Stem Cell Therapy

While stem cell therapies may seem to have appeared overnight, they have been practiced for decades. The most recent developments in stem cell science have brought exciting new opportunities for improving patient outcomes – especially over the long term.

What are stem cells?

Stem cells are primitive cells in our body serving as a reservoir, able to replenish itself and differentiate into a wide range of specialized cells, in order to replace damaged cells and regenerate tissue. They have innate intelligence, able to home in to injured areas, secrete bioactive molecules that exert local and systemic effects, reduce inflammation, and recruit local cells to assist in the healing process.

Every cell in our body can trace its origin to the ultimate stem cell – a fertilized egg. Each cell division moves the cells down a path to their final cell type such as cells of muscle, nerve, or liver. All along this journey cells make commitments that are typically irreversible. This implies that any tissue in our body may require stem cells for regeneration. Properly harnessed, stem cells have the potential to repair or reverse an incredibly broad range of conditions, such as musculoskeletal injuries, autoimmune diseases, wounds, and lung conditions.

Where are these stem cells?

Stem cells exist in varying forms in numerous places throughout the body, although with a tendency to decline in number and quality throughout our life cycle. Adult stem cells are most abundant in bone marrow, fat tissue, and blood; it is from these sources the body often recruits stem cells when they are needed. Bone marrow transplant has been a routine treatment for decades.

Stem cells are especially abundant at birth, in umbilical cord and placenta, which is why many parents choose to privately store umbilical cord blood/tissue when their babies are born. Membranes from placenta have been used to treat burns and other wounds for over a century.

Adult Tissue as Stem Cell Source

More recently, stem cells from a patient’s own fat, bone marrow, and circulating blood have been used to treat a variety of common conditions. For example, in the case of joint problems that require replacement or repair of cartilage, concentrated and directed doses of one’s own stem cells have been shown to be more effective and long-lasting than widely practiced alternatives using PRP (platelet rich plasma) or cortisol injections.

Acquiring stem cells from an adult’s blood requires many sessions and expensive processing, to harvest a useful number of therapeutic cells. Using bone marrow increases yield and requires only one session. Harvesting stem cells from fat has exciting applications and has shown efficacy for treating a variety of conditions.

However, adult stem cells from a patient’s old body are as old and as diseased as the patient himself, thus affecting their therapeutic potential, leading to inconsistent treatment results.

Birth Tissue as Stem Cell Source

Tissues typically discarded at birth (e.g. placenta, umbilical cord) is another rich source of stem cells that boast some unique properties that set them apart from adult stem cells. While adult stem cells need to be a match (much like blood transfusions) to avoid rejection by the recipient’s immune system, stem cells of umbilical cord and placental origin do not need to be matched. This is because the young cells present in birth tissues have not fully developed the surface proteins (“HLA markers”) found on the outer membranes of adult cells, and thus are able to “fly under the radar” of the recipient’s immune system. This immune-privileged status makes the transplant an easier task: instead of harvesting the cells from the patient that carries surgical risks, the doctor can now open the stem cell “medicine cabinet” to administer precise doses.

Stem cells of birth tissue origin have another unique advantage: These cells are young and have been shown to be therapeutically more active. While we do not yet know all of the mechanisms by which stem cells promote healing, we do know that these cells produce cytokines and growth factors, and recruit local cells to perform work of repair and regeneration. When birth tissue stem cells are compared to adult stem cells, they demonstrate higher level of secretion of cytokines and growth factors, higher speed of differentiation, slower cellular aging, stronger anti-inflammatory effects, and higher number of future cell divisions before eventual cell death. Also, studies have shown that umbilical cord stem cells have greater neuroprotective and neurorestorative properties compared to adult bone marrow stem cells.

Yet, it may not simply be the cells that are exerting therapeutic benefits. Recent study out of Stanford University showed that umbilical cord blood contains an abundant supply of a valuable protein called TIMP-2, which has shown to improve memory and learning, through improving hippocampal function.

1. Amniotic Membrane

Amniotic membrane products have been rapidly advancing in quality and popularity in the last few years. They show greater long-term efficacy over PRP (platelet rich plasma) or cortisol injections. Using these products does not require matching, because while the chorionic (maternally facing) membrane presents HLA markers, the fetal-facing membrane (amnion) is immune-privileged and can be used in allogeneic applications (transplantation into a different individual).

2. Umbilical Cord

Umbilical cord tissue is a dense source of MSC’s, mainly from a gelatinous material surrounding the blood vessels of the cord, called Wharton’s jelly (WJ). MSC’s (mesenchymal stem cells) were shown to have the capacity to differentiate into bone, cartilage, fat, skeletal muscle, cardiac muscle, and even neurons, or cells of the kidney, liver and pancreas. MSC’s from umbilical cords are more primitive than MSC’s derived from more mature tissue sources, and have intermediate properties between embryonic and adult stem cells. They have anti-inflammatory, immune-modulating, antimicrobial and anti-tumorigenic properties, are able to home in to sites of injury, and send out signals to recruit local cells to participate in rescue and repair. MSC’s from WJ may also be particularly helpful in the treatment of neurodegenerative conditions.

Umbilical cord blood contains hematopoietic CD34+ stem cells, which for decades have been used to treat the same panel of conditions for which bone marrow transplants were used for. Hematopoietic stem cells also help with angiogenesis (generating blood vessels) thus help ensure blood supply to the repaired tissue. There is also evidence, that a more naïve progenitor cell is present exclusively in cord blood. Recently, a valuable protein TIMP-2 was found to be abundant in the umbilical cord blood, and TIMP-2 was shown ng and hippocampal health.

*All donated cords are the by-products of normal, healthy births. At our lab, each cord is carefully screened for sterility and infectious diseases under American Association of Blood Bank standards.

Advantages of Birth Tissue-Derived Products

Non-embryonic stem cells can be harvested from various sources including bone marrow, adipose tissue, blood, amniotic fluid and birth tissue (such as umbilical cord and placenta). Among these, birth tissue-derived cell products offer many advantages, including abundance of stem cells, youthfulness of cells with higher metabolic activities, richness of cytokines and growth factors, easy harvesting, lack of need for HLA matching, excellent safety record, superior ability for replication and differentiation, higher anti-inflammatory and robust angiogenic potentials.

Although autologous stem cell transplantation (using a person’s own stem cells) is currently the most utilized form of stem cell therapy, as it avoids the risk of graft vs. host immune response, this method has significant drawbacks in the aging and chronically ill populations. Besides requiring invasive procedures to harvest the cells, in the older and chronically ill population, both the number and quality of stem cells have declined, limiting their regenerative capabilities.

Even among the young and healthy adult population, stem cells obtained from a person’s bone marrow or adipose tissue still produce less cytokines/growth factors, with lower anti-inflammatory potentials, lower rate of growth & differentiation, shorter telomeres (end sequences that protects the chromosomes), more rapid cellular aging, and less remaining generations of offsprings, when compared to the stem cells of birth tissue origin.

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