By Dr. Mercola
Kristin Comella,1 named No. 1 on the Academy of Regenerative Practices list of Top 10 stem cell innovators, has been a stem cell researcher for nearly two decades. In this interview, she discusses the enormous regenerative potential of stem cell therapy.
Comella, who holds degrees in chemical and biomedical engineering, began working with stem cells in graduate school, using a technique called magnetic cell sorting, which involves tagging nanoparticle magnets onto cells and then separating the cells based on the proteins they express.
"What we've learned over the years is that stem cells express different proteins than other kinds of cells in your body," she explains. "That began my career in the field of stem cells."
Stem Cells for Tissue Regeneration
Over the years, she's worked for several different companies. At a start-up in Maryland, she used stem cells from bone marrow (culture-expanded mesenchymal stem cells) for meniscus regeneration. By placing these cells directly into the knee joint, you can repair or even grow back a damaged meniscus.
For a time, she also headed up the Good Manufacturing Practices (GMP) facility at Tulane University, which is a U.S. Food and Drug Administration (FDA) facility located at the Tulane Center for Gene Therapy. There, her work revolved around using bone marrow mesenchymal stem cells for spinal cord regeneration.
For the past 13 years, she's worked for U.S. Stem Cell, a company founded in 1999. The company began bringing stem cells for cardiac care to the public. Muscle-derived stem cells can be used to repair heart damage associated with heart attacks. "Our company treated our first patient in 2001. Since that time, we've treated over 7,000 patients. We began looking at other indications about a decade ago. We also began looking at stem cells from a variety of different sources," she says.
Stem Cells 101
The primary purpose of stem cells is to maintain, heal and regenerate tissues wherever they reside in your body. This is a continuous process that occurs inside your body throughout your life. If you didn't have stem cells, your lifespan would be about an hour, because there would be nothing to replace exhausted cells or damaged tissue. In addition, any time your body is exposed to any sort of toxin, the inflammatory process causes stem cells to swarm the area to repair the damage.
"As an example, you might have gone to the gym this morning [and] … done some squats. As a result of that, you would get tiny tears inside the muscle. The stem cells that reside beneath the muscle would come out and repair all those tears.
The reason that, if you continuously go to the gym, you would start to build new muscle, is because those stem cells, hard at work underneath your muscle, are helping to repair and build that new muscle. This would apply to all of the tissues inside your body," Comella explains.
Nourishing and Protecting Your Stem Cells Benefits Your Health
While it's easy to think of stem cell therapy as a magic bullet, it would be wise to implement strategies that nourish and thereby help optimize the stem cells you already have in your body. As noted by Comella:
"You have to create an appropriate environment for these cells to function in. If you are putting garbage into your body and you're constantly burdening your body with toxins, your stem cells are getting too distracted trying to fight off those toxins. By creating an appropriate environment, optimizing your diet and reducing exposure to toxins, that will allow the stem cells that we're putting in to really home in and focus on the true issue that we're trying to treat.
The other thing we've discovered over the years is that [stem cell therapy] is not the type of thing where you take one dose and you're cured forever. Your tissues are constantly getting damaged … You're going to have to repeat-dose and use those stem cells to your advantage.
When you think about a lizard that loses its tail, it takes two years to grow back the tail. Why would we put unrealistic expectations on the stem cells that we're trying to apply to repair or replace damaged tissue? This is a very slow process. This is something that will occur over months and may require repeat dosing."
Stem Cell Sources
Historically, stem cells were isolated from bone marrow, and have been used for bone marrow transplants for cancer patients since the 1930s. However, you can get stem cells from just about any tissue in your body, as every tissue contains stem cells.
Your bone marrow actually has very low amounts of mesenchymal stem cells, which are now believed to be the most important, from a therapeutic perspective. Mesenchymal stem cells help trigger an immunomodulatory response or a paracrine effect, which means they send signals out to the rest of your body, calling cells to the area to help promote healing.
"What we've discovered in more recent years is that a more plentiful source of stem cells is actually your fat tissue. [Body] fat can contain up to 500 times more cells than your bone marrow, as far as these mesenchymal type stem cells go.
