"In the future, I see young people saving their cells to use them as regenerators in old age"

When he was a student at Harvard University, Robert Sackstein became exposed to bone marrow transplants; He then found that one in four patients who received the treatment died shortly after, when the graft failed: the transplanted cells could not find their way through the bloodstream to the bone marrow.

Thus he began to delve deeper into the molecular mechanisms that guide cells in this process, for which he had the help of Nobel Prize winner in Medicine and pioneer in the development of transplantation, Donnall Thomas, as a mentor.. Sackstein's research has culminated in a technology based on the modification of cell membranes through the insertion of a GPS that allows mesenchymal stem cells to be directed to damaged tissues.

Like the cells he works with to one day cure osteoporosis, this doctor and researcher also seems to have a GPS that has guided his career since he was very young.. Despite the vicissitudes of his childhood and youth, or perhaps thanks to them, he never abandoned an early fixation on treating the disease but “always understanding how.”. Current professor emeritus at Harvard and vice president of medical affairs at Florida International University in Miami, Sackstein is proud of the influence of his Cuban family, of Spanish descent, in this interview we do with him in Los Alcázares. Here he has co-directed an Advanced Therapies course organized by the Spanish Society of Hematology and Hemotherapy (SEHH), the Carlos III Health Institute and the University of Murcia.

