Each day there are more and more studies showing the benefit of autologous Stem Cells (your own stem cells used to fight an issue). From hair loss to Crohn’s complications, to arthritis and heart disease, the future of stem cell research looks promising.
One of the issues in doing this research is the cost. Studies that are funded by the NIH are in progress, but they are slow to publish and it may take years before we get a final answer or FDA approved application of the use of stem cells.
For many patients, they do not have years to wait. Even if the FDA does approve the use of autologous stem cells, it may not be a 100% guarantee it will work for 100% of the patients. For some patients, they prefer to find out now than to wait for the FDA to approve stem cell injections officially.
I have had some patients who feel the stem cell injections into their joints helped their pain and eliminated their need for surgery.
With the issue of Dry Eye, it will take years to find out if the injections of stem cells into the meibomian gland, lacrimal gland, and limbal stem cell area around the cornea will relieve dry eye symptoms or provide a cure. The issue is that with every passing year, the meibomian glands likely produce more scar tissue and increase the risk that stem cell injections will not work or be able to reestablish a normal gland structure.
It is a race against time for many with dry eye disease and meibomian gland dysfunction.
The cost is another issue. As we look to get grants, we are finding grant money is hard to obtain. Most of the surgeons doing stem cell research have to charge the patient to be able to fund the research and the machines needed to do stem cell harvesting. This is an issue for everyone involved (see link below to Forbes article. Surgeons would love to have research funds to be able to fund these research projects. Those funds in most cases are not available. Many of the treatments surgeons have used for years have been used “off label” or not approved by the FDA for the indicated reason: but surgeons knew it helped and thus used it “off label” to help patients. Most surgeons out there are honestly trying to look for relief for their patients or even a cure, just like their patients. Many surgeons have family members with the condition they are using stem cells for and have used or would use the treatment on their loved one as well.
For many patients, there may not be much of a choice right now. All stem cell injections are experimental and not FDA approved. Trials are underway but may take years for formal FDA approval: do I wait for years until it is FDA approved and risk having more scare tissue form in my eye tissues or do I give experimental stem cell injections a try? I believe it is best to give the stem cell injection a chance as there is no other option or cure for those patients who have lost their meibomian glands. Even PRP injection, which I have reported on 1 patient who had some meibomian gland structure though almost gone, has not been done on a patient that had no gland structure at all.
I will still inject PRP into meibomian glands that have not benefited from the usual options: LipiFlow, IPL, Probing, but we are about to commence with our protocol for stem cell injections into the meibomian gland, lacrimal gland, and/or limbal stem cell area with adipose derived stem cells.
Adipose-derived stem cells (ADSCs) are mesenchymal stem cells (MSCs) within the stromalvascularfraction of subcutaneous adipose tissue. ADSCs secrete growth factors and other proteins, and have been used to regenerate skin with satisfactory results.
This review focuses on the effect of ADSCs and their secretory factors on the stimulation of hair growth in vitro, ex vivo and in vivo.
The conditioned media of ADSCs (ADSC-CM) increases the proliferation rate of human follicular cells. ADSCs-derived proteins improve hair growth and protect human dermal papilla cells against cytotoxic injury caused by androgen and reactive oxygen species. Moreover, ADSC-CM induces the anagen phase and promotes hair growth in mice, and enhances the elongation of hair shafts in ex vivo human hair organ cultures.
ADSC-CM promotes hair growth in vitro, ex vivo, and in vivo. Given that ADSCs are one of the most accessible sources of MSCs, ADSC-derived proteins may be feasible clinical therapeutic agents for the treatment of hair loss.
*Department of Medicine, University of Louisville, Louisville, Kentucky; †Techshot, Greenville, Indiana; and ‡Department of Regenerative Medicine, Massachusetts General Hospital, Boston, Massachusetts.
Anorectal fistulas (ARFs) are a common, devastating, event in the life of a patient with Crohn’s disease. ARFs occur in up to 50% of patients with Crohn’s disease. Treatment begins with surgical drainage of the initial abscess, followed by antibiotic therapy, then anti-inflammatory medications. If medical therapy fails to close the fistula tract, surgical intervention is often pursued. Surgery incurs risk of incontinence because of sphincter injury. Increasingly, the role of cell-based therapy is being investigated in ARFs. We evaluated the role a bioabsorbable scaffold plays in delivering cell-based therapy using a porcine model of AFR.
ARFs were mechanically created and matured by setons. After 28 days, setons were removed; periaortic fat was harvested and processed for stromalvascularfraction (SVF). The cells were labeled with a membrane stain for later identification, then injected into the fistula or implanted through scaffold. Fistulas not treated with cells were injected with fibrin glue. Animals were monitored visually for healing at weeks 2 and 4, then euthanized to evaluate fistulas for histologic healing.
