Tag Archives: Stem Cells

Medicine: Using Stem Cells To Treat Osteonecrosis

Daniel Wiznia, MD, an orthopaedic surgeon with Yale School of Medicine, is practicing a surgical technique designed to render 10% of hip replacements unnecessary. Regenerative properties from a patient’s own stem cells are responsible for regrowing bone, restoring blood flow, and being able to avoid further interventional surgery.

Osteonecrosis, also known as avascular necrosis, occurs in more than 20,000 Americans each year. As the condition progresses, bone cells known as osteoblasts become unable to repair themselves and sustain the integrity of the bone, and ultimately die. The bone deterioration leads to a decrease in blood flow to the area, further weakening the entire skeletal structure of the upper leg.

If unaddressed, the ball portion of the hip’s ball and socket joint will cave in on itself and collapse, requiring a total hip replacement. The fact that patients often receive this diagnosis during their 30s and 40s presents a particular challenge.

While the lifespan of hip prosthetics has dramatically increased in recent years, a patient who undergoes a total hip arthroplasty, or total hip replacement, at that age will almost certainly require a revision later in life. This redo of the same surgery at an older age comes with an entirely new set of risks and potential complications, making it that much harder to manage down the road.

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Stem Cells: Bone Marrow Transplants (Mayo Clinic)

Clinical advances by the Mayo Clinic Transplant team offer new possibilities in treatment. Mayo Clinic is a world leader in setting standards for stem cell transplant. Allogenic transplant involves using stem cells from a donor and replacing diseased or damaged bone marrow. This video reviews the transplant process. Mayo Clinic is making bone marrow transplant safer and improving the lives of people who need them.

Advances by the Mayo Clinic Transplant Program are offering new possibilities in treatment for patients requiring bone marrow transplant. Autologous bone marrow transplant utilizes healthy stem cells from a person’s own body to help recover from high dose chemotherapy. This video reviews the conditions autologous stem cell transplantation is most often used to treat and what to expect throughout the process.


The stem cell dream has been present for years, but so far the dream has outpaced reality. Only A handful of stem therapies are actually useful treatments at present.

A Japanese researcher has succeeded in making iSC into eggs, and discovered that you needed supporting ovarian tissues to make the system work in mice.

Some stem cell treatments deemed  successful may have actually been due to dead cells or immunity-stimulating debris causing increased functionality, particularly in the heart.

Interestingly, as stem cells slowly differentiate into heart cells, there is a stage of cardio myocyte that beats on its own. This leads to arrhythmias if there is insufficient differentiation in stem cell treatment. Only later in differentiation does the myocyte stop beating on its own and rely upon a signal to contract, as the adult heart does.

A 3-D model of pluripotent heart stem cells has been seen to self organize. Mostly researchers have focused on building tissue around a scaffold to re-create the heart chambers structure, but a heart organoid, known as a cardioid, has been created by adding six signaling factors.

Stem cells in culture mutate about 840 times faster, creating problems. I have a friend who has his own iSC dopaminergic stem cells injected into his brain,  but the tissue culture media worryingly shows a teratoma, a type of tumor with all three embryonic tissue lines.

Stem cells had previously been classified as naïve or prime. An intermediate stage is now been discovered called  the rosette stage. The developing organism must be sure before it goes ahead.

Whether to make pluripotent stem cells from a persons own tissue, and use it for replacement therapy in that single individual, or to take a cell line that has been vetted, and use it in everybody, accepting the necessity of immunosuppression, is currently being worked out. The Japanese groups are generally going with this latter “allogenic” package and working to match histocompatibility sites.

Parkinson’s treatment is unlikely to be a cure, since the transplanted cells may eventually become diseased themselves. Stem cell treatment can improve symptoms potentially, but can’t alter the course of the disease.

Using fetal cells has proven very problematic, since a given procedure for Parkinson’s may require 4 to 12 fetuses per patient, and you have ethical problems besides.

Spinal cord injury is plagued by inter-species architectural differences, and knowing exactly how severe the injury actually is. Researchers also have to be sure they are not going to make the situation worse.

