https://drcremers.com/2017/05/in-dogs-proof-that-mesenchymal-stem.html

Here are some other key points in the dogs that were treated.
1. The lowest quantity of MSCs (1 × 106) was used for treatment due to safety concerns of stem cell clumping in a small syringe or risk of emboli and for financial concerns. 


2.. High dose of MSCs may be associated with cell clumping forming aggregates, especially when passed through a narrow needle, and these aggregates can cause pulmonary emboli or infarctions after the systemic application of MSCs34,35


3. Many injections of high doses of allogeneic MSCs affect alloreactive immune responses in recipient baboons36. 


4. A previous study with dogs showed 3 eyes of 10 severe dog eyes did not have significant increase in Schirmer tear test values with transplantation of a high amount of allogeneic MSCs (1 × 108), which corresponds to two orders of magnitude higher than the dose we used in the present study20. 


5. They show a big improvement but no total cure of severe Keratoconjunctivitis Sicca with 1 injection of MSC.


6. Authors believe multiple doses of MSCs could help these animals even further. 


7. They note mild congestion may occur after multiple MSC intralacrimal injections, even at low cell doses (2 × 106) in normal dogs21.




Here are key comments on this article 


1. This article raises concerns about intravenous injections of stem cells. They recommend lower concentrations to prevent stem cell clumping and pulmonary emboli.


While most stem cell injection protocols for dry eyes from meibomian gland dysfunction and lacrimal gland inflammation would not include intravenous injections, it is important to know all potential risks.


There is 1 report of a family of 3 who had signs & 1 had symptoms (42 yo male with chest pain) of a pulmonary emboli after intravenous stem cell injection. The only risk factor this patient had was that his father was a smoker and he had received autologous adipose tissue-derived stem cell therapy for cervical herniated intervertebral disc three times intravenously over 3 months and finished one month before his ER visit.  His parents had similar treatments and were also found to have PE’s on lung scans WITHOUT any symptoms. 


[My only issues and questions with th Jung paper are the following:
1. It was published in a very low impact journal.
2. These cases occurred in Korea likely in 2012 or 2013 when stem cell therapy was in its infancy for the treatments this family received.
3. Also: Authors write, “The suspicion of IV stem cell therapy as the cause of pulmonary embolism became more solidified when we came to know that his parents had taken the same therapy for treatment of knee osteoarthritis five times.”
Did the parents have the same issue and were treated exactly 5 times? Who was this doctor? 
How much did they all pay for these injections?
What was the concentration of stem cells used?
Who paid for the CT scan when the parents had no symptoms?
How much did the patients weigh?
Was the 42yo a former smoker?
What was his job? Was it a desk job? Did he do any exercise? What was his diet like?
It is an early report of pulmonary emboli after stem cell injection. ]




Interestingly enough, stem cells have been used to treat conditions due to cell clumping or ischemia such as strokes:


https://drcremers.com/2018/02/stem-cell-use-in-strokes-need-for.html



References:


1. 
Reference 1: 

Yonsei Med J. 2013 Sep 1; 54(5): 1293–1296.

Published online 2013 Jul 23. doi:  10.3349/ymj.2013.54.5.1293

PMCID: PMC3743204

Familial Occurrence of Pulmonary Embolism after Intravenous, Adipose Tissue-Derived Stem Cell Therapy

Jae Woo Jung, Minsuk Kwon, Jae Chol Choi, Jong Wook Shin, In Won Park, Byoung Whui Choi, and Jae Yeol Kim

Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.

Corresponding author.

Corresponding author: Dr. Jae Yeol Kim, Department of Internal Medicine, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul 156-755, Korea. Tel: 82-2-6299-1396, Fax: 82-2-825-7571, rk.ca.uac@dmmikyj

Author information ▼ Article notes ► Copyright and License information ▼

© Copyright : Yonsei University College of Medicine 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

This article has been cited by other articles in PMC.

Go to:

CASE REPORT

A forty-one year old man visited our hospital because of chest pain starting one month earlier. During the diagnostic work-up, chest CT revealed wedge-shaped consolidation at the subpleural area of the right upper lobe (Fig. 1A). In addition, multiple emboli were found in small pulmonary artery branches of both lungs with right pleural effusion (Fig. 1B). There was mild elevation of D-dimer (0.8 µg/mL, normal; 0-0.5 µg/mL) which suggested the diagnosis of pulmonary embolism and infarct. Full diagnostic work-up for hypercoagulability was done. Antinuclear antibody, anti-dsDNA and lupus anticoagulant were all negative. Levels of anti-cardiolipin antibody, homocysteine and anti-thrombin III and activity of protein C and S were within normal range. Factor V Leiden gene mutation was not detected. There was no evidence of deep vein thrombosis in his lower extremities by Doppler ultrasound. He was a non-smoker and did not have chronic illnesses. He did not take a medicine and had not recently taken airplane for a long period. We were puzzled about the cause of the multiple embolism and infarct. We checked his medical history more closely and he confessed to having taken autologous adipose tissue-derived stem cell therapy for cervical herniated intervertebral disc three times intravenously. The each stem cell therapy was at intervals of one month and the last treatment was finished one month before his visit. We considered the possibility of pulmonary embolism by intravenous infusion of hASC. The suspicion of IV stem cell therapy as the cause of pulmonary embolism became more solidified when we came to know that his parents had taken the same therapy for treatment of knee osteoarthritis five times. We invited them for diagnostic work up. They had no specific respiratory symptoms. His father was a current smoker (40 pack years) and his mother was a non smoker. Except for old age, they did not have risk factors for thromboembolism. His father’s chest CT showed similar findings: there were multiple emboli at both pulmonary artery branches with right pleural effusion (Fig. 2A). In addition, pulmonary infarct was noted at the periphery of right lower lobe. Serum D-dimer was also elevated (1.0 µg/mL). As for his mother, we also confirmed multiple emboli in the pulmonary artery branches in both lungs (Fig. 2B) with mild elevation of serum D-dimer (1.1 µg/mL). They had no abnormal findings in the tests for hypercoagulability either. The index patient was first treated with enoxafarin, and then overlapped and switched to warfarin. Anti-coagulant therapy was stopped after a month because of the development of hematuria. His parents were observed without anti-coagulation therapy. Follow-up chest CT taken three month later showed disappearance of pleural effusion in index patient (Fig. 1C) and in his father. Pulmonary emboli were not detected in any of them.

Fig. 1

Chest CT of patient. (A) Chest CT demonstrates wedge-shaped, peripheral consolidation at upper lobe of right lung (black arrow), which is consistent with pulmonary infarct. (B) Chest CT shows multiple filling defects (white arrows) at segmental pulmonary …

Fig. 2

Chest CT of his father (A) revealed multiple emboli at segmental pulmonary artery branch (white arrow head) and right pleural effusion (white arrow). Chest CT of his mother (B) showed linear emboli (white arrow) along the lumen of pulmonary artery branch …