A: PRP, or Platelet Rich Plasma, has hit the mainstream media. PRP is a mix of concentrated platelets and serum. Why is this important? Surgeons have known for years that healing depends on platelets. These very tiny blood components are rich in growth factors and help form a blood clot during injury. When you injure an area like a ligament or a muscle, they seep into the wound during the bleeding that normally occurs. They then set up a blood clot to stop the bleeding and start to release growth factors to the area to coordinate a repair response. Over the first week or so, they act as a time release “pill” that secretes various growth factors at various times. These time release growth factors do things like bring in stem cells and bring in new blood vessels to ensure that the body can get more blood to the area. PRP is created when the doctor takes blood from a vein and places it in a special centrifuge to concentrate platelets (usually 3-5 times their normal concentration).
To use a gardening metaphor, if you have a plant that is injured and not doing well, placing some more water and fertilizer in the ground may help your plant recover. Platelets are like fertilizer, their growth factors help rev up the local repair response. So PRP is generally good for helping things that may either heal on their own (given enough time) or are maybe stuck in the healing process and need a little “kick” to get things going towards resolution. While PRP may help recruit a few stem cells to the area, stem cell injection therapy is much more advanced. For orthopedics in particular, if PRP is like adding additional fertilizer and water to the plant, mesenchymal stem cells (MSC’s) are like placing new seeds in the area and hiring a gardener.
MSC’s are capable of not only differentiating into the new tissue that is lost, but also coordinating the repair response (so the seeds and the gardener). So MSC therapy would be more appropriate for degenerative diseases where there is lost tissue (like chronic arthritis, a partial tendon or ligament tear, a low back disc where there are torn fibers allowing the disc to bulge). In addition, the lab prep for MSC therapy is much more complex than PRP. While PRP can be made in a simple bedside centrifuge, MSC’s are isolated from fat. The upshot, PRP is great to kick start a healing process that may be stuck, MSC’s and other stem cell approaches will likely rule the day in regenerative medicine.
A: Stem cells are unspecialized or undifferentiated cells, capable of two processes: self-renewal and differentiation.
A: Regenerative Medicine is a new and advancing scientific field focused on the repair and regeneration of damaged tissue utilizing stem cells.
A: Adult stem cells are found in mature adult tissues including bone marrow and fat, while embryonic stem cells (ESCs) are not found in the adult human body. ESCs are obtained from donated in vitro fertilizations, which raises many ethical concerns. Because ESCs are not autologous, there is a possibility of immune rejection. Adult stem cells do not raise ethical issues nor pose any risks for immune rejection.
A: No, adult stem cells do not raise ethical questions as they are harvested from the patient’s body.
A: No. Where embryonic stem cells have been shown to form teratomas (germ cell tumors), there is no data that suggests adult stem cells have the same potential to promote the development of tumors.
A: In adults, stem cells are present within various tissues and organ systems, the most common being bone marrow and adipose or fat tissues. Current research shows stem cells are present in almost all tissue in the body.
A: The physician uses a system that uses adult stem cells from bone marrow tissue or adipose tissue. The stem cells are obtained through an aspiration procedure with little discomfort.
A: Adult stem cells are used to treat patients with damaged tissues due to age or deterioration. During a procedure, stem cells are isolated from the patient, concentrated and delivered back to the site of injury to assist in the healing process.
A: Yes, there are many types of adult stem cells found in the body which have variable differentiation potentials. The adult stem cells that aid in the repair of damaged tissue are multipotent, mesenchymal stem cells. These are located in bone marrow and adipose (fat) tissue.
A: No, cell expansion is not involved. The stem cells are harvested, processed onsite and delivered back to the patient at point of care.
A: The differentiation of stem cells is dependent on many factors, including cell signaling and micro-environmental signals. Based on these cues, stem cells are able to develop into healthy tissue needed to repair damaged tissue. For example, multipotent stem cells delivered to damaged bone will develop into bone cells to aid in tissue repair. Cells delivered into a joint or disc will develop into cartilage cells. The exact mechanism of lineage-specific differentiation is unknown at this point.
No, adult stem cells are autologous and non-immunogenic.
A: Stem cells are currently being used in both laboratory and clinical settings. Laboratories are using human and animal derived stem cells to conduct in vitro studies as well as in vivo studies with small and large animals. Autologous adult stem cells are currently being used in hospitals and clinics during surgery to aid in the repair of damaged tissues
A: Stem cells are currently being used in orthopedic, cardiovascular, trauma and plastic surgeries and to treat disease.
A: Currently, insurance doesn’t cover stem cell treatment. Please contact us if you would like to know more.
A:This is currently a highly debated subject. Dr. Raju, however, prefers adipose derived stem cells for the following reason
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