Stem Cell Medicine
by David M. Odom, MD
Our bodies are made up of cells and acellular structural materials produced by cells. Structural material may be boney or collagenous. This material serves as a lattice work for the cells, giving them collective shape or configuration.
Cells are microscopic, specialized living units made up of a nucleus with DNA, surrounded by organelles swimming in a sea of cytoplasm, which in turn is bordered by a membrane. These tiny living units exist to function in unison to benefit the body as a whole.
There are over 30 trillion (>30,000,000,000,000) cells in the human body!
But, we know that cells have a defined lifetime and will eventually die. (Thankfully not all at the same time.) In this circumstance, dying cells are replaced by newer cells produced by nonspecialized progenitor cells.
The job of progenitor cells, also called stem cells, is to replace aged or damaged specialized cells.
Stem cells are notable for the ability to divide into daughter cells, which can be either other stem cells or more specialized cells. This way, tissues can be repaired throughout life, and the body can continue to have a supply of new stem cells.
Where do stem cells come from?
Most tissues have a local cache of stem cells available to protect the integrity of organs. However, there are ready supplies of huge numbers of stem cells in certain tissues which can mobilize to repair tissues at points distant.
The bone marrow is one such stem cell source. But, immense numbers of stem cells are available and stored in fat.
Autologous stem cell transplantation
This term refers to extracting stem cells from a patient, concentrating them, activating them, then injecting them back into the same patient with the goal of promoting health benefit, such as rejuvenation of a joint.
Actually, 50% of cells in fat, by number (not by volume) , are stem cells. Fat cells are large, bloated cells that are huge in comparison to stem cells.
One milliliter (cubic centimeter or cc) of fat can contain 500,000 to 1,000,000 stem cells . But after the stem cells are extracted from the fat, they constitute a tiny dab at the bottom of a test tube.
And, that is what I noted in 2011 when I first took my stem cell training.
What is new, and a superior technique, is that no test tubes are now used. Instead of a separate laboratory room adjacent to the surgical procedure room, a counter-top device is placed next to the operating table within the procedure room itself. The fat is placed aseptically in a sterile chamber within the separation device. It is processed automatically, within the closed system, separate from open air, and the prospect of contamination. Thus, the collection and extraction of stem cells is a surgical procedure, not unlike cosmetic fat transplantation procedures that have been conducted for the past 20 years or so.
After separation of the SVF has been achieved, it is mixed with platelet rich plasma (PRP), a product produced by centrifugation of a sample of the same patient’s blood. This mixture of growth factors promotes “activation” of the stem cells.
The resultant product is then injected into a joint that needs revision, or intravenously if solutions to systemic maladies are sought.
This type of stem cell therapy is available in the United States now .
- Berman MD, Mark; Elliot Lander MD. The Stem Cell Revolution. AuthorHouse.(2015)