capacity is already pretty fully utilized for current standard-of-care treatments or clinical next-generation treatments. If a cure is found, then sure, there are companies that would be willing to sideline some of their current treatments in order to make this cure. But the data supporting it needs to be good, because otherwise, you're depriving other people of their current treatments.
alexja21 t1_j2cg6n5 wrote
> Here’s another thing: healthy people is not good for business in the pharmaceutical world. If you use something that’s too effective you won’t need to buy more of the less effective stuff.
Yeah that's why my dentist tells me to keep drinking lots of soda and my optometrist recommends sitting really close to the computer screen in a dark room all day.
You nutter.
mrPandabot35 t1_j2cgm42 wrote
You’re one of those people, huh? Completely ignore the context of the “conversation” to prove something that wasn’t brought up.
barbsam t1_j2czfc9 wrote
the entire field is shifting from embryonic stem cells to induced stem cells that come from any tissue of a patient (liver, skin, you choose). feel free to google to know more. there's also alot of research going into the direction of reprogramming cells, which is the baby step towards what OP was mentioning. Still a long way to go.
also. stop with the healthy people bad pharma agenda. It's not a real thing. I understand where it comes from and there are certainly if not mostly capitalist pricks on the top of some pharma companies. Pharma is not one big conspiracy. If they all make money off sick people that never get healthy, well then just take 2 mins to think what happens if one of them finds a cure to a disease, they make a shitton of money while all the competitors therapies will be obsolete. Yes, pharma is about profitability, but thats not a pharma problem, its a system problem.
bankymoon420 t1_j2ctp8e wrote
All very true, I believe the stem cells that are effective are harvested from your own body fat. Stem cells from other sources cause cancerous growths and are no good.
captain_joe6 t1_j2cj5wr wrote
We are, but medical development takes a loooooooooong time.
Some of the treatments just now being approved and hitting market, in 2022, began human trials in the mid 2010’s, which means that base research probably started a few years before that.