A patient will often come into our office with conflicting ideas about cortisone injections. His/her other doctors told them they are safe, effective, and will help their situation, if used sparingly. But, intuitively, the patient had doubts and concerns. (more…)
The Darrow Stem Cell Institute has published new research on the treatment of shoulder osteoarthritis and rotator cuff tears with bone marrow derived stem cells.The research appears in the peer-reviewed journal Cogent Medicine. The study can be found here in its entirety: Treatment of shoulder osteoarthritis and rotator cuff tears with bone marrow concentrate and whole bone marrow injections with a June 20, 2019 publication date.
Treatment of shoulder osteoarthritis and rotator cuff tears with bone marrow concentrate and whole bone marrow injections
Marc Darrow, Brent Shaw, Nicholas Schmidt, Gabrielle Boeger & Saskia Budgett | Udo Schumacher (Reviewing editor)
Article: 1628883 | Received 02 Jan 2019, Accepted 30 May 2019, Accepted author version posted online: 18 Jun 2019, Published online: 20 Jun 2019
Below is a summary of our findings:
Background: Human bone marrow has shown promise as a minimally invasive approach in treating a variety of musculoskeletal conditions due to the presence of stem cells, platelets, and growth factors in solution. This study examines the clinical effect of whole bone marrow (WBM) and bone marrow concentrate (BMC) injections in patients who were diagnosed with rotator cuff tears or shoulder osteoarthritis.
Results:
Conclusions: Our study demonstrated that patients diagnosed with shoulder osteoarthritis or rotator cuff tears experienced symptomatic improvements in pain and functionality when injected with bone marrow concentrate (BMC) or whole bone marrow (WBM) . Further randomized control studies are needed to validate these findings.
Explanations of research:
Patient results of note:
The outcomes of interest for this study were changes to pain (resting and active), overall improvement (percentage scale), and a joint function questionnaire. Data were collected at baseline, preceding each treatment, at 1 month, at 3 months, at 6 months, and annually after treatment. The functionality portion of the questionnaire, assessed degree of difficulty in performing daily activities, was based on 10 of 20 activities assessed in the Upper Extremity Functional Index, These included such activities as:
Both Groups 1 and 2 showed statistical significance in terms of pain and functionality when compared to baseline.
A leading provider of stem cell therapy, platelet rich plasma and prolotherapy
11645 WILSHIRE BOULEVARD SUITE 120, LOS ANGELES, CA 90025
In recent years doctors have found that by utilizing the growth factors found in the blood (specifically the platelets), a physician can activate stem cells already in the skin to grow new, younger-appearing skin.
Keypoints:
There has been a lot of research suggesting how PRP works on damaged skin and wrinkles. A September 2017 study in the Aesthetic surgery journal found that after an injection of PRP (Platelet Rich Plasma, see video below), doctors observed an increase of reticular dermis thickness (the lower of the two layers of the dermis (skin)). This thickening of the skin was due to deposition of elastic fibers (the stuff of skin elasticity) and collagen, with a fibrotic aspect (skin regeneration). (1)
A June 2017 study found that Platelet-rich plasma (PRP) induced a reduction in the manifestations of skin aging, including an improvement in wrinkles and elastosis (yellowish skin). In this research, doctors found that PRP provides growth factors that stimulate fibroblast activation (cells that start collagen production) and induce the synthesis of collagen and other components of the extracellular matrix. (The extracellular matrix is scaffold that collagen builds itself on.) The study focused on 18 women average age 49 years old. The studies findings include:
Published in the Journal of Cosmetic Dermatology, Egyptian physicians say that your own blood platelets can make your face look younger by attacking your wrinkles.
At Cairo University, also publishing in Journal of Cosmetic Dermatology, doctors found that PRP injections yielded significant improvement regarding skin turgor (appearance of plumpness from hydration) and overall vitality. For patients showed positive results for epidermal and dermal thickness.(4)
In Italy, doctors found Platelet Rich Plasma to be an emerging treatment in dermatology for skin rejuvenation. In their study twelve patients underwent 3 sessions of PRP injection at 1-month intervals. Clinical and patient evaluation showed improvement of skin texture. Skin gross elasticity, skin smoothness parameters, skin barrier function, and capacitance were significantly improved.(5)
Do you have a question?
