Read PDF Regenerative Medicine - from Protocol to Patient: 1. Biology of Tissue Regeneration

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The diabetic foot ulcer is a very serious complication that is usually localized on pressure points and it can lead to the need to amputate the limb. The diabetic patient is characterized by an impaired ability to heal wounds. Normally, the healing process of a wound follows precise steps, which in the case of a patient suffering from this disease, can be altered.

Many studies have shown that regenerative medicine can be a valuable aid in improving wound healing of diabetic patients. Stem cells can be considered an important resource because of their capability of self-renewal and differentiation. Several experiments have shown that transplanting mesenchymal stem cells MSCs into the site of the lesion may help in the realization of some steps of the resolution of the wound.

Diabetes mellitus is a major disease resulted by hyperglycemia due to a relative or absolute insulin deficiency. This is a health problem that affects a large number of individuals and the number of patients is on the increase [1]. Diabetes is a chronic disease that is related to serious complications such as retinopathy, nephropathy, neuropathy and micro vascular complications.

One of the most debilitating complications of diabetes mellitus is the development of chronic foot ulcers. The treatment of this important complication is a clinical, economical and social problem. The healing process of diabetic foot does not follow the classical progression of wound healing and this depends on intrinsic factors, such as neuropathy and vascular abnormalities, and it also depends on extrinsic factors such as wound infection, callus formation and pressure to the site [1].

Diabetic foot may be so complicated as to require amputation and it is a serious consequence.

Regenerative Medicine is a new field of research and clinical applications aimed at repairing, replacing or regenerating cells, tissues or organs to restore altered functions due to various causes including congenital abnormalities, diseases and aging [3]. Regenerative Medicine has set itself the goal to restore normal functions, so it can be considered an important opportunity for all the major therapeutic approaches [4].

Regenerative medicine is characterized by an interdisciplinary nature which includes stem cell biology, tissue and organ transplantation, genetics, molecular biology and tissue engineering. So interdisciplinary allows you to open up to new therapeutic approaches to try to solve health problems [5]. Regenerative medicine consists of five key moments, the first step consists in obtaining the original tissue, then it is necessary to isolate the cells and expand them in culture.

The next step consists in the assembly of the cells in a delivery or in a maturation system and the application of the product to the clinic. Finally, the last step includes the application of it to the patient. All these stages must take place according to precise procedures and in cleanrooms [6]. The cleanroom technology consists of activities aimed to control and minimize contaminants in the air.

It has three main purposes: protecting the process or product from contamined air, protecting persons from exposure to contaminants that could harm their health and finally preserving the outside environment from emissions generated by the operations of the facility [7]. This could be possible with stem cells. The possibility of generating replacement cells and tissues in laboratory was born with the discovery of human pluripotent stem cells.

People suffering from type 1 diabetes need insulin replacement therapy, so over the years patients were treated by injections, islet transplants. Because of the shortage of donors for transplantation, there have been different attempts to deal with this disease. Many transcription factors expressed during embryogenesis were identified, including Pdx1, Pax4 and Nkx2. One of the most important moments to get the differentiation of stem cells in vitro is the activation of Pdx1.

The activation of Pdx1 is followed by the activation of other endocrine markers, including Ngn3, Nkx2. The conclusions of several groups of researchers have outlined the steps to get to the development of pancreatic cells from stem cells: 1 definitive endoderm formation, 2 endoderm patterning, 3 pancreatic epithelium specification and finally 4 endocrine commitment. To get to the definitive endoderm formation it was necessary to understand embryo development in vitro and this has been possible through studies on stem cells of mice. A combination of Activin A and Wnt is required to achieve the first step of the development.

To ensure an efficient and reproducible differentiation it is necessary to identify markers to track and investigate endoderm development. The flow cytometry of surface markers is another test to study the differentiation and since there are no specific markers for endoderm, is used a combination of markers that allow having information. During the differentiation process some stem cells are lost; some studies are therefore aimed at the resolution of this problem, for example by introducing a bioreactor.

The third phase of the specification of the pancreatic epithelium is based on the basic knowledge of the fact that in the early stage of pancreatic development, there are distinct regions that follow different regulatory pathways even though they have common progenitors. The last stage has not been fully understood, therefore there is a high variability in the procedures put in place in the various laboratories [10,11]. One of the consequences of diabetes mellitus, as it has been explained previously, can be the onset of foot ulcers. Diabetes mellitus is characterized by the alteration of wound healing [12].

Healing from Within: The Promise of Regenerative Medicine

The normal wound healing process consists of five phases: hemostasis, inflammation, proliferation, epithelialization, and tissue remodeling. Chronic wounds, such as diabetic wounds, are wounds that fail one or more of the wound healing steps [13,14]. Normally, the healing of a wound includes specific steps: coagulation, inflammation, formation of granulation tissue, tissue remodeling [15].

The healing of a wound of a diabetic patient follows a particular course, where many processes are altered and this can lead to the formation of an ulcer. The healing of a wound of a diabetic patient has an altered course about cellular activity, the synthesis of ECM, the release of growth factors, angiogenesis and neovascularization and about inflammation, too. The keratinocytes have the task to migrate from basal membrane and differentiate to form new skin. The keratinocytes of a diabetic patient increase their proliferation but decrease their differentiation and their ability to migrate.

