FAQ

Our most frequently asked questions.

There are two sources of adult stem cells that can be used for regenerative medicine; allogeneic stem cells (derived from other people), or autologous stem cells (derived from yourself).

Unless you have a genetic condition or a transmissible disease; the medical scientific answer is to use your own autologous stem cells for the simple but critical reason that your body’s immune system is not going to reject what it recognises as it’s own; and so you are not running the 60% to 80% risks of acute to severe GVDF using allogeneic stem cells.

Using your own stem cells is more affordable. Ironically the ‘one-for-many’ allogeneic industrial stem cells costs more. If your body’s immune system will reject the vast majority of these industrial allogeneic stem cells; then the number of cells needed by the physician will be higher, and so costs will be higher to try and achieve the same treatment endpoint. Putting this cost in perspective; ten treatments of Prochymal® MSC costs $200,000 for one course and requires 10 million allogeneic MSC per kilogram of patient bodyweight, and for the average person that means using 690-840 million cells. Using your own autologous cells typically requires between 5-30 million MSC and costs a fraction of Prochymal® – a staggering difference that may encourage debate about appropriate market models.

An advantage of banking your own stem cells is that they can be immediately available if stocked in case of a sudden (stroke/heart-attack) medical need, or traumatic accident.

It takes many days to process stem cells from tissues; and your physical condition may prevent you from making a self-donation of tissue due to the progression of your illness or state of injury.

As we get older, the number and the quality of stem cells in our body decreases for intrinsic and extrinsic reasons; and fewer stem cells means less body tissue maintenance and repair capability. If you’ve ever seen how quickly a baby’s cut heals compared to the geriatric’s or diabetic’s chronic wound, you’ll get the picture.

Stem cells age as we age (cellular failure is responsible for 90% of deaths worldwide), and for many medical scientific reasons it makes sense to capture and indefinitely store your ‘biological age’ taking advantage of stem cell banking as early as possible in adult life. MSC are also being used in difficult to treat HIV-1 studies for immune non-responders and have been shown to effectively improve patient immune reconstitution; although use of cell-based therapy for HIV is in its early stages, storing a healthy population of your MSC may prove invaluable one day.

As can be seen in the graph, adipose (fat) derived MSC come out as the sample that can be acquired latest in life to purpose, are easier to harvest, and have the greatest number of potential therapeutic uses in comparison to those obtained from umbilical cord blood and bone marrow.

Very few humans have cryopreserved their umbilical cord from birth, so generally these MSC are not accessible. This leaves autologous adipose (fat) derived and bone marrow derived MSC for adult MSC banking and therapeutic purposes.

Bone marrow derived MSC are the oldest and therefore most well characterised source of MSC, hence most clinical data has been based on this source. However, there are limitations: e.g., a painful acquisition process, use of extensive anesthesia during the harvest, and a much lower cell yield of MSC compared to fat. Further, bone marrow MSC have been shown to exhibit a decline in; cell numbers, proliferation; wound healing properties; and, cell differentiation potential, along with enhanced cell death traits with advancing donor age.

Stromal vascular fraction (SVF) is an initial fraction derived from an adipose (fat) sample, and as such is a tissue of extracellular matrix (ECM) and various cells including stem cells. SVF requires much laboratory processing for isolated and quantified clinical grade MSC to be obtained from this tissue. “Quantified” is a key criteria as a physician cannot be unaware of clinical relevancy of unless the SVF is laboratory processed.

On average a ±160mL aspirate sample will yield ±100mL of adipose that has a median (not average) yield of ±3-5 million stem cells (mainly MSC). The variance of MSC in 200mL adipose tissue can range between 20 thousand to 20 million dependent on a number of factors that no medical science research group has yet been able to predicatively determine.

The minimum amount of MSC that could be considered to treat (e.g.) a early Stage I or II knee joint with osteoarthritis (OA) is some 3-5 million in the published clinical literature. It’s somewhat pointless treating OA once as it’s a progressive disease; so you would need to give another larger sample for both knees to be treated (bi-lateral), or another sample to be treated 3-months later.

What we find mystifying is when clinics treating OA with an aspirate containing MSC charge (e.g.) USD 6,000 for one knee then offer the option of paying another USD 1,000 to treat the second knee. What we have here is a clinic without any idea of ‘dose characterisation’ dividing an ‘unknown dose’ into two.

SVF has been used to reduce the rejection of fat autografts in reconstructive plastic surgery. About 50% of ‘crude’ autografts fail in some respect of objective. Plastic surgeons pioneered SVF as an adjunctive fat autoggraft treatment as does offer useful cellular cross talk to establish the ECM and capillaries to the graft.

SVF can also be a very helpful initial treatment in (e.g.) chronic wound healing and OA if laboratory processed. Unsurprisingly, SVF has failed efficacy hurdles in clinical trails for serious conditions such as heart disease and neurological conditions; principally due to its low and highly variable MSC content.

We therefore we recommend laboratory processed use of SVF for subcutaneous administration only (not intravenous) in its traditional aesthetic fields or as describe above. SVF is also a lower cost MSC tissue banking option to partly defer future costs of MSC processing from this stem cell rich tissue. If you’ve having adipose removed (e.g.) liposuction, it’s certainly an option to consider.

Embryonic stem cells (ESC) are highly ethically controversial due to the tissue source; and, there’s a major safety issue with them. ESC don’t stop growing, as the pre-birth ‘off switch’ is absent, hence an ‘off switch’ has to be engineered. Teratoma formation remains the big safety concern with ESC. If not problematical, the clinical use of ESC seems almost impossible; they’re no longer considered the potential ‘holy grail’ of regenerative medicine.

Induced pluripotent stem cells (iPS) cells have been much heralded as another potential ‘holy grail’ of regenerative medicine. iPS behave like EPS but are engineered from an autologous skin cell biopsy that’s then backward engineered to produce autologous stem cell lines. iPS solve the issues with allogeneic stem cells. However, it costs USD 50,000 plus to derive a single iPS cell line over 4-5 months in the lab. In addition to Teratoma safety concerns; iPS also escape your immune surveillance system, which is undesirable for clinical use as (e.g. viruses) might not be detected by your body’s immune system leading to viremia and serious consequences.

It’s difficult to see how medical scientists are going to engineer something better than your own stem cells or their natural secretions (e.g. exosomes) where they are currently indicated. So why have others reinvent what you already own today – your body’s own ‘medical cabinet’?