Dubious Stem Cell Clinics

Introduction

Hallmarks of pseudoscience often involve hijacking words and concepts from cutting edge research and then making claims that go far beyond what is warranted by our current level of knowledge. Many charlatans use these claims to market products and services to an unsuspecting public.

In the late Nineteenth Century, the term "Magnetic" was popular and used by many would-be healers (such as D.D. Palmer). Flash forward a century and the word "Quantum" is widely misappropriated by cranks who likely have no idea about Quantum Mechanics (such as Deepak Chopra).

"Stem Cell Therapy" -- a term that many have heard on the news -- is the subject of cutting-edge research in laboratories around the world. There has been some real progress in the treatment of certain conditions, such as in the repair of damaged corneas.

Stem cells are the cells that can self-renew and can differentiate into other cells. They are present in many tissues throughout the body. Current research is focusing on the use of stem cells as replacement therapy (to replace damaged or lost tissue), to modify the behavior of other cells, to act as targets of drug therapy, and to generate differentiated tissue for laboratory study of disease models.

There is a myriad of conditions for which stem cell treatment is under investigation. However, as of 2018, the only legitimate stem cell treatments used in clinical practice are in bone marrow transplantation, burn treatment, bone grafting in orthopedics and corneal generation from limbal stem cells in ophthalmology. And of those, only bone marrow transplantation in cancer patients has a consensus from large scale clinical trials. There currently are no other legitimate treatments that are warranted for general use by current science. We simply are not at that level.

George Daley, MD, PhD, a member of the Harvard Stem Cell Institute’s executive committee and past president of the International Society for Stem Cell Research, added,

“We are seeing a growing number [of legitimate clinical trials] but all such uses are experimental ... and there is great skepticism as to whether we have” the scientific knowledge and basis even to “predict that these will be effective.” “It may,” he said, “take decades before there is certainty.” “The only stem cell therapies that have been proven safe and effective,” he said, “are those constituting what is known as bone marrow transplantation for treatment of some cancers.”

However, such limitations do not prevent contemporary snake-oil salesmen from selling dubious treatments to desperate people by making unwarranted claims about stem cell therapies. "Stem Cell" is the new "Magnetic" and "Quantum" in the world of quackery.

As with many scams, it is sold using "sciency" words and riding on the coattails of legitimate science.

"Like snake oil salesmen, clinics claiming astonishing curative results from stem cell treatments often do not have licensed physicians administrating the treatments, no scientific evidence supporting their work, and they rely on testimonials for advertising and promoting the value of their product."

Graham Parker, Ph.D., Jeanne F. Loring, Ph.D.

History of Stem Cells

The presence of regenerative master cells has been hypothesized since the early twentieth century. After World War ll, interest accelerated as the threat of nuclear war raised concerns of dealing with radiation injury.

In 1963, researchers in Toronto discovered bone marrow cells that could replace all the blood cell lines. They found that injecting these cells into lethally irradiated laboratory animals could restore bone marrow function and the production of platelets, red and white blood cells.

Over the next two decades, bone marrow diseases like leukemia were being treated by first destroying the diseased marrow, and then infusing bone marrow stem cells back into the patient to restore normal function.

In 1975, cultured skin cells from a teratoma were used to generate large numbers of cells to provide cutaneous barriers in burn victims.

Research has been ongoing. Embryonic stem cell lines have been created for research purposes. For all intents and purposes, these lines are amortal as they can divide indefinitely and give rise to many specific types of cell lines. They were derived from human embryos.

In the United States, Executive Order 13505 was implemented in 2009 which prohibited the use of federal money for the creation of additional embryonic stem cell lines. As of 2018, 378 embryonic stem cell lines exist for research.

Other methods are being developed to convert adult cells into stem cells.

In 2006 in Kyoto, Japan, Sina Yamanoka successfully transplanted genes from a stem cell into an ordinary adult cell. This caused the adult cell to behave like a stem cell in that it could reproduce seemingly indefinitely and give rise to specialized adult cells. Such induced stem cells were made from fibroblasts with the use of a retrovirus. This process (called “reprogramming”) creates “induced pluripotent stem cells” (see below).

In 2012, Sina Yamanoka won the Nobel Prize for his work.

Since then, other techniques for developing induced stem cells have been researched. Chemical induction has been tried to mimic transcription factors. Protein-induced pluripotent stem cells have been created as well.

