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| ANTI-AGEING MEDICINE | OPINION cells. Their use follows the observation

that a rare Swiss apple known as the Uttwiler Spätlauber has an extremely long shelf-life, and indeed appears to have the ability to repair minor damage to its surface. This property is believed to be related to the presence of plant stem cells, which have even greater regenerative powers than animal stem cells. Whether the application of such cells to the human face can reverse the signs of ageing, as the manufacturers claim, is a moot point, but a number of celebrities are reported to have used such products. The use in face creams of ingredients

that stimulate stem cells is not without controversy. One issue that has been raised is safety: if these products can stimulate stem cells, what guarantee is there that cell replication will not become uncontrolled, potentially leading to conditions like cancer? In addition, it has been argued that the use of stem cell technology for anti-ageing purposes trivialises other, arguably more important areas of stem cell research in the treatment of disease. And there is also a regulatory aspect:

earlier this year the US FDA sent a warning letter to one manufacturer saying that the claims it made for its product meant that it should be treated as a drug under the federal Food, Drug and Cosmetic Act, and thus subject to the same regulatory requirements as other pharmaceutical products, including demonstration of safety and effectiveness.

Tissue augmentation The use of actual stem cells to create new tissue where it is needed is still largely experimental, although a number of successes have been claimed. Such procedures are hailed as being more ‘natural’ than traditional surgery, superior to many other types of procedure, and as offering many new possibilities in the field of regenerative medicine. Some of the applications where stem

cells are being used, or are considered to have potential, include: ● Breast

augmentation and

reconstruction. As well as women who seek cosmetic breast enhancement, candidates for this type of procedure include women who have undergone conservative breast surgery (lumpectomy) for breast cancer, and who often go on to receive radiation therapy to the breast. While saving the breast, this type of treatment often results in a breast that is

material is used to create a sling around the bladder neck and urethra, which provides support and keeps the urethra closed, especially at times of increased intra-abdominal pressure, such as during sneezing.


complications are rare, they can be serious. Muscle- derived stem cells have been used as an alternative material, with some success ● Hair replacement. The treatment of hair loss with stem cells is still largely theoretical, although there is evidence that the decrease in hair follicle size in individuals with androgenetic alopecia (common baldness) is caused by a defect in the

It has been argued that the use of

stem cell technology for anti-ageing purposes trivialises other, arguably more important areas of stem cell research in the treatment of disease.

deformed or otherwise differs in size or shape from the remaining healthy breast. Unfortunately, not all women are good candidates for traditional reconstructive measures, but stem cell implants have been claimed to deliver good results in women who were previously unsuitable for breast reconstruction ● Facial rejuvenation. Current approaches to the management of such problems as loose skin, loss of volume and deepening skin folds includes the injection of fillers such as collagen or hyaluronic acid. However, such materials are inert substances and their effects can be unpredictable. Proponents argue that it makes sense to address the underlying problem by injecting stem cells, which it is hoped will lead to the natural replacement of lost tissue. In addition, the so-called ‘stem cell face lift’ is claimed to last a lot longer than traditional techniques ● Stress urinary incontinence, a condition that affects both men and women of all ages, but particularly the elderly. If other treatments prove ineffective, surgery is considered, and this usually takes the form of a sling procedure, whereby a synthetic

conversion of hair bulge stem cells to progenitor cells. Treatments designed to activate the stem cells might therefore be expected to be of benefit in this condition ● Chronic non-healing wounds, secondary to radiation therapy or to trauma, or to vascular conditions such as diabetes. These types of wound are notoriously difficult to treat, but there have been anecdotal reports of wounds that had persisted for as long as 20 years healing within 3 months of a single treatment with stem cells. In those applications where tissue

augmentation is desired, one approach is to use a procedure known as lipoinjection. Essentially, this involves removing fat from one part of the body, usually the abdomen or buttocks, by liposuction and reinjecting it into other areas where fat has been lost, or where augmentation is required. This approach has certain advantages over the use of other materials inasmuch as autologous fat is used, which should avoid any problems of rejection or allergy. In practice, liposuction is carried out in

the normal way, except that a collecting vessel is placed between the cannula and the aspirator. The aspirated material is allowed to stand so that the fat cells can be decanted from the waste. The fat is then placed in syringes ready for injection: systems are available that carry out these steps automatically. However, the use of autologous fat

transfer for breast augmentation has been controversial, partly because of concern about microcalcifications that may complicate the evaluation of mammograms. More recently, a | January/February 2012 ❚ 65

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