The ability of stem cells to divide and become more specialized cells—such as bone, blood, or muscle—makes them attractive agents in many areas of medicine. Additionally, the ability to harvest stem cells from an individual and reimplant them in the same patient thus potentially reducing or eliminating the risk of infection makes stem cell therapy appealing to both patients and physicians.
What is a stem cell?
Although there are many different definitions of a stem cell, all share two common characteristics: In the body, the offspring of a single cell are able to reconstitute a functional tissue, also called potency, and these cells are able to proliferate or renew themselves.
The development of stem cells starts with toti-potent cells developing from the fertilized egg and having the ability to divide and become all the different cells in an organism as well as the placental cells. Embryonic cells are pluripotent, meaning they can differentiate into various cell types. Multipotent fetal stem cells can develop into more than one cell type but are more limited than pluripotent cells.
One of the proven stem cell therapies is the use of bone marrow stromal cells for tissue replacement in building bone within focal cavities. The use of stem cells in a systemic way to strengthen bone or replace cartilage, is what we do at Regenexx and what we study.
Every second, 15 million blood cells ‘drop dead’ in your body (apoptosis)—and stem cell replacement keeps you alive. The source of those blood cells is bone marrow stem cells; without them, you die.
Additionally, the pericytes located on blood vessels detach and become MSCs in the presence of inflammation or injury. These MSCs, medicinal signaling cells, not only become the first line of defense against an auto-immune reaction by stopping an overaggressive immune response, they also make molecules that stop cells from dying from apoptosis.
A phase II study has found that using MSCs to treat degenerative disk disease results in lower mean pain scores, reduced opioid use, and fewer surgical and nonsurgical interventions for persistent pain at 12 months.
Stem cells and bone.
Cells may be taken from the bone marrow space and concentrated without any manipulation other than simple centrifugation. Because research found a positive correlation between the number and concentration of colony-forming units and the volume of mineralized callus at 4 months, we now apply the technique to treating nonunion.
With regard to the use of stem cells in treating osteonecrosis of the femoral head, a prospective case series of patients with stage 1 or stage 2 osteonecrosis followed for one year demonstrated 75 percent significant symptomatic improvement; they did not require any further surgical intervention, and exhibited no further collapse.
Cartilage repair and regeneration
Concerning the use of stem cells to treat OA and delay total joint replacement, we have data to support our treatment approaches. While all interventions short of joint replacement to date are symptom modifying, stem cells introduce the potential to alter the natural history of the disease, relieve pain and regenerate the joint. The number of patients at Regenexx and Regenexx Chicago are ever increasing. You decide, joint replacement or try stem cells first.