In 2013, a small proof of concept trial was published in Lancet entitled “Enrichment of autologous fat grafts with ex-vivo expanded adipose tissue-derived stem cells for graft survival: a randomized placebo-controlled trial”. In 10 patients (13 enrolled, 3 excluded), stem cell enriched fat grafts seemed to work better than non-enhanced grafts. This has positive implications for areas such as breast reconstruction and other plastic surgeries.

In 2014, a promising technique called “stimulus-triggered acquisition of pluripotency” was described in Japan. This technique used an acid to induce the production of stem cells. However, the research data was found to have been falsified. The lead researcher committed suicide after the revelation.

In 2015, a study was published in the Lancet by Schwartz et al entitled “Human embryonic stem cell-derived retinal pigment epithelium in patients with age-related macular degeneration and Stargardt's macular dystrophy: follow-up of two open-label phase 1/2 studies”. The study consisted of 18 patients, 9 with macular degeneration and 9 with macular dystrophy. After a mean follow-up of 22 months, 13 of the patients showed microscopic evidence of a response and 10 of the 18 demonstrated better vision. The authors stated,

“The results of this study provide the first evidence of the medium-term to long-term safety, graft survival, and possible biological activity of pluripotent stem cell progeny in individuals with any disease. Our results suggest that hESC-derived cells could provide a potentially safe new source of cells for the treatment of various unmet medical disorders requiring tissue repair or replacement.”

Research is actively being done in the areas of blood diseases, burns, bone grafting, retinal disease, cornea disease, Parkinson’s Disease, Huntington’s Disease, spinal cord injuries, heart attacks, and Type 1 Diabetes. These studies have so far been in mice and rats. Some phase 2 trials are underway. Proper phase 3 human trials have not been done as of 2018.

As stated above, stem cells have only been proven for clinical use for blood disorders. Promising work is being done in other areas.

It is an exciting field, but nowhere in the science of stem cells can justification be found for the miraculous and outrageous claims being made by the numerous dubious “stem cell clinics” found proliferating all over the world.

Translational Hurdles

Scientific medicine progresses slowly. After basic science bench research identifies a potential for a type of treatment, clinical research then proceeds in phases.

These are defined as phases 1 – 4.

• phase I: safety, tolerability, pharmokinetics, pharmodynamics. Usually involves ramping doses.

• phase II: expanded version of phase I, IIa for dosing, IIb for efficacy.

(When drugs fail, they usually fail in phase II.)

• phase III: definitive, hence expensive assessment of efficacy, typically double-blind, necessary for a regulatory submission.

• phase IV: post-launch surveillance, rarer adverse effects detected here.

With few exceptions, the current state of stem cell science is mainly limited to phase 1 and 2 trials.

A 2018 special report in the New England Journal of Medicine states,

“Despite a proliferation of early-phase trials of mesenchymal stem cells, definitive studies regarding the safety and efficacy of such procedures as compared with the standard of care have been lacking.”

There are many concerns and hurdles to overcome.

Collectively, the problem is “translation”. How can we the actual translate our current understanding of stem cells into usable therapies? Yeild. One practical problem with translation is low yield. Current methods of obtaining these cells have relatively low yield. It has proved difficult to harvest enough cells for most potential clinical applications. This makes research difficult. Low yield harvesting techniques also will limit wide-spread legitimate use even it such treatments pass phase 3 trials. Homing. The next translational issue is “targeting”, also known as “homing”. How can we get a stem cell to the exact desired place in the body? If we do manage to get the cells to the desired place, how can we get the cell to behave in the way that we wish? Despite the endless claims on clinic websites, stem cells don’t just “know” what to do as if by magic.

Proving efficacy. Even if we develop high-yielding harvesting methods, and even if we can get the cells to the desired targets, will there be enough positive and measurable effects from the treatment. Many trials have been very disappointing. For instance, trials involving patients with ischemic heart disease have failed to show significant results. Ongoing trials for non-ischemic heart failure have shown more promise but have suffered from discrepancies. As of 2018, stem cell therapy for heart disease has been disappointing.

Safety. Most importantly, we have to prove safety. A huge concern about stem cell treatments is tumorigenicity. Cancer cells are just cells that replicate without restriction, usually to the detriment of the patient. Stem cells can replicate indefinitely as undifferentiated cells. It would seem that a major trick to master would be getting the cells to do their jobs (repairing or replacing aging or diseased tissues) without becoming a cancerous tumor.

