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Stem Cell Institute Los Angeles Chronic Pain Treatments

Dr. Marc Darrow

Stroma cells are connective tissue cells found in body organs and in bone marrow.Fibroblasts(cells that make collagen) andpericytes( facilitating new blood vessel formation to bring circulation to the area) are the most common stroma cells. In our practice we use bone marrow derived stem cells to regenerate damaged joints.

Doctors at the University of Iowa are experimenting with stroma cells. This is from the University: Knee injuries are the bane of athletes everywhere, from professionals and college stars to weekend warriors.

Current surgical options for repairing damaged cartilage caused by knee injuries are costly, can have complications, and often are not very effective in the long run. Even after surgery, cartilage degeneration can progress leading to painful arthritis.

But a University of Iowa orthopedics research team is working on a solution with hopes it will result in a minimally invasive, practical, and inexpensive approach for repairing cartilage and preventing osteoarthritis.

We are creating an [injectable, bioactive] hydrogel that can repair cartilage damage, regenerate stronger cartilage, and hopefully delay or eliminate the development of osteoarthritis and eliminate the need for total knee replacement, says Yin Yu, a graduate student in the lab of James Martin, PhD, UI assistant professor of orthopedics and rehabilitation. Yu is first author of the study, which is featured on the cover of the May issue of the journalArthritis and Rheumatology.

Martins team had previously identified precursor cells within normal cartilage that can mature into new cartilage tissue. This was a surprising discovery because of the long-held assumption that cartilage is one of the few tissues in the body that cannot repair itself. (Note: Prolotgerapy doctors have often documented cartilage regrowth.)

The team also identified molecular signaling factors that attract these precursor cells, known as chondrogenic progenitor cells (CPC), out of the surrounding healthy tissue into the damaged area and cause them to develop into new, normal cartilage. One of the signals, called stromal cell-derived factor 1 (SDF1), acts like a homing beacon for the precursor cells.

In an experimental model of cartilage injury, Yu loaded the custom-made hydrogel with SDF1 and injected it into holes punched into the model cartilage. The precursor cells migrated toward the SDF1 signal and filled in the injury site. Subsequent application of a growth factor caused the cells to mature into normal cartilage that repaired the injury.

This process gives us a great result, Yu says. The new cartilage integrates seamlessly with the undamaged tissue, it has normal concentrations of proteoglycans, good structural properties, and looks like normal cartilage.

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Stem Cell Institute Los Angeles Chronic Pain Treatments

The Cell Cycle – CELLS alive

During development from stem to fully differentiated, cells in the body alternately divide (mitosis) and "appear" to be resting (interphase). This sequence of activities exhibited by cells is called the cell cycle. Follow the events in the entire cell cycle with the following animation.

Interphase: Interphase, which appears to the eye to be a resting stage between cell divisions, is actually a period of diverse activities. Those interphase activities are indispensible in making the next mitosis possible. Interphase generally lasts at least 12 to 24 hours in mammalian tissue. During this period, the cell is constantly synthesizing RNA, producing protein and growing in size. By studying molecular events in cells, scientists have determined that interphase can be divided into 4 steps: Gap 0 (G0), Gap 1 (G1), S (synthesis) phase, Gap 2 (G2).

Gap 0(G0): There are times when a cell will leave the cycle and quit dividing. This may be a temporary resting period or more permanent. An example of the latter is a cell that has reached an end stage of development and will no longer divide (e.g. neuron).

Gap 1(G1): Cells increase in size in Gap 1, produce RNA and synthesize protein. An important cell cycle control mechanism activated during this period (G1 Checkpoint) ensures that everything is ready for DNA synthesis. (Click on the Checkpoints animation, above.)

S Phase: To produce two similar daughter cells, the complete DNA instructions in the cell must be duplicated. DNA replication occurs during this S (synthesis) phase.

Gap 2(G2): During the gap between DNA synthesis and mitosis, the cell will continue to grow and produce new proteins. At the end of this gap is another control checkpoint (G2 Checkpoint) to determine if the cell can now proceed to enter M (mitosis) and divide.

MitosisorM Phase:Cell growth and protein production stop at this stage in the cell cycle. All of the cell's energy is focused on the complex and orderly division into two similar daughter cells. Mitosis is much shorter than interphase, lasting perhaps only one to two hours. As in both G1 and G2, there is a Checkpoint in the middle of mitosis (Metaphase Checkpoint) that ensures the cell is ready to complete cell division. Actual stages of mitosis can be viewed atAnimal Cell Mitosis.

