What happens during an autologous stem cell procedure?
A small sample of fat tissue is removed from areas of the body that have an adequate fat supply. The extraction process typically takes 25-30 minutes and only requires local numbing.
A medical technician specially trained in the proprietary processing of adipose derived stem cells, isolates and processes the stem cells.
Stem cells are then injected back into the appropriate area of need via a delivery method specific for the medical condition which is being treated.
Common applications for autologous stem cell therapy
Chronic Obstructive Pulmonary Disease (COPD)
COPD is a lung disease that blocks airflow, causing patients to experience a difficulty in breathing. COPD can also cause coughing, the production of mucus, and shortness of breath, wheezing, and constriction of the chest¹. COPD causes a restriction of airflow in and out of the body. COPD is a progressive disease that develops slowly, but consistently becomes worse over time. There are two main conditions characterized by patients with COPD: Chronic Bronchitis and Emphysema.
·Chronic Bronchitis: results in a thickening of the airways inner lining due to mucus formation, which leads to a decrease in lung capacity.
·Emphysema: results in destruction of the air sacs and the walls between the air sacs, which leads to fewer air sacs and ultimately a reduction in gas exchange.
Patients may experience improvements in function and quality of life parameters with stem cell therapy. Recent studies have shown that adipose stem cells reduce inflammation in the airway alveoli in response to cigarette smoke exposure or other airway irritants, and also decreased lung cell death¹. Stem cells have also the potential to stimulate the formation of new capillaries which may lead to tissue repair and oxygen delivery². Mesenchymal stem cells have shown the ability to potentially suppress autoreactive T-cells, inhibit macrophage activation and autoimmune response, improving lung functionality in COPD patients³. Improvement in lung capacity can be measured by exercise capacity. Patients’ improvements may be also monitored by the St. George Respiratory Questionnaire
1.Kelly S. Schweitzer,et al. “Adipose Stem Cell Treatment in Mice Attenuates Lung and Systemic Injury Induced by Cigarette Smoking”, American Journal of Respiratory and Critical Care Medicine, Vol. 183, No. 2 (2011), pp. 215-225.
2. Alvar Agustí,et al. “Lungs, Bone Marrow, and Adipose Tissue. A Network Approach to the Pathobiology of Chronic Obstructive Pulmonary Disease”, American Journal of Respiratory and Critical Care Medicine, Vol. 188, No. 12 (2013), pp. 1396-14063.Rojas, Mauricio, et al. “Bone marrow–derived mesenchymal stem cells in repair of the injured lung.” American journal of respiratory cell and molecular biology33.2 (2005): 145-152
3. A placebo-controlled, randomized trial of mesenchymal stem cells in COPD. Authors: Weiss DJ, Casaburi R, Flannery R, LeRoux-Williams M, Tashkin DP. Source. Vermont Lung Center, University of Vermont College of Medicine, Burlington, VT 05405, USA. firstname.lastname@example.org
Chest. 2013 Jun;143(6):1590-8. doi: 10.1378/chest.12-2094.
4. A protocol proposition of cell therapy for the treatment of Chronic Obstructive Pulmonary Disease.Rev Port Pneumol. 2013 Nov 25. pii: S0873-2159(13)00107-4. doi:10.1016/j.rppneu.2013.06.008.
Orthopaedic (Osteoarthritis & Injuries)
The most common joint issues are due to arthritis and injuries. Osteoarthritis (OA), the most common form of arthritis and often called degenerative joint disease, appears when the protective cartilage on the ends of your bones wears down over time. This causes an inflammation at the joint(s) leading to an eventual loss of function. OA can occur at any joint in the body, but is most commonly found in the hands, knees, hips, and spine. This affliction it often seen among older people, but those younger, who have undergone joint injuries are more likely to also develop osteoarthritis. The most common joint injuries include but are not limited to sprains (stretching or tearing of ligaments) and fractures (joint can break as the result of a fall or some other trauma). An estimated twenty-seven million men and women age 25 and older have osteoarthritis in the United States. It is seen more commonly in men before the age of 45 and women after 45.