Legitimate stem cell researchers concern themselves with these challenges and more.

Today’s plethora of dubious stem cell clinics offer a multitude of unproven, likely useless, expensive and potentially dangerous treatments.

The “doctors” of these clinics do not seem concerned in the slightest about such challenges.

Stem Cell Quackery – the New “Quantum”

One of the dangers facing the legitimacy of stem cell therapy is the rapid rise of non-legitimate stem cell clinics around the world. As of 2018, the phrase “stem cell” is used to sell dubious and potentially dangerous untested treatments to desperate patients for high prices. The peddlers of these treatments point to the growing and promising field of stem cell research as if it is a body of evidence to support outrageous cure-all claims to the unsuspecting public.

Peddlers of pseudoscience often focus their claims to the mysterious sounding science of the day. For centuries, “magnetic healers” sold treatments using magnetism to heal just about any ailment under the sun. Animal magnetism was a term coined by Franz Mesmer to describe the body’s natural magnetic field and the potential for healing our ailments by its manipulation. Magnetic healing became popular but never proven. The words “magnet”, “field” and “energy” tap the imagination of the public. As most people even today do not really understand the meanings of these words, we tend to be lured by those who claim to not only understand them, but to harness their power to heal. Indeed, the inventor of Chiropractic, D.D. Palmer was a “magnetic healer”.

Other mysterious scientific concepts have become fodder for pseudoscientists. Quantum mechanics is one of our most successful scientific theories about the bazaar atomic and subatomic world. Yet no one understands it, at least not really. Physicist Richard Feynman famously stated, “If you think you understand quantum mechanics, you don't understand quantum mechanics.”

“Quantum” has been hijacked by pseudoscience peddlers to sell many products, services, books and seminars. A Google search for “quantum healing” reveals over 1.5 million citations. At the forefront of the quantum healing empire is Deepak Chopra, a former endocrinologist. The Wikipedia page for Quantum healing states, “The term was coined by Deepak Chopra. His discussions of quantum healing have been characterized as technobabble - "incoherent babbling strewn with scientific terms" which "drives crazy people who actually understand physics" and "redefining Wrong".”

In the Huffington Post, Chopra stated,

“It was only with the advent of quantum physics that scientists began to consider again the old question of the possibility of comprehending the world as a form of mind. Indeed, the quantum theory implies that consciousness must exist, and that the content of the mind is the ultimate reality”.

Mysterious and misunderstood subjects such as magnetic, energy, quantum spark our imagination. Potential exists in these sciences, but only the experts understand them. Now we add “stem cell” to the list of buzzwords that capture desperate consumers’ attention.

In addition to expensive seminars and treatment programs, “stem cell therapy” has become big business. In 2016, a study conducted by Leigh Turner and Paul Knoepfler found that 351 companies in the United States were producing stem cell products for 510 clinics (more on that below). That’s a lot for a technology that has never been through phase 3 clinical trials (apart from bone marrow transplantation). These clinics appear to be clustered in Southern California, Florida and the north-eastern states.

With the promise of what sounds like a magic technology, these clinics offer treatments for conditions across a wide range including orthopedics, pain management, neurologic problems, immune diseases, respiratory diseases, urologic, sexual, cosmetic, cardiovascular and dermatologic disorders. They advertise treatments for aging, diabetes, hair loss, muscular dystrophy, vision problems, gastrointestinal disorders, Alzheimer’s and autism.

Products are on sale now promoting magical-sounding claims of skin rejuvenation with the words “stem cell” attached to their names. Many products promote plant-based stem cell creams (yes, you read that correctly). One company’s advertisement claims, “(our) cutting edge technology brings an innovative anti-aging skin care line. Plant stem cells are the source of unlimited energy and the key to herbal growth and regeneration”.

Many sites use the language of pseudoscience to make specific-sounding claims, but in reality, are vacuous. Motor City StemCell claims that their products “Control the immune system”, “regulate inflammation” and “provide trophic support”. The operative words here are “control”, “regulate”, and “supports”. Skeptics recognize these as “weasel words”. They do not make specific claims for which the claimants may be held to account. Other weasel words include “boosts” and “enhances”.

When such words are used, often they are accompanied by the Quack Miranda Warning:

“These statement(s) have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.”

