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Siemionow M, Chambily L, Brodowska S. Efficacy of Engraftment and Safety of Human Umbilical Di-Chimeric Cell (HUDC) Therapy after Systemic Intraosseous Administration in an Experimental Model. Biomedicines 2024; 12:1064. [PMID: 38791026 PMCID: PMC11117770 DOI: 10.3390/biomedicines12051064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 04/30/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
Cell-based therapies hold promise for novel therapeutic strategies in regenerative medicine. We previously characterized in vitro human umbilical di-chimeric cells (HUDCs) created via the ex vivo fusion of human umbilical cord blood (UCB) cells derived from two unrelated donors. In this in vivo study, we assessed HUDC safety and biodistribution in the NOD SCID mouse model at 90 days following the systemic intraosseous administration of HUDCs. Twelve NOD SCID mice (n = 6/group) received intraosseous injection of donor UCB cells (3.0 × 106) in Group 1, or HUDCs (3.0 × 106) in Group 2, without immunosuppression. Flow cytometry assessed hematopoietic cell surface markers in peripheral blood and the presence of HLA-ABC class I antigens in lymphoid and non-lymphoid organs. HUDC safety was assessed by weekly evaluations, magnetic resonance imaging (MRI), and at autopsy for tumorigenicity. At 90 days after intraosseous cell administration, the comparable expression of HLA-ABC class I antigens in selected organs was found in UCB control and HUDC therapy groups. MRI and autopsy confirmed safety by no signs of tumor growth. This study confirmed HUDC biodistribution to selected lymphoid organs following intraosseous administration, without immunosuppression. These data introduce HUDCs as a novel promising approach for immunomodulation in transplantation.
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Affiliation(s)
- Maria Siemionow
- Department of Orthopaedics, University of Illinois at Chicago, Chicago, IL 60607, USA; (L.C.); (S.B.)
- Department of Traumatology, Orthopaedics, and Surgery of the Hand, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Lucile Chambily
- Department of Orthopaedics, University of Illinois at Chicago, Chicago, IL 60607, USA; (L.C.); (S.B.)
| | - Sonia Brodowska
- Department of Orthopaedics, University of Illinois at Chicago, Chicago, IL 60607, USA; (L.C.); (S.B.)
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Devi S, Bongale AM, Tefera MA, Dixit P, Bhanap P. Fresh Umbilical Cord Blood-A Source of Multipotent Stem Cells, Collection, Banking, Cryopreservation, and Ethical Concerns. Life (Basel) 2023; 13:1794. [PMID: 37763198 PMCID: PMC10533013 DOI: 10.3390/life13091794] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/02/2023] [Accepted: 05/25/2023] [Indexed: 09/29/2023] Open
Abstract
Umbilical cord blood (UCB) is a rich source of hematopoietic cells that can be used to replace bone marrow components. Many blood disorders and systemic illnesses are increasingly being treated with stem cells as regenerative medical therapy. Presently, collected blood has been stored in either public or private banks for allogenic or autologous transplantation. Using a specific keyword, we used the English language to search for relevant articles in SCOPUS and PubMed databases over time frame. According to our review, Asian countries are increasingly using UCB preservation for future use as regenerative medicine, and existing studies indicate that this trend will continue. This recent literature review explains the methodology of UCB collection, banking, and cryopreservation for future clinical use. Between 2010 and 2022, 10,054 UCB stem cell samples were effectively cryopreserved. Furthermore, we have discussed using Mesenchymal Stem Cells (MSCs) as transplant medicine, and its clinical applications. It is essential for healthcare personnel, particularly those working in labor rooms, to comprehend the protocols for collecting, transporting, and storing UCB. This review aims to provide a glimpse of the details about the UCB collection and banking processes, its benefits, and the use of UCB-derived stem cells in clinical practice, as well as the ethical concerns associated with UCB, all of which are important for healthcare professionals, particularly those working in maternity wards; namely, the obstetrician, neonatologist, and anyone involved in perinatal care. This article also highlights the practical and ethical concerns associated with private UCB banks, and the existence of public banks. UCB may continue to grow to assist healthcare teams worldwide in treating various metabolic, hematological, and immunodeficiency disorders.
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Affiliation(s)
- Seeta Devi
- Department of Obstetrics and Gynecological Nursing, Symbiosis College of Nursing, Symbiosis International (Deemed University), Lavale, Pune 412 115, Maharashtra, India;
| | - Anupkumar M. Bongale
- Department of Artificial Intelligence and Machine Learning, Symbiosis Institute of Technology, Symbiosis International (Deemed University), Lavale, Pune 412 115, Maharashtra, India
| | | | | | - Prasad Bhanap
- HoD OBG Department, Symbiosis Medical College for Women (SMCW), Symbiosis International (Deemed University), Lavale, Pune 412 115, Maharashtra, India
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Das M, Sloan AJ. Stem cell sources from human biological waste material: a role for the umbilical cord and dental pulp stem cells for regenerative medicine. Hum Cell 2023:10.1007/s13577-023-00922-6. [PMID: 37273175 DOI: 10.1007/s13577-023-00922-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 05/18/2023] [Indexed: 06/06/2023]
Abstract
Stem cell research with biological waste material is an area that holds promise to revolutionize treatment modalities and clinical practice. The interest in surgical remnants is increasing with time as research on human embryonic stem cells remains controversial due to legal and ethical issues. Perhaps, these restrictions are the motivation for the use of alternative mesenchymal stem cell (MSC) sources in the regenerative field. Stem cells (SCs) of Umbilical Cord (UC) and Dental Pulp (DP) have almost similar biological characteristics to other MSCs and can differentiate into a number of cell lineages with enormous potential future prospects. A concise critical observation of UC-MSCs and DP-MSCs is presented here reviewing articles from the last two decades along with other stem cell sources from different biological waste materials.