One thing that's also critically important when you're talking about isolating the cells is the number of other cells that are going to be part of that population. When you're isolating a bone marrow sample, this actually is very high in white blood cells, which are pro-inflammatory."
White blood cells are part of your immune response. When an injury occurs, or a foreign body enters your system, white blood cells will attack. Unfortunately, white blood cells do not discriminate, and can create quite a bit of damage as they clean the area out.
The Benefits of Isolating Stem Cells From Fat
Stem cells, in particular your mesenchymal cells, quiet down the white blood cells and then start the regeneration phase, which leads to new tissue. Bone marrow tends to be very high in white blood cells and low in the mesenchymal cells. Isolating stem cells from fat tissue is preferred not only because it's easier on the patient, but fat also contains a higher population of mesenchymal cells and fewer white blood cells.
"The benefit also of isolating [stem cells from] fat is that it's a relatively simple procedure. There's typically no shortage of fat tissue, especially in Americans," Comella says. "[Also], as you age, your bone marrow declines with regards to the number of cells in it, whereas the fat tissue maintains a pretty high number of stem cells, even in older individuals.
We can successfully harvest fat off of just about anyone, regardless of their age or how thin they are. The procedure is done under local [anesthesia], meaning that the patient stays awake. They don't have to go under general anesthesia. We can harvest as few as 15 cubic centimeters of fat, which is a very small amount of fat, and still get a very high number of stem cells."
Cost-Benefit Analysis
A stem cell procedure can cost anywhere from $5,000 to $15,000, depending on what you're having done, and rarely if ever will insurance cover it. Still, when you compare it to the cost of long-term medications or the out-of-pocket cost of getting a knee replacement, stem cell therapy may still be a less expensive alternative. Also, a single extraction will typically yield enough stem cells for 20 to 25 future treatments, should you decide to store your stem cells for future need.
"I think it's accessible for patients," Comella says. "It's an out-patient procedure. You plan to be in clinic for about two hours; no real limitations afterwards, just no submerging in water, no alcohol, no smoking for a week. But other than that, patients can resume their normal activities and go about their regular daily lives."
Interestingly, Comella notes that patients who eat a very healthy diet, focusing on organic and grass fed foods, have body fat that is very hearty and almost sticky, yielding high amounts of very healthy stem cells.
"We can grow much better and faster stem cells from that fat than [the fat from] somebody who eats a grain-based diet or is exposed to a lot of toxins in their diet," she says. "Their fat tends to be very fluffy, buttery yellow. The cells that come out of that are not necessarily as good a quality. It's just been very interesting. And of note, patients that are cigarette smokers, their fat is actually gray-tinged in color. The stem cells do not grow well at all."
Autologous Versus Non-Autologous Stem Cell Donation
What's been described above is what's called an autologous donation, meaning you're getting the stem cells from yourself. A number of companies provide non-autologous donations using cells harvested from other people, typically women, like amniotic or embryonic mesenchymal cells. This is an important distinction.
"There are now just a couple of studies that have been published comparing an autologous source, meaning cells from you own body, to an allogeneic source, meaning cells from someone else.
So far, what has been discovered is that the autologous cells, meaning your own cells, will outperform somebody else's cells inside your body. Now, this is not fully understood at this point. It may be that the environment that your cells function in, they're used to that environment. They recognize it. It's the same DNA and they can function well.
However, once you culture expand and get a pure population of these mesenchymal cells — not necessarily the sample that's coming right off of the liposuction, but a sample that has been taken to the lab and grown — those cells will not elicit an immune response if you use them in someone else. You could scientifically and medically use those in an unmatched person. However, there are some regulatory aspects of that with regards to the FDA."
In the U.S., there are a variety of new stem cell products available, referred to as amniotic, cord blood products or placenta products, which are prepared at a tissue bank. Such facilities must be registered with the FDA, and the products must undergo additional processing.
For example, they must be morselized, or snap frozen or blended in some way. Such processing typically breaks the membrane, releasing growth factors, and the resulting products are called acellular, meaning there are no living cells remaining in the sample.