Cancer cells reproduce relatively quickly in culture. In theCancer Cell CAMcompare the length of time these cells spend in interphase to that formitosisto occur.

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The Cell Cycle - CELLS alive

Adult Stem Cells’ Role in Disease Management and Anti-Aging

By Dr. Mercola

Since time immemorial, man has searched for the Fountain of Youth. Nothing has changed in that regard, but the methods of inquiry and discovery have certainly progressed.

Some of these ideas rival even the most outlandish sci-fi scenarios imaginable, up to and including the transfer of your consciousness into a bionic body.1 Personally, I dont want to veer too far from the natural order of things.

But the technology and science enthusiast in me cant help but be intrigued by the ideas and radical advances in the field of extreme life extension. One of the most promising techniques in this field, from my perspective, revolves around the use of adult stem cells.

Adult stem cells are undifferentiated cells found throughout your body. They multiply and replace cells as needed, in order to regenerate damaged tissues. Their value, in terms of anti-aging and life extension, centers around their ability to self-renew indefinitely, and their ability to generate every type of cell needed for the organ from which it originates.

Dr. Bryant Villeponteau, author of Decoding Longevity, is a leading researcher in novel anti-aging therapies involving stem cells. Hes been a pioneer in this area for over three decades.

Personally, I believe that stem cell technology could have a dramatic influence on our ability to live longer and replace some of our failing parts, which is the inevitable result of the aging process. With an interest in aging and longevity, Dr. Villeponteau started out by studying developmental biology.

If we could understand development, we could understand aging, he says.

Later, his interest turned more toward the gene regulation aspects. While working as a professor at the University of Michigan at the Institute of Gerontology, he received, and accepted, a job offer from Geron Corporationa Bay Area startup, in the early 90s.

They were working on telomerase, which I was pretty excited about at the time. I joined them when they first started, he says. We had an all-out engagement there to clone human telomerase. It had been cloned in other animals but not in humans or mammals.

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Adult Stem Cells' Role in Disease Management and Anti-Aging

Destructive Embryonic Stem Cell Research | Antiochian …

In this article, we will look at why the Orthodox Church has taken such a stand, how the Church has always stood uncompromisingly for the personhood of the human embryo, and what moral alternatives exist for stem cell research.

Destructive Embryonic Stem Cell Research

By Father Mark Hodges

THE STEM CELL DEBATE IS about the value of human life at its beginning. Stem cells are blank cells which can become all 210 different kinds of human tissue. Researchers hope that someday these cells could provide cures for all kinds of serious diseases, even repairing vital organs. We have stem cells throughout our bodies, but they are most abundant in human embryos. Retrieving embryonic stem cells, however, requires killing those human beings. A raging debate is going on in our nation now, over whether or not taxes should support killing human embryos in order to harvest their stem cells for experimentation.

Many influential groups have taken sides in the debate. You can guess where the pro-abortion groups stand. Drug and research companies also defend destructive embryonic stem cell research. Pro-life groups, of course, are against it. The Vatican condemned research using human embryos as gravely immoral, because removing cells kills an unborn child. U.S. Senator Sam Brownback debated on the floor of the senate: For the first time in our history, it is accept-able for medical researchers to kill one human being to help save another. Ultimately, what lies at the heart of this debate is our view of the human embryo. The central question in this debate is simple: Is the human embryo a person or a piece of property? If unborn persons are living beings, they have dignity and worth, and they deserve protection under the law from harm and destruction. If, however, unborn per-sons are a piece of property, then they can be destroyed with the con-sent of their owner.

The one, holy, catholic and apostolic Orthodox Church has spoken, too. The position of the Orthodox Church on embryonic stem cell research is, In light of the fact that Orthodox Christianity accepts the fact that human life begins at conception, the extraction of stem cells from embryos, which involves the willful taking of human life the embryo is human life and not just a clump of cells is considered morally and ethically wrong in every instance.

In this article, we will look at why the Orthodox Church has taken such a stand, how the Church has always stood uncompromisingly for the personhood of the human embryo, and what moral alternatives exist for stem cell research.

