The goal in regenerative medicine is not simply to repair injured tissue. The human body repairs tissues, such as cartilage and tendons. But the human repair process routinely falls short, either failing completely or reaching a maximum of 70-80% strength with its repair. This may be enough to present functionality for a person. However, it often leaves cartilage defects unfilled, rotator cuff tendons weakly attached, or ACL tears unstable.
In recent years, there has been a shift with musculoskeletal injury and disease to regenerative capability. The United States put a man on the moon over 40 years ago, isn't it about time we figured out how to regenerate soft tissues? Amniotic fluid has emerged as a potential superior source of regenerative components.
In the body of an expectant mother, the amniotic membrane along with its fluid and cells acts as a biologic system whose primary function is to not only protect the fetus, but also aid in fetal growth and development. The fluid has been found to be a rich source of proteins, growth factors, and multipotent stem cells essential for fetal growth and development.
Along with these components, various proteins, cytokines, carbohydrates, phospholipids, and hyaluronic acids are present. The stem cells that are present are capable of differentiating into all three germ layers of the human body. That means they have the capability to differentiate into adipogenic (fat), osteogenic (bone), myogenic (muscle), endothelial (skin), neurogenic (nerve), and hepatic (liver) cell lines.
Research has shown than unlike embryonic stem cells, those seen in amniotic fluid do not over-replicate. That means they do not have the potential to form tumors as are seen from time to time with embryonic cells.
At this point amniotic fluid based stem cell treatments have been utilized for numerous indications. They have been helpful as a biologic dressing in a broad range of clinical applications such as a wound covering. In addition, they have been successfully utilized in spinal fusion and as a scar tissue barrier around the spinal cord.
Amniotic fluid stem cell based treatments also also show some promise for the treatment of cartilage defects, tendon and ligament tears (e.g. ACL, rotator cuff, Achilles), and osteoarthritis. Soft tissue overuse syndromes also have responded anecdotally well to treatments including plantar fasciitis, carpal tunnel syndrome, medial and lateral epicondylitis (tennis elbow).
Medicine has been waiting and hoping for an effective treatment that helps bolster the body's regenerative capacity. Amniotic fluid treatments continue to show promise as a potential holy grail.
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