Amnio Products Versus Embyonic Stem Cells
The amniotic products available in the U.S. are not so much stem cell products as they are growth factor products. According to Comella, they can be useful in creating an immunomodulatory response, which can help to promote healing, but that still differs from the living stem cell procedures that can be done by either isolating cells from your fat or bone marrow. As a general rule, you don't achieve the clinical benefits when using an amniotic product, primarily because they don't contain living stem cells.
"I want to contrast that to what are called embryonic stem cells," Comella adds. "The products obtained from cord blood, from women who are having babies, are not embryonic stem cells. Embryonic stem cells are when you are first bringing the egg and sperm together. Three days after that, you can isolate what is called an inner cell mass. This inner cell mass can be used to then grow cells in culture, or that inner cell mass could eventually lead to the formation of a baby.
Those are embryonic stem cells, and those are pluripotential, meaning that they have the ability to form an entire being, versus adult stem cells or stem cells that are present in amniotic tissue, [which] are multipotential, which only have the ability to form subsets of tissue.
When you're dealing with different diseases or damaged tissue or inflammation, mostly you want to repair tissue. If somebody has damage in their knee, they don't necessarily need embryonic cells because they don't need a baby in their knee. They need new cartilage in their knee."
Can Stem Cell Therapy Cause Cancer?
A common question is whether stem cells can cause overgrowth, leading to cancer or tumor formation. As noted by Comella, this is a problem associated with embryonic stem cells, which tend to grow very rapidly and can form a teratoma because of the rapid cell growth. Adult stem cells — the cells obtained from your own body — have growth inhibitions and will not form teratomas.
"The theoretical concern that has been addressed in animal models or in petri dishes is that if you take cancer cells that are growing in a dish and apply stem cells, it may make those cancer cells grow more rapidly. But this does not translate in-vivo to humans.
If there was truly an issue with applying stem cells to a patient who has cancer, we would know about it by now, because we've been dosing cancer patients with stem cells since the '30s. The safety profile is strong and there are tens of thousands of patients documented with these treatments," Comella says.
Platelet-Rich Plasma
Another useful therapy is platelet-rich plasma (PRP). Your peripheral blood contains platelets, which act as first responders when there's an injury. They come in and start the clotting mechanism, thereby preventing you from bleeding to death. They also give marching orders to other cells. For example, platelets can command stem cells to multiply and grow, or to differentiate and form new tissue.
These platelets also have many different growth factors associated with them, which can help to promote healing and stop inflammation. PRP involves taking a blood sample and then spinning the blood in a centrifuge to isolate the platelets. The platelet-rich plasma is then injected back into the area that is inflamed.
"One of the most common uses of platelet-rich plasma or PRP is in a joint. Now, platelets are going to be most successful in something that is rich in stem cells … [such as] an acute or a very recent injury.
If you just hurt your knee, the first thing you should do is get PRP, because it's going to help promote healing, and those platelets will attach to the surface receptors of the stem cells that are already going to the area to promote healing. It would be like putting fertilizer on your seed, which are the stem cells.
If you have something more chronic, this tends to be a stem cell-poor environment. In other words, you have osteoarthritis or you've got knee pain that's 5 years old and it's been there for a long time; just putting PRP in it would be like putting fertilizer on dirt without planting a seed first."
Clinical Indications for Stem Cell Therapy
The beauty of stem cell therapy is that it mimics a process that is ongoing in your body all the time. Your stem cells are continuously promoting healing, and they do not have to be manipulated in any way. The stem cells naturally know how to home in on areas of inflammation and how to repair damaged tissue.
"All we're doing is harnessing the cells from one location where they're sitting dormant and relocating them to exactly where we want them and we need them to work," Comella says. "Basically, anything inside your body that is inflamed, that is damaged in some way, that is lacking blood supply, the [stem] cells can successfully treat.
That means orthopedics, knee injections, shoulder injections, osteoarthritis, acute injuries, anterior cruciate ligament tears … in your back — back pain associated with degenerative disc disease or damaged tendons or ligaments, herniated and bulging discs. You can also use it in systemic issues, everything from diabetes, to cardiac, to lungs — any tissue organ inside your body that's been damaged.