Legally, research on human embryos is allowed because of a faulty Supreme Court definition of personhood at viability (when a baby can lie out-side his/her mother) as worthy of state interest for legal protection. In fact, the whole pro-abortion argument hinges on the lie that there is such a thing as human life which is less than a person, hence unworthy of legal protection. Conversely, Orthodox Christians affirm the image of God from the beginning of human life, and we do not say at any time of development that one human being is of less value or less of a person than another human being.

Stem cells can be harvested from human embryos only by killing them, while the Church has always denounced any such killing and championed the sanctity of human life. The earliest extra-biblical document we have, The Didache, commands, Do not murder a child by abortion, and warns that the Way of Death is filled with people who are murderers of children and abortionists of Gods creatures (5:1-2). The Epistle of Barnabas, another very early document, was equally clear: You shall not destroy your conceptions before they are brought forth. Both call the embryo a child. St. Clement of Alexandria, in the third century, used Luke 1:41 (where John the Baptist leaped in Elizabeths womb) to prove that an embryo is a living person. He calls the earliest conceived embryos human beings who are given birth by Divine Providence, and he condemns those who use abortifacient medicines , causing the outright destruction, together with the fetus, of the whole human race.

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Destructive Embryonic Stem Cell Research | Antiochian ...

What is the difference between embryonic and somatic stem …

Embryonic stem cells : (ES cells) are stem cells derived from the inner cell mass of an early stage embryo known as a blastocyst. Human embryos reach the blastocyst stage 4-5 days post fertilization, at which time they consist of 50-150 cells.

ES cells are pluripotent. This means they are able to differentiate into all derivatives of the three primary germ layers: ectoderm, endoderm, and mesoderm. These include each of the more than 220 cell types in the adult body. Pluripotency distinguishes ES cells from multipotent progenitor cells found in the adult; these only form a limited number of cell types. When given no stimuli for differentiation, (i.e. when grown in vitro), ES cells maintain pluripotency through multiple cell divisions.

Somatic stem cells : Adult (or somatic) stem cells are found, for example, in bone marrow, blood, the eye, the brain and skeletal muscle. Their purpose is to replace and replenish cells that are continually lost by depletion and damage, such as blood cells.

Because they are already partially specialised, adult stem cells do not appear to have the same capabilities as embryonic stem cells. Under laboratory conditions, they have been manipulated to form other cell types. It may be possible, eventually, to direct these cells to function in other areas of the body to replenish damaged or diseased body tissue. However, adult stem cells are rare within the body and it is not known whether they are present in some organs, such as the heart. They are also difficult to extract and grow using the techniques that are currently available.

Bone marrow transplants are a type of adult stem cell therapy. For more than 20 years, patients with blood disorders such as leukaemia have been treated by introducing haematopoietic (blood-forming) stem cells into their bodies through bone marrow transplants. This has been possible because haematopoietic stem cells are readily accessible, unlike many other adult stem cell types found in our bodies, and they are able to replenish blood cells continuously at high rates.

SCNT : In genetics and developmental biology, somatic cell nuclear transfer (SCNT) is a laboratory technique for creating an ovum with a donor nucleus

In SCNT the nucleus, which contains the organism's DNA, of a somatic cell (a body cell other than a sperm or egg cell) is removed and the rest of the cell discarded. At the same time, the nucleus of an egg cell is removed. The nucleus of the somatic cell is then inserted into the enucleated egg cell. After being inserted into the egg, the somatic cell nucleus is reprogrammed by the host cell. The egg, now containing the nucleus of a somatic cell, is stimulated with a shock and will begin to divide. After many mitotic divisions in culture, this single cell forms a blastocyst (an early stage embryo with about 100 cells) with almost identical DNA to the original organism.

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What is the difference between embryonic and somatic stem ...

Autism – Wu Medical Center – A Leading Medical Center for …

Stem Cell Therapy for AutismMay 25th, 2015

Like Wu, Xiaojuan Wang, Freda Peng, Bo Cheng, Susan Chu

Wu Medical Center

The patient is 8-year-old boy. He was presented with language, mental, behavioral and human communication disorders for the past 5 years. He was diagnosed as Autism. He was born full-term with normal delivery. He was hyperactive, upset, agitated, impaired language development and was unable to communicate with others when he was 2 years old.

