Stem Cell Therapy - Navigating Your Needs

Stem Cell Therapy - Navigating Your Needs

If it’s not a celebrity sports person endorsing stem cell therapy, then it’s an article on the regenerative power of stem cells and their ability to heal any number of diseases. Stem cell news, it appears, is everywhere nowadays. So how is one to navigate this brave new world of stem cell therapy and separate the hype from the facts?

Let us start with a definition of stem cells. Stem cells are cells that can renew themselves; they divide to produce cells just like themselves. Stem cells can differentiate into bone, muscle, nerve, skin or whatever else is needed by the body1. Stem cells have the ability to remake the immune system which allows us to treat autoimmune diseases with stem cell therapy2.

There are a number of sources for stem cells: embryonic, amniotic, placental, autologous (your own) and umbilical cord. Embryonic stem cells come from an embryo. These are not generally used in the U.S. as in order to harvest them, the embryo must be destroyed (illegal in the U.S.).

The FDA has found amniotic fluid and placental fluid to contain large amounts of generalized debris (i.e. skin cells, urine, water) but very few stem cells3. Colorado State University in their study confirmed the FDA studies4. Amniotic fluid and placental fluid are rich sources of Platelet Growth Factor (PGF). PGF helps the body to repair.

The most common stem cells in use today are autologous stem cells which are found throughout the body – in the brain, the blood, muscle, skin, liver, fat and bone marrow. Autologous stem cells are used by the body to repair diseased or injured tissue. According to the TOBI Regenerative Medicine Symposium of 2012, at birth, an individual has one stem cell for every 10,000 cells. At the age of 16, the body has one stem cell for every 100,000 cells. At age 60, the ratio has dropped dramatically to one cell for every 2 to 3 million cells5. As we age, we produce fewer stem cells. Our health also factors into the state of our stem cells. According to research done by the National Institutes of Health (NIH), if an individual has a serious disease such as cancer or diabetes, their stem cells are impacted6. This means that sick patients have sick stem cells.

There are many clinics around the country that use autologous stem cells taken from fat or bone marrow. This requires a minor surgical procedure to remove the fat or bone marrow. If you are considering taking adult stem cells from fat or bone marrow, consider the following:

  • Be aware that results vary according to age. If the patient is under age 20, the success rate is high. The older the patient, the lower the success rate.
  • Find out how many stem cells you are getting from your own tissue; if the doctor won’t tell you, consider trying another doctor! The FDA conducted a study and found that adipose (fat) tissue contains anywhere from 4,737 to 1.55 million cells per ml and bone marrow contains one stem cell to 317,400 cells per ml3.
  • Cost. The average cost for treatment of a knee with your own stem cells is approximately $5,000 to $7,000.
  • Your health status: If you’re sick with a chronic condition, e.g., MS, COPD, heart disease, diabetes, autoimmune, etc., your stem cells will be sick and not as effective. There are several companies that use your own stem cells to treat COPD or MS. Research by the NIH suggests that these patients do not fare as well.

The FDA does not approve of, nor does it disapprove of, the use of autologous cells, amniotic cells, placental stem cells or human umbilical cord (HUCSC) at the present time. They are taking a “watch and see” approach for now. In the case of umbilical cord stem cells, the FDA has tissue banks (which also include the blood banks) to oversee the harvesting and certification of the stem cells.

Per the FDA, HUCSC are the richest source, having about 5.1 million stem cells per ml1. Per the NIH, they are very young and able to become bone, muscle, cartilage and nervous tissue. These cells are not affected by age or the general health of the recipient. The HUCSC cells that we use are classified as mesenchymal stem cells (MSC). All MSC have the ability to migrate in the body, looking for damaged cells.

HUCSC are the result of a healthy mother giving birth to a healthy baby with no known genetic defects. If the mother does not want to freeze her child’s stem cells for later use, the stem cell banks can take the umbilical cord and obtain stem cells from the cord blood. HUCSC have no HLA-DR factor as they are immune-naïve. They do not react to the host so you can give them to anyone. The stem cells I use in my practice are safe for patients because they have been tested for 17 different diseases by the company I use for stem cells. Most other stem cell companies check for about seven.

