Systematic literature review.
This study provided a systematic review of randomized controlled trials which assessed the therapeutic effects of stem cell treatments, surgical interventions, and nonsurgical treatments on the outcomes of patients diagnoses with intervertebral disk degeneration (IDD).
A MEDLINE (2000-2017), PubMed (2000-2017), and Google scholar (1995-2000) database search was performed to identify published articles reporting on patient-reported clinical outcomes. A total of 12 articles were identified and met the inclusion criteria.
Literature evaluating the comparative treatment outcomes between patients who underwent surgical versus nonsurgical interventions demonstrated mixed findings in treatment efficacy. Although studies involving the manipulation of endogenous stem cells in fibrocartilage suggested that this application could be a potentially noninvasive, stem cell–based strategy to treat fibrocartilage degeneration, especially in patients with IDD.
The reviewed literature suggested that no clinical significance exists between surgical and nonsurgical treatment for IDD. The decision to undergo surgical or conservative treatment should depend on the patient’s state of health at the time of surgery, as well as any other potentially alarming factors (altered mental status, level of consciousness, comorbidities, etc) that could be exacerbated with the proposed treatment. Mesenchymal stem cells and fibrocartilage stem cells may also be an effective therapeutic option for the regeneration of a degenerated intervertebral disk. To move forward in finding an effective therapeutic treatment protocol for IDD, further research needs to be implemented that minimizes the limitation discussed in this review.
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Stem cells are important for living organisms for many reasons. In the 3- to 5-day-old embryo, called a blastocyst, the inner cells give rise to the entire body of the organism, including all of the many specialized cell types and organs such as the heart, lung, skin, sperm, eggs and other tissues. In some adult tissues, such as bone marrow, muscle, and brain, discrete populations of adult stem cells generate replacements for cells that are lost through normal wear and tear, injury, or disease.
Given their unique regenerative abilities, stem cells offer new potentials for treating diseases such as diabetes, and heart disease. However, much work remains to be done in the laboratory and the clinic to understand how to use these cells for cell-based therapies to treat disease, which is also referred to as regenerative or reparative medicine.
Laboratory studies of stem cells enable scientists to learn about the cells’ essential properties and what makes them different from specialized cell types. Scientists are already using stem cells in the laboratory to screen new drugs and to develop model systems to study normal growth and identify the causes of birth defects.
Research on stem cells continues to advance knowledge about how an organism develops from a single cell and how healthy cells replace damaged cells in adult organisms. Stem cell research is one of the most fascinating areas of contemporary biology, but, as with many expanding fields of scientific inquiry, research on stem cells raises scientific questions as rapidly as it generates new discoveries.
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Promising early results show that longstanding Harvard Stem Cell Institute (HSCI) research may have paved the way for a breakthrough treatment of Type 1 diabetes. Utilizing research from the Melton Lab, Vertex Pharmaceuticals has developed VX-880, an investigational stem cell-derived, fully differentiated pancreatic islet cell replacement therapy for people with type 1 diabetes (T1D). In conjunction with immunosuppressive therapy, VX-880 produced robust restoration of islet cell function on Day 90 in the first patient in its Phase 1/2 clinical trial.
The patient was treated with a single infusion of VX-880 at half the target dose in conjunction with immunosuppressive therapy. The patient, who was diagnosed with T1D 40 years ago and has been dependent on exogenous (injected) insulin, achieved successful engraftment and demonstrated rapid and robust improvements in multiple measures. These included increases in fasting and stimulated C-peptide, improvements in glycemic control, including HbA1c, and decreases in exogenous insulin requirement, signifying the restoration of insulin-producing islet cells.
VX-880 is not only a potential breakthrough in the treatment of T1D, it is also one of the very first demonstrations of the practical application of embryonic stem cells, using stem cells that have been differentiated into functional islets to treat a patient, explained Doug Melton, Ph.D., co-director of HSCI, is the Xander University Professor at Harvard and an Investigator of the Howard Hughes Medical Institute. Unlike prior treatments, this innovative therapy gives the patient functional hormone producing cells that control glucose metabolism. This potentially obviates the lifelong need for patients with diabetes to self-inject insulin as the replacement cells “provide the patient with the natural factory to make their own insulin,” explained Melton.
These results from the first patient treated with VX-880 are unprecedented. What makes these results truly remarkable is that they were achieved with only half the target dose,” said Bastiano Sanna, Ph.D., Executive Vice President and Chief of Cell and Genetic Therapies at Vertex. “While still early, these results support the continued progression of our VX-880 clinical studies, as well as future studies using our encapsulated islet cells, which hold the potential to be used without the need for immunosuppression.”
“As a surgeon who has worked in the field of islet cell transplantation for decades, this approach, which obviates the need for an organ donor, could be a game changer,” said James Markmann, M.D., Ph.D., Professor of Surgery and Chief of the Division of Transplant Surgery at Massachusetts General Hospital. “We are excited to progress this unique and potentially transformative medicine through clinical trials and to patients.”
“More than a decade ago our lab had a vision for developing an islet cell replacement therapy to provide a functional cure to people suffering from T1D,” said Melton, a founder and one of the first co-chairs of the Harvard Stem Cell and Regenerative Biology Department. “These promising results bring great hope that stem cell-derived, fully differentiated islet cells could deliver a life-changing therapy for people who suffer from the relentless life-long burden of T1D. I’m so grateful that Harvard and the Harvard Stem Cell Institute have supported this work.”
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Lizards can regrow severed tails, making them the closest relative to humans that can regenerate a lost appendage. But in lieu of the original tail that includes a spinal column and nerves, the replacement structure is an imperfect cartilage tube. Now, for the first time, a USC-led study in Nature Communications describes how stem cells can help lizards regenerate better tails.
“This is one of the only cases where the regeneration of an appendage has been significantly improved through stem cell-based therapy in any reptile, bird or mammal, and it informs efforts to improve wound healing in humans,” said the study’s corresponding author Thomas Lozito, an assistant professor of orthopaedic surgery and stem cell biology and regenerative medicine at the Keck School of Medicine of USC.
These new and improved lizard tails exhibit what is known as “dorsoventral patterning” — meaning they have skeletal and nerve tissue on the upper or dorsal side, and cartilage tissue on the lower or ventral side.
“Lizards have been around for more than 250 million years, and in all that time no lizard has ever regrown a tail with dorsoventral patterning, until now,” said Lozito. “My lab has created the first regenerated lizard tails with patterned skeletons.”
To achieve this, the team of scientists from the medical schools at USC and the University of Pittsburgh analyzed how lizard tails form during adult regeneration, compared to embryonic development. In both cases, neural stem cells or NSCs — the stem cells that build the nervous system — play a central role.
Adult NSCs produce a molecular signal that blocks skeletal and nerve formation and encourages cartilage growth, effectively “ventralizing” both sides of the tail. This results in the cartilage tube typical of regenerated tails.
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Temporomandibular joint osteoarthritis (TMJ OA) is a degenerative disease, characterized by progressive cartilage degradation, subchondral bone remodeling, synovitis, and chronic pain. Due to the limited self-healing capacity in condylar cartilage, traditional clinical treatments have limited symptom-modifying and structure-modifying effects to restore impaired cartilage as well as other TMJ tissues. In recent years, stem cell-based therapy has raised much attention as an alternative approach towards tissue repair and regeneration. Mesenchymal stem cells (MSCs), derived from the bone marrow, synovium, and even umbilical cord, play a role as seed cells for the cartilage regeneration of TMJ OA. MSCs possess multilineage differentiation potential, including chondrogenic differentiation as well as osteogenic differentiation. In addition, the trophic modulations of MSCs exert anti-inflammatory and immunomodulatory effects under aberrant conditions. Furthermore, MSCs combined with appropriate scaffolds can form cartilaginous or even osseous compartments to repair damaged tissue and impaired function of TMJ. In this review, we will briefly discuss the pathogenesis of cartilage degeneration in TMJ OA and emphasize the potential sources of MSCs and novel approaches for the cartilage regeneration of TMJ OA, particularly focusing on the MSC-based therapy and tissue engineering.
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Plantar Fasciitis injuries affect both seasoned athletes and every day people that are simply on their feet all day. It is a condition where thick connective tissue that supports the arch on the bottom of the foot, running from heel bone forward to the ball of the foot, becomes inflamed. The reason for inflammation is repeated trauma from overuse or injury. A previous ankle injury may also lead to Plantar Fasciitis strain, as the instability of a loose ankle can put additional pressure on the foot.
The symptoms can start right at the beginning of the day. Some patients cannot even get out of bed, as the burning sensation in the middle of their foot makes it too difficult to stand. Traditional treatments, such as stretching exercises and ice treatments can help, and cortisone injections can reduce inflammation temporarily. The problem is that symptoms often return in a high percentage of patients. Fortunately, there is an approach to treating the Plantar Fasciitis that can help the tissue to actually heal, and provide permanent relief.
How to identify Plantar Fasciitis
There are many conditions that can cause pain similar to a Plantar Fasciitis injury, including Achilles tendon injuries, lumbar radiculopathy, stress fractures, bursitis, contusions and Tarsal Tunnel Syndrome. To correctly identify the condition, a careful exam is performed to isolate the problem area. This can be confirmed with MRI and ultrasound. We will also check the condition of the ankle, as these problems tend to be very closely related.
The Process for Treating a Plantar Fasciitis Injury
While treatments such as foot bracing, strapping and cortisone injections can provide some relief, the best way to actually heal the injury and provide long-lasting improvement is through biologic regenerative treatments such as Platelet Rich Plasma, as well as for actual tears in the plantar fascia, stem cell therapy has proven to be a viable treatment.
If you suffer with this painful condition and want avoid invasive surgeries, please contact Miami Stem Cell www.stemcellmia.com or call us for a free evaluation (305) 598-7777.