Physical examination: he was stable, Skin and mucous membrane were with no yellow stain or petechia. His heart and lung were normal. He was alert, his comprehension, judgment, attention and adaptability were bad. He was hyperactive, upset, unquiet, soliloquize and he couldnt answer questions. He could count from 1-10. He couldnt cooperate with the memory, calculation ability, or orientation examinations. He seldom had eye contact with others. He couldnt cooperate with the cranial nerves, sensation and coordinated movement during examinations. The muscle power of four limbs was at level 5, his muscle tension was normal. The tendon reflex decreased. The pathological sign was negative. All of the laboratory examination and accessory examinations were normal. He was diagnosed as Autism.

Treatment target: increase the number of normal neural stem cells (NSCs) in the brain, switch on neural development, repair and regenerate the nerves. Increase the brain function, improve the patients cognitive function and communication skills.

Treatment procedure and results: We gave the patient 4 times neural stem cells (NSCs) and 4 times mesenchymal stem cells (MSCs) implantation treatment. The stem cells were activated in the patients body to repair the damaged nerves. Together with nourishment of the neurons, improve circulation, regulating the immune, daily rehabilitation training was incorporated. After the treatment, the patient was stable, developed a good spirit and mood. He seldom gets upset and he developed more concentration. He could see movies or listen to music by himself, and the duration was increased to between 30-40 minutes than before. He speaks more with family members. He could answer questions and gained more vocabulary. He could say a sentence which is made up of 6 words. His learning skill was better. The memory, calculation ability, orientation, comprehension and attention were better. He had more eye contact with others. His nerves, sensation, coordinated movement examinations and meningeal irritation sign examination cooperation degree was better.

Case analysis: Autism is also called autistic disorder, it is one subtype of the catholicity eccyliosis. Male patients were more than female as observed. This disease onset at early infancy. The cardinal symptoms: various degrees of speech disturbance, human communication disorders, less interesting or mechanic behavior. Around 3/4 young patients accompanied with visible mental retardation. The main pathogen was unclear, it may be: heredity, perinatal period factors, abnormal immune system or imbalance of various neuroendocrine and neurotransmitter function. The patient had this disease from very young, the pathogen was unclear, and his symptoms were: abnormal mind and behaviors, cognitive disorder, bad communication skills and excitement.

There are a lot of methods to treat autism, but most of them lack medical evidences and there is no best treatment plan. Our center uses advanced NSCs transplantation technique to treats patients with autism. The NSCs is used together with MSCs to make the imbedded NSCs increase the number of brain and spinal cord nerve cells, promotes nerve differentiation and growth to improve his cognition and mental. This technique was used in this patient and he recovered well and not only his cognition and mental, his self-care ability and social skills were improved also. This provided relief of mental stress and daily burden to his relatives. This brings hope to patients with this disease.

Research under our direction, the treatment result was satisfactory. During retrospective experiment on animals, we found the same program had made great advances in nerve precursor cells structure, migration, cortical tissue, neuron differentiation and connection. For example: a small group of neurons migration lag in specific area or appear in ectopia area of the patient, could result in mental hypoevolutism, epilepsy or speech impediment. This can be fixed with implantation of nerve precursor cell. The shape and structure of cortex can be normal. The safety of this treatment was confirmed in many medical literatures. But each patient need complicated clinical technology supporting, because the brain was controlled by gene in the development process, for example: when we use the NSCs to correct neuron developmental deviation and abnormality, neuron development need growth factors participation. It also need immunological surveillance. Over growth nerve will be controlled by immune system, only in that way can we get good result. All the processes need to be controlled by experienced clinician and complicated clinical technology.

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Autism - Wu Medical Center - A Leading Medical Center for ...

The Pros and Cons of Stem Cell Therapy for COPD

Updated December 29, 2014.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Stem cells are cells found in bone marrow and other organs.

They can develop into any type of tissue that exists in the fully developed body, including any kind of blood cell: red blood cells, white blood cells, or platelets.

Because of their unique, regenerative properties, stem cells offer new hope for a variety of diseases, including diabetes mellitis, stroke, osteoporosis, heart disease and, more recently, COPD. Scientists are interested in using stem cells to repair damaged cells and tissues in the body because they are far less likely than to be rejected than foreign cells that originated from another source.

