We only use Autologous Adult Stem Cells
Autologous means ‘from yourself’, cells from your own body cannot bring any new disease or genes that can weaken your body and will also not be rejected. If we were to culture your cells before reinjecting them, this would be regarded as manufacturing and many more regulations would then be needed. These extra regulations seek to control risks such as infection, disease control and genetic change in the culture. Cultured cells are ten times larger than non-cultured cells. This means they have difficulty getting through the lungs (Pulmonary first pass phenomenon) which filter them out and struggle to cross the blood brain barrier. Non-cultured cells will go into every tissue in the body including the brain and spine.
Allogeneic means from another human (xenogeneic means from an animal or other species) Embryonic and foetal stem cells are all allogeneic, these cells are immune privileged meaning that your body will not recognize them as foreign and will therefore not attack them. However, the problem is that as they differentiate and grow into nerve, muscle skin cells etc. your body will recognize them as foreign and start to destroy them. If you are a close cross match then it will be less likely that you will need to protect them from suppressing your immune system.
Most of the early research has been on embryonic stem cells because they were thought to be more potent as they are able to grow into any cell in the body. Recent work has focused more on adult stem cells which do not make as many different cell types but are proving easier and safer to use.
Will stem cells work for me?
To answer this we need to understand how these cells work…
How do adipose stromal cells work? The natural role of these cells in the body is to repair and regenerate the tissue they are found in. These cells are found in every tissue of the body.
When we strip these cells off the outside of the blood vessels and transplant them into a new location, they make home to an area of inflammation where they attach and become permanently resident. Research shows that 60% of these cells attach within 20 minutes. The remaining 40% will have found a new home somewhere in the body well within the first 24 hours. It does not matter where the cells are transplanted, some will stay in that location and some will leave.
The stem cells in diseased tissues work overtime to repair the surrounding damaged tissues and then slowly wear out and die. Chronic inflammation accelerates this stem cell depletion. When large numbers of stem cells are transplanted with large numbers of cytokines, the chronic inflammation is stopped. The genes producing the inflammation are down-regulated almost immediately. The new stem cells restore resident stem cell numbers to normal levels. Once the inflammation has resolved the surviving stem cells are able to function normally as the tissue becomes healthier. The repair function of the damaged tissue is enhanced and healing can proceed at normal levels. If cells are damaged and not working properly they can be healed. Existing tissue can thicken, fissures can fill in, however it must be noted that large cartilage defects will not fill with new cells. These activities are referred to as paracrine activities of stem cells. (Paracrine means to secrete locally active substances)
Evidence for Osteoarthritis
There are four distinct possible outcomes that ACBIs can deliver for the complex disease of osteoarthritis. Any of these or all would significantly reduce the health burden of the disease on the Australian community.
ACBIs for joint disease and injury is routinely used in the veterinary industry to modify disease outcomes in companion animals and horses. Veterinarians have used autologous SVF to treat tendon and ligament injuries and joint disease in horses on a commercial basis since 2003 in the USA [1,2] and recently in Australia (2007). A summary of the animal literature can be found in the review by Perdisa et al (2015).
There is a body evidence in the literature that supports the use of ACBIs for knee osteoarthritis (Table 1 and 2). A total 5,336 patients have been treated safely and effectively for knee and hip disease within 44 scientific publications. The longest period being 11 years.
Within these publications there are 6 Level II studies and 4 level III studies which evidence over 20 publications with 1,628 patients for SVF derived cells; and 22 publications for 3,708 patients for bone-marrow derived cells.
A NHMRC-Body-of-Evidence-Matrix can be downloaded here.
Clinical Evidence of knee and hip joints treated by ACBIs
Table 1: Publication list of knee and hip joints treated by autologous SVF and ASCs (updated 6th July 2016)
A total of 20 SVF refereed publications with 1,638 patients for Knee and Hip disease with 2 Level II studies and 3 Level III studies. See references at bottom of this page.
Adipose SVF Publications for Knee and Hip diseases
Autologous Adipose ASC* Publications for Knee and Hip diseases
SVF – autologous stromal vascular fraction, HA – Hyaluronic acid, FG – fibrin glue, PRP – platelet rich plasma.
