Commentary Turner businesses market adipose-derived autologous mesenchymal stem cell therapies for amyotrophic lateral sclerosis (ALS), muscular dystrophy, multiple sclerosis, Parkinson’s disease, stroke, asthma, lung disease, congestive heart failure, cardiomyopathy, COPD, asthma, postmyocardial infarction, macular degeneration, lichen sclerosis, interstitial cystitis, erectile dysfunction, hair restoration, neck arthritis, spine disease and many other diseases and injuries. At least one CSN clinic also advertises ‘stem cell treatments’ for spinal cord injuries. CSN began in 2010 with the establishment of two clinics referred to as the California Stem Cell Treatment Center. There are now ten CSN clinics in California alone. Eight additional clinics are located in Florida and four are based in Arizona. The remaining clinics are spread across such states as Arkansas, Colorado, Connecticut, Georgia, Hawaii, Illinois, Indiana, Kansas, Massachusetts, Mississippi, Nebraska, Nevada, New York, North Carolina, Ohio, Tennessee, Texas and Washington. It is worth putting in proper perspective the number of clinics in this network. In 2008, one of the first efforts to conduct an empirical analysis of stem cell clinics engaged in ‘direct-toconsumer marketing’of ‘stem cell medicine’did not identify any US stem cell clinics [7]. The authors found 19 websites advertising access to stem cell treatments provided in such countries as China, Mexico, Thailand and the Ukraine. More recently, an empirical analysis published in 2013 found a worldwide total of 30 ‘stem cell treatment providers’[8]. Just one of these businesses was identified as having its primary location in the USA, though nine additional providers also listed US contact or administrative locations. Considering CSN alone, over the last 5 years there has been a dramatic increase in the number of US clinics advertising adipose-derived autologous stem cell treatments. However, CSN is not the only US business entity promoting adipose-derived stem cell therapies. It is not even the only ‘franchise’model of US stem cell clinics. Stem MD advertises ‘adipose therapy’featuring ‘mesenchymal stem cells’ as well as ‘bone marrow aspirate concentrate therapy’for COPD, rheumatoid arthritis, Type II diabetes, osteoarthritis, bursitis, degenerative disc disease and other indications. Described as a ‘national medical practice,’there are 13 Stem MD clinics, with four in Florida, three in California, two in Colorado and individual facilities in Louisiana, Missouri, New Jersey and Washington state. Other US clinics advertising adipose-derived autologous stem cell therapies operate as independent businesses. For example, StemGenex, based in California, markets ‘adipose stem cell therapy’for multiple sclerosis, Parkinson’s disease, diabetes Type II, Alzheimer’s disease, rheumatoid and osteoarthritis arthritis, COPD, stroke, pulmonary fibrosis, Crohn’s disease and HIV. Another clinic, Stemedix, based in Florida, promotes ‘autologous adipose adult stem cell therapy’for ALS, Alzheimer’s disease, chronic fatigue syndrome, COPD, lupus, multiple sclerosis, osteoarthritis, Parkinson’s disease, pulmonary fibrosis, rheumatoid arthritis, Type I and Type II diabetes mellitus and ‘age management.’Such independent clinics are increasingly common.

Many US clinics promote transplantation of autologous, adipose-derived adult stem cell ‘therapies.’However, there are exceptions to this pattern. Some orthopedic and sports medicine clinics advertise autologous cell transplants containing stem cells obtained from concentrated bone marrow aspirate. For example, the Beverly Hills Orthopedic Institute markets ‘bone marrow derived stem cell injections’ for …