{"id":835,"date":"2020-02-17T22:12:48","date_gmt":"2020-02-17T16:42:48","guid":{"rendered":"https:\/\/medicineplexus.com\/?p=835"},"modified":"2020-02-17T22:12:48","modified_gmt":"2020-02-17T16:42:48","slug":"stem-cell-therapy","status":"publish","type":"post","link":"https:\/\/medicineplexus.com\/stem-cell-therapy\/","title":{"rendered":"Stem Cell Therapy"},"content":{"rendered":"\n<p><strong>Stem Cell Therapy<\/strong><\/p>\n\n\n\n<p><strong>Stem cells&nbsp;<\/strong>are&nbsp;biological cells&nbsp;found in all multicellular&nbsp;organisms, that can&nbsp;divide&nbsp;(through&nbsp;mitosis) and differentiate&nbsp;into diverse specialized cell types and can self-renew to produce more stem cells.<\/p>\n\n\n\n<p><strong>PRIMARY SOURCES OF STEM CELLS<\/strong><\/p>\n\n\n\n<p><strong>I.&nbsp;&nbsp; Embryonic Stem Cells: <em>Derived from very early embryo, <\/em><\/strong>which are&nbsp; isolated&nbsp; from the&nbsp; inner&nbsp; cell mass&nbsp; of&nbsp; blastocysts<\/p>\n\n\n\n<p><strong>II.&nbsp; Fetal Stem Cells: <em>Collected from fetal tissue at a somewhat later stage of&nbsp; development. <\/em>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<\/strong><\/p>\n\n\n\n<p><strong>III. Adult Stem Cells: <em>Obtained from mature tissues, differentiate into narrow range of cell types.<\/em><\/strong><\/p>\n\n\n\n<p>Source : Bone marrow, Adipose tissue, which requires extraction by liposuction<\/p>\n\n\n\n<ul><li>Blood, which requires extraction through&nbsp;pheresis, wherein blood is drawn from the donor (similar to a blood donation), passed through a machine that extracts the stem cells and returns other portions of the blood to the donor.<\/li><\/ul>\n\n\n\n<p>The&nbsp; classical&nbsp; definition&nbsp; of&nbsp; a&nbsp; stem&nbsp; cell&nbsp; requires&nbsp; that&nbsp; it&nbsp; possess&nbsp; two&nbsp; properties<\/p>\n\n\n\n<ul><li>Self \u2013Renewal and Potency<\/li><li><strong>SELF \u2013 RENEWAL: <\/strong><em>Ability to renew themselves through mitotic cell division.<\/em><\/li><li><strong>POTENCY: <\/strong><em>Capacity to differentiate into specialized cell types.<\/em><\/li><\/ul>\n\n\n\n<ul><li><strong>TOTIPOTENT: <\/strong><em>can differentiate into embryonic&nbsp;&nbsp; &amp; extraembryonic cell types.<\/em><\/li><li><strong>&nbsp;PLURIPOTENT: <\/strong><em>can differentiate into NEARLY all cells types.<\/em><\/li><li><strong>&nbsp;MULTIPOTENT: <\/strong><em>can differentiate into cells of a CLOSELY RELATED FAMILY.<\/em><\/li><li><strong>&nbsp;OLIGOPOTENT: <\/strong><em>can differentiate into ONLY A FEW CELLS.<\/em><\/li><li><strong>&nbsp;UNIPOTENT: <\/strong><em>can divide into ONLY ONE CELL TYPE ,their own.<\/em><\/li><\/ul>\n\n\n\n<p><strong>Autologous \u2013 Stem Cells<\/strong><\/p>\n\n\n\n<ul><li>Sources of the patient&#8217;s own stem cells (autologous) are either the cells from patient&#8217;s own body or his or her cord blood. For autologous transplants physicians now usually collect stem cells from the peripheral blood rather than the marrow<\/li><\/ul>\n\n\n\n<p><strong>Allogeneic \u2013 Stem Cells<\/strong><\/p>\n\n\n\n<ul><li>Sources of stem cells from another donor (allogeneic) are primarily relatives (familial-allogeneic) or completely unrelated donors (unrelated-allogeneic). The stem cells in this situation are extracted from either the donor&#8217;s body or cord blood<\/li><\/ul>\n\n\n\n<p><strong><em>How stem cell therapy works?<\/em><\/strong><\/p>\n\n\n\n<p>When stem cells are transplanted into the body and arrive into the injured part, brain being targeted for tissue regeneration, the stem cells are coming in contact with growth chemical\u2019s (like EGF\u2019s , NGF\u2019s and HGF\u2019s )in the body. These chemicals program the stem cells to differentitate into the tissue surrounding it.