Mesenchymal stem cells (MSCs) are self-renewing, multipotent prognitor cells with multilineage potential to differentiate into cell types of mesodermal origin . Due to this attribute, MSCs can differentiate into chondrocytes, which are later replaced by bone. This attribute repairs the subchondral bone without any loss of articular cartilage at the surface . MSCs have shown to therapeutically alter the progression of OA by down- modulating the release and expression of the main OA inflammatory factors and chemokines (signaling proteins secreted by cells) directly involved in the progression of the disease . Additionally, there has been significant improvement in joint function through pain reduction and increase of cartilage in the affected joint [4 Mesenchymal stem cells are self-renewing, multipotent prognitor cells with multilineage potential to differentiate into cell types of mesodermal origin. This property helps in cartilage and bone regeneration. MSCs also migrate to sites of inflammation and help reduce the inflammation associated with OA.
 Clinical applications of mesenchymal stem cellsNayoun Kim1 and Seok-Goo Cho1,2
1Laboratory of Immune Regulation, Convergent Research Consortium for Immunologic Disease, 2Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
 Stem cells for repair of cartilage and bone: the next challenge in osteoarthritis and rheumatoid arthritis
Author(s):F Apparailly, C Jorgensen, D Noel and J Sany
Source: Annals of the Rheumatic Diseases. 60.4 (Apr. 2001): p305.
 Adipose-Derived Mesenchymal Stem Cells Exert Anti inflammatory Effects on Chondrocytes and Synoviocytes From Osteoarthritis Patients Through Prostaglandin E2Cristina Manferdini,1 Marie Maumus,2 Elena Gabusi,1 Anna Piacentini,1 Giuseppe Filardo,1 Julie-AnnePeyrafitte,3 Christian Jorgensen,4 Philippe Bourin,3 Sandrine Fleury-Cappellesso,3 Andrea Facchini,5 Dani`ele No el,2̈ and Gina Lisignoli1
 Symptomatic knee osteoarthritis treatment using autologous adipose derived stem cells and platelet- rich plasma: a clinical studyKhanh Hong-Thien Bui1, Triet Dinh Duong1, Nhan Thanh Nguyen1, Thanh Duc Nguyen1, Vien Tuong Le1, Viet Thanh Mai1, Nhan Lu-Chinh Phan2, Dung Minh Le2, Ngoc Kim Ngoc2, Phuc Van Pham2,*
1University of Medical Center, Ho Chi Minh University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; 2Laboratory of Stem Cell Re- search and Application, University of Science, Vietnam National University, Ho Chi Minh City, Vietnam. *Corresponding author: email@example.comReceived: 15 December 2013 / Accepted: 02 February 2014 / Published online: 7 February 2014 © The Author(s) 2014. This article is published with open access by BioMedPress (BMP), Laboratory of Stem Cell Research and Application
Rheumatoid Arthritis (RA)
Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease of unknown cause. The hallmark feature of this condition is persistent symmetric polyarthritis (synovitis) that affects the hands and feet, although any joint lined by a synovial membrane may be involved. CD4 T cells, mononuclear phagocytes, fibroblasts, osteoclasts, and neutrophils play major cellular roles in the pathophysiology of RA, while B lymphocytes produce autoantibodies (ie, rheumatoid factors). Abnormal production of numerous cytokines, chemokines, and other inflammatory mediators has been demonstrated in patients with RA. Ultimately, inflammation and exuberant proliferation of synovium leads to destruction of various tissues, including cartilage, bone, tendons, ligaments, and blood vessels.
Adipose derived stem cells have the potential to repair cartilage and joint tissue¹.Mesenchymal stem cells release immunosuppressive factors which help alleviate and avoid further progression of the disease. Besides having immune modulatory abilities, mesenchymal stem cell therapy allows for tissue repair on damage caused by chronic inflammation². Mesenchymal stem cells also induce the production of T regulatory cells, immune cells, which are responsible to abrogate autoimmune diseases². Recent studies suggest that patients achieve stable remission after stem cell treatment, due to the ‘resetting’ of the immune system.
1.Maumus, Marie, David Guérit, Karine Toupet, Christian Jorgensen, and Danièle Noël. “Mesenchymal Stem Cell- based Therapies in Regenerative Medicine: Applications in Rheumatology.” Stem Cell Research & Therapy 2.2 (2011): 2-14. Print.
2.Jorgensen, Christian, Farida Djouad, Vanessa Fritz, Florence Apparailly, Pascale Plence, and Danielle Noël. “Mesenchymal Stem Cells and Rheumatoid Arthritis.” Joint Bone Spine 70.6 (2003): 483-85. Print
3.Van Laar, J.M., Tyndall, A.”Adult stem cells in the treatment of autoimmune disease. “Rheumatology.45.10(2006):1187-1193.
Parkinson’s is a chronic, degenerative movement disorder, affecting the basal ganglia which regulates the body movements. Cells in the basal ganglia require the production and balance of the neurotransmitters dopamine and acetylcholine. In Parkinson’s disease the cells that are responsible for the production of dopamine begin to degenerate, therefore interrupting the balance between dopamine and acetylcholine. This disruption affects the basal ganglia which results in involuntary movements.
Mostly older people are affected by this disease, but it may occur in younger adults. Parkinson’s disease usually begins between the ages of 50 and 65, and it is slightly more common in men. Parkinson’s disease presents with differing combinations of bradykinesia, rigidity, tremor, and loss of postural reflexes. There are many changes that may occur in the brain of people with Parkinson’s such as the presence of Lewy bodies which are small clumps found within brain cells.
Parkinson’s disease is the second most common neurodegenrative disease which is characterized by the loss and degeneration of dopaminergic neurons (neurons involved in the secretion of dopamine). Mesenchymal stem cells, besides showing migration to the site of injury and having immunomodulatory andanti-inflammatory properties, recent studies have shown their capacity to protect and regenerate damaged dopaminergic neurons (Glavaski-Joksimovic & Bohn, 2013). The production of diffusible trophic factor produced by mesenchymal stem cells supports the activation of neurogenesis as well as the integration of new neurons in a functional network (Cava, et al., 2011). A long term-clinical study has shown improvements in symptoms such as facial expression, gait and freezing episodes (Venkataramana, et al., 2010). Additionally, the transplantation of adipose derived stem cells has shown an improvement in behaviors such as tremor and motility (CHang, Lee, & Suh, 2014).
Multiple Sclerosis (MS)
MS has been explained as a chronic autoimmune disease where the immune cells attack the myelin sheath in nerve cells from the brain and spinal cord. When the nerve cells are demyelinated their function is disrupted leading to serve physical or cognitive problems. Mesenchymal stem cells, found in many tissues in the body including adipose and bone marrow, have the ability to differentiate into different types of cells such as nerve cells and oligodendrocytes. Oligodendrocytes have the function to create the myelin sheath around the axons. Studies have shown that demyelination was improved after the transplantation of adipose derived stem cells, suggesting that stem cell therapy is a potential treatment for MS patients. Besides improving the demyelination of the nerve cells, and having immunomodulatory and anti-inflammatory properties, Ghasemi group also observed a recovery in locomotion function. Preclinical trials have also observed the migration of mesenchymal stem cells into the inflamed central nervous system (CNS) and induce the production of neuroprotective agents which help preserve the axons in the CNS.
Erectile Dysfunction (ED)
The cause of ED is multifactorial, but vascular factors are the most commonly implicated. Because the development and maintenance of a rigid erection depends on achieving a high intracavernosal pressure, it is not surprising that disorders affecting the peripheral arterial blood flow are strongly associated with erectile dysfunction. The vascular etiology of erectile dysfunction present in 60% of patients can be related to small vessel vascular diseases (as in the case of diabetes) and large vessel diseases which cause arterial insufficiency/erectile dysfunction. Stem cell therapy is an innovative therapeutic approach for erectile dysfunction. Stem cells have the innate ability to restore and renew damaged cells. Adipose derived mesenchymal stem cells are particularly adept at restoring blood vessels and veins to a functioning state and can therefore be very useful in treating patients with Erectile Dysfunction. Studies have shown that the use of stem cell therapy for ED has proven to be the new and effective choice in ED treatment, especially for patients who are resistant to pharmaceutical treatments.
Amyotrophic lateral sclerosis (ALS)
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that affects the nerves in the brain and the spinal cord. Motor neurons are responsible for sending impulses to the muscle fibers which result in muscle movement. In ALS motor neurons degenerate over time leading to their death. When these specialized neurons die, the ability for the brain to initiate and control muscle movement is lost. When muscles are no longer activated by motor neurons they begin to atrophy, becoming smaller and causing the limbs to look “thinner”. In early symptoms of ALS, patients may experience muscle weakness in arms and legs, and difficulties swallowing or breathing. In later stages of ALS, patients may become completely paralyzed. ALS, also known as Lou Gherig’s disease, is involved in the degeneration of motor neurons in the primary motor cortex, the brainstem and spinal cord. The loss of motor neurons results in the inability to control muscle movements. Mesenchymal stem cells, found in various tissues of the body such as bone marrow and adipose tissue, can differentiate into different cell types including neurons, making stem cell therapy a potential treatment for ALS patients. Recent studies have shown that regulatory T lymphocytes (responsible to modulate the immune system) are upregulated during the stable disease phase of ALS. After stem cell transplantation, studies have shown that stem cells induce the production of T reg cells and anti-anti-inflammatory cytokines, potentially slowing down the progression of ALS (Kwon, et al, 2014, pp. 206-218). Furthermore, other studies have demonstrated the modulation of motor neuronal response to cell death and inflammation (Sun, et al, 2013, pp. 1-13). Impaired glutamate uptake function of astrocytes is associated with the accumulation of glutamate around the nerve cells in ALS patients. Glutamate is known to have a toxic effect on nerve cells, therefore leading to their death. Mesenchymal stem cells have shown to regulate the uptake of glutamate, thus decreasing the levels of glutamate around the nerve cells and decreasing cell death (Ran Gu, 2010, pp. 481-486). Another recent study showed that neurotrophic growth factors (NTFs) extend the survival of motor neurons in amyotrophic lateral sclerosis (ALS) and that the combined delivery of these neurotrophic factors via stem cell therapy has a strong synergistic effect.Safety and Clinical Effects of Mesenchymal Stem Cells Secreting Neurotrophic Factor Transplantation in Patients With Amyotrophic Lateral Sclerosis Results of Phase 1/2 and 2a Clinical Trials JAMA Neurol. 2016;73(3):337-344. doi:10.1001/jamaneurol.2015.4321.
In summary, stem cells have shown promise in their ability to upregulate factors that slow down the progression of such disease. Mesenchymal stem cells are known to have the potential to form neurons and replace damaged neurons. Stem cells been shown to induce the production of anti-inflammatory cytokines and also reduce neuronal cell death.
Degenerative Disc Disease (DDD)
Degenerative disc disease (DDD) is one of the more common causes of lower back and neck pain, causing radiating pain from damaged discs in the spine. Intervertebral discs act as shock absorbers, which allow the joints in the spine to move easily. As a person ages, the spinal discs naturally undergo degenerative changes, but not all people will experience symptoms as a result of these changes (asymptomatic). Most commonly, symptoms are in seen in 30 to 50 year olds. By the age of 50, 85% of the population will show some evidence of disc degeneration. More than 65 million Americans are suffering from lower back pain each year. DDD has been found more frequently in patients who smoke cigarettes and those who do heavy physical work or heavy lifting. Obese patients are also more likely to have symptoms of degenerative disc disease.
Adipose derived stem cell therapies uses Mesenchymal Stem Cells (MSCs) to significantly display long-term proliferation, efficient self-renewal, and multipotent differentiation . Meaning the MSCs have the ability to end and reverse degeneration of spinal discs. More specifically through increasing disc height by 23.6%, disc water content, and gene expression . One of the main biological functions of MSCs is their ability to reproduce cartilage and bone tissue cells. This is important in degenerative disk disease, since a large number of cells from the outer ring (annulus fibrosus) and the inner gelatinous (nucleus pulposus) of the disks are of a cartilaginous nature . In summary, stem cell therapy has been seen to help reverse degenerative disc disease by increasing disc height, increasing disc water content, and improved appropriate gene expression
Brian C. Werner, Xudong Li, Francis H. Shen, Stem cells in preclinical spine studies, The Spine Journal, Volume 14, Issue 3, 1 March 2014, Pages 542-551, ISSN 1529-9430, http://dx.doi.org/10.1016/j.spinee.2013.08.031.
”Promising stem cell treatment of degenerative disc disease.” Stem Cell Research News 17 Mar. 2014: 5+. Academic OneFile. Web. 4 Mar. 2015.
Anisimov, S. V. “Cell Therapy for Age-related Intervertebral Disc Pathologies.” Advances in Gerontology 2.4 (2012): 300-05.
Diabetes results from the insufficient production of insulin by the pancreas or insulin resistance. Diabetes is caused by genetic and lifestyle factors and sometimes is caused by destruction of the pancreas by pancreatitis and different autoimmune processes. Insulin allows glucose to enter the cells where it is converted to energy for cellular metabolism.
Mesenchymal Stem Cells (MSCs) found in several bodily tissues, such as bone marrow and adipose tissue, have the capacity to differentiate and migrate to the site of damage and secrete growth factors or cytokines. In type 1 diabetes the insulin producing cells, B-cells within the pancreatic islets are being destroyed by the immune system. Mesenchymal stem cell implantation has shown an increase in insulin secretion and an increase in the number of islet cells in the pancreas (Pileggi, 2012). Some studies have also shown the ability of human derived mesenchymal stem cells to differentiate into B-cells which expressed the insulin gene (Timper, et al., 2006), therefore having the ability to reverse diabetes mellitus. Furthermore, mesenchymal stem cells have been shown to travel to the sight of injury, in this case in pancreatic islets and the liver where they may have contribute to tissue repair and remodeling, as well as improving metabolic function (Pileggi, 2012). Diabetes type 2 studies have shown a reductionof glucose levels in the blood when stem cell therapy was done (Renjitha, et al., 2011)
Spinal Cord Injury (SCI)
A spinal cord injury (SCI) is defined as damage to any part of the spinal cord or to the nerves at the end of the spinal canal. Often enough, these damages cause permanent changes in sensation and strength. When an injury occurs to the spinal cord, the outcome is dependent upon where in the spine the damage occurs and how many axons/cells are damaged. Less damage to the cells leads to greater recovery. Loss of function occurs below the site of injury, meaning, the higher on the spine the injury occurs, the larger the loss of function will be. Currently, there are is an estimated 12,000 SCIs yearly in the United States, while over a quarter of Americans presently live with these injuries. The majority of these injuries are caused by car accidents (36.5%), a quarter caused by falls, and the rest are due to violence, sporting accidents, etc. The average age at injury is currently 42.6 and seems to occur mostly in men. Studies have shown that the transplantation of mesenchymal stem cells (MSCs) support spinal cord repair due to its self-renewing and multipotential nature. MSCs can differentiate into distinct cell lineages and have been known to give rise to neural-like cells (neurons and glia).
. Transplanted stem cells promote neural regeneration and rescue impaired neural function after SCI by parasecreting permissive neurotrophic molecules at the lesion site to enhance the regenerative capacity thereby providing a scaffold for the regeneration of axons and replacing lost neurons and neural cells . Adipose derived mesenchymal cells inhibit H2O2-mediatedapoptosis in spinal cord-derived neural progenitor cells, improving cell survival . Through the use of these MSCs, the goal of regeneration of axons, prevention of apoptosis, replacement of lost cells in order to facilitate remylination becomes a realistic accomplishment . Stem Cells: Current Approach and Future Prospects in Spinal Cord Injury Repair NING ZHANG,1 JOHANNES WIMMER,2 SHENG-JUN QIAN,1 AND WEI-SHAN CHEN1*1Department of Orthopaedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China for Orthopedics, Campus Luebeck, University Medical Center Schleswig-Holstein, Luebeck, Germany
Anat Rec,293:519–530, 2010. VC 2009 Wiley- Liss, Inc.
 Mesenchymal stem cells in the treatment of spinal cord injuries: A reviewVenkata Ramesh Dasari, Krishna Kumar Veeravalli, Dzung H Dinh 2014 Baishideng Publishing Group Co.
Hair undergoes a regular cycle of growth. Each cycle consists of a long growing phase (anagen), a brief transitional apoptotic phase (catagen), and a short resting phase (telogen). At the end of the resting phase, the hair falls out (exogen) and a new hair starts growing in the follicle, beginning the cycle again. Each day, about 100 scalp hairs reach the end of resting phase and fall out. If more than 100 hairs/day go into resting phase, telogen effluvium (clinical hair loss) may occur. A disruption of the growing phase causing abnormal loss of anagen hairs is called an anagen effluvium.
Alopecia or loss of hair has many causes and patterns. Alopecia areata is a non- scarring condition, most commonly appearing on the scalp. This condition presents as sharply defined non-inflammed bald patches, usually on the scalp . During the active stage of hair loss pathognomonic, ‘exclamation mark’ hairs are seen (broken- off hairs of 3-4 mm long, which taper off towards the scalp). The condition may also affect the eyebrows, eyelashes and beard. Patient’s hair usually re-grows spontaneously in small bald patches. Alopecia Areata is associated with hypothyroidism, autoimmune disorders, atopy and Down’s syndrome. Topical or intra-lesional steroids are first line treatments. There are three main types of Alopecia: Alopecia Areata, Alopecia Areata Totalis, and Alopecia Areata Universalis . Alopecia Areta: is the most common type of the autoimmune disease  Most patients have small, localized patches, and some have widespread involvement. This condition has a risk for chronicity, in which factors include extensive skin involvement, onset before adolescence, and ophiasis (involvement of the peripheral scalp).
Androgenic alopecia is the most common type of hair loss.Male-pattern baldness is physiological in men over 20 years old, though rarely it may be extensive and develop at an alarming pace in the late teens. It also occurs in females, usually post-menopause. Thewell-known distribution (bitemporal recession and then crown involvement) is described as ‘male-pattern’ but this type of hair loss in females is often diffuse. Alopecia Areata Totalis: is characterized as the total loss of hair on the scalp Alopecia Areata Universalis: is the rarest form and is characterized as the loss of hair over the entire scalp and body .
Adipose derived stem cell therapy utilizes Mesenchymal Stem Cells that express immunomodulatory and anti-inflammatory properties to help mitigate the impairment to the hair follicles. Clinical responses show increased activity of hair growth and a higher number of active hair follicles. Increased activity of follicles and changes to the scalp will usually provide evidence of repair after stem cell grafts.
 About Alopecia Areata. National Alopecia Areata Foundation (NAAF). 2013. Web. 12/10/13.
Chen CC, Chuong CM. (2012). Multi-layered environmental regulation on the homeostasis of stem cells: the saga of hair growth and alopecia. doi: 10.1016/j.jdermsci.2012.02.007.
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