Chimeras are developing as a research bonanza. The idea is to take a lower species, block the development of a given organ, then inject a higher species stem cells which are more likely to fill the niche if they don’t have domestic competition. Many efforts are directed towards developing human organs in subhuman species. When using primates as the sub species, however, an additional step, blocking the possibility of stem cells becoming neurons is advisable. There’s a lot of ethics in this area.

The pancreas is the area of greatest work at the present time. Keeping an embryo alive in a dish is very important, but difficult. The “14-day rule” is being extended.

The suffix “oid” is getting very popular. We have organoids, spheroids, blastoids, and assembloids. I was a bit surprised to hear how self organizing these tissues are, and also how important are the accessory, helper cells: the ovarian support tissues, the astrocytes in the brain, the pigmented epithelial layer of the eye, the pericytes in blood vessels.

Jeanne Loring is trying to save the white rhinoceros. Just cloning the rhinoceros is not good enough. Some mutations in the germ-lines are needed to make different individuals. This also requires going from Induced stem cell retrograde over to sperm cells; the only two white rhinos still alive or both females.

Currently it requires great technique to take a somatic cell back to induced stem cell. These talented people are called “cell whisperers”.
Mention is made of the Chinese hamster ovaries cells that are commonly used to produce therapeutic proteins. They tend to float in the reactor as single cells. Pluripotent  stem cells are more fragile, and need to grow in aggregates. You must form sheets of the stem cells in order to get them to take  in the eye, for instance, in order to get them to form retinal pigmented  epithelial cells, photo receptors, horizontal cells, bipolar cells, amacrine cells, and ganglion cells. “We transplant 10-20,000 cells per eye. To recover vision you probably need hundreds of thousands of cells. Most people appreciate even a slight improvement in vision, however”.

“ All models are wrong, some are useful“ is the guiding principle of leading edge stem cell Whisperers.

—Dr. C.


The ultimate stem cell is the fertilized egg from which we came. This omnipotent stem cell divides countless times, “differentiates”, and forms more and more specialized tissues, and our body is the eventual result. All of our tissues contain some stem cells, which grow increasingly rare as we age.

Regenerative medicine takes advantage of stem cells derived from diverse sources. An embryo, an umbilical  cord, or your bone marrow contains stem cells. Even one of your mature connective tissue cells that has been dedifferentiated, or sent back along the pathway that originated from the single cell from which you came, can be induced to form a stem cell (iSC).

If the stem cell originates from your own tissues, it is  accepted by your body, as one of its own.

I have an wealthy acquaintance whose Parkinson’s disease is being treated by one of his own cells induced to form a dopamine containing neuronal stem cell.

The article posted previously regarding rotator cuff surgery apparently used stem cells to shorten the recovery time.

I have heard about the use of stem cells in heart failure, osteoarthritis, and other joint problems, and I’m sure we will hear about this increasingly as time passes. However, there are hurdles to be overcome, moral, legal and medical. The possibility (small) of induced stem cells to evolve into cancer is one medical hurdle, and if the Stem Sell originates from another individual, immunosuppressive treatment must be used in the recipient to allow the stem cells to work. Also, the use of the other individual’s stem cells may involve some moral, legal and possibly religious objections.

Please refer to the following Mayo clinic article for more information.

–Dr. C


Macular degeneration is a leading cause of visual impairment in people over 65 and can lead to blindness. One in three people will eventually suffer some degree of macular degeneration, which is caused by abnormal blood vessels under the retina, the light-sensitive part of the eye. We treat both the more common “dry” as well as the more dangerous “wet” forms of macular degeneration. While there is currently no cure for this disease, we offer the latest treatments to reduce the risk of vision loss and blindness. These include anti-VEGF drugs—which attack proteins that create the abnormal blood vessels that cause macular degeneration—and photodynamic therapy, in which patients ingest medication that is then activated with a laser.

To learn more about macular disease at Yale, visit: https://www.yalemedicine.org/departme…​.


