We’re all hearing about stem cell therapy in all the media. But what exactly are stem cells and how do they work? Stem cells are cells which have not fully differentiated or matured into a specific organ or structural components of the body. There are two major classes of stem cells; embryonic cells, and somatic stem cells. Embryonic cells are derived from the embryo. The use of embryonic cells has led to ethical controversy about their use because an embryo must be sacrificed in order to obtain them. Somatic stem cells are cells present in the patient’s own body in most organs. They act as “spare parts” to be used in the repair of damage to a particular organ. That is to say, when there is damage in a joint, for instance, there are some local stem cells, which will convert into new cartilage cells or joint lining cells as needed. Unfortunately, when a disease process advances, it may outstrip the ability of the relatively few local stem cells to reverse the process.
Interestingly, stem cells have many functions beyond their ability to replace damaged cells. The stem cells appear to be able to significantly reduce inflammation, increase blood flow to damaged tissue, reduce scarring and improve existing scar tissue and generally seem to orchestrate the interactions of all the cells involved in the repair process through a variety of cellular stimuli. Recent research has shown that these ancillary functions of the stem cells may be just as important in the resolution of symptoms as is the replacement of the damaged tissue!
How are stem cells used?
There is an incredible amount of research being done in both the human and veterinary fields on the use of stem cells. Currently, stem cell use is approved for use in dogs and horses for orthopedic applications including joint and tendon injuries. Vet-Stem, a pioneering stem cell company based in San Diego has data on over 3500 cases so far with outstanding results. On average, 75% of patients treated for chronic arthritis or tendon injuries improve significantly after a single treatment. The majority of patients improve to the point of significantly reducing the need for ancillary drugs to manage their pain. More importantly, the relief appears to last for a long period of time.
There is ongoing research in the use of stem cells to treat a variety of other diseases including liver disease, spinal cord injuries, kidney disease, heart disease and all types of auto-immune diseases. The preliminary data on most of this research is very promising and often amazing. Our veterinarians can look forward to expanding our use of stem cells to treat a variety of disease in the near future!
How are stem cells obtained and used?
Scientists have developed a process to harvest and concentrate stem cells from many tissues in the body. The best source appears to be fat cells as they are generally easy to harvest, do not leave the body deficient of important function when they are extracted and they have a relatively high concentration of stem cells. The beauty of using a patient’s own stem cells in treatment is that there is no rejection phenomenon with these cells because they are part of the patient’s own body! Using embryonic stem cells or cells from another donor pose a grave risk of rejection, where either the body rejects the foreign cells, or the foreign cells “reject” or attack the host. After over 3500 clinical cases using fat derived stem cell therapy, there have been no serious side effects involving rejection, or for that matter, any other serious reactions of any kind!
The process of stem cell therapy involves 5 stages:
- Patient evaluation
- Fat collection
- Stem Cell extraction and preparation
- Stem cell storage
- Stem cell injection
Patent selection involves obtaining a definitive diagnosis so that we are certain we are treating the appropriate problem, and appropriate joint(s). It also involves evaluating the overall health of the patient and making certain that they are appropriate candidates for this therapy. Generally a physical exam, orthopedic exam, bloodwork and radiographs are required to determine if the patient is ok for stem cell therapy.
Fat collection involves a minor surgical procedure, in which the patient is anesthetized and a sample of fat is removed from the body. The sites for fat collection may vary depending on the pet and their body type, but generally we try to take it from a fat pad behind the shoulder, or from the groin area. On very thin dogs, our veterinary team may need to harvest the fat from inside the belly. As with all of our anesthetic procedures, every effort is made to ensure the safety of your pet. If the preoperative evaluation does not show any problems, the risk from the fat harvesting is minimal. There is a slight risk for the development of a serum pocket (seroma) at the surgical site, and there is always a slim chance for infection as there would be with any surgery.
The fat that is collected is sent in a specifically designed carrier via fedex overnight delivery to the Vet-Stem laboratory in San Diego for processing. Once there, the stem cells are isolated from he remainder of the tissue and prepared for use in your pet. The cells are handled in a sterile environment throughout the processing and are packaged into sterile syringes and shipped back to us overnight, again in special packaging materials to maintain the proper temperature of the cells. Each treatment syringe generally holds 3 to 4 million stem cells. These numbers have been shown through research to be the optimal amount to treat with. Increasing the number of cells beyond this amount does not tend to show better response.
If there are more cells in the fat sample than are needed for the initial treatment, additional cells will be stored at Vet-Stem in a cryogenic freezer for potential use later in time. This makes additional treatment much simpler (and less costly) in the future. Vet-Stem will store the cells for the first year at no charge to the client. Additional storage is available at approximately $150.00 per year. Cells can be stored for the lifespan of your pet and still maintain their function.
Once the cells have been returned to us, we will bring your pet in and under heavy, reversible sedation, we will inject the affected joint(s). The injection area is shaved and surgically prepped to prevent infection. A small gauge needle is inserted into the joint and the cells are injected. The patient is released late in the afternoon.
What should pet owners expect from the treatment?
In most cases, patients will show some improvement between 2 to 6 weeks after treatment. Statistics show most dogs improving in their pain scores from severe to mild or moderate during this time. Many of the pets will return to close to full function. If there is a limited response, a second application may be considered 6 to 8 weeks after the first injection, which may improve the results.