Presented by Walter P. Drake, Director, Panama College of Cell Science
Where we are in the US as of November 1, 2019, is that the SVF fraction of stem cells from fatty tissue, collected from patients via liposuction, is still not generally permitted. SVF stands for “stromal vascular fraction”, which is isolated from fatty tissue liposuction using enzymes to separate out whole cells and various centrifugation steps to arrive at the SVF fraction. What is so important is that this fraction contains not only 400-500 times more stem cells per ml than collected from peripheral blood or bone marrow, but it also contains a mixture of important growth factors, stem cell activators, and the most important adjuvant: endothelial cells. Our students at the Panama College of Cell Science will recall that co-culture of human adult stem cells with endothelial cells yields “buckets of stem cells”.
Although the SVF fraction is widely used worldwide, US physicians only recently began experimenting with this after the FDA barred expansion protocols for stem cells isolated from peripheral blood and bone marrow. “Expansion” means the multiplication of a patient’s stem cells ex vivo, so as to have a high number of injectable stem cells in order to achieve a therapeutic result. The number of stem cells collected from bone marrow or 25-50 cc of peripheral blood is too low for most treatments. Hence, US physicians sought to proceed using the SVF fraction as a way to obtain higher numbers of adult stem cells without the need for expansion.
But the FDA, more emboldened by its recent June victory in the courts upholding the agency’s right to control stem cell treatments as a “drug” even though the cells originate from the SAME patient being treated, has discouraged the use of SVF in the United States alone, effectively blocking yet another route for patient stem cell therapy in America.
Physicians are now looking to umbilical cord blood and placental stem cells harvested from newborn deliveries in which any amniotic fluid, placenta, umbilical cord blood, and the “afterbirth” are customarily discarded. These placenta related products are rich in adult stem cells (not embryonic stem cells) as well as activating molecules called exosomes, and other growth factors.
Dr. Neil Riordan, Director of the finest stem cell treatment center overseas, the Panama Stem Cell Institute, has long championed umbilical cord adult stem cells as being “more robust” than the ordinary patient’s stem cells. What he means is that we ordinarily are harvesting stem cells form the aged patient or the patient with a disease or other serious condition. Many studies have shown that due to the cellular environment and many other factors associated with age, stem cell activity decreases. The very important “paired mice experiments” clearly demonstrated that serum from a young mouse was effective in activating repair activity of stem cells in the aged mouse. So, anytime you are going to be able to use “young” stem cells or “young” activating molecules and exosomes, your treatment results are going to be greatly improved. In addition, the fact that you are working with placental products which have superior performance due to their higher activity compared to aged stem cells means that you can obtain therapeutic activity even without the higher number of cells normally required to be injected. Dr. Riordan continues to rely heavily on umbilical cord stem cells for his amazing treatment results overseas. He was the first to postulate, in 2007, that cord blood could be transplanted to any patient with no negative immune consequences, and also to emphasize the importance of stem cell activating factors.
We can thank Marc Darrow, MD, JD of the Darrow Stem Cell Institute in Los Angeles for providing the most thorough review of the benefits and use of umbilical cord blood products, along with scientific citations, available today. Confirming what Dr. Riordan has long stated, he points out that cord blood and its associated activator molecules are immune privileged and can be transplanted to any patient with any “matching” and without fear of immune rejection. So, this discarded product from normal births can be used effectively on anyone.
He further pointed out that as with mesenchymal stem cells derived from SVF, cord blood stem cells have their own immune-modulating effects making their transfer especially beneficial: “A 2016 study from Korean researchers also demonstrated that mesenchymal stem cells (MSCs) derived from umbilical cord blood, as well as other tissues, could also suppress the allogeneic response of lymphocytes and serve as a useful source for cell therapies and allogeneic stem cell transplantation between HLA-incompatible recipients. They noted in their research that “…allogeneic MSCs derived from umbilical cord blood can be a useful candidate for allogeneic cell therapy and transplantation without a major risk of rejection”
He points as an example to a 7 year study on the use of umbilical cord products on osteoarthritis, the conclusion from which was: “Not only did the doctors report that none of the seven patients in the study needed to undergo knee replacement despite the severity of their degenerative knee disease, but umbilical cord blood stem cells appear to be safe and effective for the regeneration of durable articular cartilage in osteoarthritic knees.”
