|
|
The New Zealand Stem Cell Clinic, first and foremost in bringing clinical applications of stem cell therapy to New Zealand.
At the New Zealand Stem Cell Clinics, our aim is to bring the advances of 21st century medicine and technology into the realms of every day clinical medicine, to provide exciting and promising alternatives to the more traditional solutions that have typically involved surgery, multiple drugs (or in some cases no solution at all!), and to bring all of this within the reach of every day people. REGENERATIVE MEDICINE is poised to become the next revolution in medicine. At the New Zealand Stem Cell Clinics, our commitment is to remain at the forefront of this change, through ongoing research and updated knowledge, offering a new era of these innovative and alternative therapies. Our clinical involvement in regenerative and cellular based therapies dates back well over a decade, with vast experience in adipose (fat combined with stem cells) harvesting and transfer procedures, use of platelet derived growth factors for enhanced healing properties (both these now being key components to current stem cell procedures) and more recently, treatments specifically involving isolated Adipose Derived Adult Stem Cells.
|
The term Regenerative Medicine is used to describe techniques that use cellular (stem cells or derivatives of) and/or cellular derived components (such as various hormones or chemical messages that stimulate stem cells), to therapeutically address a range of degenerative diseases by stimulating or encorouging ones own body components or cells to self heal or "regenerate" from within (endogenous). This is in contrast to the traditional medical approach that typically bases therapy on an external interventional approach or foreign source (exogenous), such as drugs or surgery. Although still in its infancy, regenerative medicine has received intense interest and research over the last 20years and has shown increasingly promising results in thousands of animal and human studies and trials. Supported by this research, the clinical application of regenerative medicine is becoming an exciting and innovative alternative therapy, and destined to revolutionise mainstream medicine within the next decade.
At the NZ Stem Cell Clinics, we use Autologous Adipose Derived Adult Mesenchymal Stem Cells (AADAMSC) [Autologous=ones own; Adipose Derived=from fat; Adult=not embryonic; Mesenchymal=cells that have initially evolved from the mesoderm layer] for a variety of degenerative diseases and medical problems. Conditions that may show benefit from AADAMSC includes Arthritis (rheumatoid arthritis, osteoarthritis), knee and joint injuries and skeletal injuries that involve cartilage or tendon damage, inflammatory diseases such as of the bowel and lungs including Crohn's Disease and Asthma. Pre-clinical and early clinical phase trials have shown encouraging results for conditions such as Multiple Sclerosis. With rapidly increasing knowledge about AADAMSC and their actions within the human body, there is every indication that the list of diseases that may benefit from AADAMSC therapy will steadily grow, and that Stem Cells will play a significant and exciting role in future "self" (autologous) cellular based treatments of numerous medical conditions.
What are stem cells?
Stem cells are unspecialised (undifferentiated) cells that are of the same family type (lineage). They retain an ability to divide throughout life, giving rise to cells that can become highly specialised and take the place of cells that die or are lost. Stem cells contribute to the body's ability to renew and repair its tissues. Unlike mature cells, which are permanently committed to their fate, stem cells can both renew themselves as well as create new cells of whatever tissue they belong to (and other tissues). Stem cells are sometimes also referred to as progenitor cells.
Types of Stem Cells.
There are many types of stem cells, having different names usually attributed to either their tissue of origin or various characteristics they possess. Some of these stem cells occur naturally and some have been manipulated (or induced) in laboratories to possess certain characteristics. They can either be from an animal source (called xenographic; such as pigs, cattle, rodents), or they can be derived from human sources. Allogenic human stem cells are sourced from donor cell lines (other people), while autologous stem cells are those sourced from, and used to treat, the same individual (self). "Stem cells" from plant origin, though gaining alot of commercial publicity lately, have no credibility or place in human medicine currently.
Listed below are the main groups, with a brief discription, of stem cells currently relevant to research and clinical medicine.