The tactics of selling snake oil have become sophisticated over the years, but the overall strategy has remained the same. Find vulnerable customers (“marks”); make bold claims of a “cure for everything”; claim 100% safety and efficacy; use sciency-sounding technobabble; point to legitimate research as if it supports your claims; promote testimonials from happy customers; charge high fees for unproven or implausible products and services; attack your critics as being closed minded, or in the pocket of “Big Pharma”; repeat.

Stem Cell Tourism

In the early 2000’s, the first reports of unsubstantiated stem cell services emerged in the U.S. and Europe. People were eager to use what they perceived to be cutting-edge science and were frustrated by the slow progress of legitimate science. As there have been few legitimate treatments based on stem cells available, charlatans (looking to exploit the publics’ limited knowledge of the emerging science) began marketing such treatments directly to the public over the (then new) internet.

In 2001, the Bush Administration ended federal funding for the creation of new embryonic cell lines. Federal law enforcement also shut down a couple of stem cell companies in the U. S. and prosecuted the owners.

A 2006 FBI report stated: “U.S. District Judge Gray Miller sentenced Lawrence Stowe, 61, a total sentence of 78 months in federal prison to be immediately followed by three years of supervised release. In handing down the sentence, Judge Miller emphasized that Stowe “…took advantage of people dying and offered them hope.” Restitution was also ordered in the amount of $419,358 to be paid jointly and severally with co-defendant Francisco Morales, 54, of Brownsville. Morales was previously sentenced to 60 months in prison.

Stowe, of Moline, Illinois, admitted that beginning in January 2006, he utilized several businesses, Stowe BioTherapy Inc. and The Stowe Foundation to advertise and promote a medical treatment protocol for the treatment of amyotrophic lateral sclerosis (ALS) also known as Lou Gehrig’s disease, multiple sclerosis (MS), Parkinson’s, and other neurological diseases. This treatment protocol, which was named “Applied Biologics,” consisted of supplements, vaccines, patient specific transfer factors and ultimately stem cell therapy. Stowe falsely represented to patients that this treatment protocol had been reviewed by all levels of the FDA and was effective in the treatment of ALS, MS, and Parkinson’s. There is currently no cure for these diseases.”

Regulatory hurdles in the United States and similar nations led the charlatans to set up shop in countries with little to no oversight. With the benefit of the internet, they could send their unsubstantiated claims into the world to attract desperate customers.

“…a second wave of stem cell marketing operations emerged. These businesses, which were often based in developing economies, targeted both local residents and patients from wealthier nations, giving rise to what became known for a time as “stem cell tourism”. Such businesses offered cell-based or tissue-based procedures, sometimes targeting more than 100 different medical conditions, at prices of tens of thousands of dollars per treatment course. Due to vague or non-existent regulation, or lax enforcement, numerous such companies remain in operation in countries, such as Mexico, India, and Thailand.” (from The malignant niche: safe spaces for toxic stem cell marketing)

In a 2015 JAMA Neurology article, Bowman, et al, describe the industry:

“Stem cell tourism is a rising Internet-based industry that aims to offer unproven procedures to patients with incurable diseases. This unregulated activity is reaching the neurologist’s office as well as across the world, as patients request information or clearance for such procedures. Herein, we posit the need for medical societies and licensing boards to bring this issue to the forefront of neurology because it has the potential to affect patient care with risk of morbidity and mortality, as well as to undermine public confidence in legitimate stem cell research for incurable neurological diseases such as multiple sclerosis and amyotrophic lateral sclerosis.”

A 2016 cautionary article in the New York Times also described the practice.

“A growing number of clinics, often in places like Russia or China, but also in Europe and elsewhere, say on websites that they can treat, even cure, diseases like muscular dystrophy, Alzheimer’s, Parkinson’s, and spinal cord injury as well as strokes, by injecting patients with stem cells that, in theory, could develop into a missing nerve, a muscle or other cells and repair damage from an illness or an injury."

Reports by injured athletes of seemingly miraculous results have contributed to a growing interest among desperate patients. Estimates are that tens of thousands of patients around the world have had such treatments and that the industry is worth hundreds of millions of dollars.

The clinics, which are unregulated, have websites with glowing testimonials from patients, some of which… have financial interests in the clinics. The clinics often claim to be doing clinical trials, giving a veneer of legitimacy to their work.”

