- September 17, 2024
- Web Editorial Board
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- Health Guide
What is a stem cell?
Some cells in the human body have the ability to renew themselves and transform into different cell types. These cells, called stem cells, divide and multiply, unlike muscle and nerve cells, which cannot reproduce. Stem cells, which allow millions of cells to form from a single cell, can also divide and multiply in order to renew themselves.
If your body were a building, your stem cells would be the foundation. Stem cells are the only cells in your body that can differentiate. The trillions of cells in your body can create more than 200 differentiated cells, such as blood and bone cells.
How do stem cells work?
Stem cells do two things that other cells cannot:
- They constantly renew and divide to make exact copies of themselves. Typical or normal cells multiply and divide, but they have a limited lifespan.
- They are the only cells that produce differentiated cells to replace or repair specific types of cells. Hematopoietic stem cells support blood and immune cells. Basal stem cells support skin cells. Mesenchymal stem cells support bone, cartilage, muscle, and fat.
Although stem cells cannot carry oxygen or provide hormonal and neurotransmission, they do play a role in the formation of cells that will perform these vital functions. When a disease enters the body, a stem cell multiplies and transforms into other cells needed by the body, repairing the diseased tissue or organ.
What are the types of stem cells?
The types of stem cells in our body are:
- Embryonic (pluripotent) stem cells
- Tissue-specific (multipotent or unipotent) stem cells
- Induced (triggered) pluripotent stem cells (IPSs)
- Hematopoietic stem cells
- Mesenchymal stem cells
- Endothelial stem cells
Embryonic (pluripotent) stem cells:These cells have the power to develop into any cell type. Embryonic stem cells are obtained from donated cord blood or embryos developed during in-vitro fertilization.
Tissue-specific (multipotent or unipotent) stem cells:These cells can only produce new stem cells for the tissue in which they live. For example, the blood-forming stem cells in your bone marrow can produce new blood cells and platelets. But they cannot produce new lung or liver stem cells. Researchers obtain these stem cells from donated tissue.
Multipotent stem cells are also found in amniotic fluid. These stem cells are highly reactive and can expand quite a bit without a nutrient medium. Using these stem cells seems to overcome many of the problems associated with stem cells derived from human embryos.
Induced pluripotent stem cells (IPCs):These are stem cells produced in the laboratory that look and behave like embryonic stem cells. Medical researchers use these cells to study how tissues develop, how diseases affect them, and to test new drugs and treatments.
Mesenchymal stem cells:Mesenchymal stem cells: They are multipotent cells that can give rise to stromal lineage cells of the osteoblastic (bone), adipogenic (fat), myoblastic (muscle), chondrogenic (cartilage) and fibroblastic (connective tissue) lineages.
How is stem cell treatment done?
Stem cells taken from the person or a donor are transplanted to patients and used to renew the patient’s damaged cells, tissues and organs. Previously, treatment was only done with stem cells taken from bone marrow, but today they can also be taken from peripheral blood, umbilical fat and even baby cord blood. In addition, recently, stem cells can be obtained from eggs (embryonic stem cells) and fat tissue.
Stem cell treatment is done in two ways:
1. Aspirates obtained from the stem cell-rich tissues of those in need of treatment are concentrated under sterile conditions and applied to the damaged area. Belly fat and bone marrow are usually used for this. Fat tissue is the most abundant and easiest source of stem cells. In 2011, Time magazine selected stem cell production from fat tissue as one of the 50 most important inventions of the year.
2. Stem cells taken from another person are produced in a laboratory and brought to the desired number and characteristics. Here, stem cells obtained allogeneically from cord blood are used.
Bone marrow derived stem cell therapy
Bone marrow derived stem cell therapy is used in the treatment of the following diseases:
- Heart, brain and nerve diseases
- Abnormalities resulting from the congenital metabolic or enzymatic system
- Diseased or damaged bone marrow
- Stress on the immune system
- Damaged tissues and organs
Neuro-degenerative diseases
- Alzheimer’s, Parkinson’s, Multiple Sclerosis etc. diseases
- Spinal cord injuries
- Paralysis due to cerebral vascular occlusion
In some diseases and injuries, although stem cells are not effective in healing damaged areas in the brain, they provide healing by activating cells on healthy brain tissue.
Systemic and various diseases
- Congestive heart diseases
- COPD
- Diabetes
- Erectile Dysfunction
- Macular Degeneration
- Alopecia (Local baldness)
- Peripheral artery disease (Burger)
Hematological diseases
- Bone marrow cancers
- Lymphoma- Hodgkin lymphoma
- Leukemia-Multiple myeloma
- Mediterranean anemia
- Plasma cell diseases
- Bone marrow failure
- Hereditary and congenital blood diseases
Musculoskeletal system diseases
- Osteoarthritis (wear and tear in the joint)
- Meniscus problems in the knees
- Tendon and ligament problems
- Muscle diseases
- Various injuries (trauma-sports)
- Rheumatic diseases (SLE- RA)
Cosmetic applications
- Skin rejuvenation and tightening
- Hand cosmetics
- Facial bone and soft tissue trauma
- Maxillofacial surgery applications
- Hair restoration
- Plastic surgery applications
- Surgical wound repair
- Reconstructive applications (Breast etc.)