-
Embryonic stem cells: derived from the very early stage of embryo development called the blastocyst; pluripotent cells with unlimited capacity to differentiate along numerous cell lineages to form every type of cell in the human body; allogenic (from a donor); numerous registered commercially available cell cultures allows for a readily available and rapid expansion of cell population number; are the basis of much stem cell research; ethical and transplant rejection issues have prevented human clinical application.
-
Induced Pluripotent stem cells: derived from post embryonic stage (adult) precursor cells; have undergone laboratory manipulation to induce certain characteristics and pluripotency; allogenic (from a donor); numerous commercially available cell cultures for rapid expansion of cell population; gets around the moral issues involving embryonic cells but does not avoid the transplant rejection potential; used in research; concerns that their manipulation can cause possible genetic mutations and hence possible cancer concerns which has prevented their clinical use in humans to date.
-
Mesenchymal stem cells: derived from from post embryonic sources (adult and includes cord blood); may be sourced as allogenic (from a donor) or autologous (from ones own or self); may be sourced from a variety of tissues (umbilical cord at birth, bone marrow, adipose (fat) tissue); they are cells that have originally evolved from the embryonic mesoderm layer and are capable of differentiating into several tissue types (multipotent) however research supports increasing potency potential (multipotent => ?pluripotent); may be manipulated or need to be expanded if available numbers are limited (eg bone marrow derived); used in research and have been used clinically for several years now on humans.
Why Use Adult Stem Cells?
Much of the early stem cell research focussed on embryonic or foetus derived stem cells. It was initially thought that this was the only time that stem cells existed, and that these would all disappear as they progressed and developed down the various pathways to form the necessary new structures and tissues that would be present in a baby. With such huge developmental changes required, these embryonic stem cells are obviously very potent cells and can go on to develop into all the different cell types. Embryonic stem cells are pluripotent stem cells (pluri meaning many). However, using and exploiting embryos, is obviously morally and ethically wrong, and by the mid 1990's many countries had adopted legislation banning or heavily restricting the use of embryonic stem cells. This sent many researchers looking elsewhere for stem cells, and it soon became very apparent that stem cells were in fact still present in large numbers even in adults. Of early interest was the bone marrow, which continuously creates new blood cells, and as such was found to have moderate numbers of stem cells (both haematopoietic for blood production and mesenchymal for tissue regeneration). These were relatively accessible and thus bone marrow derived adult stem cells quickly became a main focus of research. However, what also became apparent, was that stem cells were not only present in these high turnover areas, but also present in many other, more "dormant", tissues and locations. In fact, we now know that stem cells are widely distributed throughout the entire adult body, and it is these cells that are responsible for numerous productive tasks including the ongoing repair and regeneration of the human body. (The first described stem cell was back in 1961, when researchers discovered an unusual small cell type adjacent to adult muscle fibre cells. They called this cell a "muscle satelite cell" and noted that it had some very interesting growth properties). Adult stem cells were initially thought to be much more specific or predetermined, with less potentential to differenciate or potency than the embryonic type. Adult stem cells have thus been termed multipotent. However, ongoing research continues to indicate that adult stem cells can develop into many more different types of cells than first thought and as time goes on, we are seeing that these cells are displaying more and more future potential. Recent research into certain types of adult stem cells (adipose derived mesenchymal included), has shown so much potential for multilineage differentiation, that they are now being termed by some researchers and doctors as possibly pluripotent.
Why use Autologous (ones own) Stem Cells?
Autologous cells have the huge advantage of not being rejected in the typical "graft versus host" reactions that often occur when foreign or donor cells are transplanted. In the case of transferred stem cells, this means donor cells have a limited time line and limited capacity to get the healing process underway, before they themselves are destroyed by the bodies own defense/attack system . Donor cells are thus a bit more akin to a tempory "sticking plaster" type only senario, whereas autologous (self) stem cells can continue to do their natural repair and regenerative job, unhindered to their full healing potential.
