How to protect athletes and let them play | Written by Jan Shultis
Baseball is known as “America’s Game,” but other athletic events certainly vie for top place in popular imagination of American culture, including American football, Ultimate Fighting Championship (UFC), and entertainment-based enterprises like World Wrestling Entertainment (WWE). From a healthcare perspective, these pursuits have things in common – like people getting hurt, a lot, especially through concussive trauma and other head, skeletal, and nervous system injuries. Whatever that says about culture, human nature, or anthropological sustainability, we leave to others to exposit. The bottom line remains that demand for these pursuits is not lessening, nor is thirst for other industries with inherently high risk of head injury, such as racing in the National Associate for Stock Car Auto Racing (NASCAR). It seems time for American society to realistically assess the landscape, acknowledge the social and fiscal cost of head injury, and develop sustainable solutions.
The state of California is making headlines this month for their draft solution - proposed legislation to ban tackle football for children.[1] Proponents of the bill cite concern for the brain health of young athletes, including some research that links childhood contact sports with later development of degenerative neurological diseases. Data shows that sports and similar recreational activities contribute to approximately 21 percent of all traumatic brain injuries among American children; of these, nearly half are sustained during bicycling, skateboarding, or skating incidents.[2] There is little explanation of the choice to focus on football, however. Even if the scope is kept narrowed to youth contact sports, to cite a single data point among many, a recent study of concussive incidence among youth in contact sports comparing rugby, ice hockey and American Football, found the highest concussion incidence density in rugby, and the lowest in football. [3] Opponents bring up political and legal considerations related to the rights of families to choose what is best for their children, including in the sports they play.
TBI is typically described in terms of severity. Though clinically distinct from sport-related concussion (SRC), mild TBI (mTBI) is often used as a synonym in popular conversation.[4]
While more and longer-term research is needed in SRC, individuals who incur mTBI, especially repeated injuries, are believed to have a higher rate of later developing degenerative brain diseases such as Alzheimer’s Disease, Parkinson's Disease, and amyotrophic lateral sclerosis (ALS), among others.[5] Potential long-term health ramifications catapult the connected costs of brain injury even higher and making the cost of brain injury very much a communal one.
Whether we as citizens gravitate toward sports or prefer other pursuits, it is a simple truth that the fiscal and social impact of nearly quarter million Americans hospitalized for TBI each year impacts us all, including but certainly not limited to injured athletes. However one feels about California’s draft legislation, if passed the bill would do little to solve our nation’s communal issue – according to the Centers for Disease Control, adults age 75 and older are the American population most likely to incur brain injury as a consequence of falls. Car accidents high on the list of TBI-causing incidents for Americans of any age.[6] Better understanding of sources of TBI emphasizes the importance of comprehensive conversation around accessibility to therapeutics with potential to dramatically reduce the impact of brain injuries on individuals, families, communities, and our healthcare system.
Medicine will look different soon, which means there is hope those numbers will dramatically change. Cellular based regenerative therapies in particular are being heavily invested in and studied for their potential to heal degenerating and injured brains. Less often touted, however, are the neuroprotective capabilities of stem cells. It is entirely possible that research will soon demonstrate cells administered prior to injury to be just as, or even more, beneficial to brain recovery than cells administered post-injury.
Texas-based biopharmaceutical company Hope Biosciences, believes cell therapy is the future of healthcare. We envision a national culture of wellness that provides for administration of cells as both a regular part of preventative medicine, and in case of injury or development of disease. Specific to head injuries incurred in sports, Hope Bio has a solution – encourage athletes to bank their stem cells as a regular part of preparing for the athletic season, just as states already do with immunizations and health check-ups for school age athletes prior to their participation in school and community sports.
Hope Biosciences uses proprietary technology to culture and expand mesenchymal stem cells, a type of adult stem cell found in many tissues in the body and in the placenta of newborns, to unprecedented volume and levels of viability. Hope Bio cultures fresh treatments on demand for patient use. In 2023, Hope Bio manufactured treatments for FDA-authorized use in more than a dozen disease and injury conditions,[7] including numerous conditions that may affect athletes in contact sports now and in the future, such as traumatic brain injury (TBI), neurodegenerative diseases, spinal cord injury, arthritis, and chronic pain. In other words, Hope Bio already does exactly what this bill says it wants to do – safeguard future health.
Hope Bio is far from the only entity to believe the solution to healing from brain injury lies with banked stem cells – the federal government believes in its value, too. In June 2023, a four-year, nearly $5 million clinical trial grant awarded was awarded to UTHealth Houston by the Department of Defense’s Office of Congressionally Directed Medical Research Programs (CDMRP) to evaluate if intravenously infused Hope Biosciences adipose-derived mesenchymal stem cells (HB-adMSCs) reduce chronic neuroinflammatory response to severe traumatic brain injury. Additional media outlets quickly picked up the story, such as Defense Post’s “US DoD Funds Stem Cell Research for Severe Traumatic Brain Injury.” The federally sponsored trial is scheduled to begin enrollment early in 2024 at UTHealth Houston and San Antonio.