1 Charles-de-Sá L, Gontijo-de-Amorim NF, Takiya CM, Borojevic R, Benati D, Bernardi P, Sbarbati A, Rigotti G. Effect of Use of Platelet-Rich Plasma (PRP) in Skin with Intrinsic Aging Process. Aesthetic Surgery Journal. 2017 Sep 7.
2 Cabrera-Ramírez JO, Puebla-Mora AG, González-Ojeda A, García-Martínez D, Cortés-Lares JA, Márquez-Valdés AR, Contreras-Hernández GI, Bracamontes-Blanco J, Ortiz JS, Fuentes-Orozco C. Plasma rico en plaquetas en el tratamiento del fotodaño cutáneo en las manos. Actas Dermo-Sifiliográficas. 2017 Jun 16.
3 Elnehrawy NY, Ibrahim ZA, Eltoukhy AM, Nagy HM. Assessment of the efficacy and safety of single platelet-rich plasma injection on different types and grades of facial wrinkles. J Cosmet Dermatol. 2017 Mar;16(1):103-111. doi: 10.1111/jocd.12258. Epub 2016 Jul 29.
4 Gawdat HI, Tawdy AM, Hegazy RA, Zakaria MM, Allam RS. Autologous platelet-rich plasma versus readymade growth factors in skin rejuvenation: A split face study. J Cosmet Dermatol. 2017 Apr 5.
5. Cameli N, Mariano M, Cordone I, Abril E, Masi S, Foddai ML. Autologous Pure Platelet-Rich Plasma Dermal Injections for Facial Skin Rejuvenation: Clinical, Instrumental, and Flow Cytometry Assessment. Dermatol Surg. 2017 Apr 3.
Marc Darrow MD, JD. Thank you for reading my article. You can ask me your questions using the contact form below.
The material in the injections that we use for our umbilical cord blood stem cell therapy comes from full-term live birth deliveries in a hospital setting. These materials are the umbilical cord blood from the discarded placenta, and of course, the umbilical cord itself.
The umbilical cord materials do not come from an aborted fetus nor are they taken from the baby. These materials are donated by the birth mother to the hospital for continuing medical research and for the development of medical products to help others. No baby is harmed.
There is controversy in the medical community about umbilical cord blood stem cells. Some insist that the injectable solution contains abundant live umbilical cord blood stem cells. Some suggest that the stem cells are not alive. I have seen the flow cytometry showing live stem cells. The research shows that these stem cells release cytokines and growth factors that awaken native stem cells.
I have tried this treatment on myself for both shoulders and knees. After great success, I started using this treatment on patients. I still use PRP and bone marrow depending on the patient’s pathology and requirements. To date the results are excellent for all of these treatments. We are in the process of doing a study on cord blood stem cells (we have done others on bone marrow and PRP) to see which treatments are the most successful. We are awaiting more long term results.
I have tried this treatment on myself, and, on numerous occasions.
Throughout this website you read about our clinical observations surrounding the use of bone marrow derived stem cells in the treatment of degenerative joint, tendon, ligament, and spine disease. In late 2018, after much research, I decided to add new products to our treatment line. Part of my decision was based on research like this, published in October 2018 in the journal Regenerative Medicine. (1)
“Stem cell-based therapy for the treatment of orthopedic diseases is arguably one of the most remarkable developments in the field of regenerative medicine. A better understanding of Mesenchymal stem cell biology and identification of Mesenchymal stem cells in (umbilical) cord blood have added umbilical cord blood to the sources of stem cells used for treatment of nonhematopoietic diseases.”
In that same study, the researchers noted: “the data conclusively establish that (umbilical cord blood) is enriched in cytokines (proteins that communicate commands to stem cells) and growth factors that play an important role in bone regeneration and repair.”
Bone regeneration and repair is certainly an appealing treatment for degenerative joint disease. Later in this article we will look at the research surrounding the impact of growth factors and umbilical cord mesenchymal stem cells not only for bone repair, but cartilage repair as well.