- Removal of burn, injury and scars
How are stem cells obtained?
Stem cells are obtained from fat tissue and bone marrow. The process of taking the cells is done under light sedation and local anesthesia so that the patient does not feel pain.
The stem cells in the fat tissue taken from the pelvic-leg bone or belly are subjected to a filtering and separation process under sterile conditions.
After the stem cell preparation process, which takes approximately 30-40 minutes, the pure stem cells obtained are ready for application.
What are the licensed products used in stem cell therapy?
- +Fibroblast from skin tissue
- Mesenchymal stem cell from umbilical cord
- Mesenchymal stem cell from adipose tissue
- Mesenchymal stem cell from cartilage tissue
- Mesenchymal stem cell from synovial tissue
- Exosome
- Stromal vascular fraction derived from adipose tissue (SVF)
- Bone marrow derived mononuclear cell
What are the stem cell applications approved by the Ministry of Health?
Here are some of the stem cell treatment application areas approved by the Ministry of Health:
- Covid-19 Pneumonia
- Idiopathic Pulmonary Fibrosis
- COPD
- Diabetic Foot Injuries
- Peripheral Artery Diseases
- Spinal Cord Injury
- Cerebral Palsy
- Traumatic Brain Injury
- Hypoxic Ischemic Encephalopathy
- Spino-Cerebellar Ataxia (Friedreich Ataxia)
- Duchenne Muscular Dystrophy
- Cystic Fibrosis
- Ischemic Cardiac Diseases
- Autoimmune Encephalitis
- Limb-Girdle Muscular Dystrophy
- Autism Spectrum Disorder
- Multiple Sclerosis
- Stroke
- Congenital Progressive Myopathy
- Optic Atrophy
- Retinitis Pigmentosa
- Erectile Dysfunction
- Ovarian Insufficiency
- Scleroderma
- Crohn’s Disease
- Short Bowel
How does stem cell therapy help with musculoskeletal diseases?
Musculoskeletal degeneration and complications from injuries have become more common as people live longer and participate in more and more activities.
Stem cell therapy offers solutions to repair, restore or replace skeletal elements and related tissues affected by acute injury, chronic degeneration, genetic dysfunction and cancer-related defects.
Some musculoskeletal diseases where stem cell therapy is used include:
Osteoarthritis: Cartilage damage, which can occur for different reasons, causes wear and tear in the knee and hip joints over time, eventually causing arthrosis, which is defined as calcification. When a cartilage cell dies, it cannot heal itself. Stem cells are a method used to reduce the progression of damage in patients who have already started cartilage damage but are too early for surgery or do not want surgery.
Meniscus tear: Stem cell therapy is used in partial and complete tears of the meniscus, which prevents the joint surfaces of the knee from rubbing together. For this, belly fat or bone marrow from the anterior surface of the tibia is used as a source. It is injected intra-articularly into and near the meniscus tissue under ultrasound.
Bone fractures and nonunions: In the bone, progenitor cells can give rise to osteoblasts, which become mature bone cells or osteocytes. Osteocytes are living cells in mature bone tissue. Stem cells can stimulate bone growth and support the healing of injured bone. Traditionally, bone defects have been treated with solid bone graft material placed in the fracture or nonunion area. Stem cells and progenitor cells are now placed with bone grafts to stimulate and accelerate healing.
Articular cartilage damage: The inner surface of the joints is called articular cartilage. Damage to joint cartilage can often lead to degeneration of the joint and painful arthritis. Current techniques for treating joint cartilage damage use cartilage grafting and transplantation to fill in the defects.
Ligament and tendon problems: Mesenchymal stem cells can also develop into cells specific to connective tissue. This can help ligament and tendon injuries, such as quadriceps or Achilles tendon ruptures, heal faster.
What is an exosome?
Exosomes are small vesicles or bubbles released from cells into the environment. They play a vital role in cell communication, carrying proteins, lipids, and genetic material (such as RNA) from one cell to another.
What is exosome therapy and what is it used for?
Exosomes help cells send signals to each other. They can carry important information that affects how other cells behave.
Exosomes released by young stem cells have an important effect in regulating regenerative processes in the body. Although exosomes are not cells, they play a critical role in all intercellular communication in the body and in cell rejuvenation.
Exosomes can be found in various biological fluids such as blood, urine, and saliva. Their presence in these fluids makes them promising candidates for non-invasive diagnostic tests.