There has been a concern that stem cells can cause cancer to grow. There are studies showing that HUCSC do not cause cancer to grow7. Bone marrow and fat stem cells do not cause cancer to grow, although they do cause the supporting structure around a cancer to grow. It is remarkable to think that we have been using stem cells since the 1950s to fight leukemia.

If you decide to use HUCSC, be sure to shop around. In the Tampa Bay Area, the cost to treat one joint can range from $2,500 upwards to $6,000. In choosing a doctor to treat you with stem cells, ask them a few questions:

  • What is the cost for treatment? Be wary if they start with a high price and work it down.
  • Exactly how many stem cells will be received during the treatment? This is important, especially when using fat or bone marrow stem cells. If the doctor is unable to give you a number, then be careful. If the government can determine the number of cells per CC, the doctor should be able to do so also.
  • What is the percentage of cells that is viable during the time of the treatment? If using HUCSC, the range can be from 50 to 90 percent viability. The higher, the better.
  • What solution does the practice use to mix their stem cells in before administering the treatment? (Example: lactated ringers, sterile water, lidocaine, normal saline, etc.). Be careful – some of these solutions kill stem cells.
  • What diseases have the stem cells been screened for? The tissue banks require seven diseases to be screened. Some companies screen up to 17 diseases. The more diseases the stem cells are screened for, the better.

If you are doing amniotic fluid or placental fluid stem cell injections, keep in mind that there are cheaper ways of giving yourself PGF. In fact, insurance companies often cover the cost so that you can save $5,000 to $6,000. Your doctor can let you know more about this.

Be sure to have your doctor go over the medications that you should refrain from using when being treated with stem cells. Also, you’re going to want to know the contraindication for not using stem cells at certain times. If you take a statin to lower your cholesterol, the statin will kill your stem cells as well. This study comes from the Tulane University School of Medicine. There are other medications that should be considered as well.

I hope this information is helpful as you navigate the new world of stem cell therapy.

John D. Young, MD

 

References:
Sanberg, P. R., Willing, A. E., Garbuzova-Davis, S., Saporta, S., Liu, G., Sanberg, C. D., El-Badri, N. S. (2006). Umbilical Cord Blood-Derived Stem Cells and Brain Repair. Annals of the New York Academy of Sciences. doi:10.1196/annals.1334.008

Autoimmune Diseases and the Promise of Stem Cell-Based. (2001). Retrieved fromhttps://stemcells.nih.gov/info/2001report/chapter6.htm
Vangsness, C., Jr. M.D., Sternberg, H., M.D., & Harris, L., B.S. (2015). Umbilical Cord Tissue Offers the Greatest Number of Harvestable Mesenchymal Stem Cells for Research and Clinical Application: A Literature Review of Different Harvest Sites [Abstract]. Arthroscopy: The Journal of Arthroscopic, & Related Surgery, 31(9), 1836-1843. doi:10.1016/j.arthro.2015.03.014
Berger, D. R., Lyons, N. F., & Steinmetz, N. J. (2015, October 25). In Vitro Evaluation of Injectable, Placental Tissue-Derived Products for Interventional Orthopedics [Interventional Orthopedics Foundation, School of Biomedical Engineering, Colorado State University Regenerative Sciences]. In Interventional Orthopedics Foundation.
Sampson, S., D.O. (2012). Mesenchymal stem cells. In TOBI Regenerative Medicine Symposium 2012
Fan, C., Zhang, Q., & Zhou, J. (2010). Therapeutic Potentials of Mesenchymal Stem Cells Derived from Human Umbilical cord [Abstract]. Stem Cell Rev and Rep. doi:10.1007/s12015-010-9168-8
Kang, S. G., Jeun, S. S., Lim, J. Y., Kim, S. M., Yang, Y. S., Oh, W. I. L., ... Park, C. K. (2008). Cytotoxicity of human umbilical cord blood-derived mesenchymal stem cells against human malignant glioma cells. Child’s Nervous System, 24(3), 293-302. DOI:10.1007/s00381-007-0515-2