| We're all hearing about stem cell therapy in all the
media. But what exactly are stem cells and how do they work? Stem cells
are cells which have not fully differentiated or matured into a specific
organ or structural components of the body. There are two major
classes of stem cells; embryonic cells, and somatic stem cells.
Embryonic cells are derived from the embryo. The use of embryonic
cells has led to ethical controversy about their use because an embryo
must be sacrificed in order to obtain them. Somatic stem cells are cells
present in the patient's own body in most
organs. They act as "spare parts" to be used in the
repair of damage to a particular organ. That is to say, when there
is damage in a joint, for instance, there are some local stem cells,
which will convert into new cartilage cells or joint lining cells as
needed. Unfortunately, when a disease process advances, it may
outstrip the ability of the relatively few local stem cells to reverse
the process.
Interestingly, stem cells
have many functions beyond their ability to replace damaged cells.
The stem cells appear to be able to significantly reduce inflammation,
increase blood flow to damaged tissue, reduce scarring and improve
existing scar tissue and generally seem to orchestrate the interactions
of all the cells involved in the repair process through a variety of
cellular stimuli. Recent research has shown that these ancillary
functions of the stem cells may be just as important in the resolution
of symptoms as is the replacement of the damaged tissue!
How are stem cells used?
There is an incredible amount of research being done
in both the human and veterinary fields on the use of stem cells.
Currently, stem cell use is approved for use in dogs and horses for
orthopedic applications including joint and tendon injuries.
Vet-Stem, a pioneering stem cell company based in San Diego has data on
over 3500 cases so far with outstanding results. On average,
75% of patients treated for chronic arthritis or tendon injuries improve
significantly after a single treatment. The majority of patients
improve to the point of significantly reducing the need for ancillary
drugs to manage their pain. More importantly, the relief appears
to last for a long period of time.
There is ongoing research in the use of stem cells to
treat a variety of other diseases including liver disease, spinal cord
injuries, kidney disease, heart disease and all types of auto-immune
diseases. The preliminary data on most of this research is very
promising and often amazing. We can look forward to expanding our
use of stem cells to treat a variety of disease in the near future!
How are stem cells obtained and used?
Scientists have developed a process to harvest and concentrate stem
cells from many tissues in the body. The best source appears to be
fat cells as they are generally easy to harvest, do not leave the body
deficient of important function when they are extracted and they have a
relatively high concentration of stem cells. The beauty of using a
patient's own stem cells in treatment is that there is no rejection
phenomenon with these cells because they are part of the patient's own
body! Using embryonic stem cells or cells from another donor pose
a grave risk of rejection, where either the body rejects the foreign
cells, or the foreign cells "reject" or attack the host. After
over 3500 clinical cases using fat derived stem cell therapy, there have
been no serious side effects involving rejection, or for that matter,
any other serious reactions of any kind!
The process of stem cell therapy involves 5 stages:
- Patient evaluation
- Fat collection
- Stem Cell extraction and preparation
- Stem cell storage
- Stem cell injection
Patent selection involves obtaining a definitive diagnosis so that we
are certain we are treating the appropriate problem, and appropriate
joint(s). It also involves evaluating the overall health of the
patient and making certain that they are appropriate candidates for this
therapy. Generally a physical exam, orthopedic exam, bloodwork and
radiographs are required to determine if the patient is ok for stem cell
therapy.
Fat collection involves a minor surgical procedure, in which the
patient is anesthetized and a sample of fat is removed from the body.
The sites for fat collection may vary depending on the pet and their
body type, but generally we try to take it from a fat pad behind the
shoulder, or from the groin area. On very thin dogs, we may need
to harvest the fat from inside the belly. As with all of our
anesthetic procedures, every effort is
made to ensure the safety of your pet. If the preoperative
evaluation does not show any problems, the risk from the fat harvesting
is minimal. There is a slight risk for the development of a serum pocket
(seroma) at the surgical site, and there is always a slim chance for
infection as there would be with any surgery.
The fat that is collected is sent in a specifically designed carrier
via fedex overnight delivery to the Vet-Stem laboratory in San Diego for
processing. Once there, the stem cells are isolated from he
remainder of the tissue and prepared for use in your pet. The
cells are handled in a sterile environment throughout the processing and
are packaged into sterile syringes and shipped back to us overnight,
again in special packaging materials to maintain the proper temperature
of the cells. Each treatment syringe generally holds 3 to 4
million stem cells. These numbers have been shown through research
to be the optimal amount to treat with. Increasing the number of
cells beyond this amount does not tend to show better response.
If there are more cells in the fat sample than are needed for the
initial treatment, additional cells will be stored at Vet-Stem in a
cryogenic freezer for potential use later in time. This makes
additional treatment much simpler (and less costly) in the future.
Vet-Stem will store the cells for the first year at no charge to the
client. Additional storage is available at approximately $150.00
per year. Cells can be stored for the lifespan of your pet and
still maintain their function.
Once the cells have been returned to us, we will bring your pet in
and under heavy, reversible sedation, we will inject the affected
joint(s). The injection area is shaved and surgically prepped to
prevent infection. A small gauge needle is inserted into the joint
and the cells are injected. The patient is released late in the
afternoon.
What should we expect from the treatment?
In most cases, patients will show some improvement between 2 to 6
weeks after treatment. Statistics show most dogs improving in
their pain scores from severe to mild or moderate during this time.
Many of the pets will return to close to full function. If
there is a limited response, a second application may be considered 6 to
8 weeks after the first injection, which may improve the results.
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