How is exosome therapy applied?
DNA, RNA, amino acids and hundreds of growth factors are found in the exosomes used in the treatment. In order to obtain exosomes from stem cells, the stem cells in the culture are first grown. Then, the exosomes are purified from the liquid medium in which the stem cells grown in the culture are located. In the next step, they are freed from the stem cells and pure exosomes are obtained.
What are the advantages of exosome therapy?
Aging, chronic diseases, environmental factors and genetic disorders can disrupt the healing process by interfering with how stem cells communicate with other cells. Exosomes are one of the new generation cellular therapies because they play a critical role in regulating these communication processes.
Degenerative diseases are caused by continuous cell deterioration affecting tissues or organs. Although stem cells are generally responsible for cell rejuvenation, some external factors can interfere with this function. It is possible to accelerate the healing and regeneration process by supporting the functions of stem cells with exosomes provided from outside.
Other advantages of exosome therapy are:
- It contains 3 different cytokines containing 50 different growth factors (proteins and peptides that enable cells to communicate with each other)
- It is a procedure that is applied without the need to take abdominal fat or bone marrow from the patient.
- It is a practical treatment compared to other stem cell methods and includes the secretions of stem cells that have been multiplied in a laboratory environment. Thus, the repair cells in the area where the application is made are coded from scratch and a more accurate repair is ensured.
- There is a very small risk of tumor development in the use of embryonic stem cells, but since exosomes do not have the ability to multiply, such a risk is not the case. Therefore, it should be known that exosome therapy is extremely safe.
- They do not cause tissue rejection. They are suitable for allogenic use. Exosomes are not cells and are smaller in size than cells.
- The most important difference from adult stem cells is that they are obtained from newborns.
- In addition, they have high potential for clinical and aesthetic use thanks to the much more growth factors they contain.
- Since they contain protein, they can last longer without deteriorating their main structure when appropriate conditions are provided.
- It is a superior product to autologous treatments since it does not require any surgical procedure during its acquisition.
- They come in a bottle that can be directly injected. In this way, there is no possibility of complications.
- They can be applied intravenously, intramuscularly, locally or by injecting into the skin.
- Exosome treatment is an extremely comfortable application for the patient.
There is no change in the patient’s daily life.
Depending on the injected dose, fibroblast cell proliferation can increase up to 80%, elastin synthesis can increase up to 3 times, and collagen synthesis can increase up to 6 times with treatment.
How is exosome therapy applied in musculoskeletal diseases?
In addition to the treatment of orthopedic injuries and various degenerative diseases, exosome therapy is frequently used due to its anti-aging properties.
When is the effect of exosome seen?
In order for the effect of exosome therapy to be seen, it is necessary to wait for the cells to complete their self-renewal process. The time period in which this process will be completed and when the results of exosome therapy will be seen may vary depending on factors such as the patient’s age, the degree of the problem to be treated and the patient’s current health status. The most important reason for this is that the body begins to respond more slowly to stem cell signals due to various factors as we age.
A certain amount of time is required for the body to repair itself. Therefore, it is necessary to wait approximately 3 months for the results of exosome therapy to appear.
What is PRP application in musculoskeletal diseases?
In PRP (Platelet Rich Plasma), the blood taken from the patient is separated with a special process. The plasma obtained after this process contains rich platelets. Platelets secrete growth factors that support healing. Therefore, PRP treatment helps damaged tissues heal. PRP is generally used in the treatment of the following diseases:
- Tendinitis
- Ligament damage
- Muscle injuries
- Cartilage damage
FREQUENTLY ASKED QUESTIONS ABOUT STEM CELL THERAPY
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Is the number of stem cells the same at every age?
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How widely is stem cell therapy applied?
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Why are doctors and scientists so hopeful about stem cells?
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What are the differences between adult stem cells and embryonic stem cells?
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Where do embryonic stem cells come from?
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What are the differences between stem cells and PRP?
- Stem cell therapy has a longer-lasting effect than PRP therapy. Stem cells support healing by starting to regenerate damaged tissue.
- PRP therapy has a faster effect, but its effect is shorter. PRP therapy is generally preferred for mild-moderate diseases, while stem cell therapy is preferred for more severe diseases.
- Stem cell therapy is performed by using live stem cells injected into damaged tissues. PRP therapy provides healing with growth factors secreted by platelets.
- Stem cell therapy is a more invasive procedure, because stem cells are mostly obtained from bone marrow or fat tissue and undergo a special process before being injected. PRP treatment is injected after the blood is separated.
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Are stem cell treatments safe?
Sources:
- Prof. Dr. Turgut Göksoy, (2024, March), Stem Cell Therapy Presentation, Istanbul, Turkey
- onlinelibrary.wiley.com
- mayo.edu
- nature.com
- physoc.org
- sciencedirect.com