The field of regenerative medicine is broad and evolving. Any research that focuses on harnessing the body’s natural healing ability could be said to be regenerative medicine. Modern medicine has focused on helping the body to use its own immune mechanisms to fight infection or cancer in the realm of immunology. The cost and burden of chronic spine and musculoskeletal conditions demands we focus our attention on trying to fix or heal these problems. Ideally, we can find a way to treat these conditions without repeated corticosteroid injections, opioid medications, and surgery.
Human Allograft Tissue
Human amniotic fluid (HAF) has been used for centuries in the treatment of different maladies and conditions. HAF has been shown to be a mixology of beneficial collagens, cytokines, elastins and growth factors that can proliferate the treatment, healing and regenerative qualities of the human body. The presence of extracellular matrices can help to provide a natural scaffold that may accelerate healing while potentially reducing the incidence of inflammation and scarring.
Human amniotic fluid is said to be immune privileged, rarely inducing a resistant reaction to the recipient. The presence of multiple growth factors such as, VEG, TGFB1, TGFB3 and GDF11 (also called GD11, BMP11, and GDF-11) can promote cell growth and regeneration of healthy collagens I, II, III, IV, V and VI that help proliferate healing.
Donated human amniotic fluid used in the clinic or hospital comes from an American Academy of Tissue Banks (AATB) accredited tissue bank only. Further, Amniotic fluid derived stem cells and growth factors are regulated through the FDA Center for Biologics Evaluation and Research (CBER) which regulates HCT/Ps under 21 CFR Parts 1270 and 21 CFR Part 1271 and Section 361 of the Public Health Service Act
PRP (Platelet Rich Plasma)
Many patients are familiar with professional athletes to undergo PRP treatments in the off-season to recover from chronic wear and tear injuries. Fortunately, costs have come down and can often be performed in the clinic or at the hospital. The process is rather simple, and nurse will draw your blood, spin it down in a centrifuge, then extract the platelets and inject them in your injury area. Platelets are known for clotting blood, but they also release powerful growth factors that play a role in healing. This is a similar concept as regenerative medicine with the stem cells.
A stem cell is essentially the building block of the human body. Stem cells are capable of dividing for long periods of time, are unspecialized, but can develop into specialized cells. FDA approved sources include bone marrow, fat cells, and amniotic fluid. The stem cells inside an embryo will eventually give rise to every cell, tissue and organ in the fetus's body. Unlike a regular cell, which can only replicate to create more of its own kind of cell, a stem cell is pluripotent. When it divides, it can make any one of the 220 different cells in the human body. Stem cells also have the capability to self-renew -- they can reproduce themselves many times over.
There is extensive research regarding the use of bone marrow obtained stem cells (mesenchymal stem cells or MSC’s) and growing research in the field of amniotic sourced stem cells and growth factors. Dr. Nash is one of the pioneers in the field of implementing amniotic sourced stem cell and growth factor treatments, with nearly four years of experience and more than 2000 injections to date. Dr. Nash has collaborated with major regenerative companies to develop protocols and further research.
Controversial or not?
When the topic of ‘stem cells’ comes up, it can be a tense subject. Fortunately, there is no moral/ethical issue when you research the source and techniques. The human allograft tissue, which may contain frozen (cryopreserved) stem cells and growth factors, ONLY comes from elective C-sections. Tissue labs accredited by the American Academy of Tissue Banks only accept elective C-section obtained amniotic fluid and tissue. These are NOT the product of abortion or unwanted embryos obtained from fertility clinics or other sources.
Growth factors are naturally occurring regulatory molecules, which bind to receptors on the cell surface. They stimulate cell and tissue function through influencing cell differentiation by changing their biochemical activity and cellular growth, and regulating their rate of proliferation. Numerous families of growth factors have already been identified and remarkable advancements have been made in understanding the pathways growth factors use to activate cellular proliferation and differentiation. Growth factors can recruit your bodies natural repair and healing cells, including new cartilage creation and blood vessel growth. Exciting new research shows that some growth factors recruit your own circulating stem cells to the target site of injury.
While the following articles are quite technical, the background and conclusions include the broad concepts and goals of treatment of familiar musculoskeletal condtions.
1) Amniotic tissue acting as a ‘stem cell magnet’ to recruit stem cells to the site of injection/implantation.
2) Exciting new applications of combination umbilical cord and amniotic membrane preparations, made by Amniox
Clarix products can help improve foot and ankle outcomes
3) Dehydrated Human Amnion/Chorion Membrane allografts as a therapy for orthopedic tissue repair – in cases of plantar fasciitis, tendinopathy, and veterbral fusion treatments.
4) Study demonstrates the benefit of combining amnion and chorion to increase the number of growth factors delivered to the action site, whether a wound or injured tissue.
Insert PDF file for Cytokines in single layer amnion allografts
5) For those of you that want to dive deeper, this is a good overview that explains how amnion/chorion tissue helps to activate the growth factors as the key to tissue healing