There are two types of stem cells that doctors work with most in both humans and animals: Embryonic stem cells are derived from a blastocyst, a type of cell found in mammalian embryos and adults stem cells which are derived from the umbilical cord, placenta or from blood, bone marrow, skin, and other tissues.

Embryonic stem cells have the capacity to develop into every type of tissue found in an adult. Embryonic stem cells used for research develop from eggs that have been fertilized in vitro (in a laboratory).

After they are extracted from the embryo, the cells are grown in cell culture, an artificial medium used for medical research. It is atop this medium where they then divide and multiply.

Adult stem cells have been found in many organs and tissues of the body, but, once removed from the body, they have a difficult time dividing, which makes generating large quantities of them quite challenging. Currently, scientists are trying to find better ways to grow adult stem cells in cell culture and to manipulate them into specific types of cells that have the ability to treat injury and disease.

There is much controversy going on in the world of stem cell therapy and COPD. Why? While autologous stem cell treatment without manipulation is legal in the United States, without manipulation, treatments are not likely to be clinically relevant. For stem cell treatments to be clinically relevant, millions of stem cells need to be implanted into a designated recipient. Because generating millions of stem cells is difficult once they are removed from the body, scientists must manipulate them somehow to produce larger quantities. The FDA says that manipulation turns them into prescription drugs, and that this practice must therefore be tightly regulated. Stem cell advocates don't agree with the FDA's stand on this, and are currently fighting to get this changed.

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The Pros and Cons of Stem Cell Therapy for COPD

PRP | PRP Injection | Platelet Rich Plasma Therapy …

Platelet-Rich Plasma (PRP) Injections can help relieve chronic pain and heal damaged tissue. Platelets are blood structures that are essential to clotting and wound healing. Without platelets, tissue repair cannot take place. Theyre tiny little particles that play a big role in healing.

So what do platelets have to do with chronic pain? Platelets release growth factors, substances in the body that stimulate cell growth and division. Your body naturally produces growth factors in response to injury, and those growth factors influence nearly every stage of wound healing. High density platelet-rich plasma injections have been known to promote healing at the site of the injury or diseased tissue.

With high density platelet-rich plasma (PRP) injections, we concentrate platelets, sometimes as high as 5 to 10 times richer than typical blood, with the result being an extremely high amount of growth factors. Through PRP injections, we can send those growth factors directly to the site of an injury that has failed to fully heal.

To prepare for a PRP injection, blood must first be drawn from a patient. The platelets are separated from other blood cells during a process called centrifugation. The concentration of platelets is combined with the remaining blood for reinjection into the damaged area.

Prolotherapy

High density platelet-rich plasma is a form of prolotherapy, where a substance is injected into the body to stimulate the bodys natural healing mechanisms. There are many types of substances that have been known to boost healing or reduce pain. High density platelet-rich plasma does just that, with the added healing power of super-concentrated growth factors from your own blood.

If we determine PRP will be beneficial to your injury, you will typically have an exam very four to six weeks; depending on the area injured and you can expect one to two injections.

PRP has been shown to be effective in the treatment of soft-tissue injuries, including sprains, strains, tendinopathy, tendinosis, muscle fibrosis and joint capsular laxity. High density platelet-rich plasma is also used successfully to treat joint inflammation, meniscal injury, arthritis, articular cartilage defects and arthrofibrosis.

Injury and chronic pain dont have to be a way of life. Prolotherapy with high density platelet-rich plasma can be the treatment you need to start your recovery process.

Dr. Payson Flattery is known throughout the Central Oregon region as the expert in regenerative medicine and prolotherapy using high density platelet-rich plasma. Call today for a consultation.

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PRP | PRP Injection | Platelet Rich Plasma Therapy ...

Stem Cell Therapy | Cellular Prolotherapy | Caring Medical

Home Stem Cell Therapy | Cellular Prolotherapy

Ross Hauser, MD

Ross Hauser, MD: the use of Stem Cell Therapy in the treatment of joint and spine degeneration.

Stem cell therapy is exploding in the medical field, and for good reason. Stem cells have the potential to regenerate into any type of body tissue. The amazing thing about stem cells is that when you inject them into the body, they know what kinds of cells your body needs for example, meniscus cells or cartilage cells. It is a very exciting time for medicine, especially in the field of regenerative medicine. In our office we often refer to this as Cellular Prolotherapy.

