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Regenerative Medicine

Stem Cells and Amniotic Tissue Allografts

Stem Cell Therapy Basics

  • Early stem cell therapy research has traditionally been associated with the controversial use of embryonic stem cells. The new focus is on non-embryonic mesenchymal stem cells (MSCs) which are found in placental tissue, the umbilical cord, bone marrow, and fat cells (3).
  • Mesenchymal Stem Cells (Non-Embryonic) are undifferentiated cells that have the ability to replace dying cells and regenerate damaged tissue. These special cells seek out areas of injury, disease and destruction where they are capable of regenerating healthy cells and enabling a person’s natural healing processes to be accelerated (4).
  • MSCs, also known as “progenitor” cells, remain dormant (do nothing) unless they witness some level of tissue injury. It’s the tissue injury that activates them (4). It has been shown that Mesenchymal Stem Cells possess the intrinsic homing ability to migrate to injured tissues and actively participate in tissue repair. In addition, MSCs possess the unique ability to modulate the immune response where they are active (8).
  • They can differentiate into bone, cartilage, fat, connective tissue, blood vessels, muscle and nerve tissue (4).
  • It is important to evaluate each individual case to assess likelihood of success with attempting regenerative therapy.

Cost of Typical Stem Cell Therapy at Ostir Physical Medicine

We openly quote fees for all procedures performed in our office for patients’ comparison purposes. All procedures include five weeks of follow up therapy in our office at no additional cost.

The following are fees for ultrasound guided knee injections, performed by our medical practitioners:

  • 1cc Stem Cell Allograft $2,200
  • 2cc Stem Cell Allograft $3,000
  • Umbilical Cells $3,500

*Spinal, hip, and shoulder stem cell injections are subject to additional procedural fees due to the need for fluoroscopic guidance and possible twilight anesthesia. These fees range from $350 to $900 depending on number in injection sites and anesthesia if needed. All fluoroscope guided injections are performed by our affiliated anesthesiologist group.

To schedule a complimentary consultation or to speak with one of the doctors, please call (815) 729-2022.

The 4 Types of Mesenchymal Stem Cells Used for Regenerative Therapy in the United States

1) Amniotic/Placental Cells

  • a) The Amniotic Membrane is the inner layer of the placenta that surrounds the baby during pregnancy. Its natural biologic role provides the tissue unique structural and compositional properties that facilitate and maximize the natural wound healing capacity.
  • b) Why use amniotic membrane stem cells?
    • i) The epithelial basement membrane and collagen-rich extracellular matrix of this allograft provide a natural scaffold for cell attachment and proliferation needed for tissue repair with minimized inflammation and scarring.
    • ii) Amniotic membrane is known to contain a suite of biological matrix proteins, cytokines, and growth factors that have been shown to support host tissue remodeling. These additional substances enhance the wound healing process and help to reduce pain at the site of application (10).
    • iii) Amniotic MSCs do not have the surface antigens your immune system looks for with any allograft or transplant, so they are considered non-immunogenic.
  • c) Amniotic Stem Cell Collection
    • i) Mothers can choose to donate the placenta after a planned C-section, which would otherwise be discarded as medical waste. “Qualified mothers donate their placenta for medical treatments and research. These donors are selected through a strict screening process which includes an extensive patient questionnaire, serological testing, and a medical staff interview to ensure donor eligibility (11).” The donated placenta is processed and only specific portions are extracted. “Two simultaneous 14-day bacterial/fungal tests performed by one internal and one third party lab, to confirm the stem cells are free of bacterial and fungal contaminants (11).”
  • d) Amniotic cells are considered a tissue allograft by the FDA and are therefore regulated by the FDA. The FDA regulations ensure that they are safe for their intended use. The tissue is processed at an American Association of Tissue Banks (AATB) accredited facility and by AATB accredited technicians utilizing aseptic technique. The tissue is processed and packaged in sterile containers, thoroughly tested, and cryopreserved to protect cell viability.
  • e) Processing procedures follow FDA Guideline 21CFR Part 1271 and the Food and Drug Administration’s Tissue Reference Group (FDATRG) guidelines. Procedures have been implemented to meet or exceed all applicable industry standards for the use of human tissue products.

2) Umbilical Cord Stem Cells

  • a) Similar to the amniotic stem cells, umbilical stem cells also contain the extracellular proteins, cytokines, and various growth factors but in much higher concentrations. Umbilical stem cells are also donated from pre-screened mothers with a planned C-section and undergo the rigorous same testing.
  • b) “The differentiating factor is that umbilical cord tissue MSCs are more fit and have a much higher rate of proliferation when compared to MSCs derived from either adipose or bone marrow.” Cord tissue mesenchymal stem cells have a faster doubling time than adult mesenchymal stem cells (because they are younger and contain a higher concentration of growth factors) (10).
  • c) Among many other things, mesenchymal stem cells from the umbilical cord tissue are known to help reduce inflammation, modulate the immune system and secrete factors that help the central nervous system to regenerate. (1)
  • d) When compared to the 4 other sources of stem cells, umbilical cord stem cells have the greatest potential in osteogenesis (bone growth), followed by placental stem cells (8).
  • e) Umbilical Stem Cell Collection
    • i) The mothers’ blood and the cord blood undergo extensive testing for HIV, STD’s, hepatitis, etc. Once we ensure the cords are free of all infectious diseases and 100% safe we process the tissue to extract the stem cells (1).
    • ii) All donated cords are the by-products of normal, healthy births. Each cord is carefully screened for sterility and infectious diseases under International Blood Bank standards (1).

