“The idea behind regenerative medicine is that we can use the body’s own reparative mechanisms to repair tissue without the need for surgery or drugs,” says Dr. Zaslav. “We may not be like salamanders who regrow their own tails, but we can repair our own tissue using mesenchymal stem cells. Our bodies do it every day.”

Mesenchymal stem cells

With all the misinformation swirling around stem cells, Dr. Zaslav is quick to point out that mesenchymal stem cells are naturally occurring cells in our body and are not embryonic. What makes them special and so dynamic in the regenerative medicine field is that mesenchymal stem cells can direct healing cells to the site of inflammation or injury when introduced via injection. Part of the mission of researchers looking into regenerative medicine has been learning how to better concentrate these types of cells, or their secreted factors at the site of tissue damage, whether it be degenerating cartilage in a knee or a weak tendon in the elbow, thereby facilitating healing without invasive measures like surgery. 

“Cartilage, bone marrow, muscle, tendon — this one cell which is found along blood vessels can become all of these, hence the term ‘stem.’ All our organs have these types of progenitor cells,” says Dr. Zaslav. “[When used in regenerative medicine treatments], however, they do not grow into anything. Think of mesenchymal stem cells like little subcontractors telling your cells how to heal. They’re medicinal signaling cells. They bring pro-growth, pro-healing proteins to the site of inflammation, injury, or infection.”

Researchers like Dr. Zaslav believe the ability to teach the body to better heal itself could lead to wider applications in health care, from re-teaching the diabetic body to produce insulin, to repairing internal injuries that don’t seem to heal themselves, to preventing cardiac issues. Regenerative medicine has the potential to completely revolutionize how we treat disease.

While there have been plenty of success stories — 80% respond to treatment — it’s the remaining 20% Dr. Zaslav thinks about when considering where the science is going next.

“Each body is different,” he says. “Unlike testing a drug, where you know what the drug is composed of and are just testing for an effect, [with regenerative medicine research] we’re still trying to determine what’s exactly in platelet-rich plasma or other orthobiologics that makes them work, so we can characterize it and use it more effectively.”

The research is ongoing while today’s treatments are showing promise. In addition to PRP, treatments offering pain relief through the use of concentrated bone marrow and minimally processed fat from your flank and abdomen are now a reality. Removing bone marrow and putting it through the centrifuge or using liposuction to remove fat and then reinjecting the minimally manipulated marrow or fat back into the site of inflammation can relieve pain and swelling.
 
Another emerging field that clinicians are excited about involves the use of amniotic allograft injections, which use amniotic fluids donated by mothers at birth to aid injury recovery and treat arthritis. Though the procedure is not yet FDA-approved, Dr. Zaslav hopes that continued research-driven results will make regenerative medicine techniques like this more and more common. The goal is to eventually have these minimally invasive treatment options fully FDA-approved and covered by insurance. Until then, Dr. Zaslav and the health care experts at Northwell will forge ahead.
 
“This is the future of medicine,” says Dr. Zaslav. “I’m excited to be at Northwell, at the tip of the spear, and I am excited about the future — what we’re going to be able to accomplish in the next five or ten years.”
 
For more information on regenerative medicine and other innovations at Northwell, visit the Center for Regenerative Orthopedic Medicine's website.