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Affiliation(s)
- Monalisa Das
- Department of Pedodontics & Preventive Dentistry, Dr. R. Ahmed Dental College and Hospital, Kolkata, India.
- , No. 2 Durganagar, Sripally, Chakdaha, Nadia, West Bengal, 741222, India.
| | - Alastair J Sloan
- Melbourne Dental School, Level 4, 720 Swanston Street, Melbourne, VIC, 3010, Australia
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Zhou L, McDonald CA, Yawno T, Penny T, Miller SL, Jenkin G, Malhotra A. Feasibility of cord blood collection for autologous cell therapy applications in extremely preterm infants. Cytotherapy 2023; 25:458-462. [PMID: 36740465 DOI: 10.1016/j.jcyt.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 12/12/2022] [Accepted: 01/06/2023] [Indexed: 02/07/2023]
Abstract
BACKGROUND AIMS Umbilical cord blood (UCB)-derived cells show strong promise as a treatment for neonatal brain injury in pre-clinical models and early-phase clinical trials. Feasibility of UCB collection and autologous administration is reported for term infants, but data are limited for preterm infants. Here the authors assessed the feasibility of UCB-derived cell collection for autologous use in extremely preterm infants born at less than 28 weeks, a population with a high incidence of brain injury and subsequent neurodisability. METHODS In a prospective study at a tertiary hospital in Melbourne, Australia, UCB was collected from infants born at less than 28 weeks and processed to obtain total nucleated cells (TNCs), CD34+ cells, mononuclear cells and cell viability via fluorescence-activated cell sorting prior to cryopreservation. Feasibility was pre-defined as volume adequate for cryopreservation (>9 mL UCB collected) and >25 × 106 TNCs/kg retrieved. RESULTS Thirty-eight infants (21 male, 17 female) were included in the study. Twenty-four (63.1%) were delivered via cesarean section, 30 (78.9%) received delayed cord clamping before collection and 11 (28.9%) were a multiple birth. Median (interquartile range [IQR]) gestational age was 26.0 weeks (24.5-27.5) and mean (standard deviation) birth weight was 761.5 g (221.5). Median (IQR) UCB volume collected was 19.1 mL/kg (10.5-23.5), median (IQR) TNC count was 105.2 × 106/kg (57.4-174.4), median (IQR) CD34+ cell count was 1.5 × 106/kg (0.6-2.1) and median (IQR) cell viability pre-cryopreservation was 95% (92.1-96.0). Feasibility of collection volume and cell count suitable for cell cryopreservation was achieved in 27 (71%) and 28 (73.6%) infants, respectively. CONCLUSIONS UCB-derived cell collection adequate for cryopreservation and subsequent autologous reinfusion was achieved in 70% of extremely preterm infants. Extremely preterm UCB demonstrated a higher CD34+:TNC ratio compared with published full-term values. Recruitment to demonstrate safety of UCB cell administration in extremely premature infants is ongoing in the CORD-SAFE study (trial registration no. ACTRN12619001637134).
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Affiliation(s)
- Lindsay Zhou
- Department of Pediatrics, Monash University, Melbourne, Australia; The Ritchie Center, Hudson Institute of Medical Research, Melbourne, Australia; Monash Newborn, Monash Children's Hospital, Melbourne, Australia.
