Autologous Adipose Stem Cell Therapy for Arthritis

 

Autologous adipose-derived stem cells are being used in clinical practice now. Regenerative medicine has brought hope to many who have suffered from arthritis and not responded to other treatments. From 2013 to 2015, 54 million adults in the U.S. had doctor-diagnosed arthritis, which translates to around 22% of people. The most common type of arthritis is osteoarthritis, but other types include rheumatoid arthritis, gout, and fibromyalgia. By 2040, around 78 million people in America are going to have arthritis.

How Stem Cells Treat Arthritis

Arthritis affects 1 in 25 working-aged people in America. Around half of people with arthritis have some type of activity limitations. Adults with arthritis are around 2.5 times more likely to have one or more falls during the previous 12 months compared to people without arthritis. Stem cells are used to repair, heal, and regenerate damaged or arthritic tissues, cartilage, and joints. The role of stem cells in arthritis treatment involves joint preservation and prevention of further degeneration.

The gristle of the joint surface is a barrier to arthritis. Once this layer of tissue becomes damaged, the joint can progress to arthritis, which causes stiffness, pain, and loss of function. Stem cell therapy is used to regenerate the gristle layer. This procedure preserves the hip and knee joint function and also treats avascular necrosis (dead bone tissue).

How Stem Cells are Collected

The adipose stem cell therapy procedure is one outpatient, so you go home the same day. The physician and staff are board-certified, with special training in regenerative medicine. Because you receive “twilight anesthesia,” you will have little memory of the procedure. The total procedure time is around 5 hours and includes the following steps:

  • Harvest – To obtain the adipose stem cells, the doctor injects/numbs the treatment area using an anesthetic. A small incision is made and a cannula is inserted. The adipose tissue is removed via gentle suction and collected in a special canister.
  • Separation – Around 200 milliliters of adipose tissues is processed in the laboratory. The stromal vascular fraction (SVF) contains the adult stem cells, and this material is separated from fat cells using advanced protocols.
  • Isolation – The adult stem cells and other progenitor cells are isolated from SVF using advanced multi-filtration techniques. Once isolated, the stem cells are added to the patient’s platelet-rich plasma (PRP), and sometimes activated with a low light laser.
  • Administration – The activated adipose stem cells are administered to the arthritic joint via injection or during an arthroscopic procedure.

Does Stem Cell Therapy Work?

Biological therapies, such as stem cell injections and platelet-rich plasma (PRP) treatment, have greatly improved patient outcomes. In veterinary medicine, stem cells from autologous stromal vascular fraction (SVF) have an 80% efficacy rate for degenerative conditions. Adipose SVF is comprised of mononuclear SVF. The MSC-like cells in SVF differentiate into osteogenic lineages, which helps with the treatment of arthritis. The adipose-derived stem cells are superior in terms of angiogenesis stimulation and immune modulatory effects.

In a recent study, clinical outcomes were evaluated in patients treated with stem cell therapy before and after a chondrocyte implantation. Clinical symptoms were reported to have improved, and upon histopathological evaluation and magnetic resonance imaging (MRI) scans, new cartilage was detected. In another study, the defect in one patient was repaired at the 12-month follow-up following stem cell transplantation.

Local administration of adult stem cells was studied in patients with osteoarthritis. The researchers examined synovial activation, osteophyte size, and cartilage damage. The researchers concluded that synovial activation was associated with anti-inflammatory and protective effects of joint deposited stem cells, which was demonstrated by low levels synovial markers.

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Resources

  • Centers for Disease Control and Prevention (CDC) (2017). Arthritis-related statistics. Retrieved from: https://www.cdc.gov/arthritis/data_statistics/arthritis-related-stats.htm
  • Rodriguez JP, Murphy MP, Hong S, et al. (2012). Autologous stromal vascular fraction therapy for rheumatoid arthritis: rationale and clinical safety. Int Arch Med, 5(5).
  • Van Dalen S, Ter Huurne M, Roth, J (2014). Treatment efficacy of adipose-derived stem cells in experimental osteoarthritis is driven by high synovial activation and reflected by S100A8/A9 serum levels. Osteoarthritis & Cartilage, 22(8), 1158-1166.

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