By Dr. Luiz Felipe Carvalho – Orthopedic surgeon, researcher in cell therapies at CPAH – Heráclito Research and Analysis Center
In recent decades, medical science has experienced remarkable advances in the understanding of stem cells and their potential use in several degenerative diseases. Among the most studied types, *mesenchymal stem cells* (or MSCs) stand out for their versatility and relatively favorable safety profile.
MSCs are *multipotent adult stem cells, that is, they have the ability to differentiate into different types of tissues in the human body, especially those originating from the mesenchyme, such as **bone, cartilage, muscle, fat and even hematopoietic tissue*. This makes them promising targets in areas such as orthopedics, neurology, rehabilitation and even in experimental regenerative medicine applied to neurodegenerative diseases.
Contrary to what is often superficially reported, we are not talking about “miracle cures” but about cellular biology applied with scientific responsibility. We are still at a stage in which protocols need to be carefully studied, validated and regulated. Most clinical indications for the use of MSCs are still in the **research field*, through clinical trials authorized and supervised by ethics committees and regulatory agencies.
One of the most fascinating mechanisms of these cells is their *chemotaxis capacity* – that is, the ability to move toward chemical signals produced by injured or inflamed tissues. When administered intravenously, for example, many of these cells “see” the inflammatory environment and are recruited to the site of the injury, be it a knee with osteoarthritis, a damaged spinal cord or a lung in a fibrotic process.
In addition to cell differentiation, MSCs perform important functions in *immune modulation and secretion of trophic factors* (such as cytokines and exosomes) that promote tissue regeneration and reduce chronic inflammatory processes. It is this “paracrine” aspect — more than their differentiation itself — that is currently attracting great therapeutic interest.
Of course, there are challenges. Standardization of the cell source (bone marrow, adipose tissue, umbilical cord), laboratory expansion techniques, ideal doses, administration routes and response time are still being intensively studied. Not to mention the ethical and regulatory frameworks that need to accompany this advance with rigor and transparency.
At our research center, we adopt a scientific and cautious approach. We work with protocols approved by Ethics Committees, in accordance with CONEP regulations and current health legislation. Our goal is to generate safe, reliable and reproducible knowledge — not to promise what science has not yet proven.
> Over the past few years, I have seen many patients regain mobility, reduce pain, or accelerate their functional rehabilitation with cell-based therapy approaches. But the most important thing is to understand that *each result is part of a collective construction of evidence*, and not an end in itself.
It is our responsibility as physicians and scientists to maintain the integrity of clinical practice, respect the limits of current knowledge, and, at the same time, continue to seriously investigate new possibilities.
Mesenchymal stem cells are, indeed, one of the most concrete promises of regenerative medicine. But their use will only be legitimate and lasting if it continues to be anchored in ethics, science, and a commitment to the well-being of the patient — without shortcuts.