| | - Courtney A McDonald
- The Ritchie Center, Hudson Institute of Medical Research, Melbourne, Australia; Department of Obstetrics and Gynecology, Monash University, Melbourne, Australia
| | - Tamara Yawno
- Department of Pediatrics, Monash University, Melbourne, Australia; The Ritchie Center, Hudson Institute of Medical Research, Melbourne, Australia; Department of Obstetrics and Gynecology, Monash University, Melbourne, Australia
| | - Tayla Penny
- The Ritchie Center, Hudson Institute of Medical Research, Melbourne, Australia
| | - Suzanne L Miller
- The Ritchie Center, Hudson Institute of Medical Research, Melbourne, Australia; Department of Obstetrics and Gynecology, Monash University, Melbourne, Australia
| | - Graham Jenkin
- The Ritchie Center, Hudson Institute of Medical Research, Melbourne, Australia; Department of Obstetrics and Gynecology, Monash University, Melbourne, Australia
| | - Atul Malhotra
- Department of Pediatrics, Monash University, Melbourne, Australia; The Ritchie Center, Hudson Institute of Medical Research, Melbourne, Australia; Monash Newborn, Monash Children's Hospital, Melbourne, Australia
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Zhou L, McDonald C, Yawno T, Jenkin G, Miller S, Malhotra A. Umbilical Cord Blood and Cord Tissue-Derived Cell Therapies for Neonatal Morbidities: Current Status and Future Challenges. Stem Cells Transl Med 2022; 11:135-145. [PMID: 35259278 PMCID: PMC8929446 DOI: 10.1093/stcltm/szab024] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/31/2021] [Indexed: 11/30/2022] Open
Abstract
Cell therapies are an emerging focus for neonatal research, with benefits documented for neonatal respiratory, neurological, and cardiac conditions in pre-clinical studies. Umbilical cord blood (UCB) and umbilical cord (UC) tissue-derived cell therapy is particularly appealing for preventative or regenerative treatment of neonatal morbidities; they are a resource that can be collected at birth and used as an autologous or allogeneic therapy. Moreover, UCB contains a diverse mix of stem and progenitor cells that demonstrate paracrine actions to mitigate damaging inflammatory, immune, oxidative stress, and cell death pathways in several organ systems. In the past decade, published results from early-phase clinical studies have explored the use of these cells as a therapeutic intervention in neonates. We present a systematic review of published and registered clinical trials of UCB and cord tissue-derived cell therapies for neonatal morbidities. This search yielded 12 completed clinical studies: 7 were open-label phase I and II safety and feasibility trials, 3 were open-label dose-escalation trials, 1 was a open-label placebo-controlled trial, and 1 was a phase II randomized controlled trial. Participants totaled 206 infants worldwide; 123 (60%) were full-term infants and 83 (40%) were preterm. A majority (64.5%) received cells via an intravenous route; however, 54 (26.2%) received cells via intratracheal administration, 10 (4.8%) intraoperative cardiac injection, and 9 (4.3%) by direct intraventricular (brain) injection. Assessment of efficacy to date is limited given completed studies have principally been phase I and II safety studies. A further 24 trials investigating UCB and UC-derived cell therapies in neonates are currently registered.
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Affiliation(s)
- Lindsay Zhou
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Paediatrics, Monash University, Clayton, VIC, Australia
- Monash Children’s Hospital, Monash Health, Clayton, VIC, Australia
| | - Courtney McDonald
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Tamara Yawno
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Paediatrics, Monash University, Clayton, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Graham Jenkin
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Suzanne Miller
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Atul Malhotra
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Paediatrics, Monash University, Clayton, VIC, Australia
- Monash Children’s Hospital, Monash Health, Clayton, VIC, Australia
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6
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Al Naem M, Bourebaba L, Kucharczyk K, Röcken M, Marycz K. Therapeutic mesenchymal stromal stem cells: Isolation, characterization and role in equine regenerative medicine and metabolic disorders. Stem Cell Rev Rep 2021; 16:301-322. [PMID: 31797146 DOI: 10.1007/s12015-019-09932-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Mesenchymal stromal cells (MSC) have become a popular treatment modality in equine orthopaedics. Regenerative therapies are especially interesting for pathologies like complicated tendinopathies of the distal limb, osteoarthritis, osteochondritis dissecans (OCD) and more recently metabolic disorders. Main sources for MSC harvesting in the horse are bone marrow, adipose tissue and umbilical cord blood. While the acquisition of umbilical cord blood is fairly easy and non-invasive, extraction of bone marrow and adipose tissue requires more invasive techniques. Characterization of the stem cells as a result of any isolation method, is also a crucial step for the confirmation of the cells' stemness properties; thus, three main characteristics must be fulfilled by these cells, namely: adherence, expression of a series of well-defined differentiation clusters as well as pluripotency. EVs, resulting from the paracrine action of MSCs, also play a key role in the therapeutic mechanisms mediated by stem cells; MSC-EVs are thus largely implicated in the regulation of proliferation, maturation, polarization and migration of various target cells. Evidence that EVs alone represent a complex network 0involving different soluble factors and could then reflect biophysical characteristics of parent cells has fuelled the importance of developing highly specific techniques for their isolation and analysis. All these aspects related to the functional and technical understanding of MSCs will be discussed and summarized in this review.
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Affiliation(s)
- Mohamad Al Naem
- Faculty of Veterinary Medicine, Equine Clinic - Equine Surgery, Justus-Liebig-University, 35392, Gießen, Germany
| | - Lynda Bourebaba
- Department of Experimental Biology, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Norwida 27B, 50-375, Wrocław, Poland.,International Institute of Translational Medicine, Jesionowa, 11, Malin, 55-114, Wisznia Mała, Poland
| | - Katarzyna Kucharczyk
- Department of Experimental Biology, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Norwida 27B, 50-375, Wrocław, Poland
| | - Michael Röcken
- Faculty of Veterinary Medicine, Equine Clinic - Equine Surgery, Justus-Liebig-University, 35392, Gießen, Germany
| | - Krzysztof Marycz
- Faculty of Veterinary Medicine, Equine Clinic - Equine Surgery, Justus-Liebig-University, 35392, Gießen, Germany. .,Department of Experimental Biology, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Norwida 27B, 50-375, Wrocław, Poland. .,International Institute of Translational Medicine, Jesionowa, 11, Malin, 55-114, Wisznia Mała, Poland.
