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What is Stem Cell Therapy?

Regenerative medicine is an emerging branch of medicine with the goal of restoring organ and/or tissue function for patients with serious injuries or chronic disease in which the bodies own responses are not sufficient enough to restore functional tissue. A growing crisis in chronic pain in our active and aging population have driven a search for new and alternative therapies beyond pain killers and steroids. Something that can actually "fix" the problem once and for all, not just cover it up. 

New and current Regenerative Medicines can use stem cells to create living and functional tissues to regenerate and repair tissue and parts of the body that are damaged due to age, disease. Areas like arthritic knees of damaged spinal discs that are resistant to other treatments. Stem cells have the power to go to these damaged areas and regenerate new cells and tissues by performing a repair and a renewal process, restoring functionality. Regenerative medicine has the potential to provide a cure to problems that before required invasive surgeries or worse chronic pain medication.  Stem cells can also be used to avoid future problems by repairing damaged tissue before the damage becomes so excessive that more invasive and risky treatments are needed. 

While some believe the therapeutic potential of stem cells has been overstated, an analysis of the potential benefits of stem cells based therapies indicates that 128 million people in the United States alone may benefit with the largest impact on patients with Cardiovascular disorders (5.5 million), autoimmune disorders (35 million) and diabetes (16 million US patients and more than 217 million worldwide): US patients with other disorders likely to benefit include osteoporosis (10 million), severe burns (0.3 million), spinal cord injuries (0.25 million).  

Our office has been on the forefront of stem cell injection treatments as one of the earliest adopters. Our team of hematologists, sports medicine and orthopedic specialists have been able to give patients relief who have otherwise been disabled due to pain. While this is by no means a miracle it does hold promise to be the breakthrough that we have all been waiting for.

Where do the stem cells come from?

This is a far more complex question. There are many types of stem cells, many of which hold great promise for tomorrow, and others that are being used today. The main dividing line is between Adult Stem Cells (ASC) and Embryonic Stem Cells (ESC). ESC’s have captured the attention of early stem cell researchers because of their inherent ability to expand into any type (tissue, bone, etc). While promising, research shows that ESC’s present a high risk of tumor formation because of their ability to reproduce without end. There is also little evidence that shows that ESC’s are ready for use in the treatment of diseases in humans. Adult stem cells, on the other hand, are the repair cells that our bodies currently use to mend wounds and heal ourselves. Unlike ESC’s, adult stem cells have been shown to be effective in animal and early human clinical models for treating a wide variety of diseases,including orthopedics and neurologic diseases. Additionally, ASC’s can be safely collected from various sources in the human body, such as fat, peripheral blood and bone marrow.

How do you get the stem cells?

In our clinic a board certified hematologist first numbs a small area of skin over the side of the iliac crest, an area near the belt line. Once the skin is numbed the deeper structures are also anesthetized including the surface of the bone where a needle is them introduced. Using a special needle the hematologist aspirates (draws back) a small quantity of blood from the bone marrow which is then spun it down in a special centrifuge to isolate the stem cells. This procedure can isolate a few hundred thousand stem cells which a second doctor, a specialist in injections, re-implants back into you where your problem is. Most stem cell clinics use this technique, known as Bone Marrow Aspirate Concentrate (BMAC).  

How are the stem cells delivered?

Likely the easiest way to separate the wheat from the chafe in stem cell therapy is by asking how the clinic plans on delivering cells. While IV delivery is attractive because of the low level of expertise and expense it takes to deliver cells, studies have consistently shown that adult stem cells delivered in this fashion are trapped in the lungs (pulmonary first pass effect). Of even more concern is a recent study showing that for patients considering the use of stem cells to treat CNS disorders, only about 1 in 200,000 cells injected via an IV route reaches the CNS (1.5-3.7% made it past the lungs, 0.295% made it to the carotid artery, and 0.0005% made it past the blood brain barrier into the CNS). At this point, until these pulmonary first pass issues are worked out, credible stem cell delivery is local. This means placing cells directly into the tissue or into the arterial circulation that directly supplies the tissue. In addition, for orthopedic applications (and likely for others), it's hyper-local, meaning that placement of cells into one part of the joint may provide results; where as non-specific placement in the joint provides no results. The same holds true for cardiac placement. Our injection specialist is board certified in pain management and uses both realtime ultrasound and x-ray imaging (fluoroscopy) to guide the stem cell placement with pin point accuracy. 

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