Stem cells are an integral part of Regenerative Medicine which focuses on novel approaches to replacing, engineering or regenerating human cells, tissues and organs, to restore normal function (by utilising the body’s stem cells and blood platelets, bone marrow concentrate and Platelet Rich Plasma). Even in middle-age, the average age of cells can be as low as 10 years; this is because stem cells are at work replacing old cells, with new ones in many parts of the body. Wellness World Team investigates this situation of stem cells today.
Certain uses are very well documented like cosmetic applications and local uses (e.g. cartilage growth etc.) Blood stem cells also, to date are the most regularly used stem cells, for therapy. For more than 50 years, bone marrow transplants are used to transfer blood stem cells to patients, to treat inherited blood disorders, like leukemia. Umbilical cord blood like bone marrow, is gathered as a source of blood stem cells, used as an alternative to bone marrow. Also certain skin, corneal disease, bone or injuries, can be treated by grafting tissues, derived from stem cells - those have been shown to be very safe.'
As children, we’re asked, ‘what do you want to be when you grow up?’ Like children with a blank slate, stem cells can evolve to be anything they want. Over time, they can choose to ‘differentiate’ themselves or renew their identity, depending on what is required of them. Their scope for endless possibilities; that’s what makes stem cells special. As they bear the promise of the future within them, so they are the promise of the future of healthcare.
What’s Special about Stem Cells?
The human body is made up of over 200 different kinds of specialised cells like nerve, muscle, skin and fat cells. Those originate from stem cells and are different, because they can divide and produce copies and either:
Differentiate themselves to become specific cells, like tissues and organs, which can replace and repair diseased and damaged cells or are..
Capable of self-renewal. Therefore, any compromise in stem cell function, significantly affects health.
Stem Cells Timeline
Scientists mainly worked with two kinds of stem cells from humans and animals. Those are - adult (somatic) stem cells (drawn from brain, bone marrow, blood, skin, liver of an adult) and embryonic stem cells (ES) (drawn from four to five days old human embryos). In 2006, scientists discovered that some specialised adult cells can be ‘reprogrammed’ genetically to take on a stem cell state. These are called induced pluripotent stem cells (iPSCs).
Stem cell types
Stem cells can be autologous, i.e. taken from one’s own cells or heterologous, i.e. taken from a donor.
Embryonic stem cells
Those will become more specialised cells, which form the foundation of our body - all of our tissues and organs.
Tissue-specific stem cells
Also called adult stem cells, have an even more specific action than embryonic stem cells. They can be difficult to find and don’t really self-renew. They make different types of cells, for specific tissues or organs, in which they live. E.g. from bone marrow, they can give rise to red blood cells, white blood cells and platelets.
Mesenchymal stem cells (MSCs) – Adult (Tissue) Stem Cells
MSCs can produce more than one type of specialised cell in the body (‘pluripotent’), e.g. those are found in skeletal tissues, but not all of them. They can differentiate into fat cells, bone cells and cartilage cells.
Induced pluripotent stem cells
Induced pluripotent stem (iPS) cells are those engineered in the lab by converting tissue-specific cells, such as skin cells, into cells which behave like embryonic stem cells. Their use at this time is still experimental.
Challenges and Ethical Considerations of Stem Cell Use
Embryonic stem cells (ES) need particular signals to differentiate into the desired cell type. Their use in therapy requires the destruction of an embryo. Moreover, their use can result in abnormal behavior and therefore, a tumour.
Adult stem cells are less controversial than using embryonic stem cells. When they have been taken from oneself, there is no risk of immune rejection. They have been successfully used for many years, for blood/bone cancers, like leukaemia, through bone marrow transplants.
iPSCs are genetically reprogrammed to an embryonic stem cell–like state. Tissues derived from iPSCs, will be a near identical match to the cell donor and thus, probably by pass rejection by the immune system.
The Shadow Behind Stem Cells
While stem cells hold tremendous unparalleled potential for the treatment of so many illnesses, many claims are unsubstantiated. How can we differentiate between a legitimate claim and a potential scam? Below are some key signs that a stem cell treatment is likely to be unproven.
