Significant degeneration of a joint surface typically leads to a total joint replacement. However, because of wear and loosening in active patients, surgery may not be a permanent solution. There is ample scientific evidence that Cell-based treatment has the ability to achieve superior structural regeneration when compared to a mechanical prosthesis.
Regenerative medicine is an emerging field that seeks to repair or restore lost or damaged tissue function due to the effects of injury, disease, and aging. I have declared an ongoing commitment to explore the potential of adult derived regenerative cells and identify those who have positioned themselves as global leaders in regenerative medicine.
Advances in understanding of the biology of adult stem cells have attracted the attention of the biomedical research and clinical community, including those studying osteoarthritis (OA). Autologous adult stem cells are immunologically compatible, can be harvested from a variety of sources, including bone marrow and adipose tissue, and have no ethical issues related to their use. Mesenchymal stem cells derived from bone marrow and adipose tissue are the most highly characterized and are considered comparable. Both have demonstrated broad multipotency with differentiation into a number of cell lineages, including adipose, osteo-, and chondrocytic lineages. However, the easy and repeatable access to subcutaneous adipose tissue, the relatively simple isolation procedure, and the approximately 500-fold greater numbers of fresh MSCs derived from equivalent amounts of fat versus bone marrow provide a clear advantage in using Adipose-Mesenchymal Stem Cells over Bone marrow-Mesenchymal Stem Cells.
Adipose-derived regenerative cells Acronym: ADRC
A population of cells derived from adipose tissue with stem cell and wound repair activities. Adipose-derived regenerative cells (ADRC) consist of several cell types, such as adult stem cells, vascular endothelial cells, and vascular smooth muscle cells, among others. These cells contribute to wound repair through a variety of mechanisms by promoting blood vessel growth and blocking programmed cell death (apoptosis). In addition, ADRC can differentiate into several tissue types, such as bone, cartilage, fat, skeletal muscle, smooth muscle and cardiac muscle.
Isolation of cells from adipose tissue entails mincing and washing, followed by collagenase digestion and centrifugation. The pellet formed from centrifugation is deemed the Stromal Vascular Fraction (SVF), which is resuspended and used as the treatment modality. The SVF contains a heterogeneous mixture of cells including fibroblasts, pericytes, endothelial cells, circulating blood cells, and AD-MSCs. As I understand it and as a result of the cells’ “minimally manipulated” nature, many autologous stem cell therapies do not require an FDA drug approval application.
While the knowledge of cellular and molecular mechanisms of Regenerative Stromal Vascular Fraction Cells has been increasing at an exponential rate, clinical progress in the management of arthritis has been minimal. An easily accessible byproduct of plastic surgery, the adipose stromal vascular fraction, contains elements directly capable of promoting regenerative potential and decrease ongoing inflammation.
While there are ongoing clinical efforts to heal small geographic cartilaginous defects using stem cells as an adjunct in the United States, to the best of my knowledge, treatment of arthritis with Adipose-derived regenerative mesenchymal cells alone to heal lesions in cartilage or alter the natural history of degenerative arthritis in the hip, knee and shoulder is not available. One would have to travel elsewhere at a substantial cost for said treatment.