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Osteoporosis
Published in Jason Liebowitz, Philip Seo, David Hellmann, Michael Zeide, Clinical Innovation in Rheumatology, 2023
Mazen Nasrallah, Marcy B. Bolster
Stem cell therapies. Stem cell and regenerative therapies are becoming increasingly important in many chronic diseases. In osteoporosis, there is growing interest in the application of mesenchymal stem cells to enhance bone repair and regeneration. Mesenchymal stem cells are stromal stem cells that can be harvested from multiple sources and differentiated into osteoblasts or osteogenic chondroblasts. The mechanism of such therapy in bone repair has not been fully elucidated; however, it acts at least partially via a paracrine effect whereby mesenchymal stem cells secrete growth factors locally.62
AI and Autoimmunity
Published in Louis J. Catania, AI for Immunology, 2021
All medical treatments have benefits and risks, but unproven stem cell therapies can be particularly unsafe. The FDA will continue to help with the development and licensing of new stem cell therapies where the scientific evidence supports the product’s safety and effectiveness.52
Turning Blood into Liver
Published in Richard K. Burt, Alberto M. Marmont, Stem Cell Therapy for Autoimmune Disease, 2019
Bryon E. Petersen, Neil D. Theise
The SDF1α/CXCR4 interaction is unique, meaning that CXCR4 is the only known receptor for SDF1α and because of its specificity and its location throughout the body it makes this protein-receptor interaction a good candidate for homing bone marrow derived cells to various sites of injury. This interaction could also be viewed as a signal to initiate the oval cell compartment in certain forms of liver regeneration. These experiments begin to shed light on the age-old problem of what exactly is the mechanism in oval cell activation, and may bring into focus the reason why cells migrate to the liver under certain injury models. This may some day lead to a better understanding of the hepatic and hematopoietic interaction in oval cell activation and proliferation. This may in turn lead to better clinical relevance in treatment of patients through stem cell therapies, but clearly, further experiments are needed.
Emerging biological therapies for the treatment of age-related macular degeneration
Published in Expert Opinion on Emerging Drugs, 2021
Masumi G. Asahi, Jaycob Avaylon, Josh Wallsh, Ron P. Gallemore
The intraocular delivery of medications carries an inherent risk of endophthalmitis, intraocular inflammation and retinal detachment, with anti-VEGF medications also having rare association with systemic side effects, such as thromboembolic events, myocardial infarction and stroke [125,126]. Currently developing therapies such as the port delivery system, gene therapy and stem cell therapy will carry their own risks as well. Given the surgical nature, more ocular adverse events were reported with the RPDS compared to monthly intravitreal injections, including vitreous hemorrhage (4.5%), retinal detachment (2.8%) and endophthalmitis (1.7%)[89]. Similarly, stem cell therapies require surgical intervention which inherently incurs more risk along with the theoretical concern for malignant transformation with these implants.
Pharmacotherapeutic considerations and options for the management of osteoarthritis in women
Published in Expert Opinion on Pharmacotherapy, 2020
Sunny Trivedi, William Fang, Ishan Ayyalasomayajula, C. Thomas Vangsness
From the Osteoarthritis Research Society International (OARSI) guidelines, the only listed pharmacotherapy treatments appropriate for specific subphenotypes of OA include acetaminophen (paracetamol), duloxetine, oral NSAIDS, and COX-2 selective and nonselective [123]. In the clinical setting, there has been a gradual shift of patients away from the reliance of medication for symptomatic control, especially due to the opioid crisis. On the other hand, more and more patients are seeking biologics and ‘stem cell’ treatments. The prospect of treating knee cartilage/osteoarthritis with biologic cell treatments has garnered significant attention from both research scientists and clinicians. The injection of mesenchymal stem cells (MSCs) into the intra-articular joint has shown to secrete various trophic factors that can attenuate both inflammation and pain. There is a growing number of clinical trials that are showing efficacy with different biological cell treatments. However, this regenerative field is still in its infancy and there is a critical lack of level I evidence. Patients and clinical providers need to be wary of the increasing numbers of unproven stem cell therapies and clinics that are appearing throughout the country. These clinics are often touting unapproved and potentially unsafe products to vulnerable patients desperate for a potential cure. As our understanding of the complex biology of osteoarthritis and the information surrounding it improves, newer and more effective treatments may decrease the suffering of osteoarthritis in a more efficient and less costly way.
Stromal vascular fraction technologies and clinical applications
Published in Expert Opinion on Biological Therapy, 2019
Isabel Andia, Nicola Maffulli, Natalia Burgos-Alonso
This review identifies broad trends of conditions in which SVF technology is used and the current clinical state of the art. The low number of published clinical studies in any pathology contrasts with the commercial expansion of automated devices and available protocols. Moreover, clinics offering unproven stem cell therapies are now widespread in the USA and Canada, offering treatments for everything from orthopedic problems to sexual enhancement to complex neurological, immunological, cardiovascular and respiratory diseases. Few clinics publish the methods used to purify and prepare cells, and in some cases, they do not share information on the cell types used [38]. Unproven SVF therapies, although likely safe, can cause large financial loss and the erosion of public trust, being evidence-free therapies.