Mesenchymal Stem Cells (MSCs) & Their Role in Stem Cell Therapy

Regenerative medicine is changing the state of healthcare as we know it today. It provides a means to repair and/or replace tissue or organs that have been affected by disease, injuries, or congenital issues. Physicians already use regenerative medicine in a number of ways, but research in the field already holds promise for curing untreatable diseases and injuries.

Mesenchymal stem cells are an important part of regenerative medicine because they possess high potential to treat acute and degenerative diseases. Below, you will learn more about stem cells, specifically mesenchymal stem cells (MSCs). We will discuss exactly what MSCs are, the role they play in regenerative medicine, and their importance to your health and longevity.


What Are Stem Cells?

Stem cells are the body’s very means to grow and maintain itself. Stem cells repair and replace dying, damaged, or diseased cells. Stem cells have two capabilities, one of which distinguishes them from all other cells of the body. This unique property also makes regenerative medicine possible. The two  capabilities of stem cells are:

  1. Self-renewal; and

  2. Differentiation.

Self-renewal means the cells can replicate themselves, while differentiation means they can renew and change into a cell with a specific function. Stem cells can be found throughout the body. Three sources of stem cells that matter most to regenerative medicine are:

  1. Embryonic stem cells (ESCs);

  2. Induced pluripotent stem cells (iPSCs); and

  3. Adult stem cells (ASCs).

The first two stem cells (ESCs and iPSCs) are pluripotent stem cells. That means they can self-renew and differentiate into just about any type of cell. ASCs, on the other hand, are multipotent stem cells, and that means they can self-renew and differentiate but only into specific cell types. ASCs includes:

  • Hematopoietic stem cells, derived from blood;

  • Neural stem cells, derived from the brain;

  • Epithelial stem cells, derived from the digestive tract;

  • Skin stem cells, derived from skin; and

  • Mesenchymal stem cells, derived from various tissue.


What Is Stem Cell Therapy & Regenerative Medicine?

Stem cell therapy and regenerative medicine are the future of medicine made available today. It is believed that stem cells hold the key to solving, correcting, curing, improving, and repairing a variety of diseases, damaged tissue and organs, congenital defects, and other medical conditions, including age-related conditions.

There are three branches of regenerative medicine:

  1. Rejuvenation, which concentrates on the body’s own capability to repair itself with minimal outside influence;

  2. Replacement, which focuses on implanting or transplanting tissue or organs to counter or address organ failure (today, according to the National Institute of Health, nearly 500,000 Americans benefit from transplants and implants each year); and

  3. Regeneration, which uses cell therapies to generate new, healthy cells or cell tissue to address medical issues.

The medical field of regenerative medicine continues to evolve and transform as research and clinical trials progress. Stem cells are central to regenerative medicine because of their ability to divide (or renew) and differentiate. There is some controversy over the use of embryonic stem cells, but to date, most regenerative medicine uses adult stem cells. Of particular interest are mesenchymal stem cells -- a type of adult stem cell -- because they can differentiate into bone, cartilage, muscle, and fat, making them the prime stem cell for regenerative medicine.


What Are Mesenchymal Stem Cells (MSCs)?

Mesenchymal stem cells are adult, multipotent stem cells. How long have we known about these stem cells? What do we know about these stem cells? And how are we using them? These are all relevant questions that you should, as a consumer, be asking.

The following provides a brief introduction into what we know and how we use mesenchymal stem cells today.

History and Discovery of MSCs?

The first ever reference to the mesenchymal stem cell may have been in 1924 by a Russian-born researcher named Alexander Maximow. He identified a type of precursor cell located within the mesenchyme (i.e., connective tissue) and showed that this cell could differentiate into blood cell types.

In the 1960s, Ernest McCulloch and James Till, both researchers, further found that marrow cells have cloning capabilities. Researchers believe these cells were what we now know as mesenchymal stem cells.

