Stem Cells and Stroma Cells

Revision Knee Surgery

Dr. Marc Darrow

Stem Cell Therapy for Osteoarthritis

Stroma cells are connective tissue cells found in body organs and in bone marrow Fibroblasts (cells that make collagen) and pericytes ( facilitating new blood vessel formation to bring circulation to the area) are the most common stroma cells. In our practice we use bone marrow derived stem cells to regenerate damaged joints.

Doctors at the University of Iowa are experimenting with stroma cells. This is from the University: Knee injuries are the bane of athletes everywhere, from professionals and college stars to weekend warriors.

Current surgical options for repairing damaged cartilage caused by knee injuries are costly, can have complications, and often are not very effective in the long run. Even after surgery, cartilage degeneration can progress leading to painful arthritis.

But a University of Iowa orthopedics research team is working on a solution with hopes it will result in a minimally invasive, practical, and inexpensive approach for repairing cartilage and preventing osteoarthritis.

“We are creating an [injectable, bioactive] hydrogel that can repair cartilage damage, regenerate stronger cartilage, and hopefully delay or eliminate the development of osteoarthritis and eliminate the need for total knee replacement,” says Yin Yu, a graduate student in the lab of James Martin, PhD, UI assistant professor of orthopedics and rehabilitation. Yu is first author of the study, which is featured on the cover of the May issue of the journal Arthritis and Rheumatology.

Martin’s team had previously identified precursor cells within normal cartilage that can mature into new cartilage tissue. This was a surprising discovery because of the long-held assumption that cartilage is one of the few tissues in the body that cannot repair itself. (Note: Prolotgerapy doctors have often documented cartilage regrowth.)

The team also identified molecular signaling factors that attract these precursor cells, known as chondrogenic progenitor cells (CPC), out of the surrounding healthy tissue into the damaged area and cause them to develop into new, normal cartilage. One of the signals, called stromal cell-derived factor 1 (SDF1), acts like a homing beacon for the precursor cells.

In an experimental model of cartilage injury, Yu loaded the custom-made hydrogel with SDF1 and injected it into holes punched into the model cartilage. The precursor cells migrated toward the SDF1 signal and filled in the injury site. Subsequent application of a growth factor caused the cells to mature into normal cartilage that repaired the injury.

“This process gives us a great result,” Yu says. “The new cartilage integrates seamlessly with the undamaged tissue, it has normal concentrations of proteoglycans, good structural properties, and looks like normal cartilage.”

The new tissue is not as mechanically strong as normal cartilage, but Yu and Martin think that mechanical loading – the type of stress that is exerted during physical therapy and exercise – might improve the mechanical properties.

“There’s really no cure for osteoarthritis except for total joint replacement, which is not particularly suitable for younger patients because the artificial joints wear out and need to be replaced multiple times,” says Martin. “Our approach aims to leverage the body’s own capacity for repair, and what we’ve shown is that cartilage does have regenerative potential; you just have to manipulate it just right.”

This gel could be available in 5 years.

Why the long wait? Other research has shown that stroma cells are difficult to deliver, this is why today, the prefered choice of getting these growth factors into the osteoarthritic joints is stem cell therapy.

Mesenchymal stem cells are multipotent stromal cells.


There is so much research centered on stem cell therapy for osteoarthritis because doctors have long known that fixing diseased or damaged articular cartilage in patients is still a challenge despite advances in surgery and MRI diagnosis. This is why mesenchymal stem cells (mesenchymal – stem cells that create soft tissue ) are being studied for their regenerative properties and why research like that above is so exciting . In related research not only did injected stem cells begin the healing process, but they also mobilized the “native” stem cells in the knee to start repairing damage – the healing environment of the whole joint was swicthed on.

Traditional treatments for the patient / athlete with osteoarthritis are designed to reduce pain and symptoms. They are not designed to rebuild the natural joint. This is why many of the treatments fail the patient’s expectations. NSAIDs, nonsteroidal anti-inflammatory drugs and/or surgical treatments may only temporary relief if not further complication and weakening as outlined in many articles on this blog.

In our practice we specialize in treatments that rebuild, rejuvenate, and strengthen joints effected by osteoarthritis. Not only do Mesenchymal stem cells (MSCs) have the potential to stop the degenerative process of Osteoarthritis they have the ability to rebuild articular cartilage, tendons, ligaments, and other soft tissue.

“With an aging population, the prevalence of osteoarthritis has increased. Mesenchymal Stem Cells (MSCs) have been proposed to be an attractive alternative candidate in the tissue engineering of articular cartilage primarily due to its abundant source, reduced cartilage donor site morbidity, and strong capacity for proliferation and potential to differentiate toward a chondrogenic phenotype (make cartilage).” 1

 

Adult stem cells are extracted from the patient’s own body and used to create a healing solution containing platelet-rich plasma and stem cells. This is done in accordance with FDA guidelines that prohibit manipulation of the stem cells. Once injected into degenerated joints and ligaments, your own newly activated stem cells go to work causing a dynamic self-repair response on the cellular level.

Adult Stem Cell Therapy has the potential to provide joint, tendon, ligament, and muscle regeneration, and is the next frontier for Prolotherapy and PRP. Treat painful back and joint problems with Adult Stem Cell Therapy. Learn more today!
1. Tang QO, Carasco CF, Gamie Z, Korres N, Mantalaris A, Tsiridis E. Preclinical and clinical data for the use of mesenchymal stem cells in articular cartilage tissue engineering. Expert Opin Biol Ther. 2012 Oct;12(10):1361-82. Epub 2012 Jul 12.