There are no clinical trials or scientific studies published backing up these experimental treatments.
Claiming many different diseases treated with the same type of stem cell/ procedure.
When patient testimonials are used to support claims of benefit with no third party verification.
When treatments are advertised via various media channels vs. through a reputed referring doctor.
When it is claimed that there are no risks involved in the treatment.
When you are asked to pay for a treatment that is not yet an accepted medical practice.
Stem Cells Dangers and Proven Therapies
Certain uses are very well documented like cosmetic applications and local uses (e.g. cartilage growth etc.) Blood stem cells also, to date are the most regularly used stem cells, for therapy. For more than 50 years, bone marrow transplants were used to transfer blood stem cells to patients, to treat inherited blood disorders, like leukemia. Umbilical cord blood like bone marrow, is gathered as a source of blood stem cells, used as an alternative to bone marrow. Also certain skin, corneal disease, bone or injuries, can be treated by grafting tissues, derived from stem cells - those have been shown to be very safe.
The list of diseases where stem cell treatments are clearly beneficial is still short - all other applications are to be proven in clinical trials and should be considered risky. Many patients are purposely misled, to believe that ‘so called’ stem cell treatments are safe, or at least are not harmful. This is mostly untrue – such dangers include:
Extreme complications (infections, infertility, organ damage, death)
Cancer
Doctors with no liability where the risk is taken by the patient
Inability to contest in a court of law any claims
Money scams
‘Stem cell research can revolutionise healthcare, more than anything since antibiotics.’
Giuseppe Mucci, Founder of Bioscience Clinic, claims that “Ours is the only centre in the UAE where it is possible to use expanded autologous mesenchymal cells (MSCs).” He continues, “We can expand those cells, cryopreserve them and use them in various aesthetic applications, hair loss, orthopaedics and wound healing.”’
Stem Cell Injections vs. PRP
With various stem cell treatments currently in the market like Platelet Rich Plasma (PRP), how are stem cell injections different? Cosmetic surgeon, Dr Maurizio Viel, who uses stem cell therapy in his practice answers, “PRP is created when doctors take blood from a vein and place it in a centrifuge to concentrate platelets – (3-5 times their concentration), because surgeons have known for years, that healing depends on platelets. Those tiny blood components, rich in growth factors, help form a blood clot during injury. While PRP may help recruit a few stem cells to the area, stem cell injection therapy is more advanced.” To give an analogy, he says, “The difference between PRP and MSCs is like that of using fertilisers versus planting new seeds altogether.”
A different kind of factory MSC’s are capable of differentiating into new tissue which is lost, but also coordinating the repair response, like in degenerative diseases where tissue is lost. In addition, lab prepping is more complicated, than that which can be made, in a simple bedside centrifuge. “MSC’s however, are isolated and grown in a sophisticated cell culture lab, by cell biologists, usually over a two-week period. So, while PRP is great to jump start a healing process, MSC’s and other stem cell approaches will eventually reign supreme in regenerative medicine,” Dr Maurizio believes.
Stem Cell Safety
As many remain sceptical about the safety of stem cell treatments, how can clients be reassured? Mucci clarifies, “Our treatments are safe because we use autologous cells (i.e. the patient’s own cells) and inject them into the tissue and never into the blood stream.’ Moreover, “Other treatments use fat or platelets, which do not require cell factories and do not expand cells, allowing for high regenerative power. Yet others use synthetic chemical products, various technologies which cannot act physiologically or generate natural, long lasting results.”
Aesthetics or Preventative Medicine
Currently Bioscience is focused on treating aesthetic imperfections rather than pathologies. Nevertheless patients are advised to store their expanded cells, while they are healthy, in order to use them in the future safely, to address various conditions that they might face, especially diabetic patients who suffer with unhealed wounds. Mucci explains “It is well known that diabetic cells are less effective in promoting soft tissue, neovascularisation and wound healing. Based on that, the banking of autologous ADC for cell based therapies is especially required. Clinical studies have shown that ADCs help close severe wounds, resistant to standard therapy and heal chronic wounds significantly faster.”