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7
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Yang C, Wu M, You M, Chen Y, Luo M, Chen Q. The therapeutic applications of mesenchymal stromal cells from human perinatal tissues in autoimmune diseases. Stem Cell Res Ther 2021; 12:103. [PMID: 33541422 PMCID: PMC7859900 DOI: 10.1186/s13287-021-02158-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 01/11/2021] [Indexed: 02/07/2023] Open
Abstract
The autoimmune diseases are characterized by overactivation of immune cells, chronic inflammation, and immune response to self-antigens, leading to the damage and dysfunction of multiple organs. Patients still do not receive desired clinical outcomes while suffer from various adverse effects imparted by current therapies. The therapeutic strategies based on mesenchymal stromal cell (MSC) transplantation have become the promising approach for the treatment of autoimmune diseases due to the immunomodulation property of MSCs. MSCs derived from perinatal tissues are collectively known as perinatal MSCs (PMSCs), which can be obtained via painless procedures from donors with lower risk of being contaminated by viruses than those MSCs from adult tissue sources. Therefore, PMSCs may be the ideal cell source for the treatment of autoimmune diseases. This article summarizes recent progress and possible mechanisms of PMSCs in treating autoimmune diseases in animal experiments and clinical studies. This review also presents existing challenges and proposes solutions, which may provide new hints on PMSC transplantation as a therapeutic strategy for the treatment of autoimmune diseases.
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Affiliation(s)
- Chao Yang
- Stem Cells and Regenerative Medicine Research Center, Sichuan Stem Cell Bank/Sichuan Neo-life Stem Cell Biotech Inc., 15 Jinquan Road, Chengdu, 610036, China.
| | - Mingjun Wu
- Stem Cells and Regenerative Medicine Research Center, Sichuan Stem Cell Bank/Sichuan Neo-life Stem Cell Biotech Inc., 15 Jinquan Road, Chengdu, 610036, China
| | - Min You
- Stem Cells and Regenerative Medicine Research Center, Sichuan Stem Cell Bank/Sichuan Neo-life Stem Cell Biotech Inc., 15 Jinquan Road, Chengdu, 610036, China
| | - Yu Chen
- Stem Cells and Regenerative Medicine Research Center, Sichuan Stem Cell Bank/Sichuan Neo-life Stem Cell Biotech Inc., 15 Jinquan Road, Chengdu, 610036, China
| | - Maowen Luo
- Stem Cells and Regenerative Medicine Research Center, Sichuan Stem Cell Bank/Sichuan Neo-life Stem Cell Biotech Inc., 15 Jinquan Road, Chengdu, 610036, China
| | - Qiang Chen
- Stem Cells and Regenerative Medicine Research Center, Sichuan Stem Cell Bank/Sichuan Neo-life Stem Cell Biotech Inc., 15 Jinquan Road, Chengdu, 610036, China. .,Center for Stem Cell Research & Application, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, China.
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8
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Qiu H, Qian T, Wu T, Wang X, Zhu C, Chen C, Wang L. Umbilical cord blood cells for the treatment of preterm white matter injury: Potential effects and treatment options. J Neurosci Res 2020; 99:778-792. [PMID: 33207392 DOI: 10.1002/jnr.24751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 12/31/2022]
Abstract
Preterm birth is a global public health problem. A large number of preterm infants survive with preterm white matter injury (PWMI), which leads to neurological deficits, and has multifaceted etiology, clinical course, monitoring, and outcomes. The principal upstream insults leading to PWMI initiation are hypoxia-ischemia and infection and/or inflammation and the key target cells are late oligodendrocyte precursor cells. Current PWMI treatments are mainly supportive, and thus have little effect in terms of protecting the immature brain or repairing injury to improve long-term outcomes. Umbilical cord blood (UCB) cells comprise abundant immunomodulatory and stem cells, which have the potential to reduce brain injury, mainly due to anti-inflammatory and immunomodulatory mechanisms, and also through their release of neurotrophic or growth factors to promote endogenous neurogenesis. In this review, we briefly summarize PWMI pathogenesis and pathophysiology, and the specific properties of different cell types in UCB. We further explore the potential mechanism by which UCB can be used to treat PWMI, and discuss the advantages of and potential issues related to UCB cell therapy. Finally, we suggest potential future studies of UCB cell therapy in preterm infants.
