Trish: Hi, I am here today with Dr Ben Herbert. He is the Associate Professor of Translation and Preventative Medicine at the University of Sydney. We are here at the Laser and Cosmetic Medicine Conference in Melbourne.
So we are just going to talk about stem cells and all the research that Dr Herbert is doing with regards to that.
So Dr Herbert, what is a stem cell, just to start off with the basics?
Dr Herbert: A stem cell I think you can think of it as a progenitor cell. Stem cells gives rise to more specialised cells so in some ways the ultimate stem cell is a fertilised egg and then turns into a person and then as you go through the process of embryogenesis, all the tissues in your body then have their own dedicated adult stem cells that are involved in tissue repair and replacement. And so a stem cell when it turns into a more specialised cell it also has to make a copy of itself.
So a stem cell is really a progenitor cell designed to support your tissue and be involved in the process of repair.
Trish: Ok, so what is cell based regenerative medicine?
Dr Herbert: The one that most people will have heard of that’s been around the longest time is bone marrow transplants and that’s been around now for 50 years or more. All the cells in your blood are made by hematopoietic cells in your bone marrow. For cancer therapy for people with blood cancers like leukemia, they are often transplanted either their own or somebody else’s stem cells to replace the damaged cells after chemo and radio therapy. So that’s the sort of therapy that people have heard about the most.
The sort of therapy we work off is not with hematopoietic stem cells, it’s with mesancheimic stem cells which are connective tissue support stem cells. There are a few of them and (with) bone marrow they live in the vasculature of your body; they’re in every tissue in your body and we work with them from fat, really because fat is relatively easy to get, it’s not incredibly invasive to get it, but fat is very highly vascular based and there are lots of mesancheimic stem cells that come when you do a fat harvest; and then they are fairly easy to purify. Their role inside your body – they’re really the basement of your immune system. They work with your immune system to modulate how it reacts to injury. And most of the injuries that you sustain, whether they’re that you cut yourself, whether you have heart attack, or stroke, or even arthritis, there is a supply of nutrient tissue it’s an ischemic injury where you’ve damaged the blood supply, and if you think about cosmetics often that’s the case as well. Whether somebody’s having a procedure where the skin is being cut, you are looking for high quality healing with minimal fibrous scarring, mesancheimal stem cells play a key role in that process. In the context of this conference, what I was talking about what people are interested in, is how can you can use these sorts of stem cells from fat, and there’s a lot of people here who work with fat frequently, how can they use fat and the stem cells in it to enhance the king of effects their getting and get better heading with less scarring.
Trish: Ok, well, the benefits of fat!
Dr Herbert: Yes, that’s right.
Trish: Liquid gold! So, how do you know where to get stem cells from if 90% are actually gone by our teenage years? Is that true?
Dr Herbert: We lose stem cells at quite a rate after we are born. And so people will notice that they scar a bit more as they age. But the interesting thing with fat is that it’s very rich in vasculature and very rich in these cells, so it’s one of the few tissues we can harvest it and get sufficient cells out of it even in quite elderly people to play a numbers game so we can you can concentrate one or two hundred mls of fat down to quite a small volume, and get a concentrated amount of these cells to the site where they can really have an effect. So in most cases, even though you are dealing with people who may be middle aged or elderly, you can still achieve a very positive outcome using cells from fat.
Trish: Ok, thank you, that’s made it a lot easier to understand. So how does your work with cell based regenerative medicine fit in with the plastic surgery industry?
Dr Herbert: When mammals evolved, what evolved with us was scarring, and the process of scarring was one of the trade-offs that we had to go through to become a mammal, it’s very energy intensive to be a mammal, and so scarring is a way to put a band aid on the problem stopping you further tissue damage. So our work is in muscular-skeletal most of the time in arthritic, but there’s scarring in joints just like everywhere else. There is scarring with the brain when you have a stroke, there is scarring on the heart, and of course everybody’s aware of fibrous scarring in the skin. What mesancheimal stem cells do is they are able to minimise a scar formation and maximise scarless healing. And so in many ways, understanding how you can use them and how they work with your immune system to get high quality scarless healing, is applicable across a whole range of different issues across the body from things like heart failure and strokes to muscular skeletal conditions like arthritis and wound healing, and that’s where applicability comes in the cosmetic industry.
Trish: Ok. That makes so much sense as well. And with the high Q stem cell therapy, are the injections themselves taken from a person’s fat tissue into their affected joints or tendons?
Dr Herbert: Yes, that’s what we’ve done. So regeous development technology was commercialised in 2011 – more than 500 people are being treated now. Most people have multiple joints treated – well over a thousand joints injected. What you typically see is lot of decreasing pain… about 80% of people see a significant decrease in pain but importantly what our work has shown, and other groups around the world are also starting to see this; that you get decreased degradation of cartilage. So the cells with their anti-inflammatory effect, are able to decrease the production of the enzymes that degrade cartilage, and so you can slow the progress of osteoarthritis. In experimental animals and in younger people, cell-therapy is able to regenerate cartilage. The older you get the harder that is to do, and the more advanced the disease is, the harder regeneration of cartilage is to achieve but even slowing and stopping the progress of the disease is a major step forward – and that combined with decreased pain is powerful for a lot of people. So that’s where our technology has been, but like I said, the understanding of what these cells do and how they work is effective in a whole range of areas.
Trish: So, it’s almost like the next step up from PRP? Would you say, or is it different?
Dr Herbert: I mean it’s the same but it’s different. So PRP you’re really looking for the anti-inflammatory proteins and the growth factors that are released by platelets, and they are certainly very rich platelets, but platelets don’t persist in the body, so the difference with stem cells is they do – they engraft and they persist and they respond to what’s happening at the local environment. So if there is an inflammatory process happening they will respond and secrete what is required. So in that sense they’re like a super charged platelet replacement therapy that’s more persistent, that’s more responsive. But essentially driven by those secrete factors.
Trish: Thank you so much, so we’re going to live a whole lot longer, and look a whole lot better. That’s been so great to hear someone with so much knowledge, and get so much insight into the new stem cell technology that is at the forefront of the industry today.