*ASC – Adipose mesenchymal stem cells which have been grown and cultured from adipose tissue
Table 2: Publication list of knee and hip joints treated by bone marrow-derived cells in knee and hip joints (updated 6th July 2016)
A total of 22 publications with 3,708 patients treated (with 4 Level II studies, and 2 Level III studies).
A-MSC – Autologous cultured mesenchymal cells, PBMC – peripheral blood monocytes, BMC – Autologous non-cultured bone marrow concentrate cells.
References – Publications – Adipose SVF & Autologous Adipose ASC* Publications for Knee and Hip diseases [Table 1]
- Gibbs, N., et al., Management of knee osteoarthritis by combined stromal vascular fraction cell therapy, platelet-rich plasma, and musculoskeletal exercises: a case series. J Pain Res, 2015. 8: p. 799-806.
- Kim, Y.S., et al., Assessment of clinical and MRI outcomes after mesenchymal stem cell implantation in patients with knee osteoarthritis: a prospective study. Osteoarthritis Cartilage, 2016. 24(2): p. 237-45.
- Kim, Y.S., et al., Comparative Matched-Pair Analysis of the Injection Versus Implantation of Mesenchymal Stem Cells for Knee Osteoarthritis. Am J Sports Med, 2015. 43(11): p. 2738-46.
- Koh, Y.G., et al., Adipose-Derived Mesenchymal Stem Cells With Microfracture Versus Microfracture Alone: 2-Year Follow-up of a Prospective Randomized Trial. Arthroscopy, 2016. 32(1): p. 97-109.
- Garza, J., et al., Use of autologous adipose-derived stromal vascular fraction to treat osteoarthritis of the knee: A feasibility and safety study. J Regen Med, 2015. 4: p. 1-6.
- Kim, Y.S., Y.J. Choi, and Y.G. Koh, Mesenchymal Stem Cell Implantation in Knee Osteoarthritis: An Assessment of the Factors Influencing Clinical Outcomes. Am J Sports Med, 2015.
- Fodor, P.B. and S.G. Paulseth, Adipose Derived Stromal Cell (ADSC) Injections for Pain Management of Osteoarthritis in the Human Knee Joint. Aesthet Surg J, 2015.
- Michalek, J., et al., Stem Cell Therapy of Osteoarthritis Using Stromal Vascular Fraction Cells – Proceeding of the STEMSO Conference. CellR4, 2014. 2(1).
- Bui, K.H.-T., et al., Symptomatic knee osteoarthritis treatment using autologous adipose derived stem cells and platelet-rich plasma: a clinical study. Biomedical Research and Therapy, 2014. 1(1).
- Pak, J., J.H. Lee, and S.H. Lee, Regenerative repair of damaged meniscus with autologous adipose tissue-derived stem cells. Biomed Res Int, 2014. 2014: p. 436029.
- Koh, Y.G., et al., Comparative outcomes of open-wedge high tibial osteotomy with platelet-rich plasma alone or in combination with mesenchymal stem cell treatment: a prospective study. Arthroscopy, 2014. 30(11): p. 1453-60.
- Koh, Y.G., et al., Second-Look Arthroscopic Evaluation of Cartilage Lesions After Mesenchymal Stem Cell Implantation in Osteoarthritic Knees. Am J Sports Med, 2014. 42(7): p. 1628-37.
- Koh, Y.G., et al., Clinical results and second-look arthroscopic findings after treatment with adipose-derived stem cells for knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc, 2013. 23(5): p. 1308-16.
- Koh, Y.G., et al., Mesenchymal stem cell injections improve symptoms of knee osteoarthritis. Arthroscopy, 2013. 29(4): p. 748-55.
- Pak, J., et al., Safety reporting on implantation of autologous adipose tissue-derived stem cells with platelet-rich plasma into human articular joints. BMC Musculoskelet Disord, 2013. 14: p. 337.
- Pak, J., J.H. Lee, and S.H. Lee, A novel biological approach to treat chondromalacia patellae. PLoS One, 2013. 8(5): p. e64569.
