There has been an explosion of interest in the possible remedial effects of mesenchymal stem cells (SCs) on osteoarthritis. In fact, in the November 2011 issue of the journal, Arthroscopy, there were two articles on mesenchymal SCs and three articles on the use of enhanced platelet rich plasma.
In addition, descriptions of mesenchymal SCs being used with various matrices for osteoarthritis are coming out of the rheumatology literature as well.
In fact, the use of materials such as mesenchymal SCs and platelet rich plasma has spawned an entire specialty, regenerative medicine.
With each new article, there is more and more evidence that SCs and associated growth factors can help the body to heal connective tissue disorders.
In previous articles I've discussed the science, the rationale, the various types of stem cells, and the variety of techniques used to perform a stem cell procedure.
With this article, I will highlight some of the dangers.
As with any new area of medicine, there are specific concerns that need to be addressed.
SC treatment is no different. The obvious first concern is infection. Since administration of stem cells involves an invasive set of procedures, it is important to realize that infection is a potential problem.
Special care to ensure the technique is performed in a sterile environment, preferably a surgical center, is advisable. Strict adherence to sterile preparation, as with any other operative procedure, is imperative.
The administration of perioperative antibiotics should be considered.
Another possible problem- less so with autologous (a patient's own) SCs, but definitely with donor or induced pluripotential SCs, is rejection. The SCs are viewed as a foreign protein by the host when considering a donor or an induced pluripotential source. The use of anti-rejection therapy is a consideration but should be administered with the utmost caution. Anti-rejection drugs carry their own set of issues.
Dove-tailing with rejection is the possibility of graft versus host reaction. This can be a complication of any organ transplant and SCs coming from any source other than the recipient can be the cause of this.
Another potential problem with SCs is the development of malignancy. The danger is probably less with autologous SCs than it is with other types. Malignancy has been reported with the use of embryonic SCs on at least two occasions in the literature.
Transmission of genetic disorders is also a danger, particularly with donor SCs. Despite careful screening, this remains a very real problem.
In summary, SC science and clinical application is an exciting new area for both research scientists as well as clinicians. Special precautions need to be taken in order to ensure, this new technology is administered in both a safe as well as effective manner.
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