And he describes in detail some of the known growth factors and activator molecules that assist in adult stem cell therapy using cord blood stem cells, particularly as relevant to osteoarthritis.
ANG-1 is an Angiopoietin. Angiopoietins are protein growth factors in a developing baby that helps with vascular development and the formation of the blood circulatory network. When this growth factor is introduced into a degenerative joint it starts talking to the endothelium tissue cells that line the patient’s blood vessels.
Basic Fibroblast Growth Factor (bFGF). Another important growth factor found in human umbilical cord blood is called basic fibroblast growth factor (bFGF). bFGF helps with the formation of new blood vessels in conjunction with ANG-1. bFGF lives in the sub-endothelial extracellular matrix of blood vessels, the growth factor pool of stem cells in the blood vessel lining. Here it helps move oxygen and nutrients to support the cells healing damaged tissue and it helps with the sprouting of new blood vessels during angiogenesis.
Vascular Endothelial Growth Factor (VEGF) is involved in vascular and blood vessel cell development. VEGF makes blood vessels that helps form new bone and cartilage.
He concludes his excellent review with:
“Let’s review: Umbilical cord blood contains a great amount of mesenchymal stem cells. Mesenchymal stem cells are part of the tissue building mechanism that makes connective tissue such as cartilage, muscles, bones, and fat pads. As a baby develops in the womb, these mesenchymal stem cells proliferate (grow) and differentiate (change) into creating the musculoskeletal system of the baby.
However, the baby needs more than stem cells. The baby needs growth factors and “cell signalers” that help the stem cells understand what they need to do…I want to emphasize that it is the growth factors and “cell signalers” in the umbilical cord blood that are critical in making stem cell therapy treatments successful.
I also want to remind the reader that in our use of umbilical cord stem cell therapy, these materials are part of the afterbirth. When the doctor cuts the umbilical cord, the baby no longer has need of this material, the mother can now donate it.”
Although Dr. Darrow limited his helpful discussion to the treatment of osteoarthritis, let’s look at the amazing and massive list of diseases and medical conditions thought to be treatable with umbilical cord blood products, as stated by the FDA approved cord blood banking company, CryoCell:
Amyotrophic Lateral Sclerosis (ALS)
Cleft Palate Repair
Spinal Cord InjuryStroke
and many more: https://www.cryo-cell.com/cord-blood-treating-diseases
This list conforms nicely to the therapies offered now by by Dr. Riordan in Panama, using umbilical cord blood products, backed up by peer reviewed studies:
Spinal Cord Injury
Because the US government is now permitting umbilical cord cell banking, it appears that the only avenue for adult stem cell therapy not blocked by the FDA at this time is umbilical cord stem cell therapy.
The US wants to continue to require that money and profit to be made out of what should be a simple medical service that any physician can do in his/her office using a patient’s own stem cells. They are now pushing physicians to use banked cord blood cells for their “stem cell treatments”. And who owns the banks? No doubt the pharmaceutical companies are well invested and represented. What should be a cheap, simple procedure, as done in most other countries, now will have layers of unnecessary expense added to it. Rather than use fresh donated placentas, which will ALWAYS be better, and cheaper, physicians will be forced to rely on “banked” off the shelf, stale products devoid of all the necessary activators, because soon will develop more rules that only those specially permitted banks will be licensed for testing against contaminants. Physicians will not be able to head over to the local hospital for some donated placenta (which can be rapidly screened at the local blood bank for viruses and contaminants) for use on their patients…they will have to BUY the off the shelf product from a pharmaceutical based entity. And not long from now, prescriptions will be required as well, with even more FDA control as to what diseases a physician can use it for!
I guaranty you that most of the prominent and foundational treatment studies showing the effectiveness of cord blood did not use “banked cells” as their source…they used fresh placental products!
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