Stem Cell and Platelet Rich Plasma (PRP) Therapies
Since late 2018 we have been using both Stem cell therapy and PRP therapy at our practice. I can see this being an incredibly exciting and useful tool in helping arthritic problems in dogs.
What is Stem Cell Therapy?
Stem cells can be harvested from a variety of tissues including skin, adipose (fat) and bone marrow. Fat-derived stem have a higher concentration than bone marrow and have shown a mix of “regenerative” cells. These stem cells, in the correct environment, can be transformed into numerous cell types including bone, cartilage, skin, nerves and muscle. Stem cell therapy involves retrieving stem cells from the patient and using them to treat the problem joints.
How do stem cells work?
At present there are several theories as to what exactly stem cells do. It is likely the more they are used the greater our understanding of their most important actions. We do know in an inflammatory environment the stem cells have three actions.
First: The stem cells can demonstrate regenerative capacity. That is to say they can change/regenerate cartilage and joint capsule cells.
Second: Stem cells support healing by releasing growth factors and cytokines that stimulate blood flow and tissue remodelling, while slowing down cell death.
Third: The stem cells act as a homing beacon, drawing circulating stem cells to the injured site. In addition the injected stem cells can migrate to areas of inflammation allowing for a targeted approach to healing.
What can stem cells treat?
At present we have only been using stem cell therapy for the treatment of chronic osteoarthritis / Degenerative Joint Disease in dogs where conventional pain relief is not doing a good enough job. In the future the conditions considered might include inflammatory bowel disease, kidney disease and atopy.
I would also hope that in the future rather than it being used as a last line of treatment for chronic cases we begin to use this treatment earlier in the disease process. Hopefully this would slow the development of the chronic degenerative conditions and so give dogs a happier life.
What does the treatment involve?
Stem Cell Harvest: The patient is anaesthetised and a small amount of fat taken through a small skin incision, normally from the groin or occasionally from the abdomen.
Stem Cell Growth: We then send this fat to an external laboratory where the patient’s own stem cells are isolated, grown, selected and grown again until there are several million stem cells. These stem cells are then sent back to us.
Stem Cells Injected: Once we know we have sufficient number of good quality stem cells we arrange for our patients to come back in. During a short general anaesthetic the stem cells can then be injected directly into the affected joints.
Platelet Rich Plasma (PRP)
Platelets are found in the blood and are responsible for the development of clots. Platelets also contain a remarkable array of growth factors involved in healing. The list includes platelet-derived growth factors (PDGF), ß-thromboglobulin, fibroblast growth factor, insulin-like growth factor 1, epidermal growth factor, and vascular endothelial growth factor. These growth factors are primarily responsible for the recruitment and differentiation of cells already in the body. This produces growth of blood vessels and new tissue.
Platelet Replacement Therapy takes advantage of the anti-inflammatory properties of platelets. Following an injury there is an immediate inflammatory response, evident by the heat and swelling noted at the injured site. Inflammation is essential to stopping the spread of infection, and for allowing the transport of inflammatory cells to the site of the injury. However, healing cannot take place until the inflammatory response stops. Platelets signal the white blood cells to help clean up the inflammation and release growth factors. This process ultimately inhibits inflammation and allows the recovery process to begin. With many chronic conditions the injured site remains in a perpetual state of inflammation, thereby impeding the healing process. PRP jump starts the recovery process by converting the injury from a site of inflammation to one of recovery.
What does the treatment involve?
Like stem cell therapy our patients undergo a general anaesthetic. Once asleep we collect some blood, which is then processed at the practice .
The red cells are removed from the blood and the the platelets present are concentrated to 3-7 times that of whole blood. This is our platelet rich plasma and this is injected directly into the affected joint(s). Thus PRP only requires a single anaesthetic and is completed at a single visit.
As with stem cells we are currently using this treatment for chronic joint and tendon injuries.
If you have any questions relating to anything above please contact us at the surgery.