Discovery of the mesenchymal stem cell, however, is most often attributed to Alexander Friedenstein. His work in the 1970s led to the more specific finding of a new type of clonal osteogenic progenitor in the bone marrow stroma. When referring to this new type of clonal osteogenic progenitor, Friedenstein first used the term osteogenic stem cells and then the term colony-forming unit-fibroblast (CFU-F). His research identified single stromal cells, which are today called mesenchymal stem cells.

The name mesenchymal stem cells, however, was not to be used until 1991 when Arnold Caplan proposed the name. The term was widely adopted a few years later, though there have been some other proposals since then with regard to the name to be applied to these types of cells. Other recommended names were “skeletal stem cell” and “multipotent mesenchymal stromal cells.”

MSC Characteristics: What Features Do We Know About MSCs?

Knowing the importance of mesenchymal stem cells in regenerative medicine, it is essential to also know their characteristics. Generally, MSCs can be characterized by their physical and functional traits.

Physical Features

When growing on a biological or laboratory surface, the body of a mesenchymal stem cell is small, thin, and long with an almost stretched appearance. The nucleus is large and round and contains a protruding nucleolus.

Functional Features

The functional traits of MSCs are what distinguish them most from other stem cells. These functional attributes include:

  • Ability to modulate the immune system

  • Anti-inflammatory properties

  • Ability to stabilize and support structure of blood vessels

  • Ability to integrate into micro-vessels of some organs and outer walls of arteries

  • Ability to be isolated

  • Ability to release bioactive molecules to restore damaged cells

  • Plasticity, meaning multiple potential and lineage capabilities.

MSC Sources: Where in the Body Are MSCs Found?

There is still much to be learned about MSCs, especially because not all MSCs are alike. Scientists know that MSCs behave differently -- as noted above -- based on their respective source. So, where are MSCs found in the body?

MSCs are known to be located in:

  • the bone marrow

  • the umbilical cord blood

  • fat tissue

  • muscle tissue.

MSC Benefits: What Conditions Could MSCs Help Treat?

MSCs are used in regenerative medicine and are currently under clinical trials to treat many different medical conditions. These conditions that may be treatable by the specific use of MSCs include:

  • Cardiovascular diseases, e.g., congestive heart failure

  • Autoimmune diseases, e.g., Crohn’s disease, rheumatoid arthritis

  • Neurological diseases, e.g., Parkinson’s, Alzheimer’s, and Multiple Sclerosis

  • Endocrine diseases, e.g., Diabetes

  • Rheumatologic diseases, e.g., Rheumatoid arthritis

  • Orthopedic conditions, e.g., knee pain, back pain, neuropathy pain.

The examples in the above list are not exhaustive. MSCs are believed to be crucial to treating many more diseases and conditions. As our understanding and knowledge grow, so, too, will the list of benefits.


What Regenerative Medicine Practices Currently Use MSCs?

Stem cells help our bodies heal. Mesenchymal stem cells are of particular significance given their features listed above and how they help our bodies regenerate tissue. But as we get older, the amount of MSCs, especially those found in bone marrow, decreases slightly. That means tissue regeneration and our bodies’ capacity to self-heal also decrease. Moving mesenchymal stem cells from a place where they are plentiful to an injured tissue where they are not can help prevent or slow down degeneration. It can also help the body continue to heal and stay healthy.

Physicians, therefore, are using mesenchymal stem cells and regenerative medicine to treat disorders, diseases, and trauma-related injuries. Two types of practices currently using MSCs include:

  1. Bone Marrow Concentrate (BMC) Therapy; and

  2. Adipose-Derived Stem Cell (ADSC) Therapy.

Bone Marrow Concentrate (BMC) Therapy

Bone marrow concentrate therapy is a type of regenerative treatment harnessing the body’s ability to heal itself through stem cells found in bone marrow. Bone marrow has multipotent stem cells and is particularly rich in mesenchymal stem cells. MSCs play a significant role in regenerative medicine generally and BMC therapy specifically.

The process is straightforward. Anesthetics are used to numb the patient. A sample of the bone marrow is aspirated from the hip bone and then placed in a centrifuge where MSCs are separated and concentrated. When a person participates in BMC therapy, the MSCs are placed into the patient’s joint, cartilage, or other tissue in need of healing. The procedure is relatively short and the patient goes home the same day.

BMC therapy has been shown to be an effective treatment for:

  • Osteoarthritis

  • Degenerated discs

  • Orthopedic injuries

  • Tendonitis

  • Partial tendon tears

  • Peripheral artery disease

  • Cardiac tissue repair

Adipose-Derived Stem Cell Therapy

Adipose-derived stem cell therapy is a type of regenerative treatment that stimulates the body’s abilities to repair degenerated, injured, or otherwise damaged tissue and organs. This therapy uses MSCs taken from fat tissue and is still a new, unproven technology available only in registered clinical trials (for most applications).

Adipose-derived stem cell therapy requires a full scientific laboratory. The stem cells are isolated from the fat tissue via collagenase digestion followed by centrifugal density gradient separation processes.

According to the FDA, collagenase treatment of fat tissue constitutes more than “minimal manipulation” of a patient’s tissue. This makes sense, as collagenase breaks down collagen proteins, which actually make up about 60% of cartilage. Can you imagine what would happen if a regenerative treatment failed to wash out some of that collagenase, and then allowed it access to cartilage tissue? It would do the opposite of what regenerative medicine should do.

So the FDA is right to view adipose-derived mesenchymal stem cell therapies as more dangerous than BMC or PRP.

Adipose-derived stem cell therapy has been studied in a small number of clinical trials to treat:

  • Ischemic injuries

  • Skeletal tissue repair

  • Myocardial infarction

  • Arthritis


What Orthopedic Conditions Can Be Treated with MSCs?

MSCs are the subject of more than 300 registered clinical trials. Because of where bone marrow MSCs are derived in the body and the features they exhibit, they have been extensively studied for the treatment of common orthopedic conditions.  This type of therapy can benefit huge numbers of people who suffer from orthopedic injury, overuse or age-related changes. Examples are chronic joint pain and ligament and tendon injuries.

Specifically, bone marrow-derived MSCs can be employed to treat:

Knee pain caused by

  • Osteoarthritis

  • Meniscus Tears (medial or lateral)

  • Chondromalacia Patella

  • Tendon Injuries (Patellar Tendonitis, Quad Tendon)

  • Ligament sprains or tears (MCL, LCL, ACL).

Hip pain caused by

  • Osteoarthritis

  • Hip Labrum Tears

  • SI Joint Dysfunction

  • Piriformis Syndrome

  • Greater Trochanteric Bursitis

  • Iliotibial Band (ITB) Syndrome.

Shoulder pain caused by

  • Osteoarthritis

  • Rotator Cuff Tendinitis

  • Tendinopathy

  • Partial Tears

  • Labrum Tear

  • Bicipital Tendinitis.

Ankle and foot pain caused by

  • Achilles Tendinitis

  • Partial Tears

  • Plantar Fasciitis

  • Ankle sprains

  • Ligament injuries.

Elbow pain caused by

  • Lateral Epicondylitis (Tennis Elbow)

  • Medial Epicondylitis (Golfers Elbow).

Wrist and hand pain caused by

  • Osteoarthritis

  • DeQuervain's Tenosynovitis.

Spine pain caused by

  • Facet Joint Arthropathy

  • Sacroiliac (SI) Joint Dysfunction.

MSCs have considerable potential to help treat orthopedic conditions and other diseases today and well into the future. As studies are conducted, our knowledge will only grow alongside the increasing use of MSCs.

Disclaimer

Adipose-derived mesenchymal stem cells are not FDA-approved for applications other than cosmetic treatments. The FDA considers them “higher risk” because they involve “more than minimal manipulation” of structural tissue. Philadelphia PRP and Stem Cell Institute uses only stem cells derived from bone marrow (BMC), which is an FDA-compliant, routine part of the practice of medicine.