In Stem Cell Therapy we use a persons own healing cells from bone marrow, fat, and blood (alone or in various combinations) and inject them straight to the area which has a cellular deficiency.

The goal is the same: to stimulate the repair of injured tissues. Stem cells aid in fibroblastic proliferation where cell growth, proteosynthesis, reparation, the remodeling of tissues, and chondrocyte proliferation occurs. Our bone marrow contains stem cells,also termed mesenchymal stem cells and progenitor cells, among other names. These immature cells have the ability to become tissues like cartilage, bone, and ligaments.

Consequently, researchers and clinicians are focusing on alternative methods for cartilage preservation and repair. Recently,cell-basedtherapyhas become a key focus of tissue engineering research to achieve functional replacement of articular cartilage.1

Not all injuries require stem cells to heal. For many patients the success rate with traditionalProlotherapyin this office is in the 90%+ range for all patients. However, for those cases of advanced arthritis, meniscus tears, labral tears, bone-on-bone, or aggressive injuries, our Prolotherapy practitioners may choose to use stem cell injections to enhance the healing, in combination with dextrose Prolotherapy to strengthen and stabilize the surrounding support structures formeniscus repair.

In our research published inThe Open Stem Cell Journal,Rationale for Using Direct Bone Marrow Aspirate as a Proliferant for Regenerative Injection Therapy(Prolotherapy). We not only showed the benefit of bone marrow derived stem cells as a Prolotherapy proliferant solution, but also that this exciting field of medicine needs doctors and scientisists working together to expand research and technique guidelines.

Typically the tissue that we are trying to stimulate to repair with Stem Cell Therapy or Cellular Prolotherapy is articular cartilage, but we can also proliferate soft tissues structures such as ligament and tendons. This is new technology so we are studying it as we use it to treat patients.

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Stem Cell Therapy | Cellular Prolotherapy | Caring Medical

Adult Stem Cells – HowStuffWorks

You can think of adult stem cells as our built-in repair kits, regenerating cells damaged by disease, injury and everyday wear and tear. These undifferentiated cells reside among other differentiated cells in a tissue or organ; they divide and become specialized to repair or replace the surrounding differentiated cells. A common example of adult stem cells is hemopoietic stem cells, which are found in red bone marrow. These stem cells differentiate into various blood cells (red blood cells, lymphocytes, platelets-- see How Blood Works for more information). For example, red blood cells are not capable of reproducing and survive for about 28 days. To replace worn-out red blood cells, hemopoietic stem cells in the bone marrow divide and differentiate into new red blood cells.

Bone marrow also contains a second type of adult stem cell known as a stromal or mesenchymal stem cell. Stromal stem cells become bone, cartilage, fat and connective tissues found in bone. Adult stem cells have also been found in many other tissues such as the brain, skeletal muscle, blood vessels, skin, liver, teeth and the heart. Regardless of the source, adult stem cells are multipotent - they can develop into a limited number of cell types.

Although adult stem cells exist in many tissues, their numbers are small, perhaps one adult stem cell for every 100,000 surrounding cells. These stem cells look like the surrounding cells, so it's difficult to tell them apart. But researchers have developed an interesting way to identify them by "lighting them up." All cells have unique proteins on their surface called receptors. Receptors bind chemical messages from other cells as part of cell-to-cell communication. Researchers use these receptors -- or markers -- to identify and isolate adult stem cells by "tagging" the chemical messages that bind to those specific receptors on the stem cell with fluorescent molecules. Once the fluorescent chemical message binds to the receptor on the surface of the stem cell, the stem cell will "light up" under fluorescent light. The "lighted" stem cell can then be identified and isolated.

Like embryonic stem cells, adult stem cells can be grown in culture to establish stem cell lines.

Adult stem cells were once believed to be more limited than embryonic stem cells, only giving rise to the same type of tissue from which they originated. But new research suggests that adult stem cells may have the potential to generate other types of cells, as well. For example, liver cells may be coaxed to produce insulin, which is normally made by the pancreas. This capability is known as plasticity or transdifferentiation

It used to be believed that there were only two types of stem cells -- embryonic and adult -- but there's another kid on the stem cell block. Keep reading to learn about this "new" type: the induced pluripotent stem cell.

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Adult Stem Cells - HowStuffWorks