Autoimmune diseases [can also be treated]. The stem cells are naturally immunosuppressant, meaning they can help quiet down an over reactive immune system and help the immune system function in a more normal way. Neurological diseases, traumatic brain injury, amyotrophic lateral sclerosis, Parkinson's. All of these have to do with tissue that's not functioning properly. The cells can be used to address that."
It's quite impressive, the list of different diseases that could benefit from this intervention. That said, I want to reemphasize that this is not a magic bullet. However, you can dramatically improve the benefits of this intervention by combining it with other healthy lifestyle factors that optimize mitochondrial function, such as eating a healthy whole food diet, exercising, sleeping well, avoiding toxins and detoxifying from toxic influences.
Stem Cells for Anti-Aging
Stem cells can also be used as part of an antiaging program. Comella has used stem cells on herself for several years, and report feeling better now than she did a decade ago.
"The ability to reduce inflammation inside your body is basically making yourself live longer. Inflammation is what kills us all. It's what makes our telomeres shrink. It's what causes us pain and discomfort. It's what makes the tissues start to die. The ability to dose yourself with stem cells and bring down your inflammation, which is most likely caused by any sort of toxin that you've been exposed to — breathing air is exposure to toxins — this is going to lengthen your lifespan.
I typically will do a dose every six to 12 months, regardless of what's going on. If I have anything that's bothering me, if I tweak my knee at the gym, then I absolutely will come in and do an injection in my knee. I want to keep my tissue healthy for as long as possible.
I want to stay strong. I don't want to wait until something is wrong with me. I think that this is the future of medicine. This is what we're going to start to see. People will begin to get their regular doses of [their own] stem cells and it'll just be common practice."
Banking Your Stem Cells Is an Investment in Your Future Health
Keep in mind there's a gradual and progressive decline in the quality and the number of stem cells as you age, so if you're considering this approach, it would be to your advantage to extract and bank your stem cells as early on as possible. U.S. Stem Cell provides a stem cell bank service, so you can store them until a later date when you might need them.
"Your stem cells are never as young as they are right now. Every minute that you live, your telomeres are shrinking. The ability to lock in the youth of your cells today can be very beneficial for you going forward, and for your health going forward. God forbid something happens. What if you have a heart attack? You're not going to get clearance to get a mini-lipo aspirate procedure.
If you have your cells waiting in the bank, ready for you, it becomes very easy to pull a dose and do an IV delivery of cells. It's almost criminal that we're not doing this for every single one of our cardiac patients. This should be standard practice. We should be having every single patient bank their stem cells at a young age and have them waiting, ready and available. The technology is there. We have it. I'm not sure why this technology is not being made available to everyone," she says.
"I think stem cell therapy is very different than traditional medicine. Stem cell therapy may actually make it so that you don't have to be dependent on pharmaceutical medications. You can actually repair the tissue and that's it. This is a very different way of viewing medicine."
More Information
If you're interested in having this procedure done, contact the U.S. Stem Cell Clinic on USStemCellClinic.com. You could either have the procedure done at their facility, or if there's a physician in your area providing the service, you can go there. U.S. Stem Cell can help you locate a qualified doctor.
Oftentimes, practitioners will specialize in specific procedures, such as spinal procedures, or knee procedures. There's also a veterinary division, called Vet Biologics, which offers treatment to small pets like cats and dogs, as well as horses.
"One of the things that we've been treating recently is traumatic brain injuries," Comella says. "We had a woman who fell two stories and hit her head. She spent months in a coma and was not able to talk or walk or do any activities. By the time she came to us, it was two years after her injury. The best hospitals in the world told her this was her life … 'You're never going to be able to talk or walk or take care of your young children again.' That was just not good enough.
She came to us and we began applying stem cells in a way to allow the cells to cross the blood-brain barrier and to get to her brain. After her first treatment, when she walked into the clinic on her own and began telling me, in full sentences, about the day she had the head injury, tears came down my face. This is the kind of thing that traditional medicine would say is impossible.
We've had patients who were wheelchair-bound, whether it's from multiple sclerosis or Parkinson's, up and out of their chair, literally jogging around cones. This is life-changing … Patients who were told they weren't going to return to sports for years are back on the field and playing. There's just many ways that you can heal your tissue to change the course of an injury or a disease."