Osteoporosis & Osteoarthritis May Have Finally Met Their Match...
The world of non-surgical orthopedic medicine took a collective gasp recently when stem cell researchers announced the discovery of the molecular agent responsible for generating the entire skeleton in your body: The Human Skeletal Stem Cell (hSSC).
Dr. Steve Coleman, D.O. // Doctor of Osteopathic Medicine
This has far-reaching implications for patients entering our Naples Stem Cell Clinic, offering concrete hope for constructing new cellular tools to turn back the clock on age-related degenerative diseases such as Osteoporosis and Osteoarthritis that plague both men and woman as they approach and pass the age of 40. Even sports injuries or bone diseases influenced by diabetes will benefit from this profound discovery which may forever change the way we treat joint pain or approach joint replacement surgeries.
The Holy Grail in Bone Research
We cannot understate the importance and joy of this medical milestone: For decades stem cell biologists, orthopedic surgeons, osteopathic doctors, and plastic surgeons, have suspected a specialist stem cell at work in crafting cartilage, stromal cells and of course, bone. While adult stem cells have been long been known to delineate into several categories including fat cells, blood cells and bone cells, finding the master cell that ONLY produces bone and cartilage has proved elusive to say the least.
While our team has had incredible success using transplanted bone marrow and fat cells from the patient’s own body – loaded with rich stem cells, growth factors and cytokines - to accelerate joint repair in knees, hips, shoulders, wrists, fingers and elbows, we’ve been waiting on a knife’s edge for the discovery of the Human Skeletal Stem Cell to provide even more favorable and faster outcomes. It’s quite literally be likened to the quest for the holy grail in the world of bone research.
Discovering The Human Skeletal Stem Cell
For decades researchers at leading Californian institutions such as Stanford University have been relentlessly refining their techniques and research to detect this powerful stem cell in fruit flies, salamanders and mice, thereby offering clues into bone formation in humans that while incredibly elegant and powerful, declines with age and injury.
For instance, a bone fracture or bone break may take 6 weeks to heal in an energetic teenager. In adults, past the age of 40, this timeline may be extended to 6 months. The reason for this is because stem cells become more sluggish with age. Each and every day of your life, these cells lay down and remodel new bone, especially when an injury occurs. In fact, stem cells keep your entire skeleton intact during the cell division process but do so at less optimal levels once we approach 50, thus explaining why the healing process takes longer.
It also explains why humans, especially women, are susceptible to debilitating degenerative diseases such as Osteoporosis, often called Brittle Bone Disease. In this scenario, the rate of bone formation lags the rate of bone absorption, leading to lower bone density. It all comes down to the age, amount and potency of your stem cells, which decline with age. Understanding how cells divide normally during cell division (or what stem cell biologists call Mitosis), is thus critically important for our stem cell physicians and doctors, literally defining the field we operate in: Regenerative Medicine.
(Dr. Coleman seen right extracting bone marrow cells from patient hip bone.)
The Salamanders' Secrets
Finding a therapeutic method to guide cells to produce more bone and cartilage, can dramatically increase the quality of life for patients suffering from both Osteoarthritis and Osteoporosis at our Stem Cell Clinic in Naples, Bonita Springs, Estero and Fort Myers.
Meanwhile, animals have displayed a remarkable ability to regenerate bone and cartilage, propelling stem cell researchers forward to isolate the cells responsible for these healing properties. The salamander has a structural musculoskeletal complexity similar to humans, yet any limb surgically removed grows back in several days, with the interlocking bones, muscles and intricate joints, all combining in the proper order and configuration. This includes the nerves and blood vessels!
Is this miracle of nature restricted to animals?
A Defining Moment in Osteopathic Medicine
"Answering this question has hinged on isolating and understanding the Human Skeletal Stem Cell in other land-based vertebrates, particularly the mouse. Humans and mice diversified from a common ancestor 100 million years ago and share some similarities, making the rodent an excellent subject through which to explore molecular pathways related to bone formation. One bold experiment focused on identifying the genes that provide the blueprint for skeletogenises and related activities associated with making bone and cartilage."
DR. Steve Coleman // Specialist in Same-Day Stem Cell Treatment
One of the biggest challenges in identifying the Human Skeletal Cell lay in the fact that bone (hard, rigid) and cartilage (soft, elastic) are extremely different in molecular composition.
Thus, how could they both come from the same master stem cell?
We have previously mentioned on MedicalMasters.org that cartilage takes a notoriously long time to heal, especially in partial meniscus tears in the knee. The same applies to partial rotator cuff injuries in the shoulder. While both bone and cartilage contain collagen, cartilage also contains an extracellular matrix made up of proteoglycan and elastin fibers. It only grows in one direction, while bone (rich in marrow) grows in both directions.
Connecting both to a single cellular parent required some ingenuity and patience.
Unlocking The Human Skeletal Stem Cell
The stem cell researchers split this ambitious task into several phases:
In phase 1, they genetically modified mice, attaching specific color markers to stem cell types. This allowed them to track the stem cell differentiation process and identify which agents were responsible for skeleton-forming cells.
The second phase involved identifying the genetic signature of the cells responsible for skeletogenesis.
In the third phase, the researchers used left-over bone fragments from human hip and knee replacement surgeries to isolate the skeletal-forming cells in lab dishes, using the gene expression insights gleaned from the earlier mice experiment.
The results were stunning and far-reaching: The stem cells showed both an ability to self-renew and cascade into bone, cartilage and stroma progenitors.
Dr. Michael Longaker, Professor of Plastic & Reconstructive Surgery
“Not only can it be isolated from fracture sites, it can also be generated by reprogramming human fat cells or induced pluripotent stem cells to assume a skeletal fate."
Regenerating The Entire Human Skeleton
In essence, the team had pioneered a stem cell family tree that definitively showed how Chondrocytes (Cartilage) and Osteocytes (Bone) were born from the Bone Cartilage Stromal Progenitor Cell, abbreviated as hBCSP. Its parent was the Human Pre-Bone Cartilage Stromal Progenitor, or hPre-BCSP.
Ultimately, the ancestor for hPre-BSCP turned out to be none other than The Human Skeletal Stem Cell (hSSC), responsible for generating the ENTIRE human skeleton
This breakthrough establishes a remarkable Cell Atlas that provides the springboard for investigating (and arguably) curing several skeletal diseases, while opening the door to powerful new non-surgical stem cell therapies. One of the end-goals of future research attached to the discovery of the Human Skeletal Stem Cell (hSSC) will be reducing the United States over-reliance on surgical approaches to treating joint pain, osteoarthritis and osteoporosis. For instance, it’s estimated that our rapidly aging population undergoes almost 2 million joint replacements each year. A further 75 million Americans live with painful arthritis, perfect candidates for future skeletal stem cell injections.
Future Stem Cell Applications
One way a future Stem Cell Clinic could operate involves using minimally invasive cameras to gently enter the joint and pinpoint any degeneration or damage. This would be followed by a prolotherapy injection containing the Human Skeletal Stem Cells, exclusively programmed to re-grow cartilage, bone and tendons.
The discovery of the Human Skeletal Stem Cell is extending into other fascinating areas of medicine. For instance, researchers are exploring how male deer manage to sprout a new pair of antlers each spring. Antlers are of course nothing more than bone, showing similar regenerative powers to that of the Salamander mentioned earlier. Two key genes have been identified in this restorative process which may open the doors to treating osteoporosis and bone fractures.
What’s been described previously, is a marvel of interdisciplinary bioscience that brings together biomedical and life science researchers, clinicians, engineers, physicians and computational scientists to unlock the genomic and stem cell secrets of the human body, including the skeleton.
In particular, the discovery of the Human Skeletal Stem Cell may turn out to be one of the most significant medical milestones of this century. Its discovery is that big and that important.
It also confirms a maxim that our physicians routinely use to describe our approach to osteopathic and regenerative medicine: “Doctors don’t heal patients; cells do.”
We look forward to integrating the research described above and future stem cell applications into our cellular modalities to help you push back the effects of aging and a live a life free of joint pain.
YOUR BONES IN SPACE
It's not only in the hallowed halls of Stanford Institute for Stem Cell Biology & Regenerative Medicine, that new molecular weapons are being constructed to end the reign of Osteoarthritis and Osteoporosis. A bevy of stem cell breakthroughs are underway at NASA's Bone Signaling Laboratory that promise to slow and perhaps even reverse bone atrophy. The pace of change is astounding and I am extremely hopeful my patients will soon see the benefits of these amazing research findings.