Evaluating a Brave New World of Regenerative Sports Medicine
DR. ALBERTO ABREBAYA AND DR. BEN PEARL
By regrowing the nascent cells, the injury can heal without the formation of dreaded scar tissue. Platelet-derived growth factors from PRP are monoclonal, therefore may be less effective in activating the damaged tissue cells to synthesize the interleukins, cytokines and prostaglandins necessary for the chemotaxis and adult stem-cell recoding. Recruitment of the subject’s adult stem cells is hampered further by the significant differentiation of the adult mesenchymal stem cell, thus blocking the pathways to regrow into tissue progenitor cell lines. To improve these odds, leukocyte-rich supernatant can be extracted from the patient, but this requires a much larger volume (about a pint) of blood exfusion.
The placenta has been used for a century as a source of human donor tissue because of the regenerative properties provided by its natural biocompatibility, undifferentiated mesenchymal stem cells and lack of host rejection.1 Mesenchymal stem/progenitor cells (MSCs) are present in the fetus (blood, liver, bone marrow, and kidney) and sparsely present in the adult human body (bone marrow, kidney, liver and lung). Research has shown that placenta-derived cells have multilineage osteogenic and adipogenic differentiation potential similar to MSCs in terms of morphology, cell-surface antigen expression, and gene expression patterns. The placenta is therefore a useful source of MSCs.
Amnion cells are immune-privileged, lacking host vs. graft rejection. This immune naiveté is characteristic of the fetally-derived and maternal blood cells formed by the villous trophoblastic barrier. This contact between fetal foreign cells to the foreign immune system is the simulate, the genesis of similar embryonic tissue cell lines in the fetus. These properties make placental an ideal treatment option for acute musculoskeletal injuries as well as chronic symptomatic conditions such as tendinosis and plantar fasciosis.