Ageing is a natural and unavoidable phenomenon that brings with it various health challenges, including arthritis, memory loss, joint degeneration, lung fibrosis, and other complications. While medicines can alleviate symptoms or modify disease progression, they cannot regenerate or rejuvenate tissues or organs. This is where the magic of regenerative or interventional rheumatology comes in, offering hope for pain relief and rejuvenation.

To understand the essence of regenerative or interventional rheumatology, it is important to first define rheumatology and the diseases it encompasses. Rheumatology differs from conditions like rheumatic fever, which affects children and adolescents following a sore throat and causes migratory joint pain. Rheumatology, however, primarily deals with autoimmune conditions, where the immune system mistakenly attacks the body's own tissues. These autoimmune disorders can cause joint pain, skin rashes, organ damage, and more. Some of the major autoimmune arthritic diseases include:

1. Rheumatoid arthritis: Affects the small joints of the hands and feet, causing morning pain.

2. Ankylosing spondylitis: Causes back pain, particularly in young to middle-aged males.

3. Other seronegative arthritides: Associated with conditions like psoriasis or chronic diarrhoea.

4. Lupus: Affects females and causes joint pain, skin rashes, and other symptoms.

5. Systemic sclerosis: Involves tightening of the skin and hardening of the lungs.

6. Dermatomyositis: Causes skin rashes and muscle pain.

7. Sjogren's syndrome: Leads to dryness of natural fluids like tears and saliva.

Rheumatology also addresses degenerative arthritis, such as osteoarthritis, which is commonly seen in the knees, hips, and back due to ageing or injury, and other conditions like gout, caused by the deposition of waste products in joints. Mechanical pain from ligaments and tendons, often due to sports injuries, obesity, or sedentary lifestyles, is another area treated by rheumatologists. Nutritional deficiencies, such as vitamin D deficiency, are also common causes of muscle and joint pain.

Interventional rheumatologists focus on providing relief for debilitating arthritis, especially knee and hip osteoarthritis, back pain, and other joint issues like shoulder, ankle, and wrist pain. Some cutting-edge regenerative treatments, which have been successfully introduced in Bangladesh, include:

1. Prolotherapy: A treatment that stimulates healing of inflamed joints, ligaments, or tendons using a dextrose solution or ozone.

2. Platelet-based treatments:

PRP (Platelet Rich Plasma): Plasma from the patient's own blood is rich in platelets that contain growth factors to repair damaged tissues.

Platelet lysate: Platelets are broken down to release growth factors and mRNA, which promote tissue regeneration.

3. Stem cell therapy: Involves using mesenchymal stem cells (MSCs), derived from the patient's own bone marrow or fat or from umbilical cord blood, to replace damaged tissues and rejuvenate joints.

4. Bone marrow and fat-based treatments: These involve using stem cells from the patient's own bone marrow and adipose tissue to provide sustainable relief from joint pain and neurological disorders like spinal cord paralysis and Alzheimer's.

5. GOLDIC therapy: Involves using gold nanoparticles to release rejuvenating molecules and growth factors from the patient's blood, promoting healing.

6. Peptide therapy: Uses amino acid sequences mimicking the body's natural healing molecules to stimulate joint repair and collagen production.

7. Exosome therapy: Involves the use of extracellular vesicles produced by stem cells, which deliver therapeutic molecules directly to the target tissue for faster healing.

These regenerative treatments, all of which use biologically active products, aim to rejuvenate painful joints and other diseased structures, offering a promising alternative to traditional medicine.

The writer is an interventional rheumatologist and stem cell specialist.
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