“The human umbilical cord is a promising source of mesenchymal stem cells. Unlike bone marrow stem cells, human umbilical cord mesenchymal stem cells have a painless collection procedure.”(2)
That’s what researchers wrote as the introduction to their paper, “Human umbilical cord mesenchymal stem cells: a new era for stem cell therapy.” The paper appeared in the medical journal Cell Transplantation. While bone marrow stem cell therapy has shown itself to be an effective and reliable treatment for musculoskeletal injury, a concern our patients had with the treatment surrounded the discomfort of the bone marrow stem cell harvest. The harvesting of bone marrow stem cells requires an aspiration of the bone marrow from the bone of the iliac crest of the pelvis. In other words, we drill into the pelvis. We numb the area of the pelvis, use a small drill device, and the marrow is aspirated within a few moments. We have done thousands of these procedures with thousands of happy patients.
However, even though we take great effort to make this procedure as painless as we can, some patients still did not like the process. Some decline a treatment that would be a great benefit to them because they cannot overcome the drilling aspect of the bone marrow treatment.
When we first offered donated umbilical cord stem cell therapy, many patients had questions. Specifically, is this treatment safe? First, these donated cells come to us from a laboratory. The cells are frozen for transit to assure safety.
Are the stem cells screened for infectious disease?
Laboratories that process human umbilical cord stem cells screen and test the donor mother with infectious disease panels.
The screening process is in accordance with and determined by the Food and Drug Administration (FDA) and American Association of Tissue Banks (AATB). We look for laboratories that surpass these governmental screening standards.
Is there a risk of rejection? Is there a risk of cell mutation?
Rejection and risk of the cell’s mutation into cancer cells is a frequent question of concern our patients have. I will refer to the research that show the safety of the treatment.
In the journal, Stem cell reviews and reports, (3) researchers noted that in looking for bone marrow donors for cancer patients and those with other immunodeficient disease, umbilical cord blood may offer a better answer for those waiting donation. Why?
Used allogenically implies that the stem cells from the umbilical cord blood can mix and intermingle with the bone marrow stem cells of a cancer or immune deficient patient whose own bone marrow had been damaged or destroyed by disease, infection, or chemotherapy. This intermingling comes with little risk of gene mutation or rejection.
This study tested the positive effects of umbilical cord blood stem cells in developing new cartilage. Researchers wrote in the journal BioMed research international (4) that umbilical cord stem cells have numerous advantages over bone marrow donor derived stem cells, including convenient collection, reduced immunogenicity (immune stimulating response), absence of tumor cell contamination, and lower risk of latent virus and pathogenic microorganism transmission.
The research that umbilical cord stem cells produced growth factors needed to rebuild bone marrow stem cells and that the umbilical cord blood donors could be unrelated or “unmatched,” to the recipient goes back to the early 1990s. Here researchers were looking for answers in helping children with various cancers who needed bone marrow transplants and who were not getting these transplants in time.
After 12 years of using unmatched donor stem cells in pediatric cancer patients, researchers recorded in 2005 in the Journal of Clinical Investigations (5) that “over the 12 years since the first unrelated-donor cord blood transplant was performed at Duke University Medical Center, there have been more than 6,000 unrelated-donor transplants performed in more than 150 locations around the world. In the vast majority of these transplants, HLA mismatching between donor and recipient was present at 1 or 2 HLA antigens.”
In other words, the most vulnerable patients, children with cancer, were not rejecting the umbilical cord stem cells from unrelated and unmatched donors.
In 2009, Joanne Kurtzberg, MD, the lead researcher in this 2005 study, published an update in the journal Current opinion in pediatrics. (6)
Despite limited enthusiasm in its early days, the field of cord blood transplantation is now firmly established.
Umbilical cord blood from related and unrelated donors, matched or mismatched at one or two antigens, is now widely regarded as an alternate donor source to matched marrow or peripheral blood for allogeneic transplantation in children as well as adults for a variety of malignant and non-malignant disorders.
This use of cord blood dramatically increases access to transplantation therapy for patients lacking matched related or unrelated adult donors.
In one of her concluding statements, Dr. Kurtzberg wrote: “In the future, (umbilical cord blood) may emerge as a source of cells for cellular therapies focused on tissue repair and regeneration.”