Autologous cell use is inherently far safer. Graft versus host reactions can cause serious health issues and usually immunosuppressive drugs ( anti-rejection drugs which can globally dampen down the entire body defense system) need to be preventatively given. Drug side effects, fevers, kidney, lung and liver damage, infection susceptability, are all common problems when donor cells are given. Autologous cells however, have none of these issues.
Autologous cell use does not transfer with it, any harmfull "hidden baggage". There are two issues to be considered here.
Firstly, infective. Although we can asume that donors have been rigorously screened for systemic and infectious diseases, there can still be some niggling concerns that either something has been overlooked, or some yet unknown virus or sub-viral infective particles have slipped through undetected. Modern medicine examples of this would be the transfer in the 1980's and 90's of the then unknown Hepatitis C and "Mad Cow" disease to recipients of transplants and transfusions.
Secondly, there is another potential time bomb that has been given very little consideration to date. Transferred donor cells take with them all of their donor's genetic DNA. Stem cells infiltrate, intergrate with, and even grow into new tissue with renewed function. In the case of donor stem cells, this process may be driven exclusively by the donor genetic coding, not your own. The future question would then arise: what (or perhaps more precisely "who") is inside you and what do you become?! Autologous stem cells, being part of self and natural to your body, do not have these issues.
Why use Adipose Derived Stem Cells rather than Stem Cells derived from bone marrow?
Adipose (fat tissue) derived cells are very readily available source of mesenchymal stem cells. They are relatively easily accessable through the process of superficial lipoharvesting (see section on procedure) under local anaesthetic and can be obtained in very large numbers. This is in contrast to bone marrow derived stem cells, in which the harvesting procedure is performed under a general anaesthetic, is much more invasive and painfull, and results only in small numbers of cells being obtained.
With such large numbers of adipose derived cells being directly available (typically in the order of 10-100's of millions of cells with our largest single harvest to date being just over 1.4 billion cells!!), treatment is a much simplified process of concentrating the cells and then immediately reinfiltrating the cells. This is done in house at the one time in the clinic, as an all in one procedure.
Bone marrow derived cells however, being low in numbers (typically 10-50 thousand cells harvested), require extensive manipulative laboratory expansion in order to produce numbers that are anything remotely adequate for use in therapy (typically 1-2million cells). With this however, there arises numerous potential issues and questions. There can be concerns over the use and effectiveness of expanded cultured cells: are they as effective as unmanipulated cells? Does manipulating or reprogramming cells have the potential to cause undesirable development such as cancer? Can their sterility or their patient of origin be guaranteed once these bone marrow cells have left the clinic, travelled to a laboratory, spent days in culture dishes etc, and then sent back to be used?
In the case of autologous adipose derived cells, there are huge numbers of cells immediately available, there is no such storage or manipulation required, and thus many of these controversial issues are null and void.
Other theoretical advantages of Adipose Derived Cells.
The concentrated fraction of cells we obtain from adipose tissue, is not only just stem cells, but actually contains a very interesting mix of other potentially useful regenerative cells. This mix includes, but may not be limited to, mesenchymal stem cells, a variety of pre-stem-like cells and progenitor cells, immune cells and numerous other biologically active hormone and growth factor seceting cells. This mix is collectively called the Stromal Fraction.
This stromal fraction of multifunctional regenerative cells, could be considered a bit like an organised taskforce of workers, all at different levels within the organisation, all cooperating and contributing towards the common goal, all with their specific individual tasks and skills and all dependent upon each other in order to achieve those tasks. Such a coordinated taskforce could achieve incredible results. This would be in contrast to a single type of cell line (such as a manipulated expanded single lineage stem cell) , albeit maybe a "CEO" type, but without the rest of the team, may not be able to achieve the desired outcome. This may explain why some studies using only cultured single lineage stem cells have shown dissappointing results, while stromal fraction has shown more encouraging results.
|
