Stem cells derived from bone marrow, or hematopoietic stem cells, are a topic of significant debate in the medical community. While they have exhibited significant potential for benefiting people with both cancerous and noncancerous diseases including immune deficiencies, not all methods for administering bone marrow are created equal. While intra-articular injections of bone marrow are more common and considered safer, intravenous methods pose serious risks, which are explored here.
Intra-articular injections involve injecting bone marrow directly into the compromised joint, whereas intravenous methods entail infusing bone marrow stem cells into the body through the veins. Intra-articular injections have shown promise in treating conditions such as osteoarthritis (OA) in joints such as the knee and has proven to achieve pain relief for moderate-to-severe cases of osteoarthritis.
Intra-articular treatments are localized, so the injected bone marrow is already in its target location upon being administered. According to research, this form of therapy is generally considered to be safe. In intravenous bone marrow transplants, however, there are serious risks associated with treatment. Bacterial infections are common, while viral and fungal infections can also occur and cause life-threatening conditions, such as organ failure.
Risk factors for developing any complication associated with intravenous bone marrow transplantations vary based on a number of factors, including the patient’s age, genetics, and type of disease being treated. With that said, due to its limited risks, intra-articular bone marrow methods appear to be the safest form of treatment currently available. Although each patient will need to discuss risk factors alongside potential benefits with his or her physician, oftentimes the risks appear to outweigh the potential benefits.
There are alternative therapies with fewer potential side effects which may be explored such as Adipose and Umbilical Cord-derived stem cells. These regenerative medicine treatments not only can treat osteoarthritis and sports-related injury conditions, but have also shown positive results in treating neurological conditions such as Multiple Sclerosis, Parkinson’s disease, Post-Stroke, and Traumatic Brain Injuries (TBI).
In a recent edition of JAMA, the results of a 30-year study examining the possible connection between stress and autoimmune disease were revealed. The findings don’t simply demonstrate a link; instead, they reveal that stress-related disorders are significantly associated with risks of developing the subsequent autoimmune disease. In the study of over 100,000 subjects, the correlation showed that individuals with a diagnosed stress-related disorder were 30-40% more likely to later be diagnosed with one of many possible autoimmune diseases.
What is a Stress-Related Disorder?
The type of stress study subjects encountered is not to be confused with the stressors we encounter during everyday life. Sitting in traffic or worrying about being late for a meeting, for example, are examples of acute stress. These forms of short-term stress generally come and go but fail to create the sort of long-term damage produced by chronic stress, or stress-related disorders.
Stress-related disorders are mental health conditions resulting from short- and long-term anxiety from mental, physical, or emotional stress. Examples of these include post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, acute stress reaction, and adjustment disorder.
Which Types of Autoimmune Disorders Are Linked to Stress?
According to the study’s findings, individuals with stress-related disorders were more inclined to be diagnosed with one of 41 autoimmune disorders. Among the many autoimmune diseases observed by the research were psoriasis, Crohn’s disease, rheumatoid arthritis, and celiac disease.
Interestingly, additional variables seemed to further increase – or decrease – one’s risks of developing an autoimmune disease. Being diagnosed with PTSD at a young age, for instance, increased risks, while receiving antidepressant treatment shortly after being diagnosed with PTSD lowered rates of subsequent autoimmune disease diagnosis. Thus, it could be inferred that receiving treatment for a stress-related disorder may help to treat not only the stress itself but also minimize the lasting implications caused by it, including increased risks of disease.
What Causes the Connection?
Further research must still be conducted to pinpoint the precise long-term effects stress has on the body, and more specifically, on the immune system. Experts speculate that factors such as changes in cortisol levels and pro-inflammatory cytokine levels may need to be examined. Another hypothesis set forth by researchers is that individuals living with conditions such as PTSD might be more inclined towards unhealthy behaviors such as drinking more alcohol or sleeping less.
Although further research into this connection has yet to be conducted, one important takeaway from the findings is the fact that seeking treatment for stress-related disorders should now be considered more critical than ever. By consulting mental health professionals, individuals living with these conditions can pursue a tailored treatment approach to support short- and long-term improvements in overall wellness. For those with an auto-immune condition, see how stem cell therapy may help your symptoms and improve quality of life.