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Affiliation(s)
- Han Qiu
- Key Laboratory of Neonatal Diseases of Health Commission of the People's Republic of China, Shanghai, China.,Department of Neonatology, National Children's Medical Center/Children's Hospital of Fudan University, Shanghai, China
| | - Tianyang Qian
- Key Laboratory of Neonatal Diseases of Health Commission of the People's Republic of China, Shanghai, China.,Department of Neonatology, National Children's Medical Center/Children's Hospital of Fudan University, Shanghai, China
| | - Tong Wu
- Key Laboratory of Neonatal Diseases of Health Commission of the People's Republic of China, Shanghai, China.,Department of Neonatology, National Children's Medical Center/Children's Hospital of Fudan University, Shanghai, China
| | - Xiaoyang Wang
- Center of Perinatal Medicine and Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Henan Key Laboratory of Child Brain Injury, Institute of Neuroscience and Third Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Changlian Zhu
- Center of Perinatal Medicine and Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Henan Key Laboratory of Child Brain Injury, Institute of Neuroscience and Third Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Chao Chen
- Key Laboratory of Neonatal Diseases of Health Commission of the People's Republic of China, Shanghai, China.,Department of Neonatology, National Children's Medical Center/Children's Hospital of Fudan University, Shanghai, China
| | - Laishuan Wang
- Key Laboratory of Neonatal Diseases of Health Commission of the People's Republic of China, Shanghai, China.,Department of Neonatology, National Children's Medical Center/Children's Hospital of Fudan University, Shanghai, China
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9
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Cord blood serum harvesting by hydroxyethyl starch: a fetal bovine serum alternative in expansion of umbilical cord-derived mesenchymal stem cells. Cytotechnology 2020; 72:551-567. [PMID: 32601794 DOI: 10.1007/s10616-020-00404-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 05/31/2020] [Indexed: 02/07/2023] Open
Abstract
As a widely used cell culture supplement, fetal bovine serum (FBS) harbor high content of growth, proliferation, and adhesion factors. However, high cost, bio-safety, possible xenogeneic agent transmission, finite accessible, and ethical controversy are major obstacles that discourage the use of this additive. Accordingly, novel alternatives have been proposed with various pros and cons. Still, caution should be taken in choosing suitable substitute given that the alteration in the main aspects of cultured cells can be biased the consequences of clinical applications. Herein, the authors evaluated the impact of cord blood serum harvesting by hydroxyethyl starch (CBS-HES), as an enriched source of growth factors, on the basic mesenchymal stem cells (MSCs) characteristics. In the present experiment, umbilical cord-derived MSCs were isolated and continuously nourished with Dulbecco's Modified Eagle Medium containing either 10, 15, and 20% CBS-HES or FBSs to compare their morphology, immunophenotype, growth and proliferation rate, death rate, cell cycle, and gene expression profiles. Although all enriched media supported the expansion of MSCs with comparable morphology, cell surface markers, death rate, c-MYC and p16 expression, and growth rate, CBS-HES treated cells significantly (P < 0.05) expressed more hTERT gene in a concentration-dependent manner. Yet no significant shift was observed in the cell cycle of cultured cells using the same concentrations of additives, a finding which further confirmed by Ki-67 immunostaining. CBS-HES as an available and affordable additive, seems to be an optimal, relatively safe, and promising FBS alternative for cultivation, propagation, and subsequent clinical applications of MSCs.
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10
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Peng X, Song J, Li B, Zhu C, Wang X. Umbilical cord blood stem cell therapy in premature brain injury: Opportunities and challenges. J Neurosci Res 2019; 98:815-825. [PMID: 31797400 DOI: 10.1002/jnr.24548] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 10/06/2019] [Accepted: 10/09/2019] [Indexed: 12/25/2022]
Abstract
Preterm birth and associated brain injury are the primary cause of cerebral palsy and developmental disabilities and are among the most serious global health issues that modern society faces. Current therapy for infants suffering from premature brain injury is still mainly supportive, and there are no effective treatments. Thus there is a pressing need for comparative and translational studies on how to reduce brain injury and to increase regeneration and brain repair in preterm infants. There is strong supporting evidence for the use of umbilical cord blood (UCB)-derived stem cell therapy for treating preterm brain injury and neurological sequelae. UCB-derived stem cell therapy is effective in many animal models and has been shown to be feasible in clinical trials. Most of these therapies are still experimental, however. In this review, we focus on recent advances on the efficacy of UCB-derived stem cell therapy in preterm infants with brain injury, and discuss the potential mechanisms behind their therapeutic effects as well as application strategies for future preclinical and clinical trials.
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Affiliation(s)
- Xirui Peng
- Henan Key Laboratory of Child Brain Injury, Institute of Neuroscience and Third Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Juan Song
- Henan Key Laboratory of Child Brain Injury, Institute of Neuroscience and Third Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Bingbing Li
- Henan Key Laboratory of Child Brain Injury, Institute of Neuroscience and Third Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Changlian Zhu
- Henan Key Laboratory of Child Brain Injury, Institute of Neuroscience and Third Affiliated Hospital, Zhengzhou University, Zhengzhou, China.,Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Center of Perinatal Medicine and Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Xiaoyang Wang
- Henan Key Laboratory of Child Brain Injury, Institute of Neuroscience and Third Affiliated Hospital, Zhengzhou University, Zhengzhou, China.,Center of Perinatal Medicine and Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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11
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Mousavi SH, Zarrabi M, Abroun S, Ahmadipanah M, Abbaspanah B. Umbilical cord blood quality and quantity: Collection up to transplantation. Asian J Transfus Sci 2019; 13:79-89. [PMID: 31896912 PMCID: PMC6910041 DOI: 10.4103/ajts.ajts_124_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 06/16/2019] [Indexed: 11/04/2022] Open
Abstract
Umbilical cord blood (UCB) is an attractive source of hematopoietic stem cells for transplantation in some blood disorders. One of the major factors that influence on transplantation fate is cord blood (CB) cell count, in addition to human leukocyte antigen similarity and CD34+ cell number. Here, we review the factors that could effect on quality and quantity of CBUs. Relevant English-language literatures were searched and retrieved from PubMed using the terms: CB, quality, collection, and transplantation. The numbers of total nucleated cells (TNCs) and CD34+ cells are good indicators of CB quality because they have been associated with engraftment; thereby, whatever the TNCs in a CB unit (CBU) are higher, more likely they led to successful engraftment. Many factors influence the quantity and quality of UCB units that collect after delivery. Some parameters are not in our hands, such as maternal and infant factors, and hence, we cannot change these. However, some other factors are in our authority, such as mode of collection, type and amount of anticoagulant, and time and temperature during collection to postthaw CBUs and freeze-and-thaw procedures. By optimizing the CB collection, we can improve the quantity and quality of UCB for storage and increase the likelihood of its use for transplantation.
