BONE MARROW VS ADIPOSE STEM CELLS

BY FRED G. ARNOLD, NMD

Two of the most common types of stem cells utilized in regenerative medicine today is bone marrow and adipose stem cells for the treatment of painful musculoskeletal conditions. There are definite benefits that have been reported with both types of cells and there are similarities and differences between these two types of cells.

Both bone marrow and adipose stem cells are considered autologous or self-derived. This means that they are gathered from their respective donor. These types of cells are considered mesenchymal stem cells (MSCs) and can be obtained from many tissues in the body, including fat, bone marrow and umbilical cord. A mesenchymal stem cell is a primitive cell with the ability to fight cell death, self-replicate and differentiate into multiple tissues such as bone, cartilage, muscle and fat. Each of these cells are anti-inflammatory and are not subject to rejection by the body since they are taken from the same body they are injected back into. Each of these cell types are used in clinical practice with both autologous platelet rich plasma (PRP) to optimize musculoskeletal tissue regeneration of ligaments, tendons and cartilage.

Bone Marrow Aspirate Concentrate (BMAC)
Bone marrow contains cells that are useful for regeneration, including MSC’s and CD34+ cells. One protein secreted by these cells is sox-9, useful in the formation of cartilage. The CD34+ cells are focused on angiogenesis or growth of new blood vessels. Bone marrow MSCs are usually extracted from the hip or knee utilizing a local anesthetic at the extraction side. The gathering process involves the concentration of the extracted cells from bone marrow and is referred to as bone marrow aspirate concentrate (BMAC). Bone marrow MSC’s have been used to safely treat various conditions with positive results. Some of the musculoskeletal conditions treated with autologous bone marrow mesenchymal stem cells include osteoarthritis, wound healing, and orthopedics.

Adipose (Fat) Derived Stem Cells (ADSC’s)
Fat is the body’s most abundant supply of adult stem cells, containing thousands of mesenchymal stem cells (MSC’s). These cells are taken from the patient’s own adipose (fat) tissue by performing a mini-liposuction procedure under local anesthetic. Since these cells are from the patient; therefore, there is not a rejection factor. Adipose derived mesenchymal stem cells are used in regenerative therapies due to their ability to differentiate into a variety of different cell types. These cells appear to be key regulators of new blood vessel formation (CD34+ cells) and mediate inflammation during tissue regeneration. As of July, 2016, there were approximately 130 active clinical trials investigating the potential of ADSCs listed on the US National Institutes of Health Website. These clinical trials involve soft tissue regeneration, skeletal tissue repair, ischemic injuries, myocardial infarction and immune disorders (including lupus, arthritis, Crohn’s disease, multiple sclerosis, diabetes mellitus, and many other conditions.

Comparison Chart: Bone Marrow vs Adipose Stem Cells

Summary
There are more similarities then there are differences with bone marrow and adipose stem cells. Both types of cells are autologous adult stem cells with the ability to regenerate tissue with documented clinical studies. Both types of stem cells have anti-inflammatory properties, promote new blood vessels and are minimally invasive. The retrieval process to gather adipose stem cells may take a little longer than bone marrow stem cells. CD34+ regenerative cells are present with each cell type. Many doctors consider bone marrow stem cells as the preferred stem cell for orthopedic injuries due to the improved focus of the bone marrow stem cells toward skeletal healing.

References:
1. Riordan, Neil PA, PhD, Stem Cell Therapy, A Rising Tide, Stem Cell Institute & Riordan-McKenna Institute, 2017,
2. ISRN Stem Cells, Volume 2013 (2013), Article ID 713959, 35 pages
3. Laura Frese, Petra E. Dijkman, and Simon P. HoerstrupTransfus Med Hemother, Adipose Tissue-Derived Stem Cells in Regenerative Medicine 2016 Jul; 43(4): 268–274. Published online 2016 Jul
26. doi: 10.1159/000448180, PMCID: PMC5040903