Conway McLean, DPM, Journal columnist

Health MattersAmericans have grown weary of the methods of modern medical care, with its dependence on drugs and surgery. Looking for an alternative, many have flocked to alternative therapies, such as acupuncture or homeopathy. There haven’t been enough options for treating many problems, other than the two established choices, pharmacologic or invasive.

Turn on your TV and watch a few commercials, you are almost certain to see one of these hawking the latest miracle medicine. It may sound like the answer, until they get to talk about all the possible side effects from the drug. Surgery is sometimes touted as the answer, the fix, but every procedure entails various possible complications, from infection to scarring. Shouldn’t it be possible to enhance the body’s natural healing abilities? This is the essence of regenerative medicine.

Regenerative medicine techniques attempt to amplify our natural healing processes where they are needed most, where there is diseased tissue. It comes in many forms and includes technological advances, an improved understanding of stem cells, cell function and biology, and tissue engineering. Some methods are so new they are not yet in practice, while others have been used for years. At a glance, these new abilities provide for enhanced healing and reduced pain. Regenerative medicine focuses on addressing the root cause of pain, instead of simply managing symptoms, as is so often the case in traditional allopathic medicine.

Regenerative medicine is a distinct major advancement in medical treatment and has opened new avenues for curing patients with challenging diseases and physically impaired tissues. The benefits of regenerative medicine are many, although some may not be obvious. For example, the absence of side effects, which we know are associated with all medications. There is no risk of rejection. Nor is there typically any down time or recovery time, as is the case with every surgical procedure.

Surprisingly, it is still unfamiliar to many people, and this includes numerous scientists and physicians. But the advantages look to open the eyes of many Americans as these techniques become commonplace and their use widespread. And a day when organs can be regrown seems not so far away.

The protagonist in the story of regenerative medicine is the stem cell. Stem cells are the foundation for every organ and tissue in your body, although they are different from other cells in the body. These are unspecialized cells, and thus cannot perform any specific functions in the body. And yet, they have the potential to become specialized. In doing so, stem cells can form muscle cells, blood cells, even brain cells. Regenerative medicine works in conjunction with your body’s naturally produced stem cells to accelerate your healing process.

Not only are there many different types of stem cells, they come from diverse places in the body, formed at different times throughout our lives. Many tissues contain small quantities of the stem cells whose job is to replace the cells damaged by the trauma of daily life. These structures include those in your skin, blood, and the lining of your gut. These stem cells, which are specific to a type of tissue, can be hard to find in the human body. They are also harder to study since they don’t seem to grow in a culture medium as easily as the other type, the embryonic stem cell.

This latter type, the embryonic stem cell, are pluripotent, a critically important characteristic which means they can produce any and every cell type in the body. These cells are incredibly valuable: they provide a renewable resource for studying human development, for testing drugs and other therapies. Embryonic stem cells exist only at the earliest stages of development, which explains the explosion of techniques utilizing amniotic tissue from a placenta.

All kinds of stem cells can make copies of themselves (termed self-renew), and also differentiate, developing into more specialized cells. But beyond these two critical abilities, stem cells vary widely in what they can do, and in the circumstances under which they can do these things. They are recruited in the body by growth factors, which are signalling molecules. They stimulate cell growth, differentiation, survival, inflammation, even tissue repair. For normal cells to maintain their viability, numerous growth factors are required.

One regenerative technique becoming more common is the administration of an amniotic fluid product, obtained from a planned C-section. Although the cells found in this way cannot be kept viable during the processing, plentiful growth factors remain, stimulating the recruitment of stem cells to the area. This procedure entails a simple injection to the painful structure in an attempt to initiate the healing cascade, the complex chain of events occurring in the body, leading to a healthy, pain-free tendon, ligament or similar body part.

Although our understanding has increased significantly, there remain important questions about the mechanisms which are at play with regenerative medicine techniques. A vital player in this process is collagen, one of the most abundant proteins in the body. It is produced at a slower rate as we age, and these methods appear to stimulate improved production. The result is the tendons, ligaments, and other structures that make up your musculoskeletal system can become stronger. Consequently, these effects make it more difficult for the structure to be damaged after this type of therapy.

Stem cell transplants are being used to replace cells damaged by disease or chemotherapy. In this case, the donor’s immune system is being harnessed to fight certain cancers as well as some blood-related diseases, such as leukemia and lymphoma. These cell transplants use adult stem cells or umbilical cord blood, not embryonic stem cells.

But stem cells have many uses, with medical research being one of them, especially studies of the causes of genetic defects in cells. In addition, they can be used to grow new cells in a laboratory, possibly employed to replace damaged organs or tissues, or correct parts of organs that don’t work properly.

Physicians and scientists are excited about the potential benefits of this new field of medicine. Although it’s in its infancy, the promise of regenerative medicine is tremendous. Stem cells may one day be used to make cells and tissues for the treatment of many diseases. Research into the use of stem cells may help us understand how debilitating conditions such as birth defects and cancer come about. In future, stem cell research seems poised to aid in many different areas of health and medical research, including Alzheimer’s, spinal cord injury, heart disease, diabetes, and arthritis.

Clearly, the benefits of these methods are substantial. Increased functionality, faster recovery, reduced risk of future injuries, all seem achievable with regenerative procedures. The potential for these practices is huge, even the “manufacturing” of new organs. Although regenerative medicine is a rapidly evolving practice, it has already found great success in treating chronic pain issues throughout the body. Perhaps your pain is one that can be resolved with stem cell therapy, amniotic fluid administration, platelet rich plasma, or one of the other new regenerative medicine techniques. The future of medicine is here.

Editor’s note: Dr. Conway McLean is a physician practicing foot and ankle medicine in the Upper Peninsula, with a move of his Marquette office to the downtown area. McLean has lectured internationally on wound care and surgery, being double board certified in surgery, and also in wound care. He has a sub-specialty in foot-ankle orthotics. Dr. McLean welcomes questions or comments at drcmclean@outlook.com.