Using growth factors to help stem cells differentiate into chondrocytes, or cartilage cells has been shown to be an effective way to maintain cartilage tissue. However, there are several different types of growth factors, and little has previously been known about which growth factors may be most beneficial for help stem cells differentiate in a way that supports cartilage.
New research published in Stem Cell Reviews has addressed this issue by looking specifically at how four specific growth factors affect differentiation of mesenchymal stem cells – and particularly – how they affect chondrogenic differentiation. The four growth factors explored in this study were: transforming growth factor beta 1 (TGF-β1), bone morphogenetic protein 2 (BMP2), parathyroid hormone-related protein (PTHrP), and fibroblast growth factor 2 (FGF2).
The scientists used methods of analyzing the levels of growth factors as well as the extent of collagen content on days 16, 23, and 30 after implementing growth factor programs. The results showed that TGF-β1 and BMP-2, when used in combination, increased short-term collagen content and other indicators of well-maintained cartilage. When PTHrP or FGF2 was applied, the overall impact of TGF-β1 and BMP-2 on cartilage tissue was initially decreased. Nonetheless, successive applications of both PTHrP and FGF2 helped to maintain the effects of TGF-β1 and BMP-2.
These results help to clarify the ways in which growth factors can be used to improve the ability of bone marrow derived mesenchymal stem cells to differentiate into cells that are viable for supporting cartilage. The specific outcomes provide critical information that can help with protocols for chondrogenic differentiation of stem cells. Future research will likely build on these findings to help scientists and clinicians better understand the best formulas for how to use growth factors to achieve desired results with stem cells.
Adipose treatment is a procedure in which stem cells are derived from a section of the abdomen then used for therapeutic purposes. Adipose-derived stem cells (ADSCs) are less invasive to extract compared to cells derived from other sources, such as bone marrow. In therapeutic applications, adding platelet-rich plasma (PRP) to ADSCs has been shown to have benefits.
What is PRP?
PRP therapy is the process by which a small sample of blood is removed from the patient. The platelets are then separated from other components of the blood via a centrifuge. The isolated platelets are shown to have high levels of diverse growth factors.
Why Are Growth Factors Important?
ADSCs are shown to have reduced proliferative potential. While they do secrete a wide range of growth factors, PRP therapy is coupled with stem cell therapy to maximize their regenerative medicine potential benefits by helping to increase their proliferation and differentiation. PRP essentially empowers the ADSCs, stimulating cell proliferation and cell differentiation when used for regenerative applications.
Which Applications Can the Therapy Be Used for?
Researchers have stated that the therapeutic potential of ADSCs is “enormous,” but by kickstarting the stem cells with PRP, it’s possible that the therapy will unlock even further medicinal possibilities. Anti-inflammatory and anti-apoptotic effects have been demonstrated by ADSCs, and there are many clinical trials which have either been completed or are ongoing to explore the treatment’s effects. Skeletal repair, soft tissue generation, and immune disorders such as Crohn’s disease and multiple sclerosis are just some of the therapeutic targets for this treatment. In specific, using ADSCs with PRP has been shown to aid periodontal tissue engineering, tendon repair, wound healing, and even bone regrowth.
Because the ADSCs are fairly easy to source and blood samples required for PRP are also simple to acquire, combining PRP to adipose stem cell therapy shows promise for delivering a powerful treatment that can address a broad variety of conditions, all with a minimally invasive approach.
Under normal circumstances, pain receptors react to painful stimuli such as burns or lacerations. Pain receptors from the body then send that information along nerves to the brain via electrical signals. Once that electrical information reaches the brain (which happens almost immediately), it is perceived as pain. This type of pain is a nociceptive pain.
Neuropathic pain, however, is different. Neuropathic pain is caused by a condition of the nerves themselves. Patients with neuropathic pain experience chronic pain without any specific injury. Neuropathic pain may be felt as a burning sensation, tingling, or a “pins and needles” sensation, or these combined. Neuropathic pain most often occurs in people with diabetes, certain vitamin deficiencies, and shingles. It may also occur after people receive certain cancer treatments following a stroke.