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Affiliation(s)
- Seyed Hadi Mousavi
- Department of Hematology, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Zarrabi
- Cord Blood Bank, Royan Stem Cell Technology Institute, Tehran, Iran
| | - Saeid Abroun
- Department of Hematology, School of Medical Sciences, Tarbiat Modarres University, Tehran, Iran
| | - Mona Ahmadipanah
- Cord Blood Bank, Royan Stem Cell Technology Institute, Tehran, Iran
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12
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Estrada EJ, Decima JL, Bortman G, Roberti J, Romero EB, Samaja G, Saavedra AR, Martínez G, Gutiérrez S. Combination treatment of autologous bone marrow stem cell transplantation and hyperbaric oxygen therapy for type 2 diabetes mellitus: A randomized controlled trial. Cell Transplant 2019; 28:1632-1640. [PMID: 31665912 PMCID: PMC6923554 DOI: 10.1177/0963689719883813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/17/2019] [Accepted: 09/30/2019] [Indexed: 01/06/2023] Open
Abstract
The objective of this study was to compare standard treatment versus the combination of intrapancreatic autologous stem cell (ASC) infusion and hyperbaric oxygen treatment (HBOT) before and after ASC in the metabolic control of patients with type 2 diabetes mellitus (T2DM). This study was a prospective, randomized controlled trial. The combined intervention consisted of 10 sessions of HBOT before the intrapancreatic infusion of ASC and 10 sessions afterwards. ASCs were infused into the main arterial supply of the pancreas to maximize the presence of the stem cells where the therapeutic effect is most desired. A total of 23 patients were included (control group = 10, intervention group = 13). Age, gender, diabetes duration, number of medications taken, body weight and height, and insulin requirements were recorded at baseline and every three months. Also, body mass index, fasting plasma glucose, C-peptide, and HbA1c, C-peptide/glucose ratio (CPGR) were measured every three months for one year. HbA1c was significantly lower in the intervention group compared with control throughout follow-up. Overall, 77% of patients in the intervention group and 30% of patients in the control group demonstrated a decrease of HbA1c at 180 days (compared with baseline) of at least 1 unit. Glucose levels were significantly lower in the intervention group at all timepoints during follow-up. C-peptide levels were significantly higher in the intervention group during follow-up and at one year: 1.9 ± 1.0 ng/mL versus 0.7 ± 0.4 ng/mL in intervention versus control groups, respectively, p = 0.0021. CPGR was higher in the intervention group at all controls during follow-up. The requirement for insulin was significantly lower in the intervention group at 90, 180, 270, and 365 days. Combined therapy of intrapancreatic ASC infusion and HBOT showed increased metabolic control and reduced insulin requirements in patients with T2DM compared with standard treatment.
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Affiliation(s)
- Esteban J. Estrada
- Hospital de Alta Complejidad Pte. Juan Domingo Perón, Formosa,
Argentina
| | - José Luis Decima
- Hospital de Alta Complejidad Pte. Juan Domingo Perón, Formosa,
Argentina
| | - Guillermo Bortman
- Hospital de Alta Complejidad Pte. Juan Domingo Perón, Formosa,
Argentina
| | - Javier Roberti
- Hospital de Alta Complejidad Pte. Juan Domingo Perón, Formosa,
Argentina
| | | | - Gustavo Samaja
- Hospital de Alta Complejidad Pte. Juan Domingo Perón, Formosa,
Argentina
| | | | - Gerardo Martínez
- Hospital de Alta Complejidad Pte. Juan Domingo Perón, Formosa,
Argentina
| | - Samuel Gutiérrez
- Hospital de Alta Complejidad Pte. Juan Domingo Perón, Formosa,
Argentina
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13
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Botein EF, Darwish A, El-Tantawy NL, El-Baz R, Eid MI, Shaltot AM. Serological and molecular screening of umbilical cord blood for Toxoplasma gondii infection. Transpl Infect Dis 2019; 21:e13117. [PMID: 31102567 DOI: 10.1111/tid.13117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 04/10/2019] [Accepted: 05/12/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Human umbilical cord blood has proven to be a successful alternate source of hematopoietic stem cells for pediatric patients with major hematologic disorders. Toxoplasma gondii is a global opportunistic protozoan which cause fatal complications in immunocompromised individuals. AIM Our goal is to study the prevalence of toxoplasmosis in umbilical cord blood (UCB) and to assess the sensitivity of ELISA and PCR for Toxoplasma infection screening. MATERIAL AND METHODS One hundred cord blood samples were collected immediately after delivery. Anti-Toxoplasma IgG and IgM antibodies were determined using ELISA method; Toxoplasma DNA was detected using nested PCR technique. Total nucleated cells (TNC) and HB were also determined. Demographic data and risk factors data related to the transmission of toxoplasmosis, were collected from mothers. RESULTS Among 100 cord blood samples, 36 (36%) were positive for anti-Toxoplasma IgG antibodies and 6 (6%) were positive for anti-Toxoplasma IgM antibodies. The nested PCR showed 11 (11%) samples containing Toxoplasma DNA from which, 6 (55%) samples were IgM positive. There was no significant association between the risk of Toxoplasma transmission and cord blood positivity for toxoplasmosis. CONCLUSION Owing to the prevalence of toxoplasmosis, its rapid progression and its fatal outcome in immunocompromised patients, cord blood screening for toxoplasmosis with nested PCR should be incorporated into cord blood bank screening protocols.