I would like to present learning points from researchers at Clemson University published in the Journal of Cell Science & Therapy (7). It reinforces the observations of these earlier studies.
“Next to hematopoeitic stem cells (those found in umbilical cord blood), the most widely studied stem cells in bone marrow are marrow-derived mesenchymal stem cells, also known as marrow stromal cells. In the adult, mesenchymal stem cells are found in highest concentration in the marrow cavity. Mesenchymal stem cell-like cells can be isolated from umbilical cord blood, placenta, perivascular (surrounding blood vessel) areas, amniotic fluid, and from the tissue surrounding the umbilical cord vessels, i.e., Wharton’s jelly. The collection of Mesenchymal stem cell-like cells from tissues that are discarded at birth is easier and less expensive than collecting Mesenchymal stem cells from a bone marrow aspirate. During the collection of these tissues, there is no health impact on either the mother or the newborn. At least in theory, these cells may be stored frozen and then thawed to provide stem cells for therapeutic use decades after cryogenic storage. . .”
More from this research indicates that:
A 2016 study from Korean researchers also demonstrated that mesenchymal stem cells (MSCs) derived from umbilical cord blood, as well as other tissues, could also suppress the allogeneic response of lymphocytes and serve as a useful source for cell therapies and allogeneic stem cell transplantation between HLA-incompatible recipients. They noted in their research that “…allogeneic MSCs derived from umbilical cord blood can be a useful candidate for allogeneic cell therapy and transplantation without a major risk of rejection.” (8)
In 2017, doctors reported their findings in the journal Stem cells translational medicine (9) of a seven-year observation of patients who had received human umbilical cords stem cell therapy for knee osteoarthritis:
Here are the safety learning points of this research:
Here are the learning points regarding the outcome of the patient’s human umbilical cord blood stem cells knee osteoarthritis treatment:
Not only did the doctors report that none of the seven patients in the study needed to undergo knee replacement despite the severity of their degenerative knee disease, but umbilical cord blood stem cells appear to be safe and effective for the regeneration of durable articular cartilage in osteoarthritic knees.
In the Chinese journal of reparative and reconstructive surgery, (10) doctors reported on the effects of umbilical cord blood stem cell therapy on their patients. Here are the learning points of their study:
Conclusion: Human umbilical cord stem cells can significantly improve the joint function and quality of life for patients with degenerative knee osteoarthritis. It takes effect after 1 month and the treatment effect can be sustained for 6 months.
A December 2018 study in the medical journal Stem cells translational medicine (11) examined single versus multiple umbilical cord blood stem cell treatments in patients suffering from knee osteoarthritis.
The patients in this study either:
In the research cited above, investigators have been able to show that human umbilical cord blood stem cells are safe and effective in treating musculoskeletal disorders. Now let’s delve a little deeper into how these stem cells work and how these stem cells interact with your own stem cells.
Let’s review: Umbilical cord blood contains a great amount of mesenchymal stem cells. Mesenchymal stem cells are part of the tissue building mechanism that makes connective tissue such as cartilage, muscles, bones, and fat pads. As a baby develops in the womb, these mesenchymal stem cells proliferate (grow) and differentiate (change) into creating the musculoskeletal system of the baby.
However, the baby needs more than stem cells. The baby needs growth factors and “cell signalers” that help the stem cells understand what they need to do. While I will explain growth factors and “cell signalers” below, I want to emphasize that it is the growth factors and “cell signalers” in the umbilical cord blood that are critical in making stem cell therapy treatments successful.
I also want to remind the reader that in our use of umbilical cord stem cell therapy, these materials are part of the afterbirth. When the doctor cuts the umbilical cord, the baby no longer has need of this material, the mother can now donate it.
In a study I referenced earlier in the journal BioMed research international, (4) researchers examined the pathway to cartilage repair with umbilical cord blood stem cells. This was not a clinical study, but rather a study to test whether umbilical cord blood stem cells could repair cartilage in a laboratory setting.
What the researchers found was that human umbilical cord blood mesenchymal stem cells could be easily induced to differentiate into mature bone and cartilage cells by stimulation with growth factors.
