[HN Gopher] First in-utero stem cell therapy for fetal spina bif...
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       First in-utero stem cell therapy for fetal spina bifida repair is
       safe: study
        
       Author : gmays
       Score  : 221 points
       Date   : 2026-03-02 14:54 UTC (8 hours ago)
        
 (HTM) web link (health.ucdavis.edu)
 (TXT) w3m dump (health.ucdavis.edu)
        
       | vpribish wrote:
       | Interesting - they had done surgery before, but not with stem
       | cells. 6 babies operated on, results were very good and they are
       | recruiting for phase 2
        
       | elric wrote:
       | Incredible to see some promising results in stem cell research.
       | Hopefully a safe and successful application can give a boost to
       | some other areas where stem cells might prove useful (like maybe
       | one day we can regrow damaged heart tissue like this).
        
         | SadErn wrote:
         | Best news is the stem cells used are from donated placentas. So
         | no political footballs, just a true blessing to a child.
        
         | doomslayer999 wrote:
         | The notion of "stem cells" are somewhat of a misnomer as modern
         | biotechnology is showing us. There are an orchestration of
         | probably 1000s of different cell types which can vary in their
         | cell states. We don't have enough knowledge of how to use these
         | various cell types to influence complex self-organization
         | processes like development. But in some cases there are clever
         | fixes without understanding the underlying process.
        
       | snyp wrote:
       | I did not even know it was possible to operate on a fetus. Its
       | insane how far we have come. Very promising results!
        
         | alexpotato wrote:
         | The first episode of the Surgeon's Cut [0] on Netflix shows a
         | doctor:
         | 
         | - operating in utero
         | 
         | - while the mother is awake
         | 
         | - in an outpatient/doctor's office setting
         | 
         | - to implant a balloon in the upper respiratory tract of a
         | fetus with a, I believe, cleft palate so that it's lungs can
         | develop normally.
         | 
         | It really is wild what modern medicine can do these days.
         | 
         | 0 - https://www.netflix.com/title/81004466
        
           | trhway wrote:
           | The Grey's Anatomy was before that with depicting Prenatal
           | Surgery fellowship.
        
         | armadsen wrote:
         | Not only is it possible, fetal surgery is more or less standard
         | treatment for spina bifida at this point. The news here is
         | about the stem cell patch being applied during the surgery. (I
         | have a child with spina bifida. We tried to get her into this
         | trial, but did not qualify.)
        
       | jillsy wrote:
       | My high school hosted the county's special day class for kids
       | with severe cognitive and physical disabilities, a majority from
       | spina bifida. If this stem cell method can actually repair the
       | spinal cord before birth, the quality of life improvement is
       | absolutely enormous.
        
       | Telemakhos wrote:
       | Does the physical repair also help with the mental developmental
       | effects? Children with spinal bifida often develop cognitive
       | abilities much slower than children without it.
        
         | armadsen wrote:
         | The main goal of physical repair of the defect in utero is
         | actually to reduce the incidence of hydrocephalus and hindbrain
         | herniation, which are very common in people with Spina Bifida.
         | The existing fetal surgery reduces the incidence of
         | hydrocephalus from about 80% to about 40%. The improvement in
         | leg and bowel/bladder function is actually a secondary benefit.
         | 
         | My understanding is that the hindbrain herniation (aka Chiari
         | Malformation Type II) is the main cause of cognitive trouble in
         | people with SB. But it's worth noting that it's very far from
         | universal in causing that. Most people with SB are basically
         | normal cognitively assuming they get good early intervention
         | (VP shunt, PT, OT, etc.). Some early cognitive development can
         | be slower as a knock on effect of not being able to move around
         | as much as a baby and toddler, and thus less able to explore
         | the environment, etc.
         | 
         | Source: I'm the parent of a toddler with spina bifida. She's
         | completely on track cognitively and with fine motor skills so
         | far. She's way behind with gross motor skills due to her
         | inability to move her legs very much.
        
