Regenerative Therapy

Pain for most of us comes and goes; some stays and you live with it day in and day out. Imagine a life where pain is constant, taking control of your life and, in some ways, the life of those close to you. Imagine having to rely on a narcotic to somewhat lessen the pain just to make it through the day. The Institute of Medicine of The National Academies state that over 116 million Americans suffer from chronic pain, 1.5 billion worldwide. Pain that is caused by trauma, aging, sports injuries, work-related injuries, diseases, the list goes on and on. Pain for most of us comes and goes; some stays and you live with it day in and day out. Imagine a life where pain is constant, taking control of your life and, in some ways, the life of those close to you. Imagine having to rely on a narcotic to somewhat lessen the pain just to make it through the day. The Institute of Medicine of The National Academies state that over 116 million Americans suffer from chronic pain, 1.5 billion worldwide. Pain that is caused by trauma, aging, sports injuries, work-related injuries, diseases, the list goes on and on.

Drugs are the “first line” of treatment for most forms of pain. To date, the goal of successful pain management is to effectively control patient pain without causing side effects from the medication prescribed. However, only 58% of those who took prescription pain medicine received any form of pain relief and only 41% of those taking over-the-counter pain medication reported relief. The incident of unintentional (and preventable) drug overdose-related deaths is growing exponentially. Of all drug-related deaths in the U.S., 43% are due to pain relief medication.

Doctors know that approximately 50% of all patients undergoing pain management will not receive adequate relief (Figure 3) at first dosing and/or are at a higherrisk of experiencing adverse, potentially life- threatening events.

80% of all pain management drugs are prescribed by the general practitioner or the internist. With the epidemic of opioid abuse so prevalent, clinicians for other methods to treat pain and injuries through injection therapy and patients, in turn, are looking for non-invasive options to avoid any type of surgical procedure. With the advancement of medical technology, regenerative medicine is now a popular and successful alternative to treat the management of pain.

In addition to baby boomers, now being an average of sixty-three, the younger generation is feeling the pressures of today’s society which has placed a tremendous focus on personal appearance. As recent as ten years ago, the average age for a woman having some type of anti-aging procedure was forty-seven; today that average age is thirty-five. Patients, both men and women, are having cosmetic treatments prior to the aging process becoming apparent in their appearance.

Regenerative medicine is gaining popularity in the fight against aging. Anti-aging procedures are becoming the fastest growing treatments in cosmetics. Treatments being utilized include platelet rich plasma, also known as the Vampire Face Lift, bone marrow aspirate, amnion liquid and umbilical cord tissues and blood, all being marketed “stem cell therapy.” (Figure 5)

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Healthy mothers donate birth tissue at the time of a scheduled cesarean section.

Through an informed consent process, expectant mothers submit their past medical and social history which is prescreened through an extensive and complete medical review and pre-natal evaluation. This process is performed prior to delivery utilizing the protocols established by various regulatory agencies. Additionally, prior to delivery, the mother is tested for communicable diseases following the requirements of the Food and Drug Administration (FDA), Center for Disease Control (CDC), and the American Association of Tissue Banks (AATB). The recovery is performed by specifically trained technicians at the time of the delivery.

Birth tissue has been used for over 100 years for a broad range of therapeutic applications. However, it is only recently that birth tissue was discovered to have great clinical benefit when cryopreserved to protect its residual cells. Since the discovery of birth tissue as a viable cellular matrix in 2005, there have been no reports of adverse events or disease transmission. Additionally, birth tissue is considered immune privileged and as such does not express Class II antigens (your body cannot reject).

Finally, Birth Tissue products are easy to use as it can be applied directly to the injured site. To date, tens of thousands of patients have been treated with these types of products. Some people may hesitate at the idea of birth tissue. Be assured that the tissue is obtained from healthy, carefully screened mothers at the time of a scheduled cesarean section and causes no harm to her or her newborn.

Also derived from birth tissue within the umbilical cord is the Wharton’s Jelly. Wharton’s Jelly, is the tissue surrounding the umbilical vein and vessels in the cord. (Figure 7)

When the vessels are removed closer to the fetal side of the cord, you have remaining tissue which contains stem cells termed mesenchymal stem cells or MSCs. MSCs areundifferentiated cells (not changed) that have the capacity to change into any specific cell type in the body. These cells, once deployed to any area of injury or disease, can readily change into the cell type that is needed to repair. Moreover, MSCs are directed to body’s cell signals that recruit hem to the site of the injury. Once they reach this area, they dock and begin repairing by releasing cytokines, growth factors and other components that are needed in the healing process.

Derived from the maternal side of the umbilical cord, this tissue containing up to50 times more growth factors and other components than the amniotic fluid. Wharton’s Jelly products are especially beneficial for patients over forty that, due to the aging process, have less viable cells than a younger patient would have.  (Figure 8)

Often misrepresented as stem cell therapy, PRP is created by drawing venous blood from a patient with an anticoagulant, injecting it in a tube and placing the tube in a centrifuge. The high speed of the centrifuge separates the platelets (Figure 9) from the red blood cells he product is then re-coagulated with thrombin and sometimes mixed with calcium chloride to induce the release of growth factors. The PRP is then ready to be used as an autologous tissue injection or introduced to a surgical site.

Platelets are normally known for their responsibility to clot blood, but they also contain proteins known as growth factors that play a vital role in healing injuries. Since the location of most sports injuries does not receive an abundant flow of blood, the injuries are deprived of the platelets and growth factors needed to regenerate damaged tissue. Studies show that PRP treatment can resolve that problem by delivering the injured part of the body with the platelets necessary to support healing.

While not as “potent” as other therapies, PRP does contain growth factors and other cytokines that are said to recruit cells to an area of injury to coordinate a repair response. Additionally, PRP activates tenocytes to proliferate quickly and produce collagen to repair tissue. PRP is said to begin working in a few weeks but, alone, can take 6-9 months to its full effect. However, PRP mixed with New Life Regenerative Medicine products may enhance the healing process and cut the time down by more than eighty percent.

Bone marrow aspirate concentrate is made from fluid taken from bone marrow. A needle is used to remove bone marrow from within the bone. This is typically done under sedation or general anesthesia. Marrow is commonly taken from the pelvis but may be taken from other sites. The pelvis is marked and prepped to keep the site sterile. A hollow needle is inserted into the bone and a syringe is used to withdraw fluid from the bone marrow. (Figure 11) After enough fluid has been collected, the needle is removed. Pressure is applied to the needle site to stop the bleeding.
A small dressing is then applied. After aspiration, there usually is pain at the pelvis that goes away within several days. A small dressing or bandage is kept at the aspiration site until it has healed.

The sample of bone marrow is removed and then spun down in a centrifuge to separate the cells. A liquid is produced that has a high concentration of stem cells. The physician injects the stem cells directly into the surgical site. This avoided in patients who have an infection or cancer. Complications may include pain, bleeding, infection and nerve injury. An intra-abdominal injury may occur because of the needle. The success of bone marrow aspirate stem cells is dependent on the age of the patient.