The potential cure in those extra kilos.

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.

5 Responses to “The potential cure in those extra kilos.”

  1. Karl Trounson says:

    Hi Worthing,
    Hmm, I believe the endpoint of this type of work was to culture and use the mesenchymal stem cells themselves. However, in the preliminary stages of the technique, which is what is taking place now, a lot of patients are receiving similar, safer, less experimental treatments. For example, blood can be taken from patients, the cellular components extracted, and the remaining platelet rich plasma injected into injured joints, as platelets aid recovery.
    In Australia, there are restrictions on the work that can be done with stem cells. However, in other countries, such as China, there are fewer restrictions, so many people have had mesenchymal stem cell therapies. The problem is, very few of these patients have been followed up, and the evidence around the effectiveness of mesenchymal stem cell therapies is largely anecdotal. This is what the Australian clinics are trying to rectify, by laying a strong foundation of clinical research as to the effects of the therapy. As you say, the microenvironment of different tissues has a huge impact on the differentiation of the stem cells. Therefore, a lot of research is being conducted around using matrices to accompany the stem cell injections, to keep the cells in place and provide them with the relevant growth factors, hormones, etc. for the location they are in.
    That’s a very interesting story about your uncle. Tell me, what do you make of the balloon angioplasty and vein stenting procedures I keep hearing about that are said to cure MS in some circumstances?

  2. worthing says:

    Very interesting!
    Do you know if the proposed treatment involves culturing the mesenchymal stem cells or actually just using the purified fat stores?
    Having done some tissue engineering and with a major in biochemistry I can’t help but cringe at the thought of introducing stem cells into the body (even if they have been taken from one place In a patient to be put in another).
    The potential for stem cell therapies was thought to be endless, only to have all of the hopes and dreams of many scientists come crashing down when they realized that stem cells have a high likelihood for tumor development when placed in new environments.
    It’s hard to imagine that the microenvironment of every tissue, and organ within our body is different. Hormone signals, growth factors and surrounding cell types all play a vital role to how cells within that environment behave and react.
    Bone marrow transplants have been the only successful application of stem cell therapies in a clinical setting that I am aware of, I was lucky enough to witness a pioneering medical advance first hand.
    My uncle had severe MS and was then diagnosed with terminal cancer, as apart of his cancer treatment he was one of the first patients in Melbourne to receive a bone marrow transplant.
    His cancer went into remission for many years and we were lucky enough to get to spend a longer time with him.
    Interestingly the bone marrow transplant also helped with the severity of his MS, he had reluctantly become wheel chair dependent for about 2 years prior to the transplant. Following his treatment he regained functional use of his legs, increased fine motor control and most of his other symptoms of his MS including his lesion sizes were greatly reduced.
    Clinicians were astounded by this occurrence, he was one of the first instances of MS remission following a bone marrow transplant. Now, some 10 years later bone marrow transplants have become a form of standardized care for those suffering severe MS.
    I must say the cheeky bugger was very thankful for regaining the function of his legs, once well enough he went to sydney just to climb to the top of the Sydney harbor bridge. I have a very impressive photo of him in the herald sun, at The top of the SHB holding his wheelchair above his head!

  3. Natalia Chodelski says:

    This is a wonderful article Karl! I had no idea fat cells could contain stem cells, and i know my own father struggled with a joint injury healing. He is one of those who could do with some healthy habits too!

  4. Karl Trounson says:

    Sure, osteoarthritis falls into the category of what these cells can treat, because this is a condition related to the loss of cartilage in joints with age.

  5. Ginger says:

    There are also similar usage on arthritis patients using fat tissues from one’s body (mainly from the bottom) and inject into the joints to treat the disease. Amazing use for the fat cells!