Future therapies
“The potentials are enormous”, explains Dr Maurizio. For instance, the safe and efficient extractions of a patient’s own cells, from their fat (Adipose Derived Cells), as well as the expansion and storage of these cells, he elaborates. “We can expand the number of available cells by 10,000 times and store them for up to 20 years. In turn, these treat skin ageing, skin disorders, soft tissue augmentation, hair loss, wound healing and orthopaedic applications.”
Medical Technology
Talking about the future of medical technology is difficult at this point as “We don’t know what studies will show, research in this field is rapid”, Mucci says. For instance, “Methods of creating a new organ needs validation, especially with regards to their safety. Currently, we can only treat diseases with cells rather than regenerate organs.”
Anti-Aging Corrections
Nobody enjoys how the passage of time reveals itself physically. Whilst aging is a complex process, cells become damaged and fewer of those cells are replaced. As we slowly decay, the introduction of new stem cells and adjunctive treatments can slow down or reverse this.
The Bioscience expertise lies in the extraction and expansion of autologous (a patient’s own) Adipose Derived Stem Cells (ADSCs). Treatments are focused on skin aging/disorders and wrinkle filling, soft tissue augmentation
(breast and buttocks augmentation) and hair loss.
Dr Maurizio clarifies, “ADCs possess unique anti-aging properties through regenerating and repairing organs, damaged by stress and toxins, and by improving immune system function. Your stem cells do what they are designed to do - communicate with other cells and facilitate regeneration. With ADC treatments, the supply of stem cells allows the body to repair and rejuvenate organs including your skin.”
ADC therapy helps fill in fine lines and deep wrinkles, by increasing the level of collagen and elastin to provide a safe and natural younger look. He emphasiSes, “There is no similar treatment which could compare.”
Breast & Buttock Augmentation ADCs vs. Liposkill
Dr Maurizio adds, “We have remarkable news for all those thinking about regenerative cosmetic medicine treatment or lipofilling, (where body fat is used as a filler, to correct skin depressions and increase the volume of face and other body parts).
There are two aspects, one bad and one good. “The bad news is that a clinical paper published in The Lancet, showed that around 85 percent of volume enhancement obtained through fat transfer, from one body part to
another, is lost within four months. This study on soft tissue augmentation, shelved the use of fat without expanded stem cells, along with its surrogates, which use mechanical procedures but have the advantage of low cost and big profit margin.”
Dr Maurizio continues, “The good news is that implants for aesthetic medicine and regenerative plastic surgery, which use stem cells, isolated from fat and then expanded in the laboratory, maintains the initial results in over 80 percent of cases. To achieve long lasting results in volume enhancement of certain body parts, like breasts (300 million cells), buttocks, cheeks, deep wrinkles (10 million cells) and soft tissues tens or hundreds of millions of stem cells from adipose tissue ADCs are required.”
Mucci explains, “Those are reached, after at least 12 days of cell culture is performed in specific laboratories or ‘cell factories’, where stem cells are isolated, expanded and cryopreserved. Thanks to cell culture processing, 100 million of mesenchymal stem cells can be obtained from just 20 millilitres of fat and distributed in 20 litres of unprocessed fat.” Clearly stem cells and derived products offer
great promise for innovative medical and aesthetic treatments but it’s vital to understand stem cell types, current and possible uses, ethical issues and the state of research and practice in order to make informed choices about undergoing procedures.”
Stem cells are an integral part of Regenerative Medicine which focuses on novel approaches to replacing, engineering or regenerating human cells, tissues and organs, to restore normal function (by utilising the body’s stem cells and blood platelets, bone marrow concentrate and Platelet Rich Plasma). Even in middle-age, the average age of cells can be as low as 10 years; this is because stem cells are at work replacing old cells, with new ones in many parts of the body.
Expert Profiles
Giuseppe Mucci CEO & Founder of Bioscience Clinic Middle East
Giuseppe Mucci graduated from the University of Urbino in the Faculty of Kinesiology in Italy. In 2005, he launched the Bioscience Foundation, dedicated to knowledge sharing. In 2013, he launched the Bioscience Clinic Middle East, located in Dubai HealthCare City, dedicated to the preservation, expansion and cell therapies of adult human cells. www.bioinst.ae