Sports Medicine

Human hematopoietic stem and progenitor cells in the restoration after the sport trauma

We can spend much time trying to convince an adult that the reparative capacities of his body in the case of trauma are much lower after eighteen. Nobody believes it. It seems that at 18 the body works like a charm and the injuries heal same quick. Meanwhile it is know that regeneration after the injuries happens even slower in the sportsmen than in the other people. It is especially relevant in the case of the small injuries that happen systemically and exhaust the resources of restoration and reparation of the damaged organs and tissues. Here we would like to talk about the physiological methods of enhancing the reparative potential that cause no questions during the doping control procedures.

The autologous hematopoietic stem cells are the cells of our own body and they are definitely not drugs. The mobilized hematopoietic stem cells (HSCs) have a huge regulatory and reparatory capacity and exhibit super power in the regeneration of the damaged tissues.

Originally, the HSCs were collected for the bone marrow transplantations after the high dose chemotherapy or radiotherapy. The technology of the HSCs collection is now a standard and licensed highly technological procedure in the Russian Federation. We have slightly modified this method and reduced the dose of the granulocyte colony stimulating factor (G-CSF) as well as the period of stimulation of hematopoiesis to a more sparing mode. The method is patented by the Russian Federation Patent RU № 2283119 C1 dating September 10, 2006 under the title The preparation of the autologous hematopoietic stem cells, the method of its production, cryopreservation and use in the therapy of the traumatic disease of the central nervous system. The composition of this preparation of the HSCs mostly consists of the hematopoietic precursors CD34+CD45-HLA DR-) and not the hematopoietic stem cells (СD34+CD45+HLA DR+). As a result the collected systems of the cells demonstrate regulatory functions of the stem cells along with highly specialized functions that make them perfect full-fledged micro-environment for the damaged cells.

The effectiveness and safety of the clinical application of HSCs and HPCs have been demonstrated in the 42 patients with sport injuries and the patients were followed up for 13 years. These HSCs and HPCs are being regularly used in humans. Certainly, this type of patients is a very small part of all cases while most of the cases are severe organic neurologic disorders treated with the effectiveness ranging from 45% to 62%. Administration of the HSCs and HPCs has been approved by the Roszdravnadzor of the Russian Federatiob in 2005 as the medical technology for the therapy of the organic diseases of the nervous systems. The technology was named The Production, Characteristics, Cryopreservation and Use of the Autologous Mobilized Cell Systems of the Human Hematopoiesis Precursors.

The method of production, standardization and storage of the HSCs and HPCs in the patients with somatic disease has been worked out. The method implies administration of the G-CSF so that the HSCs and HPCs exit the bone marrow into the peripheral blood. The cells are isolated using the flow separator when their concentration in blood is the highest. The isolated HSCs and HPCs are cryopreserved in the tubes with 5% DMSO in liquid nitrogen. Before administration they are thawed and washed with 0.9% NaCl. The cells are administered for the chronic injury of the brain and spinal cord in the series of the intrathecal or intraventricular transfusions into CSF. Sometimes, the cells are injected intravenously. The cells are mixed with the carrier in the ratio 1:3 and slowly injected. In other cases, the cells are mixed with the biodegradable polymer matrix SpheroGel© and introduced into the site of injury. The possible ways of administration of the HSCs and HPCs are

• Intracthecal into CSF or intraventricular into the ventricles of the brain;
• Intravenous and intraarterial;
• Subcutaneous and mesotherapy;
• Intra-articular;
• Intra-organic translantation of the HSCs and HPCs with the biopolymer matrix SpheroGel into the damaged tissue similarly to endoprosthetic replacement.

It should be remembered that these systems of the cells are not considered as the dope for a professional sportsmen as the cells have not been processed or co-cultured with pharmaceuticals. These are unmanipulated cells of the immune system with activated features of the immune protection and survival. Their therapeutic potential is huge and it exceeds all known pharmaceutical agents. The effects are best expressed in the professional fighters.