By: Martin Braun, MD
Regenerative medicine involves the use of early cell lines (stem cells) and cell signaling molecules to repair, renew and revitalize tissues and organs. Stem cells are unspecialized cells that have the capacity to change into any healthy cell in our body. Here are answers to the most commonly asked questions about stem cell therapy.
Why all this interest in stem cells and regenerative medicine?
Regenerative medicine is the next frontier in health care. Stem cells have the capacity to migrate to injured tissues, a phenomenon called homing. This occurs by injury or disease signals that are released from distressed cells and tissue. Once stem cells arrive, they dock on adjacent cells to commence performing their job to repair the problem. Stem cells serve as a cell replacement where they change into the required cell type such as a muscle, bone or cartilage cell. This is ideal for traumatic injuries and many orthopedic indications.
How do stem cells work?
Stem cells release proteins called growth factors and cytokines. These signaling proteins help control many aspects of the healing and repair process to regulate inflammation, which is a key mediator of disease and aging. Inflammation is a hallmark of autoimmune diseases such as rheumatoid arthritis and multiple sclerosis.
Where do doctors obtain stem cells?
Doctors harvest stem cells from your bone marrow or fat (adipose tissue). Stem cells harvested from your body are called autologous stem cells. Stem cells are also obtained from umbilical cord blood taken from elective caesarean sections. These umbilical stem cells are called allogeneic stem cells. We use autologous stem cells in our clinic harvested from your fat, whereas cancer agencies treating disease such as leukemia use allogeneic stem cells from
other donors’ bone marrow.
What is the difference between stem cells derived from bone marrow or fat?
As we age, our number of stem cells declines more rapidly in our bone marrow, especially in middle age. Fat is a more reliable reservoir of stem cells as the number does not decline nearly as much as in bone marrow. About one in 100 cells harvested from fat are stem cells. Stem cells derived from fat are called ‘adult derived mesenchymal autologous stem cells.’
Are stem cells safe?
Stem cells are undoubtedly safe. Bone marrow transplants using another donor’s allogeneic stem cells have been done for terminal diseases such as leukemia for many decades, saving thousands of lives. Like anything new in medicine, there is much work to be done to determine which conditions are best treated with stem cells, the type and amount of stem cells, and the frequency of treatment. This will take decades. Meanwhile, the only problems that have ever surfaced from autologous adult derived mesenchymal stem cells have been very, very rare.
Why all this negativepress about stem cells?
For every pioneer in medicine, there are over 1,000 self-appointed guardians of the past. The truth of this statement is self-evident with any cursory examination of medical history. The media does not report successful stem cell deployments because sensationalism is what sells.
What treatments are available?
We have completed over 250 stem cell deployments in Vancouver for a variety of inflammatory and degenerative conditions. We see people who have failed conventional medical treatments or are refusing a joint replacement or are too ill to obtain a joint replacement. All patients are followed up and our patient satisfaction rate is about 80 per cent across the board. I consider this remarkable considering the fact that virtually all these patients failed conventional treatments. I have had the procedure done twice on my knees in the past four years with success.
How do I pick a stem cell clinic?
It is important to do your homework. Do not fall for high pressure sales tactics. The first question you must ask is “am I actually getting stem cells?” Some clinics take peripheral blood and claim that this is stem cell harvesting. If there were sufficient stem cells in your blood stream to repair your problem, you wouldn’t require the clinic because your body would have cured the condition! Peripheral blood is a source for platelet-rich plasma, not stem cells. People confuse the two. Also some clinics offer amniotic fluid derived products that contain signaling proteins, but not actual living stem cells. It is a stretch to call this stem cell therapy. In Canada, it is not yet permitted to grow your own stem cells (expand them) and return them to you as the authoritiesconsider your stem cells to be “drugs.”
What is the future for stem cells and regenerative medicine?
At the present time autologous stem cell deployment is available in Canada. Unfortunately, expansion of your cells is not yet permitted. Pharmaceutical companies and universities are developing allogeneic stem cell lines as the future market for these cell lines will be incredibly lucrative. Allogeneic umbilical stem cells can be purchased from companies in the USA but American doctors are not permitted to give them to the patients. These patients fly to Mexico or Panama in order to receive these umbilical stem cells as allogeneic umbilical stem cell deployment is permitted in those countries. Canada is in an ideal position to be a world leader in stem cell technologies, but the regulators must move quickly or we will be left behind in the emerging field of regenerative medicine.
Martin Braun, M.D. graduated from the Faculty of Medicine UBC and is certified in both family and emergency medicine. He had his first stem cell treatment for knee pain in 2014 in California, and due to the success he experienced, decided to open Vancouver’s first stem cell clinic: Vancouver Stem Cell Treatment Centre.