One Way Stem Cell Therapy Works: Waking Up Local Cells

By Chris Centeno, MD /

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how do stem cells work

How do stem cells work? We know some things. For example, stem cells can both differentiate (turn into) another cell and excrete chemicals to coordinate a repair response. They can transfer good mitochondrial batteries to a dying cell with bad batteries. They can also transfer some of their RNA into another cell and make it produce proteins. Now a new study also suggests that stem cells injected into a joint may be able to wake up local cartilage repair cells.

The Structure of a Joint

To understand the new research, you need to understand the structure of a joint. We’ll use the knee as an example. Joints consist of a variety of structures that all work in unison to provide smooth and proper movement. These include bones (in the knee, this would be the distal end of the femur, or the upper-leg bone, and the proximal end of the tibia, or lower-leg bone), ligaments (e.g., anterior cruciate ligament, or ACL), muscles, nerves, and cushioning and shock absorbing structures (in the knee, this would be the cartilage and meniscus).

Arthritis affects the cartilage and bone, damaging it and wearing it down further and further over time. In mild and moderate arthritis, the cartilage has been worn down or damaged to some degree, but there is still cartilage remaining. Severe arthritis occurs when it has reached the point of bone-on-bone arthritis and no cartilage remains. There are many things that can put us at risk for arthritis, such as hypertension, metabolic syndrome, a low-fat, high-carb diet, a sedentary lifestyle, NSAIDs, steroid injections, and surgeries that remove shock absorbing material. Injuries, such as a vehicle accident, can also lead to arthritis.

In our experience and based on our published studies, stem cell therapy can be a helpful treatment for knee pain stemming from arthritic knees, but how, exactly, does this work? A new study provides one of likely many answers to this question.

New Study Suggests That One Way Stem Cell Therapy Works is by Stimulating Local Cells to Wake Up and Repair Cartilage

The new study set out to answer this question: is it the mesenchymal stem cells themselves regenerating damaged cartilage, or are they stimulating the local cells to wake up and repair the cartilage? Frankly, we have many studies which all suggest a different mechanism of action for stem cells, like all of the ones described above. So this study was never going to be definitive, but more designed to see if in this experimental design, stem cells worked a certain way.

This was a complex study in which mice were bred to recognize donor cells as their own host cells (to replicate a bone marrow stem cell therapy in which a patient’s own stem cells are harvested and reinjected). The researchers found that while the stem cells do attach to the damaged cartilage and that this is indeed imperative to regenerate the cartilage, in this study, it isn’t actually the injected stem cells that regenerate the cartilage—at least not directly. Instead, the action of the injected stem cells, the study found, is necessary to stimulate the local cells (knee, shoulder, etc.) to wake up and repair the cartilage.

Can Stem Cells Grow Me a New Joint?

Keep in mind that while stem cells can facilitate the repair of damaged cartilage via our local cells in mild arthritis, none of these cells can create new cartilage where none exists (e.g., bone-on-bone arthritis). So if you are falling under the spell of one of the many clinics out there promising to heal your severe bone-on-bone arthritis with some type of stem cell therapy, it simply isn’t true. No stem cells, regardless of the source, have the ability to do this. Injections of your own bone marrow stem cells may be able to provide long-term relief in these cases, but they simply can’t grow a new joint.

Also, make sure you keep the above study in context, as we have lots of studies showing many ways stem cells work and none is definitive, including this study. For example, we have research showing that the stem cells can stay in the joint and turn into cartilage and others that show that the cells only act as an orchestra leader for the symphony of repair.

The upshot? It’s always interesting to see new studies on how stem cells work. I’m sure we’ll see more of these studies coming down the pike in the future!

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8 thoughts on “One Way Stem Cell Therapy Works: Waking Up Local Cells

  1. Rob Sorino

    Why can’t a Silicone Cushion be placed into the Knee Joint as the shock absorber. Now I know that the medical profession has to be smarter than me. So what is the real Medical explaination.

    1. Regenexx Team Post author

      Rob,
      I’s a good question. There are clinical trials going on for this type of treatment. Long term results will be interesting. The issue is, this is still surgery and surgery is damage to accomplish a goal, and in most cases, not needed as it does nothing to address the actual cause of pain from Knee Osteoarthritis, which is nerves rather than structure, or the biomechanical issues like lax ligaments which can cause arthritis. Please see: https://regenexx.com/blog/osteoarthritis-pain-not-related-to-structure-again/ and https://regenexx.com/blog/knee-tibial-rotation-test-for-loose-knee-ligaments-to-prevent-arthritis/ and https://regenexx.com/blog/knee-tibial-rotation-test-for-loose-knee-ligaments-to-prevent-arthritis/ and https://regenexx.com/the-regenexx-procedures/knee-surgery-alternative/

  2. Danielle

    So this means if I suffer from severe arthritis a stem cell treatment won’t work any more and Ithe only solution is the joint replacement?
    Danielle

    1. Regenexx Team Post author

      Danielle,
      Not at all! This study just adds to the list of all stem cells do. These are easy to understand 2 minute videos I put together to explain all the amazing ways stem cells work which make them such a valuable tool to treat orthopedic injuries and arthritis: https://regenexx.com/blog/how-do-stem-cells-work/ and https://regenexx.com/blog/how-stem-cells-work/ and https://regenexx.com/blog/how-do-stem-cells-work-3/ and https://regenexx.com/blog/how-do-stem-cells-work-2/ and https://regenexx.com/blog/how-stem-cells-work-2/ and https://regenexx.com/blog/how-stem-cells-work-3/ and https://regenexx.com/blog/how-stem-cells-work-4/ and

  3. Don

    First you state that stem cells can not create new cartilage where none exists. But then you say we have research showing that the stem cells can stay in the joint and turn into cartilage. Does this imply that some cartilage has to be there for this to happen?
    Thanks,
    Don

    1. Regenexx Team Post author

      Don,
      The first important thing is this was not a study done using a Regenexx stem cell procedure. This was generic bone marrow, more similar to the type of procedure you might get at an Orthopedic Doctor’s office, or one of the major medical centers. A Regenexx-SD stem cell procedure is very different. The second important thing is the hyper-focus on cartilage has caused countless unnecessary knee replacements ( surgery for which the biggest longterm complication is chronic knee pain), as the goal of treatment should always be restoring function and reducing pain. These will help explain: https://regenexx.com/blog/let-us-know-think-new-regenexx-difference-video/ and https://regenexx.com/blog/stem-cells-and-bone-on-bone-arthritis/ and https://regenexx.com/blog/stem-cell-cartilage-regeneration/ and https://regenexx.com/blog/stem-cell-procedure-bone-marrow/ and https://regenexx.com/blog/pain-after-knee-replacement/

  4. Annie

    I shattered my tibia in the plateau area. Do you think stem cells will repair the damaged cartilage in my left knee??

    1. Regenexx Team Post author

      Annie,
      We’d need to know more through the candidacy process. Do you have a recent MRI?

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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