This was supported by research in the journal Molecular medicine reports,(12) which explored the effect of human umbilical cord mesenchymal stem cells on chondrocytes (cartilage building block cells) from patients with osteoarthritis in a laboratory setting. The researchers found human umbilical cord mesenchymal stem cells and chondrocytes have mutual effect on each other that causes the creation and proliferation of new cartilage cells. Therefore, human umbilical cord stem cells could significantly reduce the effects of osteoarthritis.
In research published in the International wound journal (13) doctors at Stanford University School of Medicine and the Georgia Institute of Technology along with author colleagues at collaborating medical universities, focused on growth factors presented in afterbirth material.
The researchers found these growth factors facilitated normal wound healing functions, including cell proliferation and chemotaxis (cell migration and movement to the site of injury), as well as promoting angiogenesis (blood vessel formation), deposition of Extracellular Matrix (the scaffold where stem cells grow) and regulating inflammation. I am going to explain these processes in greater detail below.
In simple terms, the growth factors found in the placenta/umbilical material:
In 2011, doctors at the University of Aberdeen published research in the journal Arthritis and rheumatism that provided the first evidence that resident stem cells in the knee joint synovium underwent proliferation (multiplied) and chondrogenic differentiation (made themselves into cartilage cells) following injury.(14)
This paper, presenting the idea that stem cells in an injured knee increased in numbers in preparation of healing, has been cited by more than 52 medical studies. If the stem cells in your knee synovial lining are abundant and could rebuild cartilage after injury, why isn’t your knee fixing itself? This is where umbilical cord blood stem cell therapy comes in.
One of those 52 medical studies I just mentioned, was performed by researchers at the University of Calgary in 2012. Among their questions, was the same question we just speculated on: “If the stem cells in the knee synovial lining are abundant and have the ability to rebuild cartilage after injury, why isn’t the knee fixing itself?” Here is what they published in the medical journal PLOS ONE.(15)
“Since osteoarthritis leads to a progressive loss of cartilage and synovial progenitors (rebuilding) cells have the potential to contribute to articular cartilage repair, the inability of osteoarthritis synovial fluid Mesenchymal progenitor cells (stem cell growth factors) to spontaneously differentiate into chondrocytes suggests that cell-to-cell aggregation and/or communication may be impaired in osteoarthritis and somehow dampen the normal mechanism of chondrocyte replenishment from the synovium or synovial fluid. Should the cells of the synovium or synovial fluid be a reservoir of stem cells for normal articular cartilage maintenance and repair, these endogenous sources of chondro-biased cells would be a fundamental and new strategy for treating osteoarthritis and cartilage injury if this loss of aggregation and differentiation phenotype can be overcome.”
In common terms, the “reservoir of stem cells for normal articular cartilage maintenance and repair,” already in the knee, are not fixing the knee because of a confused communication. The joint environment has changed from healing to degenerative and made clear communications “murky.” This is attested to in the research by this concluding statement:
“These results reveal a fundamental shift in the chondrogenic ability of cells isolated from arthritic joint fluids, and we speculate that the mechanism behind this change of cell behavior is exposure to the altered milieu of the osteoarthritis joint fluid.”
The paper suggests that getting these stem cells communicating and healing would create a fundamental new strategy in healing. Umbilical cord blood stem cell therapy helps with this problem of communication as demonstrated in the above studies.
This research was supported in a study from December 2017 published in the journal Nature reviews. (16) The paper suggested that recognizing that joint-resident stem cells are comparatively abundant in the joint and occupy multiple niches (from the center of the joint to the outer edges) will enable the optimization of single-stage therapeutic interventions for osteoarthritis.
You need blood circulation for healing – growth factors make new blood highways
From my early start in regenerative medicine until now, the role of inflammation in healing and the need to bring circulation to a degenerated joint has not changed. To heal a bad knee, a bad hip, a bad shoulder, to heal anything, you need blood circulation and the healing and growth factors blood brings to the site of injury and degeneration. These are the amazing things blood does:
Above we discussed the role of umbilical cord blood stem cell therapy in changing a diseased joint environment into a healing joint environment.
To get blood to an injury you need new blood vessels
Angiogenesis is the scientific term to describe the process of creating new blood vessels, “Angio” meaning related to blood vessels, “Genesis,” the creation of new blood vessels are formed as new branches of existing blood vessels. One of the growth factors found in human umbilical cord blood is called ANG-1.
