By Beau Whitaker, DVM, CERP
The world of regenerative therapies is constantly expanding. Every year there seems to be a handful of new options available to treat joint OA and musculoskeletal injuries. I struggle to know exactly what type of product is best to use and when. I am naturally open to new things and willing to try something if I can grasp how it works and why it may be beneficial. The more I learn about the different products and how they affect the disease process occurring in the body the more confused I can get about which one to use.
The body is such a beautiful and complicated collection of cells and proteins. It has developed a mind-numbing system of repair over hundreds of millions of years. We still don’t completely understand the process and I’m not sure we are that close to figuring it all out. Looking at the list of proteins and their functions involved in repair of tissue, many of which are inflammatory in nature, can make your head spin. Should we try and suppress inflammatory mediators like IL-1? If so when? What do IL-1 and other inflammatory proteins do as far as signaling other repair mechanisms and genes that may have beneficial downstream effects? If I want to throw some growth factors or anti-inflammatory proteins into the equation which ones are best, in what form, and when? How does the interplay of cytokines, chemokines, serotonin, bradykinin, prostaglandins, prostacyclins, thromboxane, and histamine affect long term healing and recruitment of fibroblasts and extracellular matrix components? Should I intervene somewhere to affect any of these or just leave it alone? My head hurts just writing this.
The more I study these mechanisms the humbler I become. How can I intervene to do anything with confidence that I am helping and at best not hindering the process? What downstream effects are there to adding to or suppressing parts of the tissue repair system? I am a little embarrassed at my arrogance to have thought that I could outsmart the body in the healing process and to have at times carelessly interjected in the attempt to do something. I am increasingly concluding that I should facilitate and potentially amplify what the body is already doing or get out of the way. Luckily many of our regenerative therapies are aimed at doing just that. Providing growth factors and/or cell signaling proteins to the injured area are how many of these therapies could provide benefit. But when, how, and which one is best? We certainly do not have the answers yet but some emerging therapies are providing hope and some incite.
I have personally been impressed with the effects of Hilltop Bio’s products on soft tissue repair over the last year and half. The results have been unprecedented for quality and time of healing compared to the other regenerative therapies I have used over the years. I am not saying every bullet in my regenerative medicine gun contains products like these, but the number of times I reach for it continues to increase as I monitor my results. Timing and dose are still fairly arbitrary and understanding how and when to incorporate potentially synergistic therapies is a work in progress, but I can honestly say I have not been so excited about the potential for a single regenerative therapy in my career.