The slowness of these keratinocytes can be considered one of the risk factors for the formation of an ulcer. Fibroblasts normally play a very important role in the intervention on wound healing but they are impaired in diabetic patients because of their reduced proliferation and excessive apoptosis. Extracellular matrix components help replenish cells in normal skin but in the diabetic wound they are decreased because of an excessive degradation. The quantity and quality of MSC that we all have also decreases with time.

The treatment with MSC consists of supplying the patient with as many cells as possible, thus increasing the body's capacity to protect, replace or regenerate damaged or diseased cells.

Innovative Surgical Sciences

The treatment with MSC is a process that demands advanced technical and technological capacities, and a professional team highly specialized in cellular therapy. Before cell therapy, the BioXcellerator team performs the following procedures to have the cells ready at all times for our patients:. The majority of therapies in BioXcellerator are complemented with BioXgel concentration of growth factors which are responsible for providing nutrients to the cells used and accelerating the natural process of repair, desinflammation and regeneration of tissues.

BioXgel is obtained from a small amount of blood from the same patient, which is processed with high quality standards which allows to have a concentration of these factors. Stem cells can be used in the treatment of neurological, cardiovascular, pulmonary, urological, autoimmune, musculoskeletal, gastrointestinal, skin disorders, and rejuvenation and anti-aging therapies.

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Autoimmune disorders. Indeed, Regenerative Medicine, from stem cells has impacted and influenced the field of Aesthetic Medicine, where perhaps some of the most incredible solutions are found. The ability of stem cells to renew, repair and regenerate tissues, gives them a great advantage as antiaging treatment, so this therapy has become so popular and more and more are opting for this simple, natural and effective alternative.

To qualify as suitable, certain factors must be evaluated such as the physiological condition of the patient, the current state of his illness. Our scientific medical committee is the one who decides whether a patient can or cannot receive treatment. We will not offer the treatment if we believe that there is potential danger no matter how insignificant, or if it is considered that the therapy will not provide any benefit. The same treatment can have different results among them, "says Karolynn Halpert, medical director of BioXcellerator.

Another exclusion criterion is patients with cancer or with a high risk of cancer. In turn, stem cells are not used in pregnant women. Do you have questions about stem cell treatments? We answer them. Treatments with stem cells do not represent a definitive cure to the aforementioned diseases. However, they allow advances in hope and quality of life:.


With the latest technology, BioXcellerator is the only one of its kind in the country. It is directed by Dr. Karolynn Halpert and has a team of scientific and medical specialist with extensive experience in medical centers and institutions that endorse them as the best in their area. A road accident changed Octavio Jaramillo's life when he was 30 years old. I was changing a tire to the truck I was driving. The pressure of the air played a trick on him and while he was in that job, a ring in the ring hit his face, causing him 10 fractures.

Six was the total of plastic surgeries that Octavio received to try to see each part of his face in his place again. For that moment he thought that he would wait for the medicine to advance in such a way that he could try something else again. So it was.

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After spending almost half of a life feeling the strange looks of someone who did not know what had happened to him, at 70 years old he knew the treatment with stem cells by his surgeon Luis Botero, of the Surgical Clinic. His interest and research on the subject was present from that moment, until finally in November he received the treatment. The intervention that took more than 2 hours, consisted in the injection of their own stem cells in different parts of the face, which were extracted from the fatty tissue of the abdomen and legs. The consequences of that tragic event left in his face very pronounced marks, which now have improved markedly.

Ensures that when doctors saw the before and after in their photographs, confirmed "a successful reconstruction. Surely later it will look better, since the effect of stem cells can evolve in the next 18 months, according to the report of the doctor who reviews it every month. John Jaime Arango is 53 years old and has been suffering for four years from Diabetes Mellitus type 2, a metabolic disorder characterized by hyperglycemia high blood sugar level in the context of resistance and relative lack of it; in contrast to diabetes mellitus type 1, in which there is an absolute lack of.

Jaime currently receives a treatment with stem cells in BioXcellerator that consists of several sessions, and a few months ago he had the first, which he says "has been a very good experience". The stem cells of the umbilical cord were injected into your body intravenously. These autologous own cells follow the signals of the damaged tissues and repair the affected organs.

Glossary - Center for Regenerative Medicine - Mayo Clinic Research

The patient feels satisfied since after the treatment he has received a constant accompaniment from the doctors of the clinic and his director Karolynn Halpert, for what he considers there is an excellent patient medical communication. In the same sense, he emphasizes that "the doctors do not generate wrong expectations", and they explain to the patient the operation, effects and scope of the intervention. Currently, Jaime must apply up to four times a day. The goal of treatment is to reach the point where you only have to do it once a year. BioXcellerator is a company interested in the health of people, therefore, based on positive experiences and innovation with cell therapy, offers regenerative medical therapies to treat various autoimmune, musculoskeletal, neurodegenerative diseases, among others, and so on.

BioXcellerator in Colombia, under the direction of Dr. Halpert, is a pioneer institution in the application of stem cells, which has approved therapies and with the highest standards of quality, human resources, commitment and state-of-the-art technologies. We answer the most frequent questions that our patients ask us. Home Contact Terms Privacy Policy.