ANG-1
ANG-1 is an Angiopoietin. Angiopoietins are protein growth factors in a developing baby that helps with vascular development and the formation of the blood circulatory network. When this growth factor is introduced into a degenerative joint it starts talking to the endothelium tissue cells that line the patient’s blood vessels.
What do they talk about?
It works together with the surrounding cellular matrix (the growth factors already in your body that surround your stem cells) and mesenchyme, the cells of the connective tissue, and your mesenchymal stem cells. ANG-1 also talks to your lymphatic vessels to prepare them for an increased flow of toxins and damaged tissue, that will be coming out of your joint.
Basic Fibroblast Growth Factor (bFGF)
Another important growth factor found in human umbilical cord blood is called basic fibroblast growth factor (bFGF). bFGF does many things, but in the context of this chapter, I want to focus on bFGF’s activity during injury repair.
Vascular Endothelial Growth Factor (VEGF)
As its name implies, Vascular Endothelial Growth Factor (VEGF) is involved in vascular and blood vessel cell development. VEGF makes blood vessels that helps form new bone and cartilage.
Now let’s watch the interplay between these growth factors in the development of new bone and cartilage.
So now you understand how this works in a baby and a developing adolescent, but, how does this work in the aging population and their challenges of degenerative disease? Researchers at Harvard give this recap in the medical journal Bone: (17)
Above, I touched on cell signaling, and that umbilical cord stem cells start conversations with the cells in an already damaged joint.
Basic fibroblast growth factor (bFGF) in addition to its role as a growth factor, is a signaling protein. Signaling proteins help cells communicate with each other and provide navigational signals. Navigation is obviously an important element in healing, in that healing cells need to know where they are going to in the damaged joint.
Transforming growth factor-beta (TGF-β)
Transforming growth factor-beta (TGF-β) found in umbilical cord blood is a growth factor of great interest in bone healing. What makes it so interesting is that it stimulates your own stem cells to reboot the healing process. How? By way of communicating with the other cells.
In January 2019 researchers examined the role of growth factors in helping stem cells in a damaged joint get to the point of injury. The study published in the journal Biochemical and biophysical research communications (18) found that “Endogenous (your own) bone marrow-derived mesenchymal stem cells are mobilized into peripheral blood and injured tissues by various growth factors and cytokines (messenger cells) that are expressed in the injured tissues, such as transforming growth factor-beta (TGF-β).”
In the research above, we see that umbilical cord stem cell growth factors help the damaged healing communication system in degenerative joints reset and restart. In doing so, the healing communications network starts giving commands to the cells to start healing again.
Here is some interesting research from doctors in the United Kingdom published in the November 2017 issue of Future science OA (19). The study from the University of Leeds and Leeds Teaching Hospital discusses native stem cell activity in degenerative knee disease.
The researchers found signs of tissue adaptation and attempted repair responses in osteoarthritis-affected osteochondral (bone and cartilage) tissues. What this means is that even in advanced osteoarthritis, the knee (and the stem cells within it) is trying to heal itself. But it is an attempted repair that never completes. So now the focus shifts to what can doctors do to help the stem cells complete the repair. One answer is more communicating growth factors. Where can you get them? You can get them from umbilical cord blood stem cells.
A leading provider of stem cell therapy, platelet rich plasma and prolotherapy
11645 WILSHIRE BOULEVARD SUITE 120, LOS ANGELES, CA 90025
References:
1 Sane MS, Misra N, Mousa OM, Czop S, Tang H, Khoo LT, Jones CD, Mustafi SB. Cytokines in umbilical cord blood-derived cellular product: a mechanistic insight into bone repair. Regenerative medicine. 2018 Oct 22;13(8):881-98.
2 Ding DC, Chang YH, Shyu WC, Lin SZ. Human umbilical cord mesenchymal stem cells: a new era for stem cell therapy. Cell transplantation. 2015 Mar 31;24(3):339-47.
