These days the numerous consequences of being overweight are all too well known. Recently, however, mesenchymal stem cells have been successfully isolated from adipose tissue (fat). During development, mesenchymal stem cells give rise to:
- Cartilage cells
- Connective tissue
- Bone, among many other cell types.
For anyone that has had issues with joint cartilage or ligaments, they will be well aware that these tissues are stubborn in that they do not repair readily, as they receive limited blood supply.
Putting all of this together brings us to the magic – it is possible to give patients liposuction to collect their fat, isolate and culture the mesenchymal stem cells from the fat, and inject these cells into damaged joints to enhance recovery as the stem cells differentiate into cartilage cells and connective tissue.
Joint injections (intra-articular injections) of mesenchymal stem cells could be the solution to chronic joint pain.
By Zezounet (Own work), via Wikimedia Commons
I would think such a treatment would be particularly appealing to people that have gained weight due to hampered mobility as a result of joint injury, as it can get them back exercising and the liposuction can kick start their weightloss!
However, this treatment is not only appealing to overweight individuals. At the other end of the spectrum, elite athletes, such as Melbourne Demons player Clint Bartram are undertaking this treatment option, such is its potential to enhance joint repair.
A lean Clint Bartram in his fit, playing state seen here would look quite different now, having put on a significant amount of fat in preparation for an experimental treatment.
By Rulesfan (Own work) [Public domain], via Wikimedia Commons
Bartram is said to have gained 6kg in preparation for the procedure in order for a sufficient amount of mesenchymal stem cells to be harvested.
I was fortunate enough to have recently spent time with Bartram’s Melbourne Demons club doctor Dan Bates, who is a proponent of the treatment, and was able to sit in on some private consultations. As this type of treatment is still in its early stages and much of the evidence is anecdotal, it is the aim of Dr. Bates to establish a number of clinical research units so that data can be gathered about the amount of cells to be injected, what other factors the cells should be injected with, etc.
Most of the patients visiting Bates’ practice were seeking the experimental treatment, and while it would be tempting to approve this in order to gather precious data, Bates described how he preferred to advocate fish oil, glucosamine, and oral pain relief so that patients could focus on weight loss before any stem cell therapies were used. The reason is simple – when you do the maths, the loss of just 1kg of body mass extrapolates to around 10 tonnes less weight moving through one’s knee joint each day, and no amount of stem cells can provide this level of improvement.
In this way we appear to have ultimately come full circle to the view that extra weight has an overall negative impact, because even though overweight individuals may have an abundance of mesenchymal stem cells that can be isolated, the weight they carry is likely to have contributed to the deterioration of their joints in the first place. At first glance, mesenchymal stem cells may appear to be the perfect treatment, however, I would contend that if healthy habits are not established prior to the treatment, the temptation may be for people to use this as a quick fix and short-term solution to their weight and joint problems.