Fat Stem Cell Mania and Confused Patients
I received an e-mail this week from a confused patient. I get literally hundreds of e-mails a day and sometimes they’re from patients, as I’ve always freely given out the e-mail address that arrives at my desk ([email protected]). Sometimes I’m buried in e-mail and reply later, sometimes I happen to be sitting at my desk and can respond immediately. This exchange was more the latter. The patient was mystified about why there seem to be so many fat stem cell clinics popping up and why we seem to prefer marrow as a primary cell source. She was also confused as to why these clinic websites seem to feature so much research and we claim there’s little research to support the use of fat stem cells to treat orthopedic injuries. I’m sure a great many patients are baffled about the same issues so I told her that I’d devote a blog post to the subject so I could explain more in depth. She also wanted me to review two specific websites of fat based stem cell clinics offering knee treatments, which I will do (without being rude and mentioning them by name).
The problem for many patients is that they believe a stem cell = a stem cell, not understanding that different types of stem cells are good at different types of things. For example, as I’ve blogged before, fat stem cells don’t work as well as bone marrow stem cells for orthopedic tissue repair, but would be great for cosmetic purposes. This particular issue really troubled this woman in that she was confused by research posted on these sites that purported to show that fat cells worked well for orthopedic tissues. In fact, on closer inspection, almost all of the research posted was in animal models and actually showed that cultured bone marrow cells were the cells being used.
So to help her and others understand better, a fat stem cell doesn’t equal a bone marrow stem cell. They are very distant cousins. Stem cells that usually repair orthopedic tissues are either found in those tissues or in the bone marrow (not your abdomen). For example, while you can get fat stem cells to turn into cartilage, it takes a very heavy-handed approach using multiple artificial growth factors (meaning you have to hit them over the head with the biological equivalent of a sledgehammer). None of the clinics using these fat cells anything remotely similar to this, in fact none even use the same type of fat stem cells used in these sledgehammer studies. These studies used a much more advanced technique of culturing and differentiating the fat stem cells so a pure population is used. This is not the same as the “same day” fat stem cell procedures being offered, which place a slew of different stem cells back into the patient, the vast minority of which are stem cells. In fact, few if any of these clinics even check to make sure the technique they use produces live cells capable to growing, as the providers using these kits don’t have the capability to perform these sort of checks (they have no advanced lab facilities). As an example, a same day fat stem cell procedure is a Chevy and the cultured and isolated technique used in these papers is a Maserati. They are not in any way, shape or form equal to the task of driving 200 mph, which is the equivalent of forcing fat stem cells into orthopedic tissues.
So if fat stem cells aren’t quite right for orthopedic tissue repair, why are so many clinics using them? Very few physicians have any training or experience in stem cells, nor do they know what the research says. The clinics that generally use these fat cells also treat a laundry list of diseases, many through IV therapy. These clinics didn’t develop these technologies, they are merely purchasing kits to process the cells and as a result, they took a weekend course. In addition, many have performed cosmetic liposuction in the past, so they have felt comfortable with this source of cells, regardless of whether it’s the right cell type.
What’s fascinating about this discussion of research and stem cells is not only the complete lack of research that same day fat stem cells do much for orthopedic injuries, but that almost all of the available research is on the Ferrari of ortho stem cells, or cultured mesenchymal stem cells from bone marrow. For example, literally 99.9% of all the research published in cartilage repair uses this type of cell, which is the same type found in the Regenexx-C procedure.
Here are my evaluations of the clinics the patient was interested in:
Center #1 in California:
Problems:
Cell source for orthopedics-Same day fat cells (the Chevy-not the Maserati)
Lack of Experience: 1-2 years (the Regenexx team has been doing this since 2005 by comparison)
Treating Everything-Says it treats-urology, degenerative diseases and hair restoration, orthopedics, neurology.
They also use this disclaimer: XXXX does not claim that any applications, or potential applications, using these autologous stem cell treatments are approved by the FDA, or are even effective. We do not claim that these treatments work for any listed nor unlisted condition, intended or implied. Huh? Not only do these guys not have any research on their site to show what they do works, no research they have published in patients to show it works, but they also have a disclaimer that they don’t claim it works even based on their own experience!
No Research-The site lists a long laundry list of “research” supporting it’s use of fat stem cells, but when you read the research, almost none of it supports the use of fat stem cells in orthopedic injuries. As examples, the study listed first uses bone marrow and umbilical stem cells (not fat stem cells). Study 2 uses cultured bird stem cells derived from bone marrow. Study 3 isn’t research, but an opinion piece on the future of cell use. Study 4 uses cultured bone marrow cells to repair cartilage. Study 5 is an opinion piece on fat stem cells and their potential uses. Study 6 uses cultured and gene transfected bone marrow stem cells. The list goes on and on, with the same trend. What the clinic represents to patients as actually showing that their fat stem cells repair orthopedic tissues are actually a collection of animal studies using mostly cultured bone marrow stem cells (like Regenexx-C) and much more advanced technology than is offered by the center (they offer the Chevy, but show research done with Ferrari’s).
No evidence of advanced placement using guidance-The site is moot on how the cells will be placed in the joint, so I have to assume they will use a blind injection technique. This means you’ll never know for example that the cells actually made it into the part of the knee joint where you have a problem.
Center #2-Deep South
Cell source for orthopedics-Same day fat cells (the Chevy-not the Maserati)
Lack of Experience: <1 year
This clinic is more focused on orthopedic injuries-a good sign.
The same issues with a complete lack of research showing that same day fat cells are the right tissue to use to repair orthopedic injuries.
The upshot? At this early juncture, since you’re paying Maserati and Ferrari prices for cellular therapies, don’t buy a Chevy!
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NOTE: This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.
