Orthomolecular Nutrition & Wellness Center is providing next-generation options for wound care and regenerative treatments.
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Clinical Rationale for the use of Wharton’s Jelly-Derived MSCs Wharton’s Jelly Derived Mesenchymal Stem Cells (WJ-MSCs) are a novel cellular repair matrix derived from the Wharton’s Jelly of the umbilical cord. Wharton’s Jelly is a matrix of embryonic connective tissue that is found between the amnion and the umbilical vessels.
Wharton’s Jelly is robust in hyaluronic acid and growth factors and, in comparison to amniotic tissue, contains up to 50 times more growth factors. Acellular Wharton Jelly matrix products (WJUCT) have profound regenerative properties. WJ-MSCs are unique in that they retain a combination of most of their embryonic stem cell (ESC) and mesenchymal stem cell (MSC) markers in primary culture and early passages, thus retaining their multipotent stem cell characteristics. WJ-MSCs contain both human embryonic stem cell (hESC) and human mesenchymal stem cell markers which appear to have many important advantages: they are widely multipotent, are not tumorigenic, and are not immunogenetic. Contrary to what has been observed from other sources of adult MSCs, WJ-MSCs share several of the properties unique to fetal-derived MSCs; they have a greater expansion potential in vitro than other adult MSCs and they express HLA-Class I surface markers but do not express HLAClass II markers. In addition to sharing common surface markers with bone marrow MSCs, WJMSCs also express low levels of transcription factors found in mouse and human embryonic stem cells. These factors play a central role in the regulation of pluripotency and self-renewal that include the POU (Pit/Oct/Unc) domain-containing protein Oct-4, Sox-2 and Nanog.
Indeed, it has been shown that WJ-MSCs are immune suppressive in mixed lymphocytes assays by inhibiting Tcell proliferation. This anti-inflammatory property is a desirable MSC behavior for use in cell Figure 1 therapy. The combination of the Wharton’s Jelly extracellular matrix tissue (WJ-UCT) as well as viable mesenchymal stem cells (WJ-MSCs) coordinates the tissue repair process, regenerative growth factors, and anti-inflammatory cytokines. WJ-MSC and other placenta derived MSC products have the advantage of a higher concentration of MSCs and better immunomodulatory properties compared to concentrated autologous bone marrow aspiration or fat derived stem cells where the cell count typically decreases with the donor’s age (Figure 2) and state of health. Of note, stem cells derived from umbilical cord tissue, particularly those derived from Wharton’s Jelly, have better immunomodulatory properties than with bone marrow or fat derived stem cells.
WJ-MSC products contain up to 80% MSC concentration unlike umbilical cord blood which contains 3-5% MSC concentrations. The higher concentration of mesenchymal stem cells found in Wharton’s Jelly as well as their unique primordial characteristics make WJ-MSC an ideal choice for cellular regenerative therapy. WJ-MSC is obtained from carefully screened, healthy donors at the time of scheduled cesarean section and causes no harm to mother or her newborn child making it easily accessible and without the many limitations or ethical issues of embryonic stem cells and their derivatives.
Supportive Studies/Abstracts: 1: Mobasheri A, Csaki C, Clutterbuck AL, Rahmanzadeh M, Shakibaei M. Mesenchymal stem cells in connective tissue engineering and regenerative medicine: applications in cartilage repair and osteoarthritis therapy. Histol Histopathol. 2009 Mar;24(3):347-66. doi: 10.14670/HH-24.347. Review. PubMed PMID: 19130405. 2: Qi Y, Feng G, Yan W. Mesenchymal stem cell-based treatment for cartilage defects in osteoarthritis. Mol Biol Rep. 2012 ay;39(5):5683- 9. doi: 10.1007/s11033-011-1376-z. Epub 2011 Dec 20. Review. PubMed PMID: 22183306. 3: Nöth U, Steinert AF, Tuan RS. Technology insight: adult mesenchymal stem cells for osteoarthritis therapy. Nat Clin Pract Rheumatol. 2008 Jul;4(7):371-80. doi: 10.1038/ncprheum0816. Epub 2008 May 13. Review. PubMed PMID: 18477997. Figure 2 4: Shalini Vellasamy, Pratheep Sandrasaigaran, Sharmili Vidyadaran, Elizabeth George, and Rajesh Ramasamy. Isolation and characterisation of mensenchymal stem cells derived from human placenta tissue. World J Stem Cells. 2012 Jun 26; 4(6): 53–61. Published online 2012 Jun 26. doi: 10.4252/wjsc. v4.i6.53 PMCID: PMC3443712 5: Barlow S, Brooke G, Chatterjee K, Price G, Pelekanos R, Rossetti T, Doody M, Venter D, Pain S, Gilshenan K, Atkinson K. Comparison of human placenta- and bone marrow-derived multipotent mesenchymal stem cells. Stem Cells Dev. 2008 Dec;17(6):1095-107. doi: 10.1089/scd.2007.0154. PubMed PMID: 19006451. 6: Fong CY, Chak LL, Biswas A, Tan JH, Gauthaman K, Chan WK, Bongso A. Human Wharton's jelly stem cells have unique transcriptome profiles compared to human embryonic stem cells and other mesenchymal stem cells. Stem Cell Rev. 2011 Mar;7(1):1-16. doi: 10.1007/s12015-010-9166-x. PubMed PMID: 20602182. 7: Jo CH, Lee YG, Shin WH, Kim H, Chai JW, Jeong EC, Kim JE, Shim H, Shin JS, Shin IS, Ra JC, Oh S, Yoon KS. Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a proof-of-concept clinical trial. Stem Cells. 2014 May;32(5):1254-66. doi: 10.1002/stem.1634. Erratum in: Stem Cells. 2017 Jun;35(6):1651-1652. PubMed PMID: 24449146.
Stem cell therapies have enormous promise, but the science in each use is still in the developmental stage. Professional judgment and expertise is needed in using stem cells for any therapeutic use, and we urge anyone embarking on the use of stem cell therapies to consult the national health data bases to evaluate current information from clinical trials. The FDA websites on human tissue should also be consulted to get its current evaluation of any therapy. Stem cells, like other medical products that are intended to treat, cure or prevent disease, generally require FDA approval before they can be marketed. FDA has not approved any stem cell-based products for use, other than cord blood-derived hematopoietic progenitor cells (blood forming stem cells) for certain indications.[Designated for Human Homologous Allograft use, under FDA under 21 CFR Part 1271 and Section 361 of the Public Health Service Act. Healthy live donors, provide the placental tissue at the time of scheduled Caesarian Section. Donors are pre-screened through a intensive and complete medical review and pre-natal evaluation. The placental tissue is processed, cleansed, and packaged at a AATB accredited tissue bank.]