<\/p>\n\n\n\n<p><strong>Uses:<\/strong><\/p>\n\n\n\n<p><strong>Drug Testing<\/strong><\/p>\n\n\n\n<ul><li>Stem cells could allow scientists to test new drugs using human cell line which could speed up new drug development.<\/li><li>Only drugs that were safe and had beneficial effects in cell line testing would graduate to whole animal or human testing.<\/li><li>It would allow quicker and safer development of new drugs.<\/li><\/ul>\n\n\n\n<p>Any disease in which there is tissue degeneration can be a potential candidate for stem cell therapies<\/p>\n\n\n\n<p><strong><u><br>Hematopoietic stem cell transplantation (\u201cHSCT\u201d)<\/u><\/strong><\/p>\n\n\n\n<ul><li><em>Stem cells that give rise to the lymphocytes and other cells of the immune system, also make blood cells, are called hematopoietic stem cells.<\/em><\/li><li><em>HSC\u2019s are characterized by the presence of CD 34 antigen<\/em><\/li><li><em>The process of taking stem cells from one person and putting them into another is therefore called \u201c HCST\u201d<\/em><\/li><li><em>To treat cancer patients with conditions such as leukemia and lymphoma, sickle cell anaemia,<\/em><\/li><li><em>Used in Providing a functional immune system in a person with SCID.<\/em><\/li><li><em>In Restoring the haematopoietic system<\/em><\/li><\/ul>\n\n\n\n<p><strong>STEM CELLS IN NEUROLOGY<\/strong><\/p>\n\n\n\n<p>Many&nbsp; nervous&nbsp; system&nbsp; diseases result&nbsp; from&nbsp; loss&nbsp; of&nbsp; nerve cells;<\/p>\n\n\n\n<ul><li>In Parkinson\u2019s&nbsp; disease, nerve&nbsp; cells&nbsp; that&nbsp; make the chemical&nbsp; dopamine die.<\/li><li>In&nbsp; amyotrophic&nbsp; lateral&nbsp; sclerosis, the motor&nbsp; nerve&nbsp; cells that activate muscles&nbsp; die.<\/li><li>In multiple sclerosis, glia, the cells that&nbsp; protect&nbsp; nerve&nbsp; fibers&nbsp; are lost.<\/li><\/ul>\n\n\n\n<p><strong>STEM CELLS IN CARDIOLOGY<\/strong><\/p>\n\n\n\n<ul><li>Cardiovascular disease can deprive heart tissue of oxygen, thereby killing cardiac muscle cells (cardiomyocytes).<\/li><li>A cascade of detrimental effects.<\/li><li>Eventual heart failure &amp; death<\/li><li>Restoring damaged heart muscle tissue, through repair or regeneration, is therefore a potentially new strategy to treat heart failure.<\/li><\/ul>\n\n\n\n<p><strong>STEM CELLS IN ENDOCRINOLOGY<\/strong><\/p>\n\n\n\n<p><strong>Type I DM<\/strong><\/p>\n\n\n\n<ul><li>An&nbsp; autoimmune&nbsp; disease<\/li><li>Characterized&nbsp; by&nbsp; destruction&nbsp; of&nbsp; pancreatic&nbsp; beta cells; 80%&nbsp; of&nbsp; beta&nbsp; cells have&nbsp; to&nbsp; be destroyed for clinically-evident&nbsp; diabetes.<\/li><li>Human embryonic stem cells&nbsp; may be grown in cell cultures and stimulate to form insulin-producing cells , that can be transplanted into the patient<\/li><\/ul>\n\n\n\n<p><strong>STEM CELL THERAPY IN ONCOLOGY<\/strong><\/p>\n\n\n\n<ul><li>Using iPSC derived tissue to repair or replace tissues that have been injured by radiation, chemotherapy or the surgical treatment necessary to treat tumors.<\/li><\/ul>\n\n\n\n<p><strong>Limbal stem Cell therapy<\/strong><\/p>\n\n\n\n<ul><li>The treatment is known as limbal stem cell therapy, and the patients who received the treatment suffered from chemical burn or genetic disease know as aniridia<\/li><li>By replacing the limbal stem cells, the cornea begins to clear up as the cells are replaced with the healthy transparent layer again.