No one would assume from his name that he has a Leonese grandfather. On my father's side I have Jewish family from Lithuania and Germany, and on my mother's side, from Spain. My parents met in New York, where my father was born.. He had been with the US Army in World War II, and considered himself a citizen of the world.. My mother was a Cuban pianist who was there studying with Claudio Arrau, the best interpreter of Beethoven, with a scholarship from the Batista government.. They met in the late 1940s and got married there, but my mother wanted to have her children in Cuba, so they settled in Havana, and that's where I was born.. I am Sackstein Guerrero, although I lost my second last name when I arrived in the United States.. My maternal grandmother's family comes from Seville and the Canary Islands, and my maternal grandfather was born in Villafranca del Bierzo. He went to Cuba at the age of 20 and never returned to Spain, but he always had it in mind; He told us many anecdotes about his hometown and I grew up knowing him very well. So much so that a few years ago I went to see the town and it was just as he described it to me. Is it true that your father had to leave Cuba because they thought he was a CIA spy? That's right. My father was the vice president of the American Legion, where there were army veterans. In 1960, they shot the president of that organization, a good friend of my family, and they told my mother that my father would be next. Ché Guevara himself wanted to shoot him. It was knowing it and fleeing to Miami with a suitcase. I was three years old about to turn four. Even though my parents told me we were going on vacation, I remember my mother crying a lot. I didn't understand his sadness. I see her like it was yesterday. A few years ago, I met up with one of my then neighbors in Havana and he confirmed that shortly after we left home, about thirty soldiers arrived, with trucks.. He, who was an eight-year-old boy, and his family were in hiding for a month fearing that they would also come for them. Already exiled in Miami, you were a very precocious child; It was immediately clear to him that he wanted to be a doctor. When we arrived, 19 people lived in a three-bedroom house.. My grandmother always went to sleep at 3 in the afternoon for a while, because her head hurt a lot, and I thought it was because of the war she was having, since she was a very active child.. Then we found out he had high blood pressure.. Back then there were very few treatments and I promised him that I would find one for him.. This is how, at the age of 12, I started going to the University of Miami library to study about the disease.. At that time, an expert in hypertension, Professor Murray Epstein, was doing research at that university. I asked my father to help me meet him and we made an appointment with one of his assistants. I remember that he was very surprised when he saw me, because he didn't imagine that I was a 13-year-old boy.. They couldn't offer me a job working for someone my age in the lab, but my father insisted: “My son knows how to work hard.”. And they let me volunteer. I was in charge of cleaning the rat boxes for the experiments.. I cleaned them thoroughly, with a toothbrush. He left them so clean that the data collected was free of any contaminating element and the experiments progressed very quickly.. They were soon able to begin a clinical trial with the drug, which turned out to be captopril.. As a thank you for the effort, they allowed me to include my grandmother in the study. Then I knew that I wanted to be a doctor, but also work in the laboratory. That determination in such a young person is striking.. Did he have any influence on your family? An uncle of mine was a surgeon, but what I wanted was to cure as a researcher, do science. My mother taught us music; I soon saw that it was not my thing, unlike what happened to my sister, who was very talented.. On the other hand, I had much more facilities for science. Also, when I was little I was shocked by the fact that a cousin of mine lost an eye to congenital glaucoma. How can it be that medicine is not capable of saving an eye? he thought. That reinforced my goal of being a doctor and researcher. He has certainly fulfilled it, because throughout his career he has always combined clinical practice with research. Now he is focused on the development of a somatic cell therapy to treat osteoporosis. Where is this work? We are analyzing data from an initial clinical study. It is a very prevalent and terrible disease. My mother died of osteoporosis. He was 93 years old and was capable of playing a three-hour concert from memory, but there came a time when he could not move due to a serious vertebral fracture; He ended up dying from a lung complication. I am convinced that mesenchymal stem cells can be the solution. We have to do the studies to guarantee the safety of this therapy and I cannot yet comment on the results of the trial that we are carrying out at the University of Murcia and the Virgen de la Arrixaca University Hospital, with José María Moraleda's group, but yes I can say that the data is promising. What effect do they hope to achieve with this type of cells? Each tissue in the human body has enough mesenchymal stem cells (MSC) to drive regeneration. But as you age, they are lost and so is that ability to repair tissues.. It is something visible on the skin of young and old, without going any further.. MSCs exhibit, on the one hand, an anti-inflammatory effect, and, on the other, they are capable of stimulating the cells of the tissue in which they are found.. Because of this regenerative potential, in the future I see young people saving their MSCs to use them as regenerators in old age.. They are a fountain of youth. Returning to osteoporosis, what would the cell therapy you propose consist of? How do they get the mesenchymal cell to go to the damaged bone tissue? The first barrier in regenerative medicine is getting the cells to the place you want to heal. That is the first thing to think about or, at least, it is my way of working, I have to know how the treatment I use works, that is why I investigated the mechanisms of cell migration in bone marrow transplant, and that is how I found a important protein in this process, which is Eselectin. Over time I developed a fucosylation technology that allows us to also target mesenchymal stem cells.. Just as leukocytes go to the place in the body where there is an infection or wound in a matter of seconds, using blood vessels as a highway, this technology allows MSCs to know where to go, in this case, to damaged bone tissue.. To do this, once extracted from the patients, we expand them and modify the cell membrane, through fucosylation, to install the 'GPS' that facilitates their arrival to the bone.. It is a technique that we perform through a biochemical reaction in the laboratory. In what other diseases do you think it could be useful? In systemic inflammatory diseases, such as Crohn's disease, ulcerative colitis, idiopathic pulmonary fibrosis, and also in multiple sclerosis , amyotrophic lateral sclerosis (ALS) and Alzheimer's disease. MSCs are immunomodulatory cells, which means they reduce inflammation wherever they reach. My idea is that all diseases of old age, degenerative diseases, are caused by a lack of MSC activity in the tissues.. I believe in the potential to increase the density of MSCs in places damaged by chronic inflammation. The path of somatic cell therapy, like the one you are investigating, seems more arduous than that of other advanced therapies such as CAR-T immunotherapy or gene therapy, which has already taken off in various diseases. When do you think they could have results with cell therapy? What is holding us back is the lack of funding, because carrying out a clinical study is very expensive.. There is no private interest in promoting this research, which would mean ending the need for chronic treatments for many patients.. We do academic research that seeks healing. If more efforts were added, we could prove our hypothesis in months.