While it is rather simple to treat pain caused by a burn or laceration (nociceptive pain), it is very difficult to effectively treat neuropathic pain. Standard treatments for neuropathic pain include anti-epilepsy medications such as phenytoin, gabapentin, or carbamazepine and antidepressants such as venlafaxine, duloxetine, or amitriptyline. Usually, these treatments are only modestly effective. Eventually, many patients need powerful opioid medications like morphine and oxycodone to control their pain.
Researchers at the Cleveland Clinic published research that strongly suggests that stem cells may be able to improve those battling neuropathic pain. Dr. Jianguo Cheng and his research group have shown that mesenchymal stem cell transplantation into the spinal fluid can reduce pain and pain sensitivity in an animal model of neuropathic pain. In one series of experiments, they showed that mesenchymal stem cells could relieve pain in rats who had experimental nerve damage. Researchers confirmed the benefit of stem cells for neuropathic pain in several different sets of experiments. The results have been so encouraging that Dr. Cheng and the Cleveland Clinic have applied to patent the technology.
Dr. Cheng’s group also showed intravenously administered mesenchymal stem cells are just as effective as cells administered into the spinal fluid (intrathecally). This is good news for patients since it is less invasive to put stem cells into a vein than it is to infuse them into the cerebrospinal fluid. Amazingly, the research group showed that stem cells injected through either route (vein or spinal fluid) ended up finding their way to damaged nerves where they could provide maximum benefit.
While this work in animals must be performed in humans to confirm the results, this preclinical research establishes a strong foundation for those clinical studies. These results provide hope to those who struggle with daily neuropathic pain.
Chronic fatigue syndrome, also known as systemic exertion intolerance disease, is a challenging condition for many patients, their families, and the doctors who care for them. The illness is difficult to diagnose since not all symptoms will appear in every patient. Some do experience feeling chronically fatigued yet may not have chronic fatigue syndrome.
Most patients with chronic fatigue syndrome have a sudden onset of fatigue that may occur soon after an infection, such as a cold, pneumonia, or mononucleosis. Patients with chronic fatigue syndrome usually experience overwhelming fatigue that may interfere with sleep and the ability to think and concentrate. Symptoms tend to get worse after periods of heavy physical activity, but may also occur after simply rising from a seated position or standing for a long period. Importantly, most patients with chronic fatigue syndrome began life with few or no symptoms. Many were previously high functioning in their daily lives who are now impacted by the symptoms they experience.
Just as chronic fatigue syndrome is difficult to diagnose, it is also difficult to treat. Not every treatment will work for every patient. In fact, there is no widely accepted, specific treatment for chronic fatigue syndrome. Treatment is mostly supportive and aimed at reducing symptoms. While many medications have been tried such as antidepressants, steroids, stimulants, vitamin B12, essential fatty acids (and many others), no drug treatment has been consistently successful at helping people with chronic fatigue syndrome.
A recent report by Akarsu and colleagues may offer some hope for people with chronic fatigue syndrome. Sixteen patients with confirmed chronic fatigue syndrome received 15 sessions of hyperbaric oxygen therapy over a period of three weeks. Each treatment was for 90 minutes in a hyperbaric oxygen chamber. Participants in the study agreed to stop all physical therapy or medication for chronic fatigue syndrome so that those treatments would not interfere with the results of the study.
The research group found that chronic fatigue syndrome patients tolerated hyperbaric oxygen therapy very well, and had no complications. In all measures tested, patients were significantly better after treatment than they were before hyperbaric oxygen therapy started. Specifically, patients had better scores on two clinical tests of fatigue (visual analog fatigue scale and the Fatigue Severity Scale) and in a quality of life assessment (Fatigue Quality of Life Score). The improvement in scores was not subtle—in each test, there was a clinically significant increase in the average score. The results showed that hyperbaric oxygen therapy significantly and substantially reduced fatigue and improved quality of life in patients with chronic fatigue syndrome/systemic exertion intolerance disease. These results are incredibly encouraging since they indicate hyperbaric oxygen therapy may be an effective treatment for those battling chronic fatigue syndrome.
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