- Koh, Y.G. and Y.J. Choi, Infrapatellar fat pad-derived mesenchymal stem cell therapy for knee osteoarthritis. Knee, 2012. 19(6): p. 902-7.
- Pak, J., Autologous adipose tissue-derived stem cells induce persistent bone-like tissue in osteonecrotic femoral heads. Pain Physician, 2012. 15(1): p. 75-85.
- Pak, J., Regeneration of human bones in hip osteonecrosis and human cartilage in knee osteoarthritis with autologous adipose-tissue-derived stem cells: a case series. J Med Case Rep, 2011. 5: p. 296.
- Bright, R., Adipose derived stromal cells to treat joint disease. J Cosmetic Surgery & Medicine, 2010. 5(3).
- Pers, Y.M., et al., Adipose Mesenchymal Stromal Cell-Based Therapy for Severe Osteoarthritis of the Knee: A Phase I Dose-Escalation Trial. Stem Cells Transl Med, 2016. 5(7): p. 847-56.
- Jo, C.H., et al., Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a proof-of-concept clinical trial. Stem Cells, 2014. 32(5): p. 1254-66.
References – Publications – Autologous Bone Marrow-Derived Cells [Table 2]
- Centeno, C.J., et al., A multi-center analysis of adverse events among two thousand, three hundred and seventy two adult patients undergoing adult autologous stem cell therapy for orthopaedic conditions. Int Orthop, 2016.
- Soler, R., et al., Final results of a phase I-II trial using ex vivo expanded autologous Mesenchymal Stromal Cells for the treatment of osteoarthritis of the knee confirming safety and suggesting cartilage regeneration. Knee, 2016.
- Gobbi, A., et al., Matrix-Induced Autologous Chondrocyte Implantation versus Multipotent Stem Cells for the Treatment of Large Patellofemoral Chondral Lesions: A Nonrandomized Prospective Trial. Cartilage, 2015. 6(2): p. 82-97.
- Yamasaki, S., et al., Cartilage Repair With Autologous Bone Marrow Mesenchymal Stem Cell Transplantation: Review of Preclinical and Clinical Studies. Cartilage, 2014. 5(4): p. 196-202.
- Vangsness, C.T., Jr., et al., Adult human mesenchymal stem cells delivered via intra-articular injection to the knee following partial medial meniscectomy: a randomized, double-blind, controlled study. J Bone Joint Surg Am, 2014. 96(2): p. 90-8.
- Centeno, C., et al., Efficacy of autologous bone marrow concentrate for knee osteoarthritis with and without adipose graft. Biomed Res Int, 2014. 2014: p. 370621.
- Gobbi, A., G. Karnatzikos, and S.R. Sankineani, One-step surgery with multipotent stem cells for the treatment of large full-thickness chondral defects of the knee. Am J Sports Med, 2014. 42(3): p. 648-57.
- Orozco, L., et al., Treatment of knee osteoarthritis with autologous mesenchymal stem cells: a pilot study. Transplantation, 2013. 95(12): p. 1535-41.
- Saw, K.Y., et al., Articular cartilage regeneration with autologous peripheral blood progenitor cells and hyaluronic acid after arthroscopic subchondral drilling: a report of 5 cases with histology. Arthroscopy, 2011. 27(4): p. 493-506.
- Kasemkijwattana, C., et al., Autologous bone marrow mesenchymal stem cells implantation for cartilage defects: two cases report. J Med Assoc Thai, 2011. 94(3): p. 395-400.
- Davatchi, F., et al., Mesenchymal stem cell therapy for knee osteoarthritis. Preliminary report of four patients. Int J Rheum Dis, 2011. 14(2): p. 211-5.
- Nejadnik, H., et al., Autologous bone marrow-derived mesenchymal stem cells versus autologous chondrocyte implantation: an observational cohort study. Am J Sports Med, 2010. 38(6): p. 1110-6.
- Haleem, A.M., et al., The Clinical Use of Human Culture-Expanded Autologous Bone Marrow Mesenchymal Stem Cells Transplanted on Platelet-Rich Fibrin Glue in the Treatment of Articular Cartilage Defects: A Pilot Study and Preliminary Results. Cartilage, 2010. 1(4): p. 253-261.
