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The Current Truth About Stem Cell Therapies

The Current Truth About Stem Cell Therapies. By: Patrick McLaughlin, MD. Overview. History of Mesenchymal Stem Cells ( MSCs ) Presumed Mechanism of Action: Past and Present Current Truth About Stem Cell Therapies. Definition of Stem Cell.

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The Current Truth About Stem Cell Therapies

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  1. The Current Truth About Stem Cell Therapies By: Patrick McLaughlin, MD

  2. Overview • History of MesenchymalStem Cells (MSCs) • Presumed Mechanism of Action: Past and Present • Current Truth About Stem Cell Therapies

  3. Definition of Stem Cell • An undifferentiated cell of a multicellular organism which is capable of giving rise to indefinitely more cells of the same type, and from which certain other kinds of cell arise by differentiation.

  4. Dr. Arnold Caplan, Phd.Director of Skeletal Research Center Case Western Reserve University

  5. Medications DON’T cure disease

  6. Innate Regenerative Potential

  7. Origin of Innate Regenerative Potential

  8. Culture Expansion and Transplantation Slide from Dr Applford and Dr Rathborne

  9. Kim et al 2016

  10. Popular Culture circa 2009

  11. Stem Cells are regulated by the FDA:You CAN NOT expand stem cells in culture

  12. Culture Expansion and Transplantation Slide from Dr Applford and Dr Rathborne

  13. Skip the Culture

  14. Dogma persists

  15. Tissue Engineering or Regenerative Medicine

  16. MSC’s can be derived from multiple tissues

  17. All MSCs are Pericytes

  18. Different pericytes in different tissue

  19. Actions of MSC’s

  20. MSC – Based TherapyCaplan’s New Dogma • MSCs = Pericyctes (all tissues have them) • MSCsin vitro are multi-potent but NOT in vivo • Transplanted MSCsdock at sites of broken/inflamed blood vessels • MSC actions: • Immune component • Regenerative component MANAGEMENT OF THE BODIES INNATE REGENERATIVE CAPACITY

  21. New Caplan Dogma • In Vivo, MSCs (aka Pericytes) DON NOT “REPLACE” DISEASED OR DAMAGED TISSUE • MSCs(aka Pericytes), WHEN INJECTED, DOC AT SITES OF BROKEN OR INFLAMMED BLOOD VESSELS AND MANAGE THE BODIES INNATE REGENERATIVE CAPACITY

  22. Actions of MSC’s

  23. What’s in a Name

  24. The Truth About Stem Cell Treatments “THE EXACT MECHANISM IS UNKNOW”

  25. Stem Cell Treatments Are Experimental!Clinical Results Are Varied • NO standardized preparation for clinical trials • Are all sources the same? • Is there a dose response? • Who will respond to therapy? (early is better) • What is the best application? • My hope…

  26. Thank You

  27. References 1. Dr Arnold Caplan. Lecture TOBI 2019. 2. Assessment of clinical and MRI outcomes after mesenchymal stem cell implantation in patients with knee osteoarthritis: a prospective study. Y.S Kim et al. Osteoarthritis and Cartilage Volume 24, Issue 2, February 2016, Pages 237-245 3. Office-Based Mesenchymal Stem Cell Therapy for the Treatment of Musculoskeletal Disease: A Systemic Review of Recent Human Studies. Law et al. Pain Medicine Volume 20, Number 8, 2019, Pages 1570-1583.

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