<\/li><\/ul>\n\n\n\n<p><strong><em><u>Corneal disease \/ blindness<\/u><\/em><\/strong><strong><\/strong><\/p>\n\n\n\n<ul><li>Take stem cells from healthy eye<\/li><li>Grown onto contact lenses in clinical lab<\/li><li>Lenses are worn by the patient for a period of three weeks<\/li><li>Then migration of human stem cells from lens to damaged eye and begin to repair process<\/li><li>Thus heals the damaged cornea and quickly improves the vision<\/li><\/ul>\n\n\n\n<p><strong><em><u>Stem cells in treating baldness<\/u><\/em><\/strong><\/p>\n\n\n\n<ul><li><em>As hair follicles contain stem cells \u2013 dermal papilla<\/em><\/li><li><em>Take stem cells from existing hair follicles<\/em><\/li><li><em>Multiply them in cultures<\/em><\/li><li><em>Implant the new follicles into the scalp<\/em><\/li><\/ul>\n\n\n\n<p><strong>List of FDA Approved Products<\/strong><\/p>\n\n\n\n<p>1.HEMACORD (hematopoietic progenitor cells, cord blood) \u2013NYCBB<\/p>\n\n\n\n<p>2.Autologous Cultured chondrocytes\u2013<strong>Carticel<\/strong> \u00e0<\/p>\n\n\n\n<p>\u2013Repair articular cartilage injuries in the knee of adults who had inadequate\/poor response to prior arthroscopic or other surgical repair procedure<\/p>\n\n\n\n<p>\u2013Implanted by a surgical procedure called autologous chondrocyte implantation<\/p>\n\n\n\n<p>3.Autologous Cellular Immunotherapy&#8212;<strong>Provenge <\/strong><strong>\u00e0<\/strong><\/p>\n\n\n\n<p>\u2013Autologous cellular immunotherapy for the treatment of asymptomatic or minimally symptomatic metastatic castrate resistant (hormone refractory) prostate cancer<\/p>\n\n\n\n<p>Laviv \u2013Fibrocell Technologies (autologous cultured fibroblasts)<\/p>\n\n\n\n<p>\u2013Only personalized cell therapy approved by the FDA for aesthetic use and was recently approved for the improvement of the appearance of moderate-to-severe \u201csmile line\u201d wrinkles (nasolabial folds)<\/p>\n\n\n\n<p>Gintuit\u2013Allogeneic cultured keratinocytes &amp; fibroblasts in Bovine Collagen<\/p>\n\n\n\n<p>\u2013Allogeneic cellularized scaffold product indicated for topical (non-submerged) application to a surgically created vascular wound bed in the treatment of mucogingival conditions in adults<\/p>\n\n\n\n<p>\u2013used as one application over a surgically created vascular wound bed in the oral cavity<\/p>\n\n\n\n<p><strong>Apligraf<\/strong>-Cell based device-Organogenesis<\/p>\n\n\n\n<p>\u2013<\/p>\n\n\n\n<p>\u2013Indicated for use with standard therapeutic compression for the treatment of <strong>non-infected partial and full-thickness skin ulcers due to venous insufficiency <\/strong>of greater than 1 month duration and which have not adequately responded to conventional ulcer therapy<\/p>\n\n\n\n<p><strong>.Dermagraft<\/strong>-cell based device -Advanced&nbsp; Biohealing<\/p>\n\n\n\n<p>\u2013cryopreserved <strong>human fibroblast\u2013derived dermal substitute<\/strong>. Made from human cells known as <strong>fibroblasts, placed on a dissolvable mesh material<\/strong><\/p>\n\n\n\n<p>\u2013Indicated for <strong>full-thickness diabetic foot ulcers <\/strong>that have been present for <strong>longer than 6 weeks<\/strong>.<\/p>\n\n\n\n<p><strong>PRIMARY CHALLENGES<\/strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<ul><li>Stem cell development or proliferation must be controlled once placed into patients.<\/li><li>&nbsp;Possibility of rejection of stem cell transplants as foreign tissues is very high.<\/li><li>&nbsp;Contamination by viruses, bacteria, fungi, and Mycoplasma possible.<\/li><li><strong>Ethical debate &#8211; <\/strong>Harvesting ES cells destroys the blast cyst of embryo \u00e0 murder<\/li><\/ul>\n\n\n\n<p><strong>ICMR Guidelines<\/strong><\/p>\n\n\n\n<ul><li>Stem cells and their derivatives fall under definition of <strong>\u2018Drug\u2019 <\/strong>as per the Drugs and Cosmetics Act 1940, and are categorized as \u2018Investigational New Drug (IND)\u2019 or \u2018Investigational New Entity (INE)\u2019 when used for clinical application.<\/li><li><strong>Informed consent + video consent<\/strong> as per schedule Y and CDSCO&nbsp; 2014.<\/li><li>Need to explain about<\/li><li>Need of screening of transmittable disease<\/li><li>Procedural risk<\/li><li>Cell lines genetic manipulation and potential for commercialization.