- Centeno, C.J., et al., Safety and complications reporting on the re-implantation of culture-expanded mesenchymal stem cells using autologous platelet lysate technique. Curr Stem Cell Res Ther, 2010. 5(1): p. 81-93.
- Wakitani, S., et al., Safety of autologous bone marrow-derived mesenchymal stem cell transplantation for cartilage repair in 41 patients with 45 joints followed for up to 11 years and 5 months. J Tissue Eng Regen Med, 2011. 5(2): p. 146-50.
- Centeno, C.J., et al., Regeneration of meniscus cartilage in a knee treated with percutaneously implanted autologous mesenchymal stem cells. Med Hypotheses, 2008. 71(6): p. 900-8.
- Centeno, C.J., et al., Increased knee cartilage volume in degenerative joint disease using percutaneously implanted, autologous mesenchymal stem cells. Pain Physician, 2008. 11(3): p. 343-53.
- Kuroda, R., et al., Treatment of a full-thickness articular cartilage defect in the femoral condyle of an athlete with autologous bone-marrow stromal cells. Osteoarthritis Cartilage, 2007. 15(2): p. 226-31.
- Centeno, C.J., et al., Partial regeneration of the human hip via autologous bone marrow nucleated cell transfer: A case study. Pain Physician, 2006. 9(3): p. 253-6.
- Wakitani, S., et al., Repair of articular cartilage defects in the patello-femoral joint with autologous bone marrow mesenchymal cell transplantation: three case reports involving nine defects in five knees. J Tissue Eng Regen Med, 2007. 1(1): p. 74-9.
- Wakitani, S., et al., Autologous bone marrow stromal cell transplantation for repair of full-thickness articular cartilage defects in human patellae: two case reports. Cell Transplant, 2004. 13(5): p. 595-600.
- Wakitani, S., et al., Human autologous culture expanded bone marrow mesenchymal cell transplantation for repair of cartilage defects in osteoarthritic knees. Osteoarthritis Cartilage, 2002. 10(3): p. 199-206.
Patients who are suffering from bone on bone OA can become symptom free but will not grow cartilage across the bone. This demonstrates that you do not need to have cartilage. You can be fully functional and totally free of pain and still be bone-on-bone.
These are conditions with very small numbers treated and no clear data…
Nerve, spine and brain damage can be repaired if the cells are alive but not working properly. Dead cells will not be regrown with this therapy.. Conditions like trigeminal neuralgia have nerves that are alive and generating pain. These nerves can be healed to help decrease the pain.
Vickers et al, A preliminary report on stem cell therapy for neuropathic pain in humans, J Pain Res. 2014; 7: 255–263
Asthma can respondwe collect a daily asthma diary for 12 months before the treatment and another 12 months after the treatment to compare the change.
Knight DA et al, Mesenchymal stem cells for repair of the airway epithelium in asthma. Expert Rev Respir Med. 2010 Dec;4(6):747-58
Migraine and Tension Headache respond so dramatically to Stromal Cell Therapy using StroMed (cells that have been separated using ultrasonic cavitation) that we have filed a patent for this application. We have patients who have achieved 98 and 99% clearing from migraines. Several of these have had headaches for 20 days in every month over many years.
Bright et al Migraine and tension-type headache treated with stromal vascular fraction: a case series, Journal of Medical Case Reports 2014, 8:237
We currently have a migraine trial starting, if you would like to know if you are eligible go to our trial section and download the application forms. If you are not eligible for the trial it is still possible for you to be treated.
Multiple Sclerosis, Rheumatoid Arthritis
The pathophysiology (the way the disease works) is similar for these diseases but the targets are in different tissues. The immune system often decides that the cells are foreign and therefore tries to destroy them. When the immune system is calm (or quiescent) it won’t attack the cells. At this time it is said to be ‘tolerating’ the cells which is referred to as a state of ‘Tolerogenesis’. Anything that challenges the immune system can cause an attack on your own body. A challenge could be an invading virus or bacteria (infection such as a cold) or it could be physical or emotional stress. The illness or death of someone close is enough to precipitate a decline.
