What is Cellular Therapy?
Mesenchymal stem cell therapy deposits stem cells, growth factors (PRP/platelet lysate), and supportive cells locally at the site of damage or arthritis, or intravascularly for delivery to distant organs and nerves. Mesenchymal stem cells are known to differentiate into cartilage, bone, muscle, ligament, and nerve cells, control inﬂammation, and attract other stem cells and growth factors to the injured area.
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Cellular Therapy FAQs
Are there any ethical issues with cellular therapy?
No, adult stem cells reside in many tissues of your own body and are not derived from embryos. They have the ability to become many types of cells, including muscle, cartilage, bone, and nerve, but have internal controls that prevent their becoming an entire human being or growing into a tumor. Gathering and concentrating your cells from an area where they are plentiful, such as your bone marrow, and re-injecting them into an area that needs to heal is considered a type of tissue transplantation procedure and is within the scope of practice of a medical doctor.
What conditions may benefit from cellular therapy?
Many joints, ligaments, tendons, muscles, nerves, and other tissues that has been damaged as a result of an injury, disease, or as part of a degenerative process can benefit from cellular therapy. There is published evidence that mesenchymal (adult) stem cell therapies can result in improvement in the symptoms and MRI findings in arthritis. There are ongoing studies in sports injuries, stroke, spinal cord injury, heart failure. peripheral artery disease, and COPD using the same processes as are used at BOUNDLESS.
Are there any side effects to cellular therapy?
It is a very safe procedure. Some patients may experience pain and soreness during the post-operative period and as with most procedures there are slight risks of infection or bleeding, but overall the complication rate is less than 1/1000. Because autologous bone marrow typically is used, there are minimal chances of allergic reactions and no risk of rejection. The procedure is done in an office setting, under local anesthesia, eliminating the risks associated with surgery or general anesthesia.
What are the potential benefits of cellular therapy?
Healing, repair and regeneration of a variety of traumatic and degenerative injuries. In the right environment, adult stem cells can become muscle, tendon, bone, nerve and/or cartilage cells and, when injected, migrate and congregate in damaged tissues. Meniscal tears, ligament tears, rotator cuff tears, tennis elbow, arthritis and other sports and spine conditions have been found to respond to cellular therapy. In addition to their regenerative capacity, cellular therapy has been shown to decrease inflammation and pain and help in chemotaxis, drawing more stem cells and other healing factors to the site of the injury, initiating a healing cascade.
How do you get the cells?
The cells we use are present throughout your body. There are high concentrations of them in your fat and, to a lesser degree, in your bone marrow. There are also options of buying stem cells that have been derived and purified from another donor. At BOUNDLESS we have access to all of the above options and will discuss with you which is optimum in your case. In general, however, your own fat-derived adult stem cells, obtained via a mini liposuction procedure, are typically best for the following reasons: 1. there are lots of them – a single mini-liposuction produces 50-100 million cells, as compared to bone marrow at less than 100 thousand and donor vials that contain less than 500 thousand cells. 2. There is some research that indicates that your own stem cells will work better for you than those from another donor. 3. The mini-liposuction procedure is less painful and is associated with less risk than a bone marrow aspirate.
How do I know if the cells are injected in the correct place?
At BOUNDLESS, we use the most up-to-date technology, including real-time ultrasound and/or fluoroscopic (X-ray) guidance to deliver the cells with pinpoint accuracy to the injured areas for optimum effectiveness.
How soon can I return to my regular activities?
The procedure is ambulatory. Patients are usually sore during the first few days after the injection. Patients can return to normal activity after a day or two, depending on the site of the treatment and the job requirements.
Is cellular therapy approved by the FDA?
There are no clear protocols to treat any disease with cellular threapy in the U.S. With the advance of science and more research, laws and regulations in the field of regenerative medicine will be changing rapidly. Although cellular threapy is not FDA approved, we follow the standard regulations for patient safety and laboratory practices.
Cellular Therapy Research
Intra-articular injection in the knee of adipose derived stromal cells (stromal vascular fraction) and platelet rich plasma for osteoarthritis
Full Text, 2017 (Jun. 19); Bansal, et. al.
Dr. Bunyak notes this text from the conclusion, “SVF combined with PRP has a great potential as a therapeutic agent in regenerative medicine especially in orthopedic conditions. The high numbers of MSCs in SVF make it a suitable source for cellular medicine. Preliminary studies suggest that it is a safe and effective method for treating osteoarthritis. Both qualitative and quantitative measurements showed statistically significant improvements during the follow up period of 2 years.”
Mesenchymal Stem Cell-Conditioned Medium Reduces Disease Severity and Immune Responses in Inflammatory Arthritis
Full Text, 2017 (Dec. 21); Kay, et. al.
Dr. Bunyak notes, “MSC-conditioned media (containing exosomes and signalling molecules) reduces cartilage damage and suppresses inflammation in inflammatory arthritis.”
Tissue source determines the differentiation potentials of mesenchymal stem cells: a comparative study of human mesenchymal stem cells from bone marrow and adipose tissue
Full Text, 2017 (Dec. 6); Xu, et. al.
Dr. Bunyak notes this text from the conclusion, “The epigenetic memory obtained from either bone marrow or adipose tissue favored MSC (mesenchymal stem cells) differentiation along an osteoblastic or adipocytic lineage. The methylation status of the main transcription factors controlling MSC fate contributes to the differential differentiation capacities of different source-derived MSCs.”
Effects of bone marrow aspirate concentrate and platelet-rich plasma on patients with partial tear of the rotator cuff tendon
Full Text, 2018 (Jan. 3); Kim, et. al.
Dr. Bunyak notes, “BMAC-PRP (bone marrow aspirate concentrate therapy combined with PRP) improved pain and shoulder function in patients with partial tear of the rotator cuff tendon.”
Concentrated Bone Marrow Aspirate for the Treatment of Chondral Injuries and Osteoarthritis of the Knee
(Chahla, Dean, et. al., Orthopaedic Journal of Sports Medicine, 1/2016)
From the abstract: “All 3 studies regarding osteoarthritis and all 8 studies regarding focal chondral defects reported good to excellent overall outcomes with the use of BMAC.”
Multilineage Cells from Human Adipose Tissue: Implications for Cell-Based Therapies (Zuk, Zhu, et. al.)
Adipose-Derived Stem Cells for Regenerative Medicine (Gimble, Katz, et. al.)
“These 2 articles talk about the similarities between the stem cells we can get from bone marrow and from fat. Fat-derived stem cells can be grown and differentiated in the lab into several tissues, including bone, cartilage, muscle, and nerve. Additionally, the fat-derived stem cells are easier, safer, and more comfortable to remove (a small liposuction technique vs. a bone marrow aspiration). A small liposuction produces many more mesenchymal stem cells per collection than a bone marrow aspiration, allowing us to inject many more stem cells during a same-day procedure and eliminating the need for a multi-day culturing process.”-Dr. Bunyak
Adipose Tissue-Derived Stromal Cells as a Novel Option for Regenerative Cell Therapy (Kaneda, Nakagami, et. al.)
“Comment from Dr. Bunyak coming soon.”-Dr. Bunyak
“Comment from Dr. Bunyak coming soon.”-Dr. Bunyak