Revitalize Your Knee Health: The Power of Stem Cell and Exosome Therapy

Introduction

Knee pain is a common complaint among older adults. There are estimated 30.8% individuals aged 55 years and older residing in Kuala Lumpur, Malaysia suffering from knee pain^[1].

These problems are often a result of aging, wear, and stress on the knee joint. Prolonged knee pain can have a significant impact on daily activities, such as sleep, prayer, walking, climbing stairs, playing sports, and even one's ability to work.

Some initial treatments are usually performed to relieve knee problems such as:

1. taking over-the-counter pain reliever
2. physiotherapy
3. wearing knee support or braces etc.

While these treatments can help reduce pain and inflammation to some extent, they do not regenerate damaged joint tissues and may have adverse effects such as gastrointestinal damage and dependency.

We believe that surgery might be the last option of people in the case if the pain persists after all initial treatments, but invasive surgery is often accompanied by long postoperative recovery time, high recurrence rate, and postoperative complications^[2].

Structure of Knee Joint

The knee joint is the largest joint in the body and is a synovial joint consisting of a synovial membrane and synovial fluid. The synovial membrane and fluid act as a lubricant, protecting the joint and reducing friction between bones.

The articular cartilage covers the ends of the bones that make up the synovial joint. This cartilage is a supportive connective tissue with a dense and highly organized extracellular matrix that contains chondrocytes. It acts as a shock absorber, distributing forces evenly on the joint and enabling smooth movement with minimal friction.

Chondrocytes are essential elements in cartilage formation and can be found within the cartilage matrix. They maintain the structure, strength, and support of the cartilage.

Osteoarthritis

• A degenerative and progressive joint disease that may eventually lead to disability
• Cause breakdown of articular cartilage within a joint
• Bones rub against each other, causing pain, swelling, stiffness, and reduced flexibility
• Severe cases may lead to bone spur formation and increased risk of premature death due to decreased mobility^[4]

Solving Knee Joint Problems: Knee Therapy

At Luxxo Wellness, a combination of stem cell therapy and exosome therapy known as Knee Therapy is introduced to address knee joint problems, specifically osteoarthritis. Stem cells play a role in enhancing joint tissue regeneration, while exosomes are effective in managing pain.

Stem Cell Therapy for Knee Joint Problems

Stem cell therapy, also known as regenerative medicine, uses the unique properties of stem cells to promote positive changes within the knee joints. Stem cells have the ability to develop into different cell types and can be used to repair diseased, dysfunctional, or injured tissue. This therapy is being widely used in biomedical research and therapeutics development.

Learn more about Stem Cell Therapy here.

Clinical trials have shown promising results with different types of stem cells:

1) Umbilical cord-derived mesenchymal stem cells (UC-MSCs)

Patients with knee osteoarthritis patients receiving 2 doses of UC-MSCs experienced 86% pain reduction and 89% improvement in mobility as opposed to 38% and 50% in the patients injected with hyaluronic acid, respectively^[5].

2) Bone marrow derived mesenchymal stem cells (BM-MSCs)

Patients with chronic knee pain exhibited rapid and progressive improvement in an osteoarthritis functional test, that is from 65% to 78% one year after injection^[6].

3) Adipose derived mesenchymal stem cells (AD-MSCs)

Patients with knee osteoarthritis experienced a 69% pain reduction after 12 months of treatment with two AD-MSCs injections.

Advantages of Choosing Umbilical Cord derived Stem Cell

Luxxo Wellness offers umbilical cord mesenchymal stem cells (UC-MSCs) sourced from Wharton’s Jelly of umbilical cord, as a new choice to treat your knee joint problems, due to the following reasons:

• Contains multipotent stem cells

Multipotent stem cells can differentiate into mature cells making up different organs and tissues and identify the affected area for repair and regeneration.

• Minimal risk of contamination

The umbilical cord is protected by the placenta barrier, which minimizes the risk of contamination by bacteria or virus.

• No ethical issue

There is no ethical issue as collection of umbilical cord does not harm the donors.

• Low immunogenicity and oncogenicity

This reduces the likelihood of rejection, prevents undesirable immune response, and has low capability of inducing tumor formation.

Benefits of Stem Cell Therapy

1) Reduce inflammation

Infusion of stem cells to the knee can help boost recovery of localized wound, by releasing cytokines and regenerating damaged cells at the site of injury.

Cytokines are signaling proteins that serve to reduce inflammation and enhance healing.

It is proven in a study by Dhillon and colleagues, showing an improvement in visual analog scale (VAS) for pain among patients undergoing injection of human umbilical cord MSCs^[8].

