Stem cell science available at your doctor’s office

Last week I wrote about how your own fat has the best source of growth factors and stem cells to regenerate healthy tissue in all parts of your body.

That’s according to world-renowned physician-researchers who presented at a recent San Diego Academy of Regenerative Therapies (SDART) annual conference.  Let me share some of the science they presented and the real-world applications that are now available to you…

Mesenchymal stem cells from your own fat

Fat stored in your belly and thighs contains your largest and most effective supply of stem cells, also called “adult mesenchymal stem cells” or MSCs. These stem cells will differentiate into a variety of cell types, and therefore are often termed, “multipotent” stem cells. That is, they become blood vessels, connective tissue such as skin (collagen and hair), fat, cartilage, muscle, blood vessels, nerves or other tissue types — wherever it is transferred to.

When your fat is harvested and then processed properly, scientists call this the “Stromal Vascular Fraction” (SVF). Your own SVF contains all of the multipotent stem cells (like seeds to be planted) and the growth factors (like fertilizer for the soil) for optimal results.

Compare this with just fat that is harvested and not processed, serum-containing cytokines and growth factors from donor bone marrow tissue, or even stem cells that are derived from donor amniotic fluid.

Even though amniotic fluid contains more stem cells than adult bone marrow does, the SVC from your fat contains many more stem cells than even amniotic fluid, plus the growth factors to go with it (both seeds and fertilizer).

This is best for injection using a blunt tip cannula into your

• face areas needing lift and correction of age-related volume loss such as temples, cheek hollows, jaw, lower face, and even lips
• larger body areas such as breasts and buttocks

When your SVF is further processed, it is known as nanofat. As I previously reported, nanofat is a wonderful aesthetic tool for reshaping and regenerating the face. For example, nanofat transfer using a blunt tip cannula is used for:

• Reshaping the face from sagging, sunken, deep creases,
• smaller, more delicate facial areas such as under eyes (tear trough), nasolabial folds, lip lines (a.k.a. “smoker’s lines”), lip contouring, and dorsal hands.

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Add in the PRP

Platelet Rich Plasma (PRP) from your own blood contains growth factors that stimulate stem cells to proliferate wherever it is placed. PRP helps direct the stem cells to know where to repair tissue. Adding your own (PRP) to tissue where your nanofat is placed (done concomitantly, but not mixed prior to injecting it), is like adding more fertilizer and is therefore even more effective at causing healthy tissue to grow. Therefore, PRP is the perfect additional ingredient to add to the autologous fat transfer recipe for medical aesthetics.

PRP has also long been well proven to be effective in joint regeneration. Compare this to joint surgery, which comes with considerable cost, down-time, and scarring.

Therefore, PRP is used for any place you want tissue to grow or heal such as hair restoration, joints, and along with nanofat transfer anywhere in the body

Amniotic stem cells

Research shows us that amniotic fluid has become a promising source of mesenchymal stem cells for therapeutic transplantation. In 2007 researchers knew that a subset of cells found in amniotic fluid and placental tissue is capable of differentiating into multiple progenitor cell types in adults.

In 2012 researchers showed us that these cells stimulate the repair of injured tissue through a local cell to cell communication. In this model, a cell produces a signal which induces changes in nearby cells, thus altering the behavior of those cells.

While fat transfer has its many therapeutic applications, injecting it into your bloodstream would be dangerous if fat cells made it into the nanofat mixture. However, stem cells purified from amniotic fluid can either be infused by an IV route (where they will land in all your body organs and tissues) or injected directly into an otherwise non-healing joint, tendon or ligament (with or without ultrasound guidance). In a 2012 report, researchers summarize the viability of using amniotic fluid stem cells for the treatment of articular cartilage defects with the aim of joint regeneration.

Related: The joint regenerative power of stem cell therapy

Therefore, amniotic stem cells plus PRP can be used to regenerate non-healing joints or tendons in your:

• shoulder
• elbow
• wrist
• back or neck
• hip
• knee or patellar tendon
• ankle
• Achilles tendon
• foot plantar (fasciitis)

The main drawback to amniotic fluid-derived stem cells is the cost. Doctors can purchase it for $800 to $1,500 for just one ml of this fluid. The mark-up to the patient goes way up from there.