           | wincy wrote:
           | Another sb parent here, my kid is seven now, she's also on
           | track intellectually. We got the decompression surgery for
           | the Chiari II a few months after she was born, and the VP
           | shunt even earlier than that. Aside from some stammering
           | (which her non SB sister also has, so I suspect it's
           | hereditary), and weirdness with foods (OT has helped a lot)
           | she's totally on track intellectually.
           | 
           | Our daughter was a particularly severe case too, and these
           | interventions seem to have helped a lot. For the first four
           | years she'd hold her breath every time she was upset, and
           | need CPR, but we got her breathing again every time, so we
           | don't think there's any brain damage. If we'd missed once,
           | maybe I'd be telling a different story now. Thank goodness
           | her head grew!
        
       | asah wrote:
       | Conditions like SB affect the entire family.
       | 
       | Long ago, my next door neighbor's daughter had severe SB and was
       | confined to a wheelchair, slow mental and emotion development,
       | etc. Nobody thought she'd live, but in fact got to adulthood. It
       | was basically a full-time job for her (single) mom.
        
         | wincy wrote:
         | Sadly, the divorce rate is over 50% for parents of spina bifida
         | children. My daughter is almost 7 and my wife and I are happy,
         | we have a good life and I'm fortunate to have a career that
         | lets her stay at home to tend to our daughters multiple monthly
         | doctors appointments, and one where I can largely work from
         | home to help when she needs carrying (which is often!)
         | 
         | That said, our daughter is a miracle, she's intellectually
         | sharp, and we do everything we can to give her all the
         | experiences any other bright and outgoing child would have. I
         | hold her up so she can play the games she can't reach at Dave
         | and Busters, even if my arms get tired. We go on hikes with an
         | expensive stroller that's also a bike made for off road biking
         | because we read Little House and she wanted to know what
         | prairie looked like. We plan on getting an RV to take her to
         | national parks.
         | 
         | Her wheelchair tennis coach recently tried an exoskeleton that
         | allows him to walk at a research lab in New York, she was
         | elated. She asks me when her robot legs are coming. I tell her
         | we don't know but robots in every house would certainly help
         | that sort of technology move forward. I tell her "they've got
         | to test it on adults before kids can get one!"
         | 
         | When she was one, they told us to make plans for the future, to
         | get our affairs in order. Three years later the palliative care
         | worker who had told us our child wouldn't live past her second
         | birthday came to visit us during a hospital visit and talk to
         | us, so happy to see a case where they'd all been wrong. I'm so
         | happy they were.
        
       | Aboutplants wrote:
       | Truly remarkable! Despite the darkness in the world most days,
       | news like this lifts my spirits and gives me hope.
        
       | jey wrote:
       | What does the stem cell treatment help with beyond the existing
       | fetal surgery? Since it's in addition to the usual surgical
       | treatment
        
         | nickburns wrote:
         | The CuRe Trial is exploring whether stem cells can add
         | regenerative power to surgery, potentially improving mobility
         | and quality of life.              "This is a major step toward
         | a new kind of fetal therapy, one that doesn't just repair but
         | potentially helps heal and protect the developing spinal cord,"
         | said Aijun Wang, co inventor of the placental-derived stem cell
         | treatment technology and the study's co-principal investigator
         | [ . . . ].
        
           | jey wrote:
           | That doesn't really explain anything biologically. Just
           | vaguely says "potentially helps heal and protect"
        
       | doomslayer999 wrote:
       | China is going to be way ahead of us in biological treatments
       | because they are willing to actually remove the red tape and in
       | fact encourage scientists to try these sorts of experimental
       | treatments. Meanwhile, we have a dinosaur FDA, a bureaucratic
       | academia second to only Europeans.
        
         | dekhn wrote:
         | What's the plan in China for when one of these expedited
         | treatments has a terrible side effect?
         | 
         | The FDA's slowness is about maintaining a low level of risk
         | because the reputation cost of a really bad incident is huge.
        
           | doomslayer999 wrote:
           | Well, I'm no ethicist, but I don't think they really care.
           | They'll catalog the results and try again.
        
         | Aboutplants wrote:
         | The good news is that the rest of the world will benefit from
         | China's treatment philosophy.
        