2) Enhance repair and regeneration of joint tissues

UC-MSCs have a great potential in promoting the regeneration of chondrocytes and differentiation into cartilage.

A study validated the regenerative effect of Wharton’s Jelly-Mesenchymal Stem Cells (WJ-MSCs) on cartilage by arthroscopic implantation of collagen scaffolds containing WJ-MSCs. 1.5, 6, and 12 months after operation, a large amount of regenerated tissue was observed through MRI images, and the surrounding cartilage and subchondral bone were fused^[9].

3) Delay deterioration of articular cartilage

UC-MSCs delay contain natural content of hyaluronic acid, glycosaminoglycans and collagen that maintain the elasticity of cartilage and strengthen joint muscles.

UC-MSCs also show higher capability to transform into chondrocytes and produce collagen 3 times higher than bone-marrow MSCs^[10]..

Learn more about Stem Cell Therapy here.

Exosome Therapy for Knee Joint Problems

Exosome is often introduced as a booster to existing stem cells to maximize the effects of stem cells.

They are nano-sized (30-150nm) vesicles that mediate intercellular communication and promote healing. As they are much smaller and less complex than their parent cells, which enable them to circulate much more easily through the body to reach sites of injury or disease and trigger healing.

They deliver and transfer beneficial outputs of stem cells including proteins, bioactive lipid and nucleic acid cargo to neighboring diseased or injured cells, thereby promoting tissue regeneration.

Compared to adult stem cells, exosomes contain nearly 3 times the amount of growth factors which give them a better ability to restore and revitalize target cells in a shorter period.

1) Regulate inflammatory responses and reduce pain

3) Promote angiogenesis that supports wound healing

Angiogenesis refers to forming a new capillary based on the existing one. Exosomes can enhance blood vessel formation and improve blood flow. Exosomes also contain a variety of growth factors and cytokines that regulate immunity and tissue repair. They are like small clones of stem cells and have a multiplier effect on stem cell therapy.

Risks and Limitations of Knee Cell Therapy

Potential risks

While stem cell therapy offers immense potential for treating knee joint problems, stem cells possess a minimal risk of teratoma formation in cancer patients. MSCs have contrasting effects on tumor growth because they are able to either favor tumor initiation or inhibit progression of existing tumors^[11].

In a cancer patient, stem cells will home to the developing tumor and accelerate the spread of cancer cells throughout the body. Hence, we do not encourage the use of stem cells on cancer patients unless the cancer has been clear for at least 5 years.

Limitations

Stem cell and exosome have demonstrated great potential in therapeutic applications. Meanwhile, both have their own limitations.

1) Limited and insufficient research on exosome-based therapeutics

Exosome therapy is relatively new as it emerged only for the past 10 years. Although various methods have been established to isolate exosomes, there is also no standardized method of isolation, standard dosage and clinical protocol to ensure the quality of cell culture.

2) Challenges in large-scale production

Another limitation is the long time needed to obtain millions of stem cells to fulfil clinical demand. During long-term culture, MSCs may lose their potential to differentiate and begin to exhibit morphological changes. It might even lead to the increased probability of malignant transformation.

3) The safety of MSCs are still controversial

Majority of clinical studies report that the use of MSCs is safe due to their low immunogenicity (tendency to trigger an unwanted immune response) and malignancy properties.

However, there were rare cases of adverse reaction being reported. Infusion of high doses of poorly characterized MSC to Covid-19 patients may lead to potentially lethal blood clot^[12]. A thrombotic event was reported in a 41-year-old man who received 3 doses AD-MSCs^[13].

Thus far, human MSCs obtained from umbilical cord (hUC-MSC) is safe and show no signs of malignant transformation or chromosomal aberrations.

Patient Testimonials

Client Mr. A hurt his knee a long time ago, however proper treatment was not given, leading to the recurrence of knee pain. Initially, he felt minor discomfort when he bent his knee and climbed up the stairs. It eventually happened that the pain increased along with crackling sound in the knee.

After 2 sessions of regenerative (stem cell) therapy, Mr. A feel energetic and stamina has improved. No more pain in his knee and he is able to carry out outdoor activities as he wishes.

How to make an informed decision?

As stem cell therapy is growing and getting more attention from the public, it is important to choose a stem cell treatment provider who can bring the most benefits to cater your health problem and boost your health. Here are 2 points you need to pay attention to that will guide you in choosing a therapy aligned with your health objectives.

1) Go for consultation and ask questions before starting any therapy

You can explore the origin of the stem cells involved, investigate diverse types of regenerative therapy and ask the physician for their background and experience.

