Mixed Cells, Not Stem Cells | Orthopedics This Week

Mixed Cells, Not Stem Cells

Source: Wikimedia Commons and Hermann Rorschach

Two words, ‘Stem Cells’, are a kind of Rorschach’s test for patients, physicians and researchers.

Patients see visions of near-magical healing. Physicians see packed waiting rooms and researchers see rising impact factors. (Or two bears dancing.)

These different understandings and, therefore, expectations have given the words—stem cells—exceptional economic power and (misplaced) authority.

‘Stem Cell’ Clinics at a Strip Mall Near You

Two years ago, Leigh Turner, Ph.D. (an investigator with the Center for Bioethics at the School of Public Health in the University of Minnesota) and Paul Knoepfer, Ph.D. (with the Institute of Pediatric Regenerative Medicine at Shriner’s Hospital for Children and a member of the Department of Cell Biology at the University of California, Davis campus) counted the number of stem cell clinics in the United States.

Turner and Knoepfer found 351 U.S. businesses engaging in direct-to-consumer marketing of stem cell interventions at 570 clinics. Six states were hotspots for stem cell clinics—California (113 clinics), Florida (104 clinics), Texas (71), Colorado (37), Arizona (36) and New York (21).

After doing our own Google search, we’d guess that the number of such clinics have probably doubled since Turner and Knoepfer published their study in 2016.

What Are So-Called ‘Stem Cells’ Supposed to Do?

If these clinics are to be believed (and the FDA’s warning letter from August 2017 would suggest the majority are full of BS), the ‘stem cells’ they inject in patients will:

  • Relieve pain and improve function in arthritic large joints
  • Relieve soft tissue inflammation
  • Grow bone
  • Treat spinal cord injuries
  • Treat immunological conditions
  • Ameliorate cardiac disease and pulmonary disorders
  • Treat ophthalmologic disease and injury
  • Relieve urological disorders
  • Treat Alzheimer’s
  • Treat essential tremor diseases
  • Address necrotic bone
  • Provide a facelift
  • Augment breasts
  • Enhance sex

To be blunt, marketing has gotten way ahead of the science.

Mixed Cell Therapies, not Stem Cell Therapies

As defined by the NIH[i][National Institutes of Health] “Stem cells differ from other kinds of cells in the body. All stem cells have three general properties: they are capable of dividing and renewing themselves for long periods; they are unspecialized; and they can give rise to specialized cell types.”

Constance R. Chu, M.d., Professor of Orthopedic Surgery at Stanford University observes that PRP (platelet rich plasma) and other concentrated and minimally manipulated blood, bone marrow, adipose or amniotic tissue products are principally uncharacterized biologic materials of variable composition where the cell populations, if present, are mixed.

To quote the American Academy of Orthopaedic Surgenons (AAOS)/NIH U13 consensus statement recently published in the Journal of the American Academy of Orthopaedic Surgeons which described these mixed cell concentrations and therapiesii: “Stem and progenitor cells are the least abundant cell type in these preparations. Depending on the tissue of origin, only one in one thousand to one in one million cells harvested from healthy tissues are stem or progenitor cells that are capable of differentiating into one or more connective tissues such as bone, cartilage, and fat.2


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