All fistulas (6/6) treated with SVF + scaffolds healed by week 2, compared with only 4/6 with just SVF and 0/5 treated with fibrin glue. Scaffolds retained SVF within the fistula tract more readily than injection method and SVF+scaffold treatment accelerated the healing process. Robust neovascularization was also seen in fistulas treated with SVF+scaffold. No adverse events occurred.
Scaffold technology may improve cell-based therapy healing rates for Crohn’s ARFs. This advance should be investigated by human trials.
Facial bone defects are frequently encountered problems in clinical practice. Bone grafts, flaps, and alloplastic materials are often used in their treatment. This leads to donor site morbidity and prolongation of the operation. The authors have planned this study to examine whether adipose tissue derived stromalvascularfraction (SVF) has an osteogenic effect in the critical sized membranous bone defect of the zygomatic bone.
MATERIALS AND METHODS:
Twenty male Wistar Albino rats were used. Bilateral zygomatic arches were opened with lateral incisions. A standard 3-mm bone defect was created bilaterally on the zygomatic arches of the rats. In the experiment side, the stem cell-rich SVF that was obtained by applying centrifugal process to the adipose tissue derived from the inguinal fat pad was injected into the site of the right zygomatic arch bone defect. In the control side, left zygomatic arch was left for secondary bone healing without any treatment after a 3-mm critical bone defect was created. In the postoperative 10th (n:5) and 20th weeks (n:13), the healing areas of bone defects were assessed by a 3-dimensional tomography, and then, the rats were sacrificed and bone healing was examined histologically.
There were no statistically significant differences on the 10th week results. At the 20th week new bone formation amount calculated from the 3-dimensional computed tomography results was significantly higher in the experiment side (P = 0.033). In the histological examination at the 20th week, there was significantly more callus formation in the experiment side (P = 0.0112).
Stem cells can increase the rate of bone healing by differentiating into certain tissues. It is predicted that adipose tissue-derived SVF rich with mesenchymal stem cells can increase bone healing in facial bone defects and this application could replace the use of bone grafts and flaps in clinical practice. As a result, it is concluded that adipose tissue-derived stem cells can potentiate osteogenesis and reduce the possibility of developing necrosis on the bone ends.
For advanced arthritis pain, stem cell treatment is a promising therapy.
The jury is still out on whether stem cell therapy can cure arthritis, but recent research has shown that stem cells implanted in arthritic cartilage can produce healthy cells to replace defective tissue.
How does stem cell treatment work?
Stem cells are “blank slate” cells with the ability to become several kinds of different cells in the body. In theory, these cells can replace or repair damaged tissues, eliminating the need for surgery. For example, if injected into a person’s spinal cord, the stem cells mimic spinal cord cells.
So promising is this research that Keck Medicine of USC recently established the Department of Stem Cell Biology and Regenerative Medicine to study how the body’s own developmental and repair mechanisms can restore damaged cells, tissues and organs — redefining regenerative medicine treatments for human diseases. The initiative includes tissue engineers, developmental biologist, geneticists and clinicians collaborating on stem cell research.
Who could benefit from stem cell treatment?
Andy McMahon, MD, PhD, chair of stem cell biology and regenerative medicine, predicts that because stem cell treatments would replace damaged tissue with healthy tissue, treatments would be more than remedies – they would be cures. This outcome could reach many different types of patients in the next decade, including those with osteoarthritis, HIV/AIDS, Alzheimer’s disease, dry age-related macular degeneration and immune system damage due to chemotherapy.
For arthritis patients, enough progress has been made in cell transplant therapy that autologous chondrocyte implantation (ACI), a cell transplant therapy using the patient’s own cells, is now widely used to replace cartilage between joints.
Doctors believe stem cell therapies can help patients have a more sustainable and rewarding life.
Where can I have stem cell therapy?
There are no FDA-approved therapies using stem cells to treat arthritis, but there are clinical trials to test the effectiveness of stem cell treatment. As part of a 2016 trial, neurologist Charles Liu, director of the USC Neurorestoration Center, through a clinical trial sponsored by the California Institute for Regenerative Medicinethrough Asterias Biotherapeutics, and involving five other clinical sites, squeezed ten million stem cells into a paralyzed patient’s spinal cord. Within months, the patient could lift weights, write his name and feed himself.
The study is not complete, and the treatment is not standard therapy. But the promising results prompted researchers to extend the treatment to people with less-severe spinal injuries who would have been too risky to include in initial tests.