Stem cells for anti-aging

Two small recent human clinical trials show that stem cell therapy is both safe and quite effective in reversing symptoms of age-associated frailty.

In these studies, they measured physical performance before and then six months after their one stem cell infusion such as a 6-minute walk test, short physical performance exam, and a breathing test (forced expiratory volume in 1 second). They also measured their blood for immune markers of frailty (B cell intracellular TNF-α levels) six months after the infusion. And, they gave them a female sexual quality of life questionnaire.

In the more recent study, patients ages 76 years on average were given just one infusion with a high concentration of human bone marrow mesenchymal stem cells (20 million, 100 million or 200 million cells) from donors aged 20 to 45 years old. They found that those who received 100 million cells had significant improvement in all parameters measured as described above. There were no adverse effects.

You can see why I am so excited to further my clinical skills using autologous nanofat transfer plus PRP in my growing medical aesthetics practice.

To aging beautifully and feeling good,

Michael Cutler, M.D.

Sources:

1. Lange-Consiglio A, Tassan S, Corradetti B, Meucci A, Perego R, Bizzaro D, Cremonesi F. “Investigating the efficacy of amnion-derived compared with bone marrow-derived mesenchymal stromal cells in equine tendon and ligament injuries” — Cytotherapy. 2013 Aug;15(8):1011-20. PubMed PMID: 23602577
2. Tonnard P, Verpaele A, Peeters G, Hamdi M, Cornelissen M, Declercq H. Nanofat grafting: basic research and clinical applications — Plast Reconstr Surg. 2013 Oct;132(4):1017-26. PubMed PMID: 23783059
3. PRP and Stem Cells | Patient Information — Colorado Sports Doctor
4. Delo DM, De Coppi P, Bartsch G Jr, Atala A. “Amniotic fluid and placental stem cells” — Methods Enzymol. 2006;419:426-38. Review. PubMed PMID: 17141065.
5. Prusa AR, Marton E, Rosner M, Bernaschek G, Hengstschläger M, “OCT4-expressing cells in human amniotic fluid: a new source for stem cell research?” — Hum Reprod 2003. 18:1489–1493.
6. In’t Anker PS, Scherjon SA, Keur CK, Noort WA, Claas FHJ, Willemze R, Fibbe WE, Kanhai HHH, “Amniotic fluid as a novel source of mesenchymal stem cells for therapeutic transplantation” — Blood 2003. 102:1548–1549.
7. In’t Anker PS, Scherjon SA, Keur CK, Groot-Swings GMJS, Claas FHJ, Fibbe WE, Kanhai HHH, “Isolation of mesenchymal stem cells of fetal or maternal origin from human placenta” — Stem Cells 2004. 22:1338–1345
8. Clonal Amniotic Fluid-Derived Stem Cells Express Characteristics of Both Mesenchymal and Neural Stem Cells — Biology of Reproduction
9. Rennie K, Gruslin A, Hengstschläger M, Pei D, Cai J, Nikaido T, Bani-Yaghoub M. “Applications of amniotic membrane and fluid in stem cell biology and regenerative medicine” — Stem Cells Int. 2012;2012:721538. PubMed PMID: 23093978.
10. Preitschopf A, Zwickl H, Li K, Lubec G, Joo G, Rosner M, Hengstschläger M, Mikula M. “Chondrogenic differentiation of amniotic fluid stem cells and their potential for regenerative therapy” — Stem Cell Rev. 2012 Dec;8(4):1267-74. PubMed PMID: 22869300.
11. Golpanian S, DiFede DL, Khan A, Schulman IH, et al. Allogeneic Human Mesenchymal Stem Cell Infusions for Aging Frailty — J Gerontol A Biol Sci Med Sci. 2017 Oct 12;72(11):1505-1512. PubMed PMID: 28444181