According to grant reviewers, the DoD award is based on solid safety and treatment results from an earlier Phase I study on traumatic brain injury conducted by Hope Biosciences at UTHealth Houston. Preliminary results from that 24-patient study (NCT04063215) were presented in May during the Cellular Therapies and Transfusion Medicine in Trauma and Critical Care (CTTACC) 2023 Conference in Scottsdale, Arizona. In that trial, repeated intravenous administration of HB-adMSCs demonstrated that Hope Biosciences’ cells are safe and potentially reduce chronic neuroinflammation.
While results of the TBI trials currently underway will be some time in forthcoming, several peer-reviewed manuscripts published in the last year detail the effects of HB-adMSCs in neurodegenerative conditions and other health concerns that may include athletes in contact sports, including:
· Functional recovery of a 41-year-old quadriplegic spinal cord injury patient following multiple intravenous infusions of autologous adipose-derived mesenchymal stem cells: a case report (Frontiers in Transplantation, Dec 2023)
· Multi-Dose Hope Biosciences-Adipose-Derived Mesenchymal Stem Cell (HB-adMSC) Therapy for a Patient with Cerebral Palsy: A Case Report (International Journal of Stem Cell Research & Therapy, Oct 2023)
· Long-term, repeated doses of intravenous autologous mesenchymal stem cells for a patient with Parkinson's disease: a case report (Frontiers in Neurology, Sept 2023)
Under U.S. law, it is every athlete’s right to decide whether to play, take preventative healthcare measures that safeguard their health, and pursue their sport of choice, with other individuals who also willingly agree to engage in that activity. Concerns about injury are valid, but pretending there are no solutions other than legislation that restricts participation in certain sports, is not. Hope Biosciences has a solution – bank your stem cells at Hope, with hope, in case of future injury or disease, and continue pursuing research that fully plumbs the potential of stem cells to support our healthiest brains.
About Hope Biosciences
Hope Biosciences is a biopharmaceutical company developing adult stem cell therapeutics for a variety of clinical indications, and the only clinical grade adult stem cell banking facility in the nation serving both adults and newborns. Hope Biosciences occupies a unique position in the regenerative medicine space, noteworthy both for patented cell culture methods and effectiveness getting cells to patients through robust collaboration with academic and clinical research organizations. Hope Bio’s proprietary cell culturing process makes Hope Biosciences the gold standard in producing high volume, consistent, repeatable mesenchymal stem cells for clinical purposes. Hope Bio prides itself on banking for actual use.
[1] According to the LA Times, the bill was originally written to prohibit children under age 12 from playing tackle football. Amended in committee, the current version bans the sport for children 5 or younger beginning in 2025 (next year), progressively raising the ban age to 9 years in 2027, and 11 years in 2029.
[2] Johns Hopkins Medicine, https://www.hopkinsmedicine.org/health/conditions-and-diseases/sports-injuries/sports-injury-statistics.
[3] Prien, A., Grafe, A., Rössler, R. et al. Epidemiology of Head Injuries Focusing on Concussions in Team Contact Sports: A Systematic Review. Sports Med 48, 953–969 (2018). https://doi.org/10.1007/s40279-017-0854-4
[4] McKeithan L, Hibshman N, Yengo-Kahn AM, Solomon GS, Zuckerman SL. Sport-Related Concussion: Evaluation, Treatment, and Future Directions. Med Sci (Basel). 2019 Mar 15;7(3):44. doi: 10.3390/medsci7030044. PMID: 30884753; PMCID: PMC6473667.
[5] Gardner RC, Yaffe K. Epidemiology of mild traumatic brain injury and neurodegenerative disease. Mol Cell Neurosci. 2015 May;66(Pt B):75-80. doi: 10.1016/j.mcn.2015.03.001. Epub 2015 Mar 5. PMID: 25748121; PMCID: PMC4461453.
[7] Conditions include, but are not limited to” COVID-19, “Post-COVID” Syndrome, Parkinson’s, multiple sclerosis, Alzheimer’s, traumatic brain injury (TBI), amyotrophic lateral sclerosis (ALS), primary lateral sclerosis (PLS), cerebral palsy, stroke, spinal cord injury, polyneuropathy, muscular dystrophy, lupus, chronic musculoskeletal pain, severe osteoarthritis, psoriatic arthritis, diabetes, numerous forms of cancer, and for palliative care. FDA-authorized work continues at multiple academic, hospital, and research locations. Of particular note, this year Hope Biosciences’ autologous adipose derived mesenchymal stem cells (HB-adMSCs) were authorized for use in a rare form of pediatric drug-resistant epilepsy, the first FDA authorization of its kind of which Hope Biosciences is aware.