3 Weiss ML, Troyer DL. Stem cells in the umbilical cord. Stem Cell Rev. 2006;2(2):155-62.
4 Li X, Duan L, Liang Y, Zhu W, Xiong J, Wang D. Human Umbilical Cord Blood-Derived Mesenchymal Stem Cells Contribute to Chondrogenesis in Coculture with Chondrocytes. Biomed Res Int. 2016;2016:3827057.
5 Kurtzberg J, Lyerly AD, Sugarman J. Untying the Gordian knot: policies, practices, and ethical issues related to banking of umbilical cord blood. J Clin Invest. 2005;115(10):2592-7.
6 Kurtzberg J. Update on umbilical cord blood transplantation. Curr Opin Pediatr. 2009;21(1):22-9.
7 Larson, Andrew & Gallicchio, Vincent. (2017). Amniotic Derived Stem Cells: Role and Function in Regenerative Medicine. Journal of Cell Science & Therapy. 08. 10.4172/2157-7013.1000269.
8 Lee HJ, Kang KS, Kang SY, et al. Immunologic properties of differentiated and undifferentiated mesenchymal stem cells derived from umbilical cord blood. J Vet Sci. 2016;17(3):289-97.
9 Park YB, Ha CW, Lee CH, Yoon YC, Park YG. Cartilage Regeneration in Osteoarthritic Patients by a Composite of Allogeneic Umbilical Cord Blood-Derived Mesenchymal Stem Cells and Hyaluronate Hydrogel: Results from a Clinical Trial for Safety and Proof-of-Concept with 7 Years of Extended Follow-Up. Stem Cells Transl Med. 2016;6(2):613-621. (1025)
10 Wang Y, Jin W, Liu H, Cui Y, Mao Q, Fei Z, Xiang C. CURATIVE EFFECT OF HUMAN UMBILICAL CORD MESENCHYMAL STEM CELLS BY INTRA-ARTICULAR INJECTION FOR DEGENERATIVE KNEE OSTEOARTHRITIS. Zhongguo xiu fu chong jian wai ke za zhi= Zhongguo xiufu chongjian waike zazhi= Chinese journal of reparative and reconstructive surgery. 2016 Dec;30(12):1472-7.
11 Matas J, Orrego M, Amenabar D, Infante C, Tapia‐Limonchi R, Cadiz MI, Alcayaga‐Miranda F, González PL, Muse E, Khoury M, Figueroa FE. Umbilical Cord‐Derived Mesenchymal Stromal Cells (MSCs) for Knee Osteoarthritis: Repeated MSC Dosing Is Superior to a Single MSC Dose and to Hyaluronic Acid in a Controlled Randomized Phase I/II Trial. Stem cells translational medicine. 2018 Dec 28.
12 Wang H, Yan X, Jiang Y, Wang Z, Li Y, Shao Q. The human umbilical cord stem cells improve the viability of OA degenerated chondrocytes. Mol Med Rep. 2018;17(3):4474-4482.
13 Koob TJ, Rennert R, Zabek N, et al. Biological properties of dehydrated human amnion/chorion composite graft: implications for chronic wound healing. Int Wound J. 2013;10(5):493-500.
14 Kurth TB, Dell’accio F, Crouch V, Augello A, Sharpe PT, De Bari C. Functional mesenchymal stem cell niches in adult mouse knee joint synovium in vivo. Arthritis Rheum. 2011 May;63(5):1289-300. doi: 10.1002/art.30234.
15 Krawetz RJ, Wu YE, Martin L, Rattner JB, Matyas JR, Hart DA. Synovial Fluid Progenitors Expressing CD90+ from Normal but Not Osteoarthritic Joints Undergo Chondrogenic Differentiation without Micro-Mass Culture. Kerkis I, ed. PLoS ONE. 2012;7(8):e43616. doi:10.1371/journal.pone.0043616.
16 McGonagle D, Baboolal TG, Jones E. Native joint-resident mesenchymal stem cells for cartilage repair in osteoarthritis. Nature Reviews Rheumatology. 2017 Dec;13(12):719.
17 Hu K, Olsen BR. The roles of vascular endothelial growth factor in bone repair and regeneration. Bone. 2016;91:30-8.
18 Yu J, Kim HM, Kim KP, Son Y, Kim MS, Park KS. Ceramide kinase regulates the migration of bone marrow-derived mesenchymal stem cells. Biochemical and biophysical research communications. 2019 Jan 8;508(2):361-7. / 1169
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Marc Darrow MD, JD. Thank you for reading my article. You can ask me your questions about this article using the contact form below.