The article describes a gentleman named Jim Gass, a 66 year old lawyer who suffered a stroke and was looking to cure his left-sided paralysis with stem cell injections.

Dubious U.S. Stem Cell Clinics (and how they get away with it)

In the years following 2010, more and more so-called stem cell clinics have begun advertising within the United States. The actual number is changing. A quick Google search for stem cell clinics in the United States yields millions of hits for what is likely thousands of clinics.

In a 2016 study entitled “Selling Stem Cells in the USA: Assessing the Direct-to-Consumer Industry” by Leigh Turner and Paul Knoepfler, they found “351 U.S. businesses engaged in direct-to-consumer marketing of stem cell interventions offered at 570 clinics.”

This is big business. Clinics typically charge between $2,000 to $100,000 for treatment for a range of ailments that are limited only by one’s imagination. They target desperate patients who may have to spend their retirement savings or tap the generosity of friends and family to fund their miracle treatments.

In the United States, clinics are supposed to adhere to the regulations that define how products and services are to be used.

A review of the federal regulations concerning biologic products appeared in the March, 2018 New England Journal. (Note: HCT/P refers to “human cell and tissue products,” a defined subset of which are regulated as biological drugs by FDA)

“The decision regarding which regulatory pathway a given product must follow rests in part on whether the product meets or does not meet the criteria of the regulations promulgated under the Code of Federal Regulations part 1271 of Title 21, which have been in place since 2005.

In brief, products that are regulated solely under Section 361 generally are those that :

· do not undergo substantial processing (minimal manipulation),

· are used in a manner in the recipient that is similar to that in the donor (homologous use),

· are not combined with another drug or biologic product, and

· do not have a systemic effect, unless they are designed for autologous transplantation, first- or second-degree–related allogeneic transplantation, or reproductive use.

Examples include corneas and heart valves. Such cells and tissues are subject to FDA regulations only to prevent the transmission of communicable diseases.

All other HCT/P products are regulated as drugs, biologics, or devices and require appropriate regulatory submissions for the conduct of clinical trials and marketing.”

One key to the industry’s growth has been the exploitation of a once obscure provision in the federal code, CFR 1271.15(b), known as the “same surgical procedure” exception:

“You are not required to comply with the requirements of this part if you are an establishment that removes HCT/P’s from an individual and implants such HCT/P’s into the same individual during the same surgical procedure”

So, if stem cell clinics use products that are “minimally manipulated”, are extracted and given back to the same patient, are not combined with drugs and do not have a “systemic effect”, then the FDA will not regulate the products and services as “drugs”. The FDA’s only oversight is the prevention of infections from the procedures. Some of the stem cell procedures provided by U.S. clinics are then exempt from FDA regulations. Many are clearly not.

Many clinics advertise commercially available products that clearly do not come from the patient and have been processed.

“MotorCity StemCell” claims

“OUR CELLS ARE BETTER THAN YOURS! Amniotic derived MSC are preferable to adipose based tissue for musculoskeletal regeneration.”

They buy a commercial product from a company that claims to prepare amniotic mesenchymal stem cells from volunteer expectant mothers. Clearly, this does not qualify for an FDA exemption.

Since there are FDA rules against such treatments, typical U.S. clinics have developed various modus operandi.

Many use something we may call the “Clinical Trial Ruse”. Taking a page from Stanislaw Burzinski, some U.S. stem cell clinics operate under the guise of conducting clinical trials. Many register such trials on ClinicalTrials.gov. They then charge desperate patients to participate in their “studies”.

An article in Forbes by Stephen Salzberg describes the practice:

"In recent years, companies offering questionable stem cell therapies got the bright idea that they could describe their treatments as clinical trials, register them on ClinicalTrials.gov and thereby get some free advertising. Most stem cell treatments are not FDA-approved, and many have little or no data supporting their effectiveness, but clinics can still register their "trials" on the NIH site, making it appear that they are supported and endorsed by the government."

"What's especially worrisome is that some stem-cell treatment clinics charge patients very high fees to participate in their "trials." Some patients (perhaps most) don't know that legitimate clinical trials virtually never charge fees."

"Most patients think, mistakenly, that if a clinic offers stem cell therapy, it must have been approved by the FDA. That's not true–clinics offering these therapies don't have FDA approval, and they argue that they don't need it (which might be correct,

but that's a topic for another day)."

