What else is there for arthritis besides the Nanoplasty? What's Wharton's Jelly good for?

What else is there for arthritis besides the Nanoplastytm? What’s Wharton’s Jelly good for? How long will that last?

 

Austin Yeargan III MD

 

Arthritis Treatments are either catabolic or anabolic.  Wharton’s Jelly is an anabolic treatment that is now offered in regenerative medicine clinics across the nation amid some deserved controversy.  

 

Corticosteroids are catabolic treatments.  When most pain clinics say ‘stem cell treatments’ they are talking about an off-the-shelf product called “Wharton’s jelly” or “Umbilical Cord Stem Cells”.  These products have not been proven safe or effective but their widespread use continues. There may be some clinical utility in the management of arthritis symptoms that has yet to be revealed and experimentation is ongoing. 

 

Wharton’s jelly is extracted from the umbilical cord and processed to concentrate valuable healing proteins called cytokines and growth factors.  In addition, the concentration of hyaluronic acid is high in wharton’s jelly. Hyaluronic acid activates a serine protease inhibitor that prevents destruction of the cartilage matrix. 

 

Catabolic treatments kill the inflammatory response, which is also known as the healing response.  These treatments are instantly detrimental to tissues like cartilage and cause more rapid progression of arthritis.  Corticosteroid injections like ‘cortisone’ are catabolic treatments that have destructive consequences for the joint.  Cartilage sparing treatments should not include corticosteroid treatments.   

 

Anabolic treatments enhance the healing response through anti-inflammatory and immunomodulatory signaling pathways.  These pathways stimulate cell proliferation, differentiation, growth and specialization. The pathways are mediated through biological processes that your body carries out when it heals naturally.  Anabolic treatments activate second and third phase healing proteins that repair and regenerate, then remodel degenerative tissues. 

 

Wharton’s jelly treatments, also known as Umbilical cord treatments or umbilical stem cells are allograft tissues, meaning they come from someone else.  That doesn’t mean they are necessariliy bad, it’s just not your own body’s proteins and potentially someone else’s genetic material. No one really knows what the potential of these treatments is and more importantly, what the negative consequences could be.  

 

Logically, these treatments should be relatively inexpensive as they are experimental and based more on hype than scientific evidence or even clinical accolades.  Costs to clinics are roughly 1000-2000 with mark ups as high as 20k in some pain medicine clinics in North Carolina. 

 

Wharton’s jelly or Umbilical cord treatments are often sold to patients as ‘regenerative medicine stem cell treatments’ which they are not.  What they are is an anabolic allograft treatment that may have some utility in the treatment of arthritis symptoms but does not address the cause the way that signaling cell treatments like the Nanoplastytm do.  The cells that may be present in the Wharton’s Jelly treatments are not alive but dead cells do carry the genetic material of other patients and that may be problematic and consquences potentially fatal in the case of neoplastic transformation (cancer). 

 

Platelet rich plasma, or PRP is another anabolic treatment that has a role in the treatment of arthritis symptoms and has demonstrated short term results from three to six months can be excellent in that setting.  The advantage of PRP over umbilical cord treatments like Whartons’s Jelly is that PRP is an autologous treatment, meaning that the proteins that drive the treatment results are taken from you, they don’t come from an unknown, but tested source.

 

Platelet rich plasma treatments do not contain the signaling cells necessary for complete repair and regeneration or remodeling and neither do umbilical cord products like Wharton’s Jelly.  What they do contain is anabolic anti-inflammatory and immunomodulatory signaling molecules that fool the joint lining into thinking that it needs to focus on repair rather than letting the joint breakdown (the catabolic joint).  PRP works really well for a short time and that makes sense from a scientific standpoint. If PRP is priced appropriately it is a really good value and can provide up to a year of relief from the symptoms of arthritis. Most patients experience about six months of relief before they require another injection of PRP or another treatment to address their symptoms. Wharton’s jelly is more expensive, unproven and potentially detrimental to patient health.  Application of umbilical cord products should be carefully considered in each case. 

 

Results with PRP can be enhanced depending on the formulation used and the experience of the provider with patient selection in particular.  The use of multiple other modalities in the setting of non-operative treatment for knee arthritis can amplify treatment results. Wharton’s jelly and other umbilical cord treatments are not FDA regulated and the responsibility for product safety often relies on corporate ethics. Use is off-label and the treatment is experimental. 

 

In summary, PRP is a relatively inexpensive, anabolic treatment for the symptoms of joint arthritis that won’t cause harm to your joint, may slow the progression of arthritis and avoids the sinister catabolic consequences of corticosteroid injections.  Wharton’s jelly and other umbilical stem cell products do not contain live stem cells but may contain protein cytokines and other healing and growth factors that provide short term relief from the clinical symptoms associated with arthritis. Both are relatively low-cost, anabolic treatment options for arthritis. 

Author
S. Austin Yeargan III, MD Orthopedic Surgeon Molecular Immunobiologist

You Might Also Enjoy...

TSG-6

TSG-6 is a secreted protein associated with inflammation. It plays a huge role in the signaling cell procedure we perform by providing growth factors and protection for hyaline cartilage, preventing it from destruction. Learn more about TSG-6!

Inflammation is healing

Inflammation IS healing! That’s a key concept. Without inflammation, there is no healing. So the healing response IS the inflammatory response.

The Biogenic Inflammatory Theory

When mechanical alignment is off, load is being placed on a part of your body. This breaks down/ softens your cartilage putting more pressure onto your bones causing them to become hard. This article goes further in depth about the background of arthritis.