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Affiliation(s)
- Eman F Botein
- Department of Pediatrics, Faculty of Medicine, Hematology/Oncology Unit, Mansoura University, Mansoura, Egypt
| | - Ahmad Darwish
- Department of Pediatrics, Faculty of Medicine, Hematology/Oncology Unit, Mansoura University, Mansoura, Egypt
| | - Nora L El-Tantawy
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Rizk El-Baz
- Department of Pediatrics, Faculty of Medicine, Genetics Unit, Mansoura University, Mansoura, Egypt
| | - Mohamed I Eid
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ali M Shaltot
- Department of Pediatrics, Faculty of Medicine, Genetics Unit, Mansoura University, Mansoura, Egypt
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14
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Souri M, Nikougoftar Zarif M, Rasouli M, Golzadeh K, Nakhlestani Hagh M, Ezzati N, Atarodi K. Comparison of human umbilical cord blood processing with or without hydroxyethyl starch. Transfusion 2017; 57:2758-2766. [PMID: 28836380 DOI: 10.1111/trf.14290] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 03/27/2017] [Accepted: 06/16/2017] [Indexed: 12/16/2023]
Abstract
BACKGROUND Umbilical cord blood (UCB) processing with hydroxyethyl starch (HES) is the most common protocol in the cord blood banks. The quality of UCB volume reduction was guaranteed by minimum manipulation of cord blood samples in the closed system. This study aimed to analyze and compare cell recovery and viability of UCB processed using the Sepax automated system in the presence and absence of HES. STUDY DESIGN AND METHODS Thirty UCB bags with a total nucleated cell (TNC) count of more than 2.5 × 109 were divided in two bags with equal volume. HES solution was added to one bag and another was intact. Both bags were processed with the Sepax. To determine cell recovery, viability, and potential of colony-forming cells (CFCs), preprocessing, postprocessing, and thawing samples were analyzed. RESULTS The mean TNC recovery after processing and after thaw was significantly better with the HES method (p < 0.01 for the postprocessing step and p < 0.05 for the postthaw step). There were no significant differences to mononucleated cells (MNCs) and CD34+ cell recovery between the two methods after processing and after thaw. TNC and MNC viability was significantly higher without HES after processing and after thaw (p < 0.01). The results of the CFC assay were similar for both methods after processing and after thaw. CONCLUSION These results showed that processing of UCB using the Sepax system with the without-HES protocol due to the lower manipulation of samples could be used as an eligible protocol to reduce the volume of UCB.
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Affiliation(s)
- Milad Souri
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine
| | - Mahin Nikougoftar Zarif
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine
| | - Mahboobeh Rasouli
- Department of Bio-Statistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Khadijeh Golzadeh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine
| | - Mozhdeh Nakhlestani Hagh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine
| | - Nasim Ezzati
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine
| | - Kamran Atarodi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine
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15
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Caruthers C, Fernandes H, Shams A, Rodrigues J, Knutsen AP, Bhatla D. Outcomes for Umbilical Cord Blood Transplantation in Severe Combined Immunodeficiency Disorders: Ten-Year Experience. PEDIATRIC ALLERGY, IMMUNOLOGY, AND PULMONOLOGY 2017; 30:171-180. [PMID: 35923009 DOI: 10.1089/ped.2017.0785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The treatment of severe combined immunodeficiency (SCID) is immune reconstitution using hematopoietic stem cell (HSC) transplantation early in life. HLA-identical related donors are the preferred source of HSCs. Since sibling donors are available in <30% of patients, other sources of HSCs are considered-mismatched related donor, umbilical cord blood (UCB), and matched unrelated donor bone marrow. We report the outcome of 10 patients with SCID or combined immunodeficiency (CID) 10 years after UCB transplantation (UCBT) at our institution using a retrospective chart review. Eight patients were alive 10 years post-transplantation. This was the second transplant for 2 patients due to initial transplant engraftment failure. Immunologic reconstitution was demonstrated after transplant with presence of memory T cells at 3 months, naive T cells at 12 months, B cells at 3 months, and normal tetanus/diphtheria toxoid antibody responses at 2 years. Immune response remained robust 10 years post-transplantation. Eight patients developed stage I acute graft-versus-host disease (GvHD), 2 patients developed grades 2-4 GvHD, and 1 child developed chronic GvHD with bronchiolitis obliterans. UCB should be considered as an alternative HSC source for patients with SCID and CID because of its robust and sustained recovery of immune function, low risk of severe GvHD, and accessibility.
