Chapter 9.6, Problem 1CSR

Body, Heal Thyself

Bartolo Colón’s physicians wanted to give Colón’s arm every possible chance to heal rapidly and completely. In any wound, platelets leak from nearby blood vessels and deliver growth factors that stimulate cell división and promote healing. However, the limited blood supply of ligaments and tendons may not provide enough platelets, and hence enough growth factors, to allow full healing. To correct this deficit. Colón's physicians administered platelet rich plasma (PRP) therapy a few weeks after his stem cell Section. Some of Colón’s blood was removed, the platelets were concentrated into a small volume, and the resulting PRP was injected into the wound.

Bartolo Colón’s saga sounds like a fairy tale come true: Injured, aging pitcher receives stem cell and PRP therapy and returns to stardom. But did stem cell and PRP therapy really help Colón? The truth is. no one really knows. Although there are several reports of spectacular results on individuals such as Colón, maybe he would have healed anyway. or maybe he just happened to have an injury that stem cells and PRP worked for. and most other people would not be so lucky. Perhaps there will be long-term problems, such as migration of some injected stem cells to other locations in his body, that Colón won’t discover for 20 years or more.

There have been very few clinical trials of PRP therapies in humans. Research in dogs and horses has found that arthritic or injured joints improved following PRP therapy, but the studies often had small sample sizes, used different methodologies, or were not designed as clinical trials. Finally, not all the studies found significant improvement in PRP treated animals compared to the controls. PRP therapy is now an almost routine part of some joint surgeons in both humans and animals, but physician and patient confidence may be based as much on hope as on evidence.

Stem cells are even more of an unknown. Stem cells taken from bone marrow are routinely used as treatments for certain cancers of the blood and immune system, but clinical teals of other stem cell therapies are just beginning. Although researchers can’t be sure that they will work, the range of possible applications is breathtaking: not just joint injuries, but multiple sclerosis. Parkinson’s disease, amyotrophic lateral sclerosis (ALS. or Lou Gehrig’s disease), and certain types of blindness.