3) Adipose Stem Cells

  • a) Adipose stem cells are found within your own fat cells. Adipose tissue is the most abundant source of adult stem cells in the body. It has the highest concentration of stem cells per volume (up to 1,000 times as much as bone marrow) (5). But, fat stem cells are essentially sequestered and are not available to the rest of the body for repair or immune modulation (1). Adipose-derived cells are ideally suited for treating systemic autoimmune and inflammatory conditions. They also play a significant role in regenerating injured tissue. Adipose tissue also contains T-regulatory cells which modulate the immune system (1).
  • b) A recent study by Han Chao et al has also demonstrated that fat derived stem cells also have a higher proliferation potential for neural tissue and are a better source for nervous system regeneration (5). Adipose stem cells have also demonstrated far greater regenerative properties to make new blood vessels, a process that is essential for oxygen and nutrient delivery to the tissues (2).
  • c) However, adipose derived stem cell injections lack the extra proteins, cytokines, and other growth factors. This makes them better suited for systemic healing, not so well suited for orthopedic applications. Umbilical stem cells would be the preferred choice for joint repair.
  • d) Adipose tissue collection
    • i) Each patient’s fat tissue is collected via mini-liposuction. The surgeon will determine the most appropriate location(s) to perform the incision(s) for the required fat tissue extraction. The procedure typically takes about an hour (1).
    • ii) Due to the small size of the liposuction procedure performed, risks are vastly minimized.

4) Bone Marrow Stem Cells

  • a) The bone marrow stem cell is the most studied of the stem cells, since it was first discovered to in the 1960s. Originally used in bone marrow transplant for leukemia and hematopoietic diseases, numerous studies have now expanded experimental use of these cells for conditions such as peripheral vascular disease, diabetes, heart failure, and other degenerative disorders (1).
  • b) Bone marrow collection
    • i) Patients are put under general or regional anesthesia, and a needle is drilled into/inserted into the rear hip bone which contains a large concentration of bone marrow. Several bone punctures are required to harvest a sufficient amount of bone marrow. This process usually takes 1-2 hours (7).
    • ii) You may have soreness, bruising, and aching at the back of the hips and lower back for a few days. Some people may feel tired or weak, and have trouble walking for a few days (7).
    • iii) Risks of the bone marrow aspiration procedure could include infection of the skin, infection of the bone or bone marrow, nerve or muscle damage, or long-lasting pain at the needle insertion sites (7).
  • c) Why bone marrow stem cells are not the preferred source any longer...
    • i) There are some limitations in using bone marrow stem cells due to the high degree of viral exposure and the significant decrease in cell number and proliferation/differentiation capacity with the increasing age of the donor. It is also a painful, invasive, and expensive procedure to obtain bone marrow from patients for stem cell use (8).
    • ii) The growth curve showed that the proliferative capacity of stem cells from the umbilical cord, adipose, and placental stem cells were significantly greater than that of the bone marrow stem cells (8).
    • iii) For the reasons listed above, Ostir Physical Medicine does not perform bone marrow extractions.

Conditions That May Improve with Stem Cell Therapy

  • Knee pain
  • Shoulder pain
  • Chronic Neck, Low Back, Hip pain
  • Degenerative joint disease of the large or small joints
  • Carpal Tunnel Syndrome
  • Knee Tendon and Ligament Injuries
  • Peripheral Neuropathy
  • Sciatica

Conditions That May Be Improved with Advanced Stem Cell Therapy

  • ALS
  • Carpal Tunnel Syndrome
  • Chronic Low Back Pain
  • Congestive Heart Failure
  • COPD
  • Degenerative Disc Disease
  • Diabetes: Type 1 & 2
  • Fibromyalgia
  • IBS
  • Kidney Disease
  • Knee Tendon & Ligament Injuries
  • Liver Dysfunction
  • Lupus
  • Multiple Sclerosis
  • Parkinson’s
  • Peripheral Neuropathy
  • Rheumatoid Arthritis

*Disclaimer: Ostir Physical Medicine is not offering stem cell therapy as a cure for any condition, disease, or injury. No statements or implied treatments on this website have been evaluated or approved by the FDA. All statements and opinions provided by this website are given for educational and informational purposes only. Our procedures fall under the category of physician’s practice of medicine, wherein the physician and the patient are free to consider their chosen course of treatment. The FDA does have guidelines about treatment and manipulation of patient’s own tissue. Our facility adheres to all FDA guidelines for current stem cell treatment.

Resources Cited

  1. https://www.cellmedicine.com
  2. http://www.whatisstemcelltherapy.com/Adult-Stem-Cell-Therapy/FAQs#sc_faq3
  3. http://www.chicagostemcelltherapy.com/knee-stem-cell-therapy.php
  4. http://www.chicagostemcellsinstitute.com/about-us/faqs#19
  5. https://thrivemdvail.com/achieving-cartilage-regeneration-fat-derived-stem-cells-vs-bone-marrow
  6. http://www.arthritisresearchuk.org/arthritis-information/surgery/knee-replacement/how-long-will-it-last.aspx
  7. https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/stem-cell-transplant/donors.html
  8. http://stemcellrevolution.com/wp-content/uploads/Comprehensive-characterization-of-four-different-populations-of-human-mesenchymal-stem-cells-as-regards-their-immune-properties-proliferation-and-differentiation.pdf
  9. http://www.mayoclinic.org/tests-procedures/liposuction/details/risks/cmc-20197277
  10. http://predbiotech.com
  11. https://www.surgenex.com/index.html

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