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Affiliation(s)
- Carrie Caruthers
- Division Allergy and Immunology, Department of Pediatrics, Saint Louis University, St. Louis, Missouri
| | - Hermina Fernandes
- Division of Hematology and Oncology, Department of Internal Medicine, Saint Louis University, St. Louis, Missouri
| | - Alireza Shams
- Department of Pathology, Saint Louis University, St. Louis, Missouri
| | - Jonathan Rodrigues
- Division Allergy and Immunology, Department of Pediatrics, Saint Louis University, St. Louis, Missouri
| | - Alan P Knutsen
- Division Allergy and Immunology, Department of Pediatrics, Saint Louis University, St. Louis, Missouri
| | - Deepika Bhatla
- Division of Hematology and Oncology, Department of Pediatrics, Saint Louis University, St. Louis, Missouri
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16
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Girard M, Laforce-Lavoie A, de Grandmont MJ, Cayer MP, Fournier D, Delage G, Thibault L. Optimization of cord blood unit sterility testing: impact of dilution, analysis delay, and inhibitory substances. Transfusion 2017; 57:1956-1967. [PMID: 28474347 DOI: 10.1111/trf.14147] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 03/22/2017] [Accepted: 03/27/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Different methods are used by cord blood banks to prepare samples for sterility testing. Suboptimal methods can result in the release of contaminated products. In our organization, samples are prepared by diluting the final product in RPMI-1640 medium. In this work, we have compared our method with different approaches to verify whether optimization should be sought. STUDY DESIGN AND METHODS Cord blood units (n = 6 units per bacterial strain) characterized to contain inhibitory substances or not were inoculated (10 colony-forming units/mL) with Streptococcus agalactiae, Staphylococcus epidermidis, Klebsiella pneumoniae, Escherichia coli, or Bacteroides fragilis. After plasma and red blood cell removal, stem cell concentrates were diluted in RPMI-1640, thioglycollate, or the unit's plasma. These products, as well as final product, plasma, and red blood cell fractions, were held from 0 to 72 hours at 20 to 24°C before inoculation in culture bottles and detection using the BacT/ALERT 3D system. RESULTS Dilution of cell concentrates in RPMI-1640 allowed bacterial detection in 93.3% of noninhibitory cord blood samples after a 24-hour storage period. Thioglycollate medium better promoted bacterial growth in inhibitory cord blood samples that were held for 72 hours before testing (66.7%) compared with RPMI-1640 (45.0%). Less than 33% of all spiked plasma samples were detected by the BacT/ALERT 3D system. CONCLUSION Diluting cord blood samples in culture medium containing bacterial growth promoting substances is a suitable option for sterility testing, whereas the use of plasma should be proscribed, because it might lead to false-negative results. Because inhibitory substances affect bacterial growth, inoculation of culture bottles should be done rapidly after sample preparation.
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Affiliation(s)
- Mélissa Girard
- Research and Development, Héma-Québec, Québec, Québec, Canada
| | | | | | | | | | - Gilles Delage
- Medical Affairs, Héma-Québec, Montréal, Québec, Canada
| | - Louis Thibault
- Research and Development, Héma-Québec, Québec, Québec, Canada
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17
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Urbinati F, Wherley J, Geiger S, Fernandez BC, Kaufman ML, Cooper A, Romero Z, Marchioni F, Reeves L, Read E, Nowicki B, Grassman E, Viswanathan S, Wang X, Hollis RP, Kohn DB. Preclinical studies for a phase 1 clinical trial of autologous hematopoietic stem cell gene therapy for sickle cell disease. Cytotherapy 2017; 19:1096-1112. [PMID: 28733131 DOI: 10.1016/j.jcyt.2017.06.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 05/26/2017] [Accepted: 06/06/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND AIMS Gene therapy by autologous hematopoietic stem cell transplantation (HSCT) represents a new approach to treat sickle cell disease (SCD). Optimization of the manufacture, characterization and testing of the transduced hematopoietic stem cell final cell product (FCP), as well as an in depth in vivo toxicology study, are critical for advancing this approach to clinical trials. METHODS Data are shown to evaluate and establish the feasibility of isolating, transducing with the Lenti/βAS3-FB vector and cryopreserving CD34+ cells from human bone marrow (BM) at clinical scale. In vitro and in vivo characterization of the FCP was performed, showing that all the release criteria were successfully met. In vivo toxicology studies were conducted to evaluate potential toxicity of the Lenti/βAS3-FB LV in the context of a murine BM transplant. RESULTS Primary and secondary transplantation did not reveal any toxicity from the lentiviral vector. Additionally, vector integration site