Regenerative medicine is an innovative treatment method that uses stem cells to restore the function of damaged tissues and organs. This article will explain in detail the series of steps patients undergo when receiving regenerative medicine and how stem cells work in the body.
Treatment Process in Regenerative Medicine
1. Initial Consultation and Counseling
The treatment in regenerative medicine begins with an initial consultation and counseling. The doctor thoroughly checks the patient’s health condition and medical history to determine if regenerative medicine is appropriate. At this stage, detailed explanations about the effects, risks, and costs of the treatment are provided, and patients decide whether to receive the treatment based on a full understanding.
2. Stem Cell Collection
After deciding to receive treatment, the next step is stem cell collection. In many cases, stem cells are collected from the patient’s own body (autologous stem cells).
Collection from Adipose Tissue:
Under local anesthesia to minimize pain, a small amount of adipose tissue (about 5-10mg) is collected from areas such as the patient’s abdomen. This method is relatively less burdensome and can yield a large number of stem cells, making it a focus of recent attention. The collection process usually takes about 30 minutes.
Collection from Bone Marrow:
There is also a method of collecting bone marrow fluid from the hip bone. This method requires general anesthesia and may necessitate hospitalization.
3. Stem Cell Culture and Proliferation
Stem cells are isolated from the collected tissue and cultured and proliferated in specialized cell culture facilities. This process typically takes 3-5 weeks. During cultivation, stem cells are increased to the number necessary for the patient’s treatment. Quality control tests, including cell count, viability, and sterility, are also conducted.
The following points are carefully monitored during the culture process:
- Maintenance of a sterile environment
- Supply of appropriate nutrients
- Monitoring of cell proliferation status
- Regular testing for quality control
4. Stem Cell Administration
The cultured stem cells are administered to the patient’s body using an appropriate method based on their condition and treatment purpose. The main administration methods include:
- Intravenous Administration: Stem cells are administered throughout the body via infusion. This is suitable for systemic diseases or conditions affecting multiple organs.
- Local Injection: Stem cells are directly injected into the affected area. This is effective for localized problems such as joint diseases or skin conditions.
- Arterial Catheter Administration: This method is used to deliver stem cells efficiently to specific organs or tissues. It may be used in the treatment of heart diseases or cerebral infarction.
The administration typically takes about 1 to 1.5 hours.
5. Follow-up Observation
After stem cell administration, regular follow-up visits are conducted. Depending on the symptoms, multiple infusions may be given every 2-3 months. Check-ups are performed 1-16 weeks after stem cell administration.
The following points are checked during follow-up observations:
- Degree of symptom improvement
- Presence of side effects
- Overall physical condition
- Consideration of additional treatment if necessary
Mechanism of Action of Stem Cells in the Body
When stem cells are administered into the body, they circulate in the blood vessels, then move through the vessel walls towards the affected area and enter the tissue of the affected cells. The stem cells that have entered the affected area release special substances to repair and regenerate damaged cells, activating the target cells over 3-4 months. They exert therapeutic effects through the following mechanisms:
1. Homing Effect
Administered stem cells possess a special ability called the “homing effect.” This is the ability of stem cells to sense specific chemical substances (cytokines and chemokines) released from damaged tissues or inflammatory sites and move towards their destination following the concentration gradient of these substances.
The homing effect allows stem cells to automatically gather at necessary locations, increasing the efficiency of treatment. It also helps to suppress stem cell proliferation and action in unnecessary areas, potentially reducing side effects.
2. Paracrine Effect
Stem cells secrete various growth factors and cytokines, influencing surrounding cells. This action is called the “paracrine effect” and brings about the following effects:
- Anti-inflammatory Action: Secretion of anti-inflammatory cytokines such as IL-10 and TGF-β to suppress inflammation.
- Tissue Repair Promotion: Secretion of growth factors such as VEGF, HGF, and IGF-1 to promote tissue repair.
- Cell Survival Promotion: Suppression of apoptosis (cell death) of surrounding cells and promotion of survival.
3. Differentiation and Replacement
Stem cells can differentiate into various types of cells as needed and replace damaged cells. For example, they have the ability to differentiate into various types of cells such as bone, cartilage, muscle, and nerve cells. The differentiated cells directly complement the function of damaged tissues.
4. Immunomodulatory Action
Stem cells have a powerful regulatory effect on the immune system:
- Suppression of T cell and B cell activation, reducing excessive immune responses.
- Promotion of regulatory T cell production, suppressing autoimmune reactions.
- Conversion of macrophage polarity from pro-inflammatory (M1) to anti-inflammatory (M2) type.
These actions are expected to improve symptoms of autoimmune diseases and chronic inflammatory diseases.
5. Promotion of Angiogenesis
Stem cells promote the formation of new blood vessels:
- Secretion of angiogenic factors such as VEGF stimulates the formation of new blood vessels.
- Improved blood flow increases the supply of oxygen and nutrients to damaged tissues.
6. Tissue Remodeling
Stem cells promote tissue reconstruction:
- Regulation of the balance between production and degradation of extracellular matrix.
- Suppression of scar tissue formation and promotion of normal tissue structure recovery.
These complex mechanisms allow stem cells to promote the repair of damaged tissues and functional recovery. However, the degree of effect varies depending on the type of disease and individual condition.
Conclusion
Regenerative medicine is an innovative treatment that utilizes the diverse capabilities of stem cells to aim for functional recovery of tissues and organs that were difficult to treat with conventional methods. The treatment process is carefully and meticulously planned, from initial consultation to stem cell collection, cultivation, administration, and follow-up observation.
Stem cells administered into the body gather at necessary locations through the homing effect and promote tissue repair through paracrine effects and differentiation abilities. Furthermore, they provide systemic therapeutic effects through immunomodulatory actions and angiogenesis promotion.
Regenerative medicine is a rapidly developing field, and further research and expansion of clinical applications are expected in the future. The potential of regenerative medicine is vast, but it also requires careful handling. It is important to fully consider the condition of each patient and select the optimal treatment method. With the advancement of future research, the realization of safer and more effective regenerative medicine is anticipated.
<References>
1. Fujita, M., Hatta, T., & Ide, K. (2022). Regenerative medicine provided as treatment, safety and efficacy questioned – Structural issues in regenerative medicine law? Center for iPS Cell Research and Application (CiRA), Kyoto University. https://www.cira.kyoto-u.ac.jp/j/pressrelease/news/220902-000000.html
2. Kinshukai Medical Corporation. (n.d.). Stem cell therapy. Official Anti-Aging Site | Kinshukai Medical Corporation. Retrieved February 28, 2025, from https://kinshukai.or.jp/haac/stemcell/
3. Nagoya University School of Medicine. (n.d.). Regenerative medicine using adipose-derived stem cells. Nagoya University School of Medicine. Retrieved February 28, 2025, from https://www.med.nagoya-u.ac.jp/kidney/patient/regeneration_therapy_asc.html
4. Renée Clinic Tokyo. (n.d.). Stem cell therapy – Regenerative medicine clinic | Renée Clinic Tokyo. Retrieved February 28, 2025, from https://renee-clinic.jp/about/stemcell/
5. Saishukan Hospital. (n.d.). Treatment flow – Saishukan Hospital Regenerative Medicine Special Site. Retrieved February 28, 2025, from https://saishukan.jp/saisei/nagare/