I would like to share with you new research supporting the use of cells derived from amniotic and cord blood/placenta extracts.
A new study from researchers at Ohio State University, Brigham & Women’s Hospital, and Weill-Cornell Medical School published January 2019, in the journal Clinics in sports medicine,(1) suggests:
Researchers from Rush University Medical Center and Indiana University School of Medicine made these observations of the healing elements amniotic-derived products in the December 2018 issue of The journal of knee surgery.(2)
A lot of research surrounds that which surrounds the stem cells of amniotic-derived products – the Placenta extracts. The reason for this intense interest is the growth factors in the placenta material have shown that they can stimulate native stem cells to restart the repair process in a damaged joint.
Researchers from the National Academy of Sciences of Ukraine and the Institute for Transfusion Medicine, in Germany explain the healing potential of the placenta extract in the journal Stem Cell International.(3)
Here is some interesting research from doctors in the United Kingdom published in the November 2017 issue of Future science OA. (4) The study from University of Leeds and Leeds Teaching Hospital discusses native stem cell activity in degenerative knee disease.
The researchers found signs of tissue adaptation and attempted repair responses in osteoarthritis-affected osteochondral (bone and cartilage) tissues. What this means is that even in advanced osteoarthritis, the knee (and the stem cells within it) is trying to heal itself. But it is an attempted repair that never completes. So now the focus shifts to what can doctors do to help the stem cells complete the repair. One answer is more growth factors.
The study points out that bone remodeling is an active and dynamic process that depends upon the tightly regulated balance between bone formation and bone resorption. (Our bodies breakdown bone and recycle to bone elements to make new bone.) They drew attention to “The key cellular players in bone remodeling,”
One of the key points of their paper is an examination of the molecular communication between these key player cells involved in this coordinated process.
In research on amniotic/placenta materials published in the International wound journal (5) doctors at Stanford University School of Medicine and the Georgia Institute of Technology among others, focused on growth factors presented in the material as a means of promoting molecular communication and repair instructions between native stem cells in the damaged joint.
They found these amniotic/placenta growth factors demonstrated support in a normal wound healing, including cell proliferation and chemotaxis (the communication network necessary to organize cell migration and movement to the site of injury), as well as promoting angiogenesis (blood vessel formation), deposition of Extracellular Matrix (the scaffold where stem cells grow) and regulating inflammation.
In simple terms, the growth factors:
In this brief research we are able to point to studies that outline how stem cell therapy works by revitalizing the stem cells and healing components already present in your damaged joint. Let me know if you have questions.
STEM CELL INSTITUTE
A leading provider of bone marrow derived stem cell therapy, Platelet Rich Plasma and Prolotherapy
11645 WILSHIRE BOULEVARD SUITE 120, LOS ANGELES, CA 90025
PHONE: (800) 300-9300
1 Duerr RA, Ackermann J, Gomoll AH. Amniotic-Derived Treatments and Formulations. Clinics in sports medicine. 2019 Jan 1;38(1):45-59.
2 Hannon CP, Yanke AB, Farr J. Amniotic Tissue Modulation of Knee Pain—A Focus on Osteoarthritis. The journal of knee surgery. 2018 Dec 13.
3 Pogozhykh, O., Prokopyuk, V., Figueiredo, C., & Pogozhykh, D. (2018). Placenta and Placental Derivatives in Regenerative Therapies: Experimental Studies, History, and Prospects. Stem cells international, 2018, 4837930. doi:10.1155/2018/4837930
4 Ilas DC, Churchman SM, McGonagle D, Jones E. Targeting subchondral bone mesenchymal stem cell activities for intrinsic joint repair in osteoarthritis. Future Science OA. 2017;3(4):FSO228. doi:10.4155/fsoa-2017-0055.
5. Koob TJ, Rennert R, Zabek N, et al. Biological properties of dehydrated human amnion/chorion composite graft: implications for chronic wound healing. Int Wound J. 2013;10(5):493-500.