       | dclowd9901 wrote:
       | As the brother of a young, amazing man who we lost due to another
       | genetic ailment (CF), whenever I see stories like this, it makes
       | me so hopeful for families in the future never having to see a
       | loved one deteriorate due to a bad roll of the dice.
       | 
       | Hats off to everyone out there putting in the hours to make the
       | lived experience of these folks much better than they would have
       | otherwise been. If only we had more of you in the world.
        
         | unglaublich wrote:
         | Completely agree, this is why we need to detect bad rolls and
         | give people the ability to reroll.
        
           | ASalazarMX wrote:
           | Since this is genetic theraphy, it would be amazing if it
           | corrected the bad roll permanently. Being in-uthero, this
           | might be the case here.
        
       | willio58 wrote:
       | Tangentially related, but it is increasingly obvious that there's
       | an ever-growing chasm between these two aspects of medicine in
       | the U.S.:
       | 
       | - What's possible for medical professionals to do for certain
       | conditions, in large part due to the amazing levels of investment
       | into research and implementation.
       | 
       | - How difficult it is for ordinary people to receive care.
       | Primarily due to private insurance companies intentionally making
       | it more difficult to get care.
       | 
       | Like the fact we're giving stem cell therapy to fetuses
       | successfully is amazing, yet any time I go to a doctor's office
       | or bloodwork company I hear an elderly person explain to the
       | front desk person that they've been on the same insurance for
       | decades and only recently started receiving bills they can't
       | afford, or listening to the front desk person explain that now
       | medicare no longer covers them for a routine thing.
       | 
       | Ideally, we could have both great research _and_ great general
       | care in this country. I just don't know if I will ever see that
       | day.
        
         | ecshafer wrote:
         | I think the largest issue with health care right now is that
         | the US is artificially shrinking the supply of Doctors. This is
         | due to:
         | 
         | 1. Size of medical school classes not increasing with
         | population
         | 
         | 2. US has an artificially small amount of residency slots.
         | 
         | These are largely due to AMA lobbying afaik and bad bills. But
         | if we allowed every _qualified_ medical student to enroll, and
         | gave a residency slot to every graduate. In a decade we would
         | have really shrunk the gap.
        
           | iamtheworstdev wrote:
           | the largest issue in American health care is private equity
           | and middle men raising the cost of everything.
           | 
           |  _edit_ if doctor scarcity were the issue then doctors would
           | have a lot more leverage in salary negotiations than they do,
           | which is to say they don 't have much. because the hiring
           | practices are limited by what they can bill, which they have
           | no power over.
        
             | doomslayer999 wrote:
             | Private Equity is the effect not the cause. We need them to
             | create efficiency because of the shenanigans that the AMA
             | guild did in limiting doctor supply. Just allow people to
             | take an exam to get credentialed, we'd have foreign doctors
             | flown in by the hundreds of thousands and care would be as
             | cheap as it is in India.
        
           | exhilaration wrote:
           | Does that matter though? My impression is that most people
           | don't see doctors anymore. Every urgent care visit I've had
           | in the past few years has been with a physicians assistant or
           | nurse. Same for our pediatrician, I can't remember the last
           | time we saw her instead of one of the nurses.
           | 
           | I actually have a routine visit with a specialist at one of
           | the top hospital systems in the country in 2 days, and I see
           | in the portal I'm seeing a "CRNP, MSN", not a doctor.
        
             | ecshafer wrote:
             | This affect is _because_ of the doctor shortage though.
             | 
             | I am in the process of trying to find a primary care
             | provider, and I cant find anyone accepting new patients.
             | 
             | Bigger places you basically see the doctor for 2 minutes
             | when you actually need one. I went to a ortho surgeon and
             | they had a dozen patients "seeing them" at the same time.
             | As he just went between rooms and nurses prepped
             | everything.
        
