Advanced regenerative treatments utilizing various forms of stem cells are beginning to take their rightful place in helping thousands of patients get better.
When it comes to regenerating joints, the non-surgical options range from amniotic tissue, amniotic fluid, to cord blood; and the surgical options include bone morrow and adipose tissue.
For either type, the product is obtained and then a simple injection into the joint is performed that takes no more than 10 minutes. But this is only the tip of the iceberg, as there are over 40 medical conditions, including cardiovascular, pulmonary, autoimmune, neurologic and digestive disorders, which can be treated with intravenous infusions derived from mesenchymal stem cells harvested from adipose tissue.
These options have allowed people who had no hope of recovery the opportunity to drastically improve their function and quality of life, while decreasing their reliance on harmful medications.
Accordingly, this subject is gaining so much traction that the state of Texas just passed the life-changing bill HB810, titled “Relating to the provision of certain investigational stem cell treatments to patients with certain severe chronic diseases or terminal illnesses and regulating the possession, use, and transfer of adult stem cells; creating a criminal offense,” or the “Stem Cell Act.”
In the U.S., stem cell therapy is allowed as long as nothing is added to the stem cells and they assist in the healing mechanism. But these stem cells cannot be grown for greater concentration and healing potential. The Texas bill makes exceptions for those who have a terminal illness or chronic disease. People from all ages who suffer from any of the above problems are candidates for this treatment.
A simpler procedure
If looking to make a referral for a patient to receive regenerative cell therapy, you would think the choice would be clear given the fact that bone marrow harvesting requires a surgical procedure that includes opening up the hipbone and scraping out marrow, which can potentially cause permanent pain at the site, vertebral misalignment due to the pressure exerted during the process, and even fracture the hip.
Whereas fat-derived adult stem cell therapy requires a simple procedure involving a mini-liposuction of the abdominal or flank area.
With manual suction and a small amount of lidocaine, the process is accomplished in less than 30 minutes with little pain during and after the procedure. In other words, the bone marrow patient undergoes a surgical procedure that requires weeks—if not months—of healing time and the adipose patient is able to drive home the same day.
Based on your understanding of human anatomy, spinal alignment and the detrimental effects of spinal misalignment, why would you want to refer your patients to an invasive bone morrow harvesting clinic for stem cell therapy if there were a simpler alternative?
One argument is that the amount of stem cells available in red bone morrow is higher than anywhere else in the body, but that thought is based on initial research into mesenchymal stem cells in the 1950s, in which it was generally accepted that it was the only place where these cells were located.
Conversely, the current literature strongly refutes that notion. In fact, it turns out there is a far higher concentration of mesenchymal stem cells (MSCs) in fat compared to that of bone morrow—to the tune of over 400 times more.
Only the facts, Jack
In a 2008 study that looked at adipose tissue (AT) versus bone marrow (BM) for harvesting mesenchymal stem cells (MSCs), it was found that MSCs derived from adipose tissue (AT-MSCs) possessed the highest proliferation potential.1
Adipose tissue is emerging as a source of stem cells that can be obtained by less invasive methods and in larger quantities than that available from bone marrow.
In addition, AT-MSCs grew at the highest speed and kept almost the same growth speed throughout 10 generations, whereas BM-MSCs grew at a relatively slow speed over 10 generations. This slowdown is referred to as cellular senescence.
According to an article published in 2017, researchers in South Korea found that “AT-MSCs have a higher proliferation and lower senescence (laziness in reproducing them- selves) than BM-MSCs” and “over extended periods, AT-MSCs exceed BM-MSCs by more than two orders of magnitude.”2
Furthermore, according to a 2015 study, AT-MSCs exhibit a significantly greater rate of population doubling than BM-MSCs, showing their higher proliferation potential.3
The foregoing discussion raises the question of why most orthopedic surgeons continue to champion the use of BM-MSCs. Other practitioners, including family practitioners, plastic surgeons and other non-surgical specialists are choosing AT-MSCs for their superior stem cell content.
Perhaps there are differences in billing codes, or it could be that you cannot teach an old dog new tricks.
Brent J. Detelich, DC, is president of Stem Cell Institute of America. He helps chiropractic and integrated offices make better decisions about their practices. He can be contacted through americastem.com, where you can learn more about regenerative medicine.
1 Peng L, Jia Z, Yin X, et al. Comparative anal- ysis of mesenchymal stem cells from bone marrow, cartilage, and adipose tissue. Stem Cells Dev. 2008;17(4):761-73.
2 Gun-Il Im. Bone marrow-derived stem/ stromal cells and adipose tissue-derived stem/ stromal cells: Their comparative efficacies and synergistic effects. Journal of Biomedical Materials Research. (Review article). 2017; 105,(9):2640-2648. doi: 10.1002/jbm.a.36089
3 Li CY, Wu XY, Tong JB, et al. Comparative analysis of human mesenchymal stem cells from bone marrow and adipose tissue under xeno-free conditions for cell therapy. Stem Cell Res Ther. 2015;6:55.