Osteoarthritis of the knee is a common problem for which only symptomatic treatment is currently available. In recent years, the use of stem cells (SCs) has drawn interest as a therapy that might help to slow down or perhaps even reverse this condition.
The use of SCs in medicine is not new. They have been used in bone marrow transplant procedures for almost half a century.
What is also known is that these cells have a number of desirable features including the ability to repair damaged tissue, reduce inflammation, modulate the immune system, and respond to areas of injury through a complex series of messages sent via cytokines, protein "Pony Express" riders.
It is only recently that these properties have stimulated the interest of researchers who view these cells as having "pharmaceutical" potential in treating disease.
SCs are the body's basic building block cell. They are essentially "blank slate" cells that can renew themselves and mature into various cell types in organs as diverse as the heart, the gut, muscle, and joint tissue.
In previous articles I've discussed the different types of SCs that have been used in basic as well as clinical research.
Embryonic SCs are the cells that have been mentioned in the news most frequently. They are unique in that they are capable of differentiating into any type of mature cell in the body.
They were once touted as the "miracle cell" that would be used to make entire new organ systems.
However, the harvesting of SCs from embryos requires the destruction of the embryo, a process opposed by conservative religious groups.
On a different note, the perpetual capacity to divide can lead to the formation of SC induced cancers.
By contrast, adult SCs have less ability to differentiate, but can reduce inflammation as well as stimulate blood vessel formation. This latter property is useful for tissue repair. In fact, they are often referred to as "repair SCs."
Some companies are developing allogeneic products designed to be eventually marketed just as any pharmaceutical product would be. These cells are harvested from a healthy donor. They are then cultured outside the body in order to increase the total number of stem cells. Theoretical problems include transmission of disease as well as rejection, by either the host or by the SC graft.
The autologous approach, using a patient's own SCs, is the subject of interest by a number of biotech companies. Various investigations into proprietary methods for enhancing stem cell number and potency have attracted much attention.
This approach of using the patient as their own source of "medicine" eliminates the risk that the cells will be rejected.
There are multiple branches of medicine where there is growing enthusiasm to use these healing cells. In particular, our center has been conducting procedures where there is early, yet undeniable proof of improvement in both clinical as well as objective parameters in the treatment of osteoarthritis of the knee.
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