               | fleshdaddy wrote:
               | I went down a Reddit rabbit hole, a sub called /r/noctor.
               | Basically people, mostly doctors, complaining about the
               | prevalence of nurse practitioners, PAs practicing
               | independently/outside of their scope, etc. The general
               | consensus I see there is that the only people benefiting
               | from this are private equity firms trying to squeeze more
               | profit since they bill the same based on whether you see
               | a doctor or an NP. This in turn has an affect where it
               | doesn't make sense financially to go through so much
               | school and take on so much debt.
        
         | holoduke wrote:
         | The US is a country of cowboys. There is literally nothing that
         | can be considered fair. The only thing what is left is the
         | kindness of it's people. If that detoriates, well...
        
         | slibhb wrote:
         | Does that really happen "any time you go to a doctor's office"?
         | 
         | That aside, what if novel therapies like this are linked to the
         | fact that US healthcare is expensive? If you make it cheap --
         | as in other countries -- there's less incentive for companies
         | to invest and you get less research and fewer breakthroughs.
         | Also fewer doctors, hospital beds, and more rationing.
         | 
         | In an ideal world, everyone would have exactly the right amount
         | of healthcare. But our world isn't ideal, it runs on
         | incentives, and it's not clear to me that all the hand-wringing
         | over US healthcare will lead to positive changes.
        
           | willio58 wrote:
           | > Does that really happen "any time you go to a doctor's
           | office"?
           | 
           | Yes. I recently made a resolution to get established with all
           | the medical professionals I don't have set up. So a primary
           | care, dermatologist, etc. over the past 2 months I've visited
           | and had to go back a couple of times. I've literally
           | overheard insurance-related issues in all cases. Whether it
           | was the person in line before me or just overhearing people
           | complaining while I'm in the waiting room.
           | 
           | Just last week I was waiting to get my blood drawn and the
           | woman at the front desk, after continued prodding by an
           | elderly man frustrated with lack of coverage, out loud said
           | "Well, that's insurance in America for you. Go ahead and call
           | the number on the back of your insurance card because we
           | can't do anything for you." Just deeply disheartening stuff
           | to watch a late 80s man not realize after 15 minutes of being
           | tossed between automated insurance phone responses that he
           | simply won't get the help he needs.
        
       | wincy wrote:
       | This is amazing to see. Spina Bifida is tough as it can range
       | anywhere from "wheelchair bound and substantial intellectual
       | disability" to "has a hard time with potty training", and you
       | won't really know until your child has been born.
       | 
       | My daughter is seven now and was born with spina bifida and it's
       | been a long journey full of pain, but also joy. The first nine
       | months she had breath holding any time she'd get upset (which for
       | a baby is all the time) so she was simultaneously the healthiest
       | and least healthy baby in the NICU.
       | 
       | She's wheelchair bound, but intellectually very sharp. Getting
       | her a spinal shunt a few weeks after birth helped alleviate
       | spinal fluid pressure in her brain, although it elevates
       | scenarios of "kid has an headache" to "maybe we need to go to the
       | ER at 3am in the worst snowstorm of the season", but she's
       | extremely sociable and a light to everyone that meets her.
       | 
       | I'm glad work is being done that can mitigate this and improve
       | quality of life for these children. She keeps asking me when
       | she'll get her robot legs and we tell her they have to test it
       | out on adults first to make sure it's safe! Exciting times for
       | people with physical disabilities.
        
         | armadsen wrote:
         | Thanks for sharing about your daughter. It's good to hear from
         | other parents dealing with it. My daughter with spina bifida is
         | only 18 months. It's early of course, but so far she's right on
         | track cognitively and socially. I expect she'll be in a
         | wheelchair full time, but don't know for sure yet. She's also
         | just the most joyful, loving, social, happy toddler.
         | 
         | I know what you mean about elevating otherwise normal kid
         | illness. She had her first shunt failure in January. It was
         | pretty stressful going from "hmm, she's fussy" to surgery
         | within less than 24 hours. But she was back to her happy self
         | with hours of the surgery too, which was a pretty stark
         | indicator of how much the shunt is doing for her.
        
       | trhway wrote:
       | It sounds like stem cells come from unrelated people and no
       | rejection, etc?
        
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