Dr. Pamela Schwartz, DVM, DACVS, CCRP is a Staff Surgeon at The AMC. Dr. Schwartz is also a Certified Canine Rehabilitation Practitioner. Her current interest and professional focus includes soft tissue and orthopedic surgery, as well as stem cell therapy. Recently, she participated in the 2013 NYC Olympic Distance Triathlon in order to raise money for a fund available to help sick animals that would otherwise not have had a chance.
Stem Cell Therapy
Pamela Schwartz, DVM, DACVS, CCRP
The discovery that cells, which already reside within each of us, have the capability to regenerate and enhance repair or promote self-healing has made stem cells the topic of a lot of investigation. Simply put, stem cells are primitive cells that have the capability of self-renewal (dividing) and differentiating or turning into a particular cell line, for example, a skin cell or a cardiac muscle cell. There are two types of stem cells: embryonic stem cells and adult stem cells.
Embryonic stem cells come from the cells of the early stage of an embryo. These cells are intended to form animals as a whole and can differentiate into any cell type. These cells, if used medically, could be rejected as they would have a different genetic makeup from the potential donor. This and due to the fact the embryonic stem cell research is very controversial makes them less appealing for use in veterinary medicine.
Adult stem cells are present in most tissues. They can differentiate into many tissue types and there is no risk of rejection if the cells are used autologously, meaning derived or transferred from the same individual's body. Studies are also being developed looking into the use of stem cells within the same species. Use of adult stem cells medically also avoids the controversy seen with embryonic stem cells.
Stem cells are present in almost every tissue within the body, however, they are readily available within the bone marrow and in fat. When stem cells are obtained from the bone marrow they have to go through a process called expansion or culture because the numbers obtained from a single sample are small. The benefit of isolating stem cells from fat is that no expansion is needed because of a higher number of stem cells within fat. Stem cells derived from fat have been shown to have the capability of self-renewal and differentiation into particular cell lineages.
What makes stem cells so exciting, is not only can they turn into particular cells types, but that they also have many other mechanisms by which they can repair tissue. Stem cells work by a process of signaling. The cells produce proteins, which is a way the cells communicate to one another. Certain environments within the body can promote a lot of signaling. For example, inflammation is a form a signaling. If cells are damaged, they let out proteins (signals) to communicate with other cells that help is needed to repair the area. Stem cells like signaling, so if put within this environment, they will help with repair. They can help with repair in several ways. To name a few, they can decrease bad inflammatory signaling and increase good inflammatory signaling, they can decrease scar tissue formation, they stimulate resident stem cells to become activated, and they also have a direct effect on pain receptors.
There are potentially many indications for the use of adult stem cells in the veterinary world. For orthopedic problems, there are studies that show adult stem cells are both safe and efficacious for use with chronic arthritis in dogs, in particular in the hip and elbow. These studies showed that stem cells decreased lameness, increased range of motion, and decreased pain in dogs that received stem cells injected directly into their arthritic hips or elbows. The author has used stem cells to treat several dogs with arthritis in the hips and/or elbows. There is a screening process that dogs and cats should go through to ensure they are a good candidate for stem cell therapy. Likewise, there are certain disease processes that may exclude your pet from being a good candidate for stem cell therapy. Stem cell therapy has also been used for other orthopedic conditions such as tendon injuries or other inflammatory joint diseases.
There are also a plethora of soft tissue conditions that may be alleviated by stem cell therapy in both people and animals: liver disease, kidney disease, cardiac disease, wound healing, dental disease (ie. stomatitis), dermatologic diseases to name a few. Stem cell therapy is still at its infancy for many soft tissue disorders. Many studies in the form of clinical trials are needed to determine if they are effective. There is an ongoing clinical trial at the Animal Medical Center for qualifying cats with chronic kidney disease. The purpose of this study is to investigate the efficacy of the administration of autologous fat derived stem cells to aid in the enhancement of renal function by their regenerative capabilities, with the ultimate goal of improving survival in cats with chronic kidney disease. If your cat qualifies, he or she would receive free stem cell therapy and long-term management (up to 3 years) in the clinical trial.
Stem cells can also be obtained from your pet at the time of spay or neuter and cryopreserved for later use in the medical therapies, similar to umbilical cord blood banking in people. People and animals have a higher number of stem cells when they are younger, as you slowly utilize stem cells throughout life. Therefore, you can obtain a higher yield of stem cells in younger patients. Whether or not adult stem cells are obtained from a young or older pet, because stem cells can be replicated, a pet should have a continual or lifetime supply of stem cells for the future.
Stem cell therapy in both people and animals holds much promise in the medical world. Although we know a great deal about stem cells and what they do, there is still much to learn. Ongoing research in the human and veterinary world has exciting potential for major advances in how we treat several disease processes.
To determine if your pet is a candidate for treatment with adult stem cells or a candidate for one of AMC's ongoing clinical trials, you can contact the Animal Medical Center at 212-838-8100.
The Animal Medical Center is a non-profit veterinary center that has been a national leader in animal care since 1910. As an academic veterinary hospital, The AMC promotes the health and well-being of companion animals through advanced treatment, research and education. The AMC staff is comprised of 103 veterinarians who utilize an interdisciplinary team approach combining expertise across specialty areas and services to care for your pet 24 hours a day, 365 days a year. For more information about The AMC:
http://www.amcny.org
http://www.amcny.org/surgery/neurosurgery/stem-cell-therapy
http://www.amcny.org/node/83
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