Friday, October 5, 2018

√ Clinic Versus Clinic? Internecine Conflicts Among Direct-To-Consumer Stem Cell Firms

Stem cell clinics marketing non-FDA approved therapies directly to consumers have been in various tense situations at times with the FDA or academics over the years, but more recently these stem cell clinic-related firms also appear in conflict with each other sometimes. The most notable recent example of conflict involves Dr. Christopher Centeno of Regenexx very strongly and publicly criticizing a firm called Stem Cell Institute of America.


FDA approved therapies directly to consumers have been in various tense situations at time √ Clinic versus clinic? Internecine conflicts among direct-to-consumer stem cell firms
Screenshot from the Regenexx blog, circles added by me.

Centeno is vocal on his Regenexx blog about stem cell-related various issues. He is outspoken in other ways too and my impression from his comments over the years is that he’s not exactly a fan of academics like me who weigh in on stem cell clinics. Interestingly, lately some of his posts have included strong criticism of other stem cell clinics including especially Stem Cell Institute of America, which is involved in the marketing of amniotic stem cells via scores of “partner locations” that seem to be amniotic clinics selling to consumers in this case. For example, you can see this strongly worded review of Stem Cell Institute of America by Centeno back in 2016 subtitled, “Chiropractic Amniotic Bait and Switch.” The Philadelphia Inquirer described his criticism as “blistering”:


“On his blog, Centeno has written blistering critiques of chiropractor-run stem-cell enterprises, particularly Stem Cell Institute of America, a Canton, Ga.-based firm that shows hundreds of “partner locations” on its online map.”


Already in 2018 Centeno has also done other posts on Stem Cell Institute of America and raised questions about a new “documentary” film series that apparently promotes unproven stem cell offerings including adipose stem cells (see screenshot above from his blog).



In fact, Centeno has what seems to be his own investigational type video (see above on YouTube) that asks the provocative question, “Is this stem cell fraud?” The video using the word “fraud” even in the form of a question is surprising and has certain risks attached to it.


I asked Centeno by email why he has stepped up his challenges to certain clinic-related businesses on his blog as well as via his video, and why he’s critical of the chiropractic amniotic stem cell area. Here is what he wrote back:


“Orthopedic stem cell therapy using bone marrow concentrate (BMC) has gained a reasonably large following with academic physicians at Stanford, Mayo, and Emory all offering this as a treatment for MSK conditions outside of clinical trials. Hence, it’s close to the point of gaining enough academic street cred to transition into common use. The chiropractic and amniotic “stem cell” trends threaten to take a serious field with mounting evidence and turn into an alternative medicine “pixie dust” therapy. This damages the credibility of orthopedic BMC use.”


Strong words.


So what’s Stem Cell Institute of America’s take on this situation?


I emailed to ask Brent Detelich, who is in a leadership role at Stem Cell Institute of America, for comment on Centeno’s various criticisms on his blog, etc. and got back a few emails from the organization with some critical words for their critic, and this comment for The Niche:




All Clients of the Stem Cell Institute of America have the purpose to educate patients about all forms of stem cell therapy, including adipose derived MSCs, bone marrow derived MSCs, human umbilical wharton’s jelly and other types of treatments such as PRP and Amniotic Tissue Matrix.  Amniotic has a particular quality of cells and growth factors which create healing activity.  The Stem Cell Institute of America does not dictate which choice of the above regenerative therapies it’s clients chose to use with their patients. The decision of which regenerative choice is best for each individual patient is a medical decision and not the place of a consultant.  The medical decision of how they diagnose and treat each patient lies with each office’s medical team. These medical decisions are only made after complete history, consultation, examination and any necessary X-rays or MRI studies are done.”



I have a feeling we haven’t heard the end of this story.


To be clear, I’m not taking sides here in this specific situation. Over the years I’ve been skeptical generally of amniotic stem cell” offerings and adipose stem cell “therapies”, but I’ve also asked questions about some of what Centeno and Regenexx clinics are or were doing with bone marrow cells (e.g. I reviewed a paper of his here and noted its hard to interpret the data due to lack of control subjects.)


More broadly, why would those in the for-profit direct-to-consumer clinic sphere (clinics themselves and affiliated businesses) seem to be more often in conflict with each other? One factor is that it’s getting crowded out there. You can see data on the spread of new U.S. clinics in the recent paper from Leigh Turner and I here.


Also reflecting a cramped direct-to-consumer clinic sphere, I’ve noted that many of these firms including Stem Cell Institute of America (see Seattle Times ad for them) are now using mainstream media ads for non-FDA approved offerings. These ads are very expensive so the firms must think it’s worth it to get consumers aware of them.


Another possible explanation for clinics getting into it with each other is that certain businesses may be firm believers in their own approach (e.g. one specific kind of stem cell type or methodology) and view other stem cell offerings with skepticism. Certain firms may be concerned that others that they view as problematic in their opinion could give their field a dent to its reputation overall.


It’s also worth noting that some stem cell clinic firms are going the opposite direction and linking up together, even as others are in conflict.


We are likely to see more examples of direct-to-consumer stem cell clinic businesses butting heads with each other in coming months and these situations may provide new insights into the overall direct-to-consumer stem cell clinic dynamic.



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