<\/li><li>Further contact in future<\/li><li>It is mandatory that the stem cells or their products\/derivatives are <strong>processed in CDSCO licensed Good Manufacturing Practices (GMP) compliant facility<\/strong><\/li><li>As per ICMR DBT guideline there is <strong>no approved indication for stem cell therapy as apart of routine medical practice, other than Bone Marrow and Limbal stem cell Transplantation.<\/strong><\/li><li><strong>Accordingly all stem cell therapy other than BMT shall be treated experimental<\/strong>. It should be conducted only as clinical trial after prior approval from Drug Controller General of India(DCGI).<\/li><li><strong>The follow-up period should be at least two years.<\/strong> It could even be longer depending on the type and source of cells used, the intended clinical application and age and gender of the recipient.<\/li><li><strong>Prohibited Area of Research<\/strong><\/li><li>Human <strong>germ line gene therapy <\/strong>and reproductive cloning.<\/li><li>&nbsp;<strong><em>In vitro <\/em>culture of intact human embryos<\/strong>, regardless of the method of their derivation, beyond <strong>14<\/strong> days of fertilization or formation of primitive streak, whichever is earlier.<\/li><li>Clinical trials involving <strong>xenogeneic cells or research on Xenogeneic-Human hybrids.<\/strong><\/li><li>Research involving <strong>implantation of human embryos&nbsp; <\/strong>after <em>in vitro <\/em>manipulation, at any stage of development, into uterus in humans or primates.<\/li><li><strong>Preclinical Safety Studies<\/strong><\/li><li><strong>Single and repeat dose <\/strong>toxicity studies should be performed<\/li><li>The study duration might be <strong>longer<\/strong> as compared to standard single dose studies for chemical entities.<\/li><li><strong>Toxic dose <\/strong>and a NOAEL need to be calculated.<\/li><li>&nbsp;<strong>Interaction<\/strong> of stem cells with drugs<\/li><li><strong>Tumorigeneic <\/strong>potential should be assessed in immune-deficient mice.<\/li><li><strong>Genotoxicity and immunogenicity <\/strong>need to be assessed.<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"678\" height=\"355\" src=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-347.png?w=678\" alt=\"\" class=\"wp-image-852\" srcset=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-347.png 678w, https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-347-300x157.png 300w\" sizes=\"(max-width: 678px) 100vw, 678px\" \/><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Stem Cell Therapy Stem cells&nbsp;are&nbsp;biological cells&nbsp;found in all multicellular&nbsp;organisms, that can&nbsp;divide&nbsp;(through&nbsp;mitosis) and differentiate&nbsp;into diverse specialized cell types and can self-renew to produce more stem cells. PRIMARY SOURCES OF STEM CELLS I.&nbsp;&nbsp; Embryonic Stem Cells: Derived from very early embryo, which are&nbsp; isolated&nbsp; from the&nbsp; inner&nbsp; cell mass&nbsp; of&nbsp; blastocysts II.&nbsp; Fetal Stem Cells: Collected from[&#8230;]\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","footnotes":""},"categories":[3],"tags":[],"_links":{"self":[{"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/posts\/835"}],"collection":[{"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/comments?post=835"}],"version-history":[{"count":0,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/posts\/835\/revisions"}],"wp:attachment":[{"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/media?parent=835"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/categories?post=835"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/tags?post=835"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}