Why adipose-derived stem cells?

So why do we take stem cells from fat?

First, fat (or adipose tissue) contains stem cells that are capable of developing into a variety of cell types.  This is called multilineage differentiation capacity.  The stem cells can turn into bone, cartilage, cardiac muscle, skeletal muscle, nerve tissue, and even blood vessels. That ability makes these cells useful in a multitude of treatment scenarios, for many types of disease processes.  Specifically, these cells work for orthopedic injuries because they can help regenerate bone, cartilage, ligament, and/or tendon, while also helping to provide new vascular supply to the injured area.

Secondly, these cells are rather easily obtained, and in large numbers.The process of tumescent liposuction has minimal morbidity and is relatively benign for the patient.  The alternative is obtaining stem cells from bone marrow, a procedure that involves punching a hole through the bone, usually in the hip, and then extracting marrow from the inner space of the bone.  This can be quite uncomfortable, and requires a larger incision.

Lastly, fat seems to result in an overall larger number of viable stem cells than bone marrow.  This is important in that this higher cell count could result in more viable cells being used in the treatment area, with a potentially greater chance of a beneficial outcome.

(For those interested, the first two points are mentioned in a review article published in 2005 titled Multipotential differentiation of adipose-derived stem cells, by Strem, et. al.  The last point comes from independent research from a group in Florida that has studied stem cells from both fat and marrow.)

Because of these things, our first choice is to obtain cells from fat when possible, using bone marrow aspiration as a back-up plan.  And it is usually possible to get enough adipose tissue from patients in the general population, as we do not need a large amount.

The stem cells are isolated from the adipose tissue by tissue washing and enzymatic digestion, and separated from other cellular material via a centrifuge.  The preparation can take 1.5 to 2 hours, after the actual liposuction procedure that can take an hour or more. Thus, this is a same-day procedure, with minimal discomfort and essentially no down time.

Introduction

Hello, and welcome to the first installment of the Colorado Stem Cell Therapy blog!  My goal with this blog is to keep the general public up-to-date on the current advancements in stem cell research and treatments, and I will attempt to make the science easily understood by non-medical readers.  This first blog will be a rather general overview, not particularly detailed or too focused on one thing.

First, here is a little about me.  My background as a physician has taken a rather non-linear route since medical school.  My formal residency training was in the field of Anesthesiology, and I practiced in that field for many years.  I was proficient in all types of general anesthesia, spinal and epidural anesthesia, and conscious sedation.  I also performed regional anesthesia which involved a variety of nerve blocks and injections for pain control.  I subsequently studied the diagnosis and treatment for varicose and spider veins with my medical practice partner, Dr. William Schuh.  I learned to use a laser for certain surgical procedures for vein disease, and have been performing these over the past three years.  That development of laser surgery skills then led me to the practice of laser liposuction/liposculpture.  And that in turn has most recently allowed me to pursue the therapies involving isolation and use of stem cells.

The stem cell treatments that we will focus on in our practice involve the use of a patient’s own fat (or possibly bone marrow).  This is usually a one day procedure, over the course of a few hours.  There is no ethical dilemma such as the media has brought to the public’s attention in regard to the use of embryonic stem cells, nor is there a problem with rejection of the cells since they are the patient’s own tissue. 

In order to get the patient’s stem cells, it is first necessary to obtain fat.  This is done through a liposuction procedure performed in our office, with local anesthesia and some oral medications to help with anxiety and pain.  The recovery of the stem cells can be combined with a more traditional liposuction procedure as well, if so desired by the patient.  The fat then has to go through a rather rigorous processing procedure that includes enzymatic washing and cell isolation.  The stem cells that were dormant in the fat tissue are then ready to be used for a variety of clinical applications.

Stem cell therapy can be useful in treating the symptoms of a wide array of medical conditions.  Our practice is mostly focused on treatment of orthopedic injuries.  This can include sport-related injuries, arthritis, joint pain, and muscle/tendon/ligament pain.  Once the stem cells are isolated, they can be injected into the affected joint or tissue.  When the stem cells are in that environment, the patient’s body basically directs these cells to turn into different kinds of cells, such as cartilage, muscle, bone, etc.  The body will determine what is needed, and then the stem cells do their thing!

This kind of therapy doesn’t work for everyone, nor does it always work after just one treatment.  It can take time for the effect to become noticeable, and there are a variety of things that can influence the outcome.  Examples include smoking, alcohol consumption, diet, age, and activity level, just to name a few.  We will counsel individuals in these types of areas to best manage their problem/condition, and attempt to maximize the benefit. 

Again, this is just a quick overview of current advances in stem cell therapies.  Future blogs will cover current research topics, current clinical advances, and updates about our practice.  Feel free to comment or ask questions – I will do my best to address them all.