"Patients also assume that trials listed on ClincialTrials.gov must have been approved by some government agency, but that's not true either. The site is a clearinghouse that uses the honor system, nothing more, to ensure that trials listed there are legitimate. If you read its disclaimer (but who does?), you find that studies listed on the site are not necessarily funded by NIH or approved by the FDA. What these stem cell clinics are doing is not a clinical trial, and advertising their services through ClinicalTrials.gov is reprehensible. For now, if a doctor or clinic tries to charge you to participate in a clinical trial, your best course may be to find another trial–and another doctor."

Stem cell researcher and author of The Niche blog, Paul Knoepfler, is also concerned about the misuse of ClinicalTrials.gov.

“Dubious stem cell clinics are taking advantage of this loophole to get an air of legitimacy and often use their listing in Clinicaltrials.gov as a marketing tool to convince their potential customers that their trials are approved by the federal government (see hypothetical example below of such a web marketing approach), which at best is misleading.

Another level of strangeness to this situation is that although Clinicaltrials.gov is intended primarily to be a database for trials of experimental new drugs (keep in mind that stem cells products often are biological drugs), the dubious clinics–despite listing their “trials” on the site–claim that their stem cell products are not drugs.”

Leigh Turner wrote in 2017,

“Numerous US businesses that engage in direct-to-consumer advertising of stem cell interventions that are not US FDA-approved also recruit clients by listing ‘pay-to-participate’ studies listed on ClinicalTrials.gov. Individuals considering enrolling in such studies and NIH officials responsible for overseeing the database need to be aware that some businesses are using the registry to promote unapproved stem cell interventions that study subjects are charged to receive. Inclusion of such studies in ClinicalTrials.gov reveals that the database needs better screening tools. In particular, screening should evaluate whether studies submitted to the registry have been reviewed and permitted to proceed by the FDA in the case of clinical studies requiring FDA clearance in addition to institutional review board approval.”

With a few exceptions, clinics cannot make specific medical claims that contradict established fact. As a strategy to appear scientifically accurate, they will make matter-of-fact statements about stem cells and the about certain medical conditions.

For instance, the company “U.S. StemCell Clinic” states,

“Orthopedic conditions are ailments and disorders in muscles, ligaments, and joints”

and

“According to research, stem cells have self-renewal qualities which aid in the reproduction of cartilage and bone tissue cells, the restoration of joint function, and the reduction of pain.”

These statements are true.

They then make the unsubstantiated claim,

“This mean that stem cell transplants could be used to treat some of the most common orthopedic symptoms.”

Clinics therefore use “weasel words” to skirt around making actual claims while maintaining the appearance of promising the world. Notice the word “could” is conveniently inserted into the statement. No actual claim is made.

As mentioned above, infamous weasel words include “support”, “enhance”, “treat”, “help” and “boost”.

“Amirastem” uses phrases such as, “have the potential” , “may” and “can” – as opposed to “are known to”, “cures” or “does”.

“Your own Stem Cells have the potential to regenerate all kind of cells of the body. Scientists have developed the technology to differentiate Stem cells into neural cell, blood cells, skin cell and hair cells. These cells may be used to replace the old cells of body with new and young cells to treat the aging related diseases.”

and

“stem cells treatment involves administration of concentrated cells in the targeted area, wherein they can colonize in the damaged area, adapt the properties of resident stem cells and initiate some of the lost functions that have been compromised by the disease or injury.”

Next, clinics heavily advertise testimonials by seemingly happy patients. They offer these testimonials as their main source of “evidence”. As we know, testimonials are not evidence, but they are convincing. A known advertising technique is the promotion of celebrity testimonials.

The home page for “StemGenex” prominently features video testimonial by the wife of “Happy Days” star Donny Most (who played Richie Cunningham’s buddy, Ralph Mouth). Mr. Most has Parkinson’s Disease and his wife claims that he made progress after stem cell treatments.

By quoting people in testimonials, they give the impression that they are making scientifically valid statements. They are not.

Another common ruse (and dead give-away for pseudoscience) is the “cure for everything”. However, many U.S. stem cell clinics are careful enough not to claim actual cures. They simply state what ailments for which they offer treatments, and then claim that the treatments are “beneficial” in some way. Apparently, “beneficial” means whatever the people in the testimonial videos say.

One Michigan clinic called "The Knee Institute & Regenerative Medicine" claims the following: