HISTORY OF STEM CELLS

Adult stem cell research began about 50 years ago

Stem cell discoveries in 1960s:

  • Bone marrow contains 2 populations of stem cells

    • Hematopoietic stem cells – forms all blood cell types

    • Bone marrow stromal cells – mixed cell population that generates bone, cartilage, fat and fibrous connective tissue

  • Rat brain contains two regions of dividing cells, which become nerve cells

Stem Cell Discoveries in the 1990s:

  • Neural stem cells are able to generate the brain’s three major cell types:

    • Astrocytes, Oligodendroglial cells, Neurons

1998 - Researchers first extract stem cells from human embryos

1999 - First Successful human transplant of insulin-making cells from cadavers

2001 - President Bush restricts federal funding for embryonic stem-cell research

2002 - California allows stem cell research

2004 - Harvard researchers grow stem cells from embryos using private funding

2004 - Ballot measure for $3 Billion bond for stem cells

2009 - Rabbit umbilical cord stem cells completely abolish rat mammary carcinomas with no evidence of metastasis or recurrence hundred days post- tumor cell inoculation

2013-2017 - National Pain Centers has Multiple Firsts with Autologous and Non-Autologous Stem Cell products

TYPES OF STEM CELLS

Totipotent

  • Each cell can develop into a new individual

  • Cells from early (1-3 days) embryos

Pluripotent

  • Cells can form any (over 200) cell types

  • Some cells of blastocyst (5 to 14 days)

Multipotent

  • Cells differentiated, but can form a number of other tissues

  • Fetal tissue, cord blood, and adult stem cells

    • Umbilical cord stem cells - Umbilical cord blood contains stem cells similar to those found in bone marrow.

    • Placenta derived stem cells - up to ten times as many stem cells can be harvested from a placenta as from cord blood.

    • Adult stem cells - Many adult tissues contain stem cells that can be isolated.

AUTOLOGOUS STEM CELLS

Stem Cells from the same patient

Adipose Derived Adult MSCs

  • Adult stromal cells intended for regenerative therapy can be isolated from the patient's adipose tissue

  • Mesenchymal stem cells may differentiate into the cells that make up bone, cartilage, tendons, and ligaments, as well as muscle, neural and other progenitor tissues, they have been the main type of stem cells studied in the treatment of diseases affecting these tissues

  • The number of stem cells transplanted into damaged tissue may alter efficacy of treatment

  • It takes approximately 60cc’s of adipose to obtain 1cc with over a million cells

Bone Marrow Aspirate Concentrate (BMAc)

  • Marrow stromal cells have been used for a while in orthopedics (i.e. knee microfracture surgery)

  • BMAc produces a very dilute MSC population but still show promise for joint repair

  • BMAc are usually transferred with growth factors for success

  • Unknown which component is more efficacious

PROS

  • Known source of MSCs

  • Reduced risk of rejection or inflammation

  • Reduced potential for bacteria or virus transmission

CONS

  • Requires a surgical procedure

  • Additional capital, disposable, surgical and time costs

  • Potential morbidity complications

  • Low concentrations

  • Lipoaspirate 4,500 – 450,000 MSCs per CC

  • BMAC – 30 – 300 MSCs per CC

NON-AUTOLOGOUS STEM CELLS

Stem Cells from another patient

Typically derived from Wharton’s Jelly of the Umbilical Cord

PROS

  • High concentrations of MSCs

  • Epigenetically young cells

  • Quick, easy and reproducible

  • No capital, surgical or time costs

  • No known complications

CONS

  • Potential for bacteria or virus transmission

  • Less than blood transfusion

  • Logistics and handling considerations

  • Products must be shipped and stored -200º C