Blogging from the Caymans Again!

by Chris Centeno, MD /

caymans-beach

I’m down at our advanced stem cell practice site in Grand Cayman this week. This licensed site is where we take our more challenging patients who need more stem cells. As stem cells as a concept get more popular in the U.S., we’re seeing more and more patients do their homework and want to have access to this advanced care.

Same-Day vs. Cultured Stem Cells

In any same-day stem cell procedure, whether it’s a bone marrow, fat, amniotic, or cord blood, the number of stem cells is in the tens to hundreds of thousands range. For most patients this is fine, but some patients need a higher dose. When they do, we use culture-expanded cells. What does that mean?

If you’ve talked to some providers on the number of stem cells they inject, you may hear numbers that get thrown around that are in the many millions range. Regrettably, if you hear this about any stem cell procedure currently available in the U.S., that number isn’t a stem cell count but is instead a nucleated cell count. What’s that?

The total number of cells in a sample is often called a nucleated cell count (also known as total nucleated cell count, or TNCC). In all US-based stem cell treatments, no matter which type, only a small fraction of cells in the injection are stem cells. So if you hear in a fat stem cell procedure that the doctor is injecting 4 million cells, only 1–3% of those cells are stem cells. For a bone-marrow-based procedure, there are many more cells available, so you may hear a number like 400 million cells. However, accordingly, there is only a small fraction of that bigger number that is stem cells. In an amniotic or cord-blood procedure, you may hear a number like 5 million cells, but again, only a few percent of those are stem cells. In these types of fetal injections, it’s also likely that these stem cells are dead!

If the patient needs millions of stem cells, there’s only one way to get to that number, and it’s called culture expansion. This means that the tens to hundreds of thousands of stem cells in a sample are grown to tens to hundreds of millions over 1–2 weeks. These stem cells can then be injected and/or saved in cryopreservation for future use. This means that the cells are frozen down to almost the temperature of deep space. Unlike the awful job of freezing and recovering stem cells done by amniotic, placental, and cord-blood cell manufacturers where the process kills cells, a lab that specializes in culture expansion and storing stem cells can take the time to recover cells the right way to ensure that viability rates are very high.

The upshot? If you need millions or tens of millions of stem cells, there are only a few places on earth that have extensive experience in culture expanding stem cells and saving them for future use. Those sites aren’t available in the U.S., hence the reason I’m down in Grand Cayman right now. This advanced stem cell site is where we utilize our technology that we first developed 11 years ago so that these lucky patients can have access to millions and millions of their own stem cells!

The Regenexx-C procedure is not approved by the US FDA and is only offered in countries via license where culture-expanded autologous cells are permitted via local regulations. 

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10 thoughts on “Blogging from the Caymans Again!

  1. Stephany Gearhart

    Looking forward to my draw and injection in the coming months! Thank you to you and your awesome team for this!

  2. stef

    How far are you in the approving process to bring regenexx-C back to the continent ?

    1. Regenexx Team Post author

      Stef,

      Unfortunately, don’t see it happening…

  3. Thomas Delaney

    Can you give some examples of the types of patients that would be better served using the cultured-expanded cells approach? Specifically, what types of orthopedic conditions warrant this method? If a patient had many body parts which all needed stem cell therapy and it was determined that they were good candidates for each of those parts, would that be one possible scenario that you would encourage the patient to use the culture-expanded cells technique? Are there other scenarios you can offer?

    1. Regenexx Team Post author

      Thomas,
      Yes. Each stem cell procedure requires a certain dose of stem cells, so treating many joints with stem cells at the same time is generally not possible with a same day procedure. Culturing the stem cells gives us an average of 100X’s the amount harvested so it gives us great flexibility to treat many different issues at once. Please see: http://www.regenexx.com/continuing-advance-orthopedic-regen-med-msc-augmented-prp/ Other scenarios could be severe Hip arthritis as the needed dose of stem cells in some cases can exceed what is possible in a same day procedure, and either specific issues or people’s schedules that can benefit from being able to store your cells for treatment years from now frozen in time at your current age.

  4. Richard kingham

    I’m currently here in GC with Dr Centeno. I”m very excited about this procedure and even more excited as to what the future holds as these guys are also on top of the game research wise. This team is a class act from the guys who pick you up at the airport to the office staff. Wish I got involved with this process years ago.

  5. Sandi

    hi – i am one of those complicated cases. living with a ms diagnosis since ’84. i had stem cell treatment with dr slavin in tel aviv in ’10 (not hsct). i had 9 amazing weeks where i could walk on my tippy toes for the first time in over 25yrs……so i KNOW stem cells work. but i had 2 other treatments of non expanded cells (india & bahamas) which did nothing. i august ’16 i had fusion for my S1 disc which was causing me to be dropped to the floor when the nerve gets hit. so far the surgery hasn’t helped with that as i got dumped this morning:( i had looked seriously into seeing you guys in phoenix where my brother lives – but i am unsure with this info if that would be the right route to take. thanx for any/all input!!! and God bless you and your work!

    1. Regenexx Team Post author

      Sandy,
      Unfortunately, SI joint fusion generally doesn’t help in the long run. Please see: http://www.regenexx.com/blog/si-joint-fusion/ The SI joint is a key energy transfer mechanism, so SI Joint fusion eliminates that important shock absorber. The hip joint and lower lumbar spine are the next levels that will be overloaded once the SI joint no longer moves. We see joints replaced without being the source of the problem more often than we would like to. If you’d like us take a look to identify and treat what is actually causing the problem, please submit the Candidate form.

  6. Zeenat

    Would a calcified bulging disc respond to the cultured stem cell treatment? I am told that successful treatment of bulging disc with cultured stem cell injections can reduce the bulge by 20-30%. Wondering if it would work if the disc is calcified and is there a way to determine ahead of time if the disc is calcified?

    1. Regenexx Team Post author

      Zeenat,

      An Xray can show a calcified disc. Unfortunately, it’s unlikely that cultured stem cells would help.

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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