Amniotic Stem Cell Therapy

Ross Hauser, MD

Amniotic stem cell therapy is not stem cell therapy

The first thing that should be pointed out about amniotic stem cell therapy is that amniotic stem cell therapy is not stem cell therapy. Many companies who collect and process amniotic fluid material from new mothers following a C-section birth describe their processed materials as “Amniotic stem cell therapy.” This is inaccurate.

These companies are selling material that they tell people are ready to be injected and ready to bring new, fresh stem cells to replace old, tired, worn out, ineffective stem cells. Fresh stem cells, the patient is told, will be more potent than their own stem cells and enable healing. This is also false.

One company was asked to stop their marketing practices by the FDA’s Inspections, Compliance, Enforcement, and Criminal Investigations unit. Other amniotic stem cell companies followed suit and put up FDA disclaimers about their amniotic fluid products.

Amniotic “stem cells” marketed by many doctors are, in reality, micronized amniotic fluid. The micronization process takes amniotic fluid, freeze-dries it, and then processes it. The process kills the stem cells. NO live stem cells are present.

What then is the selling point of “dead” amniotic stem cells? The key to regenerative medicine is growth factors. Adipose (obtained from a patient’s fat) stem cells contain live growth factors. Bone marrow stem cells contain live growth factors, Platelet rich plasma (PRP) contains live growth factors. Micronized amniotic fluid contains growth factors, NOT stem cells.

Initial comparison…

Growth Factors and Extracellular Matrix: the key to how Amniotic Stem Cell Therapy works

Once again, we will use the term Amniotic Stem Cell Therapy, despite its inaccurate portrayal of what the treatment actually is.

The selling point for amniotic stem cell treatment is the remnants of the extracellular matrix that once surrounded the live amniotic stem cells may stimulate your own stem cells. Of course, this throws out the selling point about new, fresh stem cells coming in to replace your old, tired ones.

What is Extracellular matrix?

Extracellular matrix is a chemical fluid that surrounds a cell. The cell itself secretes it. In regenerative medicine one of these cells is called a Chondrocyte. Chondrocytes are the building blocks of cartilage. When cartilage has a hole in it, our body calls the chondrocytes to the area where the hole needs to be fixed. The chondrocytes throw themselves into the hole and secrete an extracellular matrix to serve as glue to hold themselves in place. When the extracellular matrix is secreted, it sends chemical signals to other cells to come to the area. This is part of cell signalling – the actual healing process of regenerative medicine.

This subject is discussed at length in our article The Extracellular matrix (ECM) and cell signalling. 

To recap: amniotic treatments rely on the freeze-dried amniotic extracelluar matrix to tell YOUR OWN stem cells to go to work.

This is why Amniotic Stem Cell Therapy as a title is deceptive. It is not amniotic stem cells from carefully selected mothers who are doing the work. Your own stem cells are being told by the extracellular matrix injected into your joint to go to work.

So now that we understand how amniotic treatments work, let’s compare much less costly options.

As mentioned before, your own blood platelets can deliver this message to your own stem cells when we inject Platelet Rich Plasma Therapy (PRP).

Is your own blood just as effective or better than amniotic material?

With PRP Prolotherapy, we draw your blood from your arm. The blood is then centrifuged to separate the healing platelets for easier collecting and processed right in the office. These concentrated platelets are then injected back into the problem area(s).

Doctors at the University of Florence published findings in which they described the growth, healing, and repair factors found in platelet rich plasma. One such factor is PDFG.

It cannot be said more clearly than that.

Is simple sugar better than amniotic stem cells?

Of obvious interest to doctors and researchers is how to make stem cells more viable and effective once in the diseased joint environment. The answer may be glucose or dextrose, which is the main ingredient used in traditional Prolotherapy injections.

Here is one study that explored how simple sugar made more stem cells.

One source of injectable stem cells is adipose (fat) tissue as mentioned above. Adipose-derived stem cells are an excellent source of multipotent stem cells (cells that can transform themselves into other cells, i.e., cartilage) and are capable of differentiating into a variety of other cells that are useful for musculoskeletal conditions.

Researchers at Duke University subjected human-adipose-derived stem cells to concentrations of glucose. Of interest in this study was not only did the higher concentrations of glucose cause the stem cells to proliferate (grow), but their differentiation into osteogenic (bone) stem cell lines was only observed when the glucose concentrations were physiologically at normal to high levels.  If this research is applied to humans in vivo (in the body) versus in vitro (in a cell culture) then for a stem cell to differentiate into a cartilage, for instance, a normal or high glucose level is needed.1

An important paper on stem cell research from Purdue University confirmed the notion that dextrose, especially hypertonic (high level) dextrose is a significant factor in the ability of mesenchymal stem cells from bone marrow to proliferate.2

The mesenchymal stem cell consumption of glucose increased proportionally with the glucose concentration in the medium. The higher the glucose concentration in the medium, the greater the glucose consumption by the bone marrow stem cells. The primary results note that the higher glucose and serum concentrations appear to produce higher cell populations over time.

Here are some points that amniotic stem cell salespeople are selling:

The amniotic stem cell fact check:

25 years of Regenerative medicine, tens of thousands of patients.

Our clinic has been offering regenerative medicine for over 25 years. We have always explored many new healing opportunities for our patients. While amniotic material therapy may provide results for some, we do not offer it because the results are not consistent, the cost is more prohibitive, and many of the claims made are not backed by good science.

1. Mischen BT, Follmar KE. Metabolic and Functional Characterization of Human Adipose-Derived Stem Cells in Tissue Engineering. Plastic & Reconstructive Surgery. 2008;122:725-738. [Pubmed]

2. Deorosan B, Nauman EA. The Role of Glucose, Serum, and Three-Dimensional Cell Culture on the Metabolism of Bone Marrow-Derived Mesenchymal Stem Cells. Stem Cell International. 2011;  Article ID 429187, 12 pages. Doi:10.4061/2011/429187

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