Steve Price : you’ve heard me talk many times on the program about macquarie stem cells and obviously Dr. Ralph Bright, macquarie stem cells’ sponsor for this program. We thought we should find out more about the process. Now you hear me talk about the treatment of osteoarthritis and it affects many of you listening to me and 1 in 11 Australians. And I can’t imagine how difficult it would be to live with chronic pain. I can’t deal with a headache, let alone having constant pain, whether it be in your hands, your wrists, in your knees, and plenty of you listening to me tonight would have to experience that on a daily basis; stiffness, restricted function, it’s just not good. And to go have a full knee reconstruction is something that’s a major operation. Now, I’ve spoken to Dr. Ralph Bright here, he’s got an ambition, that people in the future won’t have to have a mechanical knee replacement. We thought we’d get him in to have a chat. He’s a physician and cosmetic surgeon at Macquarie Stem Cells, he’s in the studio, great to finally eyeball you
Dr. Ralph Bright: thanks steve and lovely to be here
SP: when someone comes and sees you and says “i’ve got chronic pain” clearly, you are a sympathetic ear, that must be an awful thing to live with.
RB: absolutely it is and it’s terrible that it robs people of so much of their lives, you know you can’t get on, you can’t play with your grandchildren you can’t walk across the park, there is so many things that restrict you, it’s just not nice
SP: Is it you’ve never suffered from chronic pain yourself?
RB: I have regular pain in my back from bending over an operating table all the time, but apart from that I’ve not had that terrible affliction that people have when they can’t sleep at night.
SP: yeah well you spend a lot of time on your feet so you’re able to have a dodgy back, I once had a couple of tunnel operations on my right wrist and the pain from that which was, as you’d know as a surgeon, a tightening of that nerve that runs down through your wrist and into your hand, was so bad the only way I could relieve it, and thank god it only lasted a few weeks till I went and got it operated on. I had to go and walk around the block at 2 o’clock in the morning, it’s awful, awful
RB: yes that’s totally invasive and very disabling.
SP: so what are we talking about here? What is the biological treatment you are talking about ?
RB: basically what we are doing is using you own cells to heal yourself. So we are simply taking them from one part of your body, and putting them into another part which wakes them up and allows them to start to do the things that they naturally do, which is to heal the tissues that are damaged.
SP: so where are you taking the material from on my body? So, I present to you and I’ve got chronic osteoarthritis and I say; look I think that stem cells are for me and I want to go through the procedure, what do you then say?
RB: what I’m looking for basically is I’m looking for some fat and it can be anywhere in your body
SP: plenty on me, won’t have a problem finding that!
RB: so we go to those areas that have the largest depos and the easiest to harvest and that’s where we take it from
SP: where would that most normally be ?
RB: most people it’ll either be in the abdomen or in the love handles
SP: so you extract that material, and then you extract from that stem cells and then in your procedure you then reinject that back into the body, is that how it works?
RB: that’s correct
SP: and tell me about why this works? And it doesn’t work for everyone, does it?
RB: no it doesn’t and we are working on finding out why it doesn’t work
SP: I want to ask you about that in a moment, but when it does work how come it works?
RB: the natural role of these cells is to heal and regenerate the tissues that they are living in and these cells are found in every tissue of your body, we just go to fat because it has such a wonderful supply of them and it’s one of those few places in your body where you are happy to give away some of your tissue.
SP: Is it a particularly invasive procedure?
RB: it’s a minor surgical procedure, it’s not a big procedure but it’s still a surgical procedure, so we still need to do all the things correctly, but it’s a very simple task, we can do it with you wide awake or we can give you a little bit of sedation if you’re a bit worried, but it’s a very straightforward thing to do. The surgical process takes about 20 minutes, so it’s relatively quick to harvest the fat.
SP: we are talking to Dr. Ralph Bright from Macquarie Stem Cells. So this procedure happens all at once, so it’s not like you harvest from the fatty part of the body, take it away and then I come back again. It all happens in one procedure.
