Autologous Stem Cell Treatments
In recent years, the use of stem cell therapy has garnered much interest. Stem cells’ multipotent value makes them clinically applicable for a wide range of regenerative and cancer-fighting treatments. In addition, their capacity for healing inflammation and boosting immune systems make them particularly attractive as a choice therapy. Autologous stem cells refer to those cells that are taken from a patient’s own body, as compared to a donor. This method circumvents rejection during time of transplant, a huge advantage. While several limitations to their widespread use do exist, autologous stem cell treatments are already being used in a number of exciting ways.
Characteristics of autologous stem cells
Autologous stem cells are harvested from a patient, either from bone marrow or blood. These cells are then expanded in a laboratory setting until sufficient numbers are reached at which point they are cryopreserved. Autologous cells are particularly useful because they are readily accepted back into a patient’s body as their own. This prevents a complication of traditional, donor-derived cellular transplantation called host-versus-graft-disease (HVGD) wherein donor cells attack recipient cells causing a cascade of damage that’s hard to medically mitigate.
Stem cells are naturally used in the body to regenerate tissue lost due to aging, injury, and disease. These progenitor cells are located in the brain, heart, liver, gut, blood vessels, skeletal muscles, teeth, skin and bone marrow. When it comes to obtaining adult stem cells, most often it is mesenchymal stem cells (MSCs) that are sought. These cells are found in the bone marrow and adipose tissue and give rise to bone, cartilage, and muscle cells. Though the mechanisms are not entirely understood, even these cells of unlimited potential are susceptible to degradation as a person ages or becomes ill.
When stem cells are taken from a patient’s own body for future use, they must be carefully managed in a laboratory setting while grown to sufficient quantity for clinical use. However, the patient is not required to undergo immune system down-regulation in order to accept their transfusion back into the body. This feature alone makes autologous stem cell transplants especially favorable.
Applications for autologous stem cell therapy
The lack of risk to a patient undergoing autologous stem cell transplant is by far its biggest advantage. With little to no medical recovery needed between stem cell capture and transplantation, the invasiveness of this procedure is very low. This makes it an attractive and sought-after therapy, particularly for patients with severely compromised immune systems or younger patients with injuries.
For patients with complaints that have evaded traditional medical treatment, the prospect of healing from stem cells is very exciting indeed. Currently, autologous stem cells are approved for transplant in the form of injectables for a number of orthopedic uses.
On the horizon, there are numerous applications that hold immense promise. These include dental treatments, grafting for skin and bone loss, organ regeneration, nerve and spinal cord disease, as well as a host of metabolic disorders. Currently, the amount and variety of studies investigating stem cell use is one of the fastest growing sectors of medical research. In fact, many believe that biological care models will largely replace the pharmacological and surgical models of care used today.
It was that one day where I actually had that moment of I don’t notice my toes anymore, I’m not trying to avoid this, I’m not limping, I’m not in pain as I’m walking
Limitations for therapeutic use
Most of the studies investigating autologous stem cells use donations from young and healthy donors. However, in clinical use, the patients needing autologous stem cell transplants are typically aged, and/or dealing chronic disease. Studies have shown that while older adult stem cells are still produced in sufficient quantities, their ability to proliferate and migrate within the body to repair damage and disease are negatively affected by both age and extended illness. Interestingly, hyperglycemic and obese patients are also shown to have this decrease in stem cell functionality too.
This lessening of functional ability presents the most concerning limit to autologous stem cell therapy. Most patients are not in need of biological therapy until affected by injury and disease processes; these tend to predominantly occur in older age groups. In other words, by the time these patients could benefit from therapies using their own stem cells, the cells themselves are not as useful. This presents a catch-22 for clinicians who must weigh the decreased risk of immune complications for autologous transplants against their decreased regenerative efficacy. For some medically compromised patients this may still be preferable to using donor tissue, but the decision must be made on a case-by case basis.
However, for younger and healthier patients, autologous stem cell transplants are largely available for orthopedic injury treatment now and have shown great outcomes. Additionally, there has been some promise shown for the use of ‘hypoxic preconditioning’ to treat “older” autologous stem cells prior to transfer that enhances their survival and capabilities. While disagreements over the precise length of exposure to low oxygen levels exist, further research will likely solve this.