Stromal cells will induce a state of tolerogenesis and help the body to heal itself. Maintaining tolerogenesis is difficult and usually needs an immunosuppressant. good improvements in Rheumatoid Arthritis have been reported amongst patients maintained on Methotrexate who are able to stop all other medication such as prednisone, NSAIDs and paracetamol.
Riordan et al, Autologous Stromal Vascular Fraction Cells: A Tool for Facilitating Tolerance
in Rheumatic Disease, DOI. 10.1016/j.cellimm.2010.04.002
Work from around the world.
Stem cells are the key to future healing
The versatility of the stem cell therapy treatment makes it a very valuable scientific medical procedure. Every month scientists are discovering new ways to use stem cell therapy and so the boundaries of this medical science continues to be extended.
It is important when reading these announcements to be aware of the type of stem cell being used and if they are being used in humans. Many treatments that work in animals do not work in humans.
Recently scientists from the National Institute for Health Research in the UK were able to create teeth structures containing enamel, roots and dentine using human and mouse gum tissue. In the future we may be able to grow jaw bone and teeth using stem cell technology.
Stem cells have been found to aid in the production of blood cells as well as other regenerative cells needed to heal bodily wounds.
Caplan et al, The MSC: An Injury Drugstore, DOI 10.1016/j.stem.2011.06.008
Stem cells can be sourced from bone marrow as well as reintroduced to bone marrow via a stem cell transplant to replace damaged cells. Diseases such as leukemia have used this procedure as part of the healing process after chemotherapy.
Wayne AS et al, Hematopoietic stem cell transplantation for leukemia. Pediatr Clin North Am. 2010 Feb;57(1):1-25. doi: 10.1016/j.pcl.2009.11.005.
Spinal Cord Injury
Scientists have seen an improvement in the spasticity and general limb function after applying stem cell therapy to spinal cord injuries in rats. This treatment offers promise to people who have suffered severe spinal injury
McDonald et al, Transplanted embryonic stem cells survive, differentiate and promote recovery in injured rat spinal cord, Nature Medicine 5, 1410 – 1412 (1999)
Amyotrophic lateral sclerosis (Lou Gehrig’s/Motor Neuron disease)
Stem cell therapy may possibly be able to regenerate motor neurons which degenerate in patients with ALS. The problem with this treatment at the moment is the amount of motor neurons required to fulfill this treatment.
Gowing et al, Stem cell transplantation for motor neuron disease: current approaches and future perspectives. Neurotherapeutics. 2011 Oct;8(4):591-606. doi: 10.1007/s13311-011-0068-7.
Myocardial Infarction (MI or heart attack)
Studies have shown the stem cells may have the potential to heal damaged areas of the heart post-heart attack.Krishna et al, Myocardial infarction and stem cells, J Pharm Bioallied Sci. 2011 Apr-Jun; 3(2): 182–188.
Stem cells have shown potential in regenerating damaged muscle fibres in the body which become affected by muscular dystrophy. They may also possibly reduce inflammation in the affected areas.
Sohn et al, Stem cell therapy for muscular dystrophy. Expert Opin Biol Ther. 2004 Jan;4(1):1-9
Studies have shown that type 1 diabetes may be healed with stem cell therapy. In this treatment stem cells will work to regenerate insulin producing cells which the body’s immune system attacks with type 1 diabetes.
Soria et al, From stem cells to beta cells: new strategies in cell therapy of diabetes mellitus, Diabetologia (2001) 44:407-415
It has been found that bowel and gastrointestinal destruction caused by Crohn’s Disease may be improved with the use of the regenerative power of stem cell therapy.
Hawkey CJ, Stem cell transplantation for Crohn’s disease, Best Practice & Research Clinical Haematology
Vol. 17, No. 2, pp. 317–325, 2004
Stem cell transplants have shown some success in treating cancer patients. When it comes to the treatment of cancer using stem cells, the cells will often be extracted from the patient’s body before they undergo chemotherapy treatment. The stem cells will be stored until after they finish their treatment after which they will then be reinserted to begin the regenerative process.
Wayne AS et al, Hematopoietic stem cell transplantation for leukemia. Pediatr Clin North Am. 2010 Feb;57(1):1-25. doi: 10.1016/j.pcl.2009.11.005.