RB: yes that’s right, it all happens in one location. Harvest the fat, we then put you into recovery where you can look at the ceiling, read a book, watch TV, and while you are there the fat will then be broken down. We can throw the fat away, keep all of the other cells which we need, which will be doing the repair for you and then we can clean them up, count them, and put them into syringes ready to be injected into the various parts of your body that need to be injected.
SP: And what pain problems can this help to solve? I mean, we talk about osteoarthritis what is osteoarthritis for people who don’t know?
RB: osteoarthritis is when you get that inflammation and the cartilage on the surface of your bones gets worn down and can be in fact totally worn out so that you’re walking bone on bone
SP: that would be dreadful
RB: yes it is very painful, very debilitating and with that of course you get the stiffness and you get the inability to move your joints in the way you want
SP: Is it mainly knee or hips, ankles, hands? What is it?
RB: you’ve gone right to the most common ones. Knees are from far the most common, followed by hips, and then probably backs and then you get into the other smaller joints the fingers and the toes.
SP: so if I’m having this procedure and I’ve got a dodgy knee and that’s the principal area that we are trying to fix, are you going to use the cells that you extract to put into my other joints just as an insurance so that down the track I don’t get you know bad wrists or bad hips?
RB: We wouldn’t inject directly into the joint unless there’s a problem in the joint.
SP: Ok, so unless I’ve got a problem, you say don’t do it
RB: that’s right, but what we will do is to give you some intravenous cells and when we put those cells into a vein, they will then travel all around your body and they will be attracted to anywhere in your body that’s inflamed.
SP: I mentioned that you are doing some research because as you’ve said right off the top, this procedure doesn’t suit everybody, so you’re putting a lot of time and effort and money into research to get a test developed that will be able to be used to tell whether it will or won’t work. Is that what you are trying to do?
RB: that’s correct and the first goal is to find what’s called a biomarker, or a simple test which we can then run and it will predict whether you should have the treatment or not and if you’re not going to respond then we tell you sorry we can’t do it for you, if it does respond hopefully we’ll also be able to tell you how much improvement you’ll get.
SP: the importance of that of course is that people have had the procedure and it doesn’t work and clearly if you’re going to go through with this you would want it to work and when it doesn’t you wouldn’t be very happy
RB: very very disappointed, not only the patients are unhappy but I’m very unhappy too. It’s very upsetting when you have people who are in so much pain and you just can’t help them and it’s just really really hard.
SP: I know professionals like you don’t go on gut feeling but what is your gut feeling about why it works on some people and not others?
RB: it looks from the work that we’ve done so far to be a difference in their genetic expression. So some people’s genes are either turned off or too much turned on and that combination of some genes being turned off, some genes being turned on seems to give us the pattern that we’re looking for that will allow us to predict who’s going to respond. And of course once we know which ones they are, we can look at the pathway and then we can say well how can we modify that pathway to change what’s not working and hopefully make it work so that we can take a non responder and turn them into a super responder.
SP: if you get this biomarker developed, I mean it’s going to save a lot of people a lot of inconvenience, I mean a knee replacement is a major procedure right?
RB: it is a major procedure, and they do it very well these days
SP: but it’s a big operation
RB: it’s still a big operation
SP: and they don’t last forever
RB: well that’s true too
SP: I mean so if we could eliminate the need for that sort of procedure that would be wonderful for people.
RB: there is no doubt that we will dramatically reduce the number of people needing joint replacements. As I said, not everyone responds so we won’t be able to replace it for everybody but there will be a dramatic decrease in the number of people who will need to have total joint replacements.
SP: And of course I should remind everybody if you’d like to know more, we’ve given you the website for Dr Bright and his team at Macquarie Stem Cells, I can send you some information. They’ve got a phone number 9824 3044, but Macquarie stem cells we should reiterate uses your own biological process but it is a surgical procedure so you do actually need to get a second opinion.
RB: this is a surgical procedure so you will need a second opinion to confirm that you are fit for a minor surgery
SP: Dr Ralph Bright, great of you to come into the studio. Is there a website that we can point our people to have a look to see if this works for them?
RB: yes there is and we can go to
SP: Macquarie stem cells.com
SP: nice to have you in the studio thanks a lot
RB: thank you very much