The field of regenerative medicine includes emerging therapies that have the potential to heal damaged and painful tissues in ways that were unheard of a few years ago.
Regenerative therapies have the potential to fully heal traumas and chronic conditions that might otherwise be beyond repair. And they provide an alternative to more invasive interventions such as surgery, while lessening the risk of developing dependence on painkilling drugs such as opioids.
An aging population has created a growing demand for alternative therapies to help them maintain their level of function and avoid the impact of chronic diseases such as diabetes, heart failure, and degenerative joint,
bone and nerve conditions. The cell therapies that comprise regenerative medicine are health care solutions based on the concept that the body heals from within. You are likely familiar with this idea. If you’re not yet familiar with regenerative therapies, now is the time to learn.
An established modality
The earliest form of cell therapy was the transfusion of blood, which is now commonplace in clinical settings.
Next was the transplantation of bone marrow, giving patients with radiation damage or blood cancer a chance to make new, healthy blood cells using the donor’s bone marrow stem cells.
Cell therapy using a patient’s cells is also used in cases of severe burn and scald injuries when a patient does not have a sufficient amount of undamaged skin for skin graft treatment.
The first organ and bone marrow transplants were performed decades ago. Today, advances in cellular and developmental biology and immunology have opened the door to the refinement of existing therapies and development of new ones.
Regenerative medicine typically takes three interrelated approaches:
Rejuvenation: methods that boost the body’s ability to self-heal. Even tissues that were once thought beyond the ability to heal once they were damaged, such as nervous tissue, have been shown to remodel and self-heal to some extent.
Replacement: the use of healthy cells and tissues to replace damaged ones. These tissues may come from living or deceased donors. Examples include organ transplants, such as the heart and liver, and tissues including skin, nerves, and heart valves.
Regeneration: the delivery of special types of cells and cell-based products (e.g., stem cells) to restore tissue and organ function.
The master cells
Stem cells are a key component of regenerative medicine. The body uses stem cells as one way of repairing itself. Studies have illustrated that if adult stem cells are harvested and then injected at the site of diseased or damaged tissue, reconstruction of the tissue is feasible under the right circumstances.
What sets regenerative medicine apart from many traditional interventions is that the former aims to treat the root cause of a patient’s condition by replacing lost cells or organs, whereas the latter mostly treat symptoms. This is because stem cells have the ability to differentiate—or mature—into the three primary groups of cells that form humans:
Ectodermal: gives rise to the skin and nervous system.
Endodermal: forms the gastrointestinal and respiratory tracts, endocrine glands, liver, and pancreas.
Mesodermal: forms bone, cartilage, most of the circulatory system, muscles, connective tissue, and more.
Stem cells can potentially produce any cell or tissue the body needs to repair itself such as skin cells, brain cells, and lung cells. This “master” property is called pluripotency.
Pluripotent stem cells have the ability to self-renew. This means that they can make more copies of themselves perpetually.
Ethical considerations
Stem cells have garnered considerable media coverage. The first research paper reporting how stem cells could be taken from human embryos
was published in 1998.1 Since then,debates over the ethics of stem cell research have divided scientists, politicians and religious groups. However, the most recent research has shown that there are many therapeutic options available that do not involve embryonic stem cells.
Alternatives to using embryonic stem cells have broadened the acceptance of stem cell research and therapies. Scientists have discovered ways to take ordinary cells, such as skin cells, and “reprogram” them by introducing several genes that convert them into pluripotent cells.
Researchers are just beginning to understand the subtle differences between the different kinds of pluripotent stem cells, and studying all of them offers the greatest chance of success in devising ways of using them to help patients.
Regenerative medicine and chiropractic
Every day regenerative medicine is making continual progress. Once this new technology becomes widely used in clinical practice, the potential bene- fits to the U.S. health care system and the economy will be enormous.
Regenerative medicine procedures must be performed by skilled medical professionals under the direction of a medical physician and are beyond the scope of most chiropractors.
This means that chiropractors interested in having their patients receive stem cell therapies must make a referral to a medical doctor outside of their practice or work in collaboration with a medical doctor in a multidisciplinary practice setting.
Since its inception, the chiropractic profession has embraced non-drug health care that improves the body’s ability to heal itself. Given chiropractors’ understanding of anatomy and the self-healing nature of the body, it makes sense to explore alternatives to drugs and surgery that maintain the integrity of the original anatomy.
Regenerative medicine provides patients with options that allow them to improve their function and quality of life, and decrease their possibility of becoming dependent on harmful medications.
Mark Sanna, DC, ACRB Level II, FICC, is a member of the Chiropractic Summit, the ACA Governor’s Advisory Cabinet, and a board member of the Foundation for Chiropractic Progress. He is the president and CEO of Breakthrough Coaching and can be contacted at 800- 723-8423 or through mybreakthrough.com.
Reference
1 Shamblott MJ, Axelman J, Wang S, et al. Derivation of pluripotent stem cells from cultured human primordial germ cells. Proceedings of the National Academy of Sciences of the United States of America. 1998;95(23):13726-13731.