Regenerating Health

Regenerating Health

What can stem cell and platelet-rich plasma treatments do for you?

What if you could put your own body to work healing itself? That’s the basic premise of regenerative medicine, which is being used in various ways to restore damaged tissues and speed the body’s healing process. 

Regenerative medicine — which uses cells to create living, functioning tissue — holds the promise of repairing damaged tissues and organs by stimulating these tissues to heal themselves, according to the National Institutes of Health. 

Stem cell therapy and platelet-rich plasma (PRP) — two of the best-known types of regenerative medicine — may make a difference in disease care and pain management in fields ranging from ophthalmology to orthopedics. Research is ongoing, though, and so far few stem cell treatments have been proven safe and effective, according to the International Society for Stem Cell Research.

Sizing up stem cells

In stem cell therapy, a doctor injects stem cells — usually from an external source — into a patient’s tissue, where the stem cells can then morph into cells matching that tissue.

Stem cell therapy works better in some areas of the body than others. Stem cells are found in many tissues, but different types of stem cells have different regeneration capacities and tissues vary in their ability to incorporate them, explains Jalees Rehman, MD, director of research in the division of cardiology and professor of medicine, pharmacology and bioengineering at the University of Illinois College of Medicine in Chicago. 

“The heart has very little ability to regenerate on its own,” Rehman says. “The skin, on the other hand, has beautiful regenerative capabilities.”

“Blood-forming stem cells in the bone marrow make billions of new blood cells every day,” Rehman says. For those who have blood diseases like leukemia, transplanting blood-forming stem cells in the bone marrow can create needed new blood cells.

Rehman’s lab is researching the use of stem cells to regenerate heart muscle after a heart attack and regenerate blood vessels in the lungs after severe infections like pneumonia.

Stem cells also are being studied for treating degenerative and hereditary retinal diseases such as advanced “dry” age-related macular degeneration, retinitis pigmentosa and Stargardt macular degeneration, explains Manjot Gill, MD, a retinal surgeon and associate professor of ophthalmology at Northwestern University Feinberg School of Medicine. 

While stem cells aren’t expected to cure vision problems like retinal disease, they may delay its progress. “The hope is that stem cell therapy would at least slow it down, so that patients can preserve vision longer than they otherwise would if the disease were left to progress,” Gill explains. 

But it’s important to understand the current limitations of stem cell therapy, Gill says. Stem cell treatments in the eyes are still in clinical trials and have not yet received FDA approval. She cautions patients to avoid any stem cell treatment outside of an approved clinical trial because of the risk of unchecked cell growth, inflammation and possible loss of vision. 

Putting PRP to the test

Platelet-rich plasma has become an increasingly popular therapy for use in some orthopedic conditions, specifically rotator cuff and tendon repair, hamstring injuries and even mild to moderate arthritis, though much of the research is still in the preliminary stages. 

With PRP, the patient’s blood is processed to produce a high concentration of platelets and some white blood cells, says Michael Chiu, MD, an orthopedic surgeon who specializes in sports medicine at Illinois Bone & Joint Institute. The platelets secrete cytokines and growth factors that can help in healing injuries.

“PRP contains growth factors that can augment the body’s own healing response, reduce inflammation, lead to significant reduction in pain and possibly repair damaged tissue,” Chiu says. Since PRP is autologous — meaning it comes from the patient directly, rather than from a donor — patients don’t have to take immunosuppressive drugs or worry about acquiring a new infection from the donor.

But the varying concentrations and lack of standardization of PRP formulations makes it difficult to compare results among studies, Chiu says. This leads to some skepticism from insurance companies, which rarely cover PRP treatment despite some promising results.

Finding the right treatment

While regenerative medicine holds great promise for the future, it pays to be cautious now, physicians warn. There has been limited data to support the efficacy of stem cell treatments in orthopedics, Chiu says, beyond decreasing inflammation. More research needs to be done as stem cell and PRP therapies develop.

Stem cell clinics are lightly regulated at best, Chiu adds, and patients should avoid clinics that promote regenerative treatments for all manner of ailments. Also avoid clinics that list many testimonials on their websites but cite few or no studies, or studies with animal models only, Rehman notes.

Before signing on to a stem cell or PRP treatment, check whether the type of therapy you need has gone through phase 2 or 3 of clinical trials, which indicates that it has been evaluated for safety, or ask if there are any current clinical trials that might be appropriate for you. Find out about effectiveness and potential harms, even with reputable providers.

Regenerative medicine is already proving helpful for some conditions. It’s making a difference in orthopedics, eye diseases and conditions like leukemia, among others. In the future, it will likely be used to regrow damaged tissue and reduce the need for organ donation. 

In the meantime, researchers are looking forward to the day when regenerative medicine will generate many more groundbreaking treatments.

Originally published in the Fall 2019/Winter 2020 issue.