During the consultation, it is recommended to understand the procedures, potential benefits, expected changes and risks of the recommended treatment. Fully understanding the pros and cons will help you to make the right decision.

2) Pre-screening

Diagnosis by the doctor normally will be performed by pre-screening of cancer markers, blood test and/or your medical report. Pre-screening ensures you are free of cancerous cells to minimize the risk of tumor growth.

Conclusion

Knee Therapy combines both stem cell therapy and exosome therapy to enhance its effect. Stem cell therapy promotes joint tissue repair and regeneration, while exosomes provide rapid relief from pain and inflammation in the knees.

However, there are risks and limitations associated with stem cell and exosome therapies. It is therefore important to choose a trusted healthcare provider that would not compromise on quality and safety.

Luxxo Wellness offers high-quality stem cells manufactured in certified cGMP labs under standardized conditions. Our orthopedic specialist will guide you through the Knee Therapy process, ensuring safe and personalized care. Contact us at +6019 388 2775 to schedule a consultation or learn more about our Knee Therapy.

References:

1. Mat et al. 2019. Ethnic differences in the prevalence, socioeconomic and health related risk factors of knee pain and osteoarthritis symptoms in older Malaysians. PLOS ONE 14(11): e0225075. https://doi.org/10.1371/journal.pone.0225075
2. Wu et al. 2023. Exosomes treating osteoarthritis: hope with challenge. Heliyon, 9(1): e13152. doi: 10.1016/j.heliyon.2023.e13152.
3. https://www.cdc.gov/arthritis/basics/types.html
4. https://orthoinfo.aaos.org/en/diseases--conditions/arthritis-of-the-knee/
5. Matas et al. 2018. Umbilical Cord-Derived Mesenchymal Stromal Cells (MSCs) for Knee Osteoarthritis: Repeated MSC Dosing Is Superior to a Single MSC Dose and to Hyaluronic Acid in a Controlled Randomized Phase I/II Trial. Stem Cells Translational Medicine, 8(3), 215-224.
6. Orozco et al. 2013. Treatment of knee osteoarthritis with autologous mesenchymal stem cells: a pilot study. Transplantation, 95, 1535-1541.
7. Julien et al. 2019. Adipose-derived mesenchymal stem cell therapy in the treatment of knee osteoarthritis: a randomized controlled trial. Regenerative Medicine, 14(3), 213-230.
8. Dhillon et al. 2022. Umbilical Cord–Derived Stem Cells for the Treatment of Knee Osteoarthritis: A Systematic Review, Orthopaedic Journal of Sports Medicine, 10(7):23259671221104409. doi: 10.1177/23259671221104409.
9. Sadlik et al. 2017. Knee cartilage regeneration with umbilical cord mesenchymal stem cells embedded in collagen scaffold using dry arthroscopy technique. Advances in Experimental Medicine and Biology, 1020, 113-122. doi: 10.1007/5584_2017_9.
10. Wang et al. 2009. A Comparison of Human Bone Marrow–Derived Mesenchymal Stem Cells and Human Umbilical Cord–Derived Mesenchymal Stromal Cells for Cartilage Tissue Engineering. Tissue Engineering, 15(8).
11. Yu, Zhang and Li, 2014. Exosomes derived from mesenchymal stem cells. International Journal of Molecular Science, 15(3), 4142-57.
12. Moll et al. 2020. MSC Therapies for COVID-19: Importance of Patient Coagulopathy, Thromboprophylaxis, Cell Product Quality and Mode of Delivery for Treatment Safety and Efficacy. Frontiers in Immunology, 11, 1091.
13. Czerweic et al. 2023. Adipose-Derived Mesenchymal Stromal Cells in Basic Research and Clinical Applications. International Journal of Molecular Sciences, 24(4), 3888.
14. Riekstina et al. 2009. Embryonic Stem Cell Marker Expression Pattern in Human Mesenchymal Stem Cells Derived from Bone Marrow, Adipose Tissue, Heart and Dermis. Stem Cell Rev., 5, 378-386.
15. Heo et al. 2016. Comparison of Molecular Profiles of Human Mesenchymal Stem Cells Derived from Bone Marrow, Umbilical Cord Blood, Placenta and Adipose Tissue. Int. J. Mol. Med., 37, 115-125.
16. Zong et al. 2022. Isolation and Culture of Bone Marrow Mesenchymal Stem Cells from the Human Mandible. JoVE J. Vis. Exp., 182, e63811.
17. Zhang et al. 2022. Comparison of therapeutic effects of mesenchymal stem cells from umbilical cord and bone marrow in the treatment of type 1 diabetes. Stem Cell Research & Therapy, 13(1), 406. doi: 10.1186/s13287-022-02974-1.