There is an ongoing controversy regarding the application of adipose stem cells. There is a myriad of documented positive effects when using stem cells in various medical treatments. This is especially true in situations when neither medicament therapy nor surgical approach has been successful. On the other hand, the use of stem cells is being associated with serious medical risks such as cancer and the occurrence of genetic mutations.
As it generally is the case, the truth is somewhere in the middle. The science and medicine have acquired the skills which help isolate particular types of stem cells, but are still unable to completely control their activity; those are embryonic (fetal) cells and IPS cells (induced pluripotent cells). These cells can grow and differentiate to give any type of tissue, but are not safe to use. Therefore, their application for medical purposes is strictly forbidden. Other cell types, which are effectively applied in medicine, have been well researched and their safety has been repeatedly confirmed. These are some examples:
• Hematopoietic stem cells give rise to blood cells. They are present in bone marrow and also in blood. The body uses them to produce erythrocytes, thrombocytes, leukocytes and the cells of the immune system. The transplantation of these cell types in hematology has virtually replaced a bone marrow transplant.
• Mesenchymal stromal cells are harvested from different body regions (adipose tissue, skin, dental gum tissue, bone marrow). These cells have the ability to divide and differentiate and are considered adult stem cells. They are widely and successfully used in orthopedics, sports medicine, as well as treating burns and in reconstructive surgeries.
The procedure for harvesting stem cells consists of several stages:
Extracting material. This part is done in local anesthesia or in sedation; the special tumescent Klein solution is introduced under the skin. The application leads to the swelling of the adipose tissue and the constriction of blood vessels, and it ensures that the procedure goes smoothly. After 15-20 minutes, a trained specialist uses a thin cannula with a special technique to gently collect approximately 150 ml of adipose tissue under sterile conditions.
Processing. In a laboratory, a biologist purifies adipose tissue and starts the process of extracting a special fraction from the SVF sample (stromal vascular fraction). In order to isolate the tissue, a special method which uses an enzyme collagenase is used. SVF fraction can be extracted from the rest of the fraction in three hours. An SVF fraction consists of a special mix of cells which have a good regenerative potential. Among cells in this fraction, there are progenitor cells, preadipocytes (the cells that give rise to adipose cells), endothelial cells, fibroblasts, mesenchymal stem cells. SVF can be used as a standalone cell product.
Forming of the culture of mesenchymal stem cells derived from adipose tissue. The cells obtained in the previous stage, are cultivated in special bottles or cellular fabrics. The walls of the bottles and the MSC membranes have adhesive properties, so MSC cells can bond to walls. Other cell types remain in the liquid cellular layer and are removed when the nutritive medium in which the cells are cultivated is replaced. Under the conditions that allow for cells to divide (temperature, the optimal composition of gases, the presence of certain microelements in nutritive medium), the forming of cell culture begins. The process takes between 6 to 8 weeks and provides 10 therapeutic doses (100-150 million cells per dosage). All cells are tested for sterility, non-pyrogenicity, imunophenotypization, and genome stability.
Application of cells. Depending on the indications, the methods of applying cells can vary. When treating joints and ligaments, the cells can be introduced by using ultrasound or fluoroscopic navigation, and in that case, the cells are introduced into the joint. In chronical conditions of the respiratory system, we use the inhalation method. In certain neurological conditions, we use the intrathecal and intranasal application of cells.