Life Uncoded is at the forefront of possibilities in medicine, breaking new ground in the use of stem cells in osteoarthritis.

The ability of stem cells to regenerate and revitalise human tissue holds boundless potential for the world of restorative and cosmetic medicine.

Although the term was first coined at the turn of the century, it wasn’t until the 1960s that research into the potential role of stem cells in medicine gained traction.

There are many different types of stem cells, each with very different potential to treat disease. Whilst embryonic stem cells exist only in the earliest stages of embryonic development, and go on to form all the cells in the adult body, adult stem cells are tissue-specific, and are committed to becoming a cell from their tissue of origin.

First isolated by Professor James Thomson, embryonic stem cells can today be removed and grown in a lab, continuing to divide indefinitely, and retaining the ability to form the more than 200 adult cell types.

With adult stem cells, taken from bone marrow, for example, scientists have not been able to achieve this. However, scientists can genetically modify adult stem cells, to make them behave like an embryonic stem cell. With their potential to take on any of the cell types in the body, these cells are referred to as induced pluripotent stem (iPS) cells.

While we wait for definitive results from Randomised Clinical Trials, there are many clinical trials currently investigating the potential role of stem cells to treat osteoarthritis.

Cosmetic surgeon Dr Mario Marzola has recently led a study on cell-based therapies for osteoarthritis. He reported that 75 percent of his osteoarthritis patients who received stem cell therapy showed significant improvement in pain and mobility of between 50 and 100 percent over the six-month assessment. Although these studies are not clinical trials, they contribute to a growing body of evidence to support the use of stem cells.

“While there are no double blind placebo controlled trials published as yet, there are thousands of other articles describing technique, safety and positive outcomes for correctly chosen patients,” says Dr Marzola.

Despite such promise, like IVF before it, regenerative medicine has fuelled controversies, and many urge caution in assuming stem cells are the ‘new frontier’ in medicine.

“There is the conundrum of do we wait and allow patients to go to joint replacement with its considerable morbidity, or do we offer them this alternative treatment with little morbidity?” says Dr Marzola.

Leading the way is Life Uncoded, which opened a new stem cell clinic in Melbourne to provide patients with medical technologies that harness the potential of stem cells.

“Life Uncoded was established as a recognised medical service provider to help people suffering from the debilitating effects of osteoarthritis who are seeking alternatives to surgery,” says Director Ruby Liu. “The clinic offers stem cell therapy for osteoarthritis based on the studies and results reported by doctors and thousands of patients in Australia and the US.”

Life Uncoded brings together Australian medical practitioners practising in stem cell therapy, using excellent protocols to deliver positive results.

The ethos at Life Uncoded is to adhere to the highest medical standards of patient handling, working in accredited premises and with accredited laboratories.

“Stem cell therapy has a track record of efficacy and safety if performed conservatively. It involves a team of doctors trained in liposuction for the harvesting of fat, an accredited laboratory to extract the stem cells from this fat, pathology testing and ultrasound guidance for safe joint injection,” says Dr Marzola, who has been appointed as Medical Director at Life Uncoded.

Osteoarthritis, a heavy burden of disease

According to an Australian Institute of Health and Welfare (AIHW) report (2014), arthritis and other musculoskeletal conditions affected an estimated 6.1 million Australians (28% of the total population) in 2011-12. More than half of people with arthritis (1.8 million) reported having osteoarthritis.

The Australian Burden of Disease Study (2011) revealed osteoarthritis is reported more frequently by females than males (10% compared to 6%) and was one of the leading diseases along with other musculoskeletal conditions, anxiety disorders, back pain and problems, and depressive disorders.

It also revealed that the prevalence of arthritis (including osteoarthritis, rheumatoid arthritis and other forms) varies in all ages and increases steadily across life stages (from less than 1% in children aged 0-15 to 19% in people aged 35-64 and 51% in those aged 80 or over).
The 2013 AIHW report showed that one in 20 deaths in 2013 were directly caused by or contributed to by musculoskeletal conditions (6,963 deaths).

According to the AIHW report on the Health Expenditure Australia, in 2008-2009, $5.7 million was spent on arthritis and other musculoskeletal conditions. From 2003-04 to 2012-13 there was a 47% rise in total knee replacements for osteoarthritis.

With the introduction of the Excluded Goods Order No. 1 of 2011, the Australian Therapeutic Goods Administration (TGA) draws a line separating the use of fat, cell-enriched fat and stromal vascular fraction cells from single lines of mesenchymal stem cells. The stem cell therapy through Life Uncoded is therefore permitted under the TGA, as it involves the use of stem cell therapy from a patient’s own fat. This therapy is regarded as having a reliable safety record.

Stem cell therapy in practice

Osteoarthritis is a degenerative joint condition that mostly affects the hands, spine and joints such as the hips, knees and ankles.

Age is the strongest factor in the development and progression of osteoarthritis. Other more modifiable risk factors are: being overweight, physical inactivity, joint trauma and repetitive joint loading tasks.

While early treatment of osteoarthritis focuses on the use of anti-inflammatory and pain relief drugs, medical practitioners developed alternative treatments to address different stages and severity of the condition including loss of function and more intensive pain.

Treatments range from minor procedures such as arthroscopy and hyaluronic acid injections to major operations involving total joint replacement. Injections of platelet rich plasma (PRP) into the joint are also successfully used. Dietary supplements include glucosamine and chondroitin, however the exact mechanism of action remains unknown.

Stem cell therapy can be used as an integrated approach to managing osteoarthritis. It can effectively provide relief from intense joint pain for people aged over 45, and can similarly prove effective for young or active people who have osteoarthritis after recovering from an injury or trauma.

“Diagnosis is key,” says Dr Marzola. “X-rays and MRI are analysed, and sports physicians, orthopaedic surgeons and physiotherapists are consulted to choose the correct treatment for the presenting complaint. It will be quite clear after this filtering which patients will be accepted for treatment. Arthroscopy may be required first to “clean out” the joint, or the osteoarthritis may have progressed to a point which is not recoverable with stem cells.”

“What we do know is that stem cells are as variable as we are as humans – some work very well and very quickly at healing, while others are a little slow. Most joints will need further injections over the years through more wear and tear, either of PRP or more stem cells,” says
Dr Marzola.

“A great majority of our patients experience an improvement described as no night pain, little daytime pain and more mobility, enabling everyday activities to be carried out with more comfort.”

The future of regenerative medicine

With its exciting and successful regenerative results and the increased knowledge about its virtually limitless potentials, there’s no denying that stem cell therapy is an area of medicine that is growing.

Dr Marzola says, “All medical treatments improve with time but it is fair to say that stem cell research is developing at a very fast rate. The expectation is that more osteoarthritis will be treated this way in the future.”

Through advancements in the understanding of genetics and cell biology, we are seeing the emergence of a new approach to treating many medical conditions that may someday ultimately replace the need for many surgeries and pharmaceuticals.

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