This high quality video shows several aspects of macular degeneration. It discusses treatments with stem cells that are in the research phase; in the future there may be replacements for the abnormal support cells, the vascular cells and pigmented epithelium, that are diseased in macular degeneration.

Current treatment centers on control of abnormal blood vessels either by photo active laser, laser coagulation, or anti-VEGF.
Macular degeneration has two forms, wet and dry. The wet macular degeneration has accumulations, or Drusen, under the epithelium. There are also machines to check the thickness of the macula, which is an aid in diagnosis.

The main symptom of macular degeneration or loss of vision especially in The center of the visual field, which is essential for reading.
As I mentioned in my podcast, I made a posting on macular degeneration that includes an amsler grid. Some early symptoms of macular degeneration include waviness of the lines of this grid. Certainly if you have any visual distortion or loss you should see an ophthalmologist.

If your medical plan permits it, I feel but a regular check buy an ophthalmologist approximately every 6 to 12 months, is very useful. My own ophthalmologist checks my  retinal thickness, optic nerve, pressure and peripheral Field ( to pick up glaucoma) as well as my vision on each visit.

Dr. C.


The Stanford researchers figured out how to regrow articular cartilage by first causing slight injury to the joint tissue, then using chemical signals to steer the growth of skeletal stem cells as the injuries heal. The work was published Aug. 17 in the journal Nature Medicine.

“Cartilage has practically zero regenerative potential in adulthood, so once it’s injured or gone, what we can do for patients has been very limited,” said assistant professor of surgery Charles K.F. Chan, PhD. “It’s extremely gratifying to find a way to help the body regrow this important tissue.”

STANFORD MEDICINE (Aug 17, 2020): Researchers at the Stanford University School of Medicine have discovered a way to regenerate, in mice and human tissue, the cushion of cartilage found in joints.

Loss of this slippery and shock-absorbing tissue layer, called articular cartilage, is responsible for many cases of joint pain and arthritis, which afflicts more than 55 million Americans. Nearly 1 in 4 adult Americans suffer from arthritis, and far more are burdened by joint pain and inflammation generally.

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Stanford has come up with a Promising new approach to the surgical treatment of osteoarthritis. Unfortunately for the suffering public, this approach is still in the rodent experimental stage.

The pain of osteoarthritis is caused by the LOSS of the CARTILAGE which insulates the bone of the joints. The wonderful cartilage coating prevents the pain which would result from the rubbing of bone on bone. The best solution in osteoarthritis would be to replace the cartilage, and I have no doubt that this will be possible some day.

STEM CELLS is the theoretical method most commonly imagined when it comes to replacing lost tissue.. Brain cells, cardiac muscle cells, and pancreatic islet cells are some of the research areas. The development of stem cells from the cells of the Patient herself (iSCs) obviates the need for immunosuppression, which plagues allographs ( stem cells or organs from other humans).

Recently, in situ transformation of neighboring cells has been described, which sidesteps the need to introduce any cells. For instance the transformation of astrocytes (a type of brain cell) into neuronal stem cells of the dopamine lineage would be a great boon to Parkinson’s disease.

The Stanford method somewhat resembles this last-mentioned technique. An injury is created where the cartilage is desired. Like any injury, bleeding, clotting, and cell infiltration follows, destined to form a scar. However, the researchers added BMP-2, which in this milieu causes the pro-fibroblasts to head toward the bone (osteoblast) lineage. Since cartilage forms first in a tissue destined to be bone, they then added a VEGF antagonist, which interrupts the transformation in the desired cartilage stage. Both BMP-2 and anti-VEGF have already been approved for use, facilitating the development of this attractive therapy.

The researchers have even identified an excellent potential Patient Population: Osteoarthritis patients scheduled for surgical removal of the first metacarpal articulation with the wrist. They could do their procedure on this area, and if there is no benefit, They could just go ahead with the original plan of removal. The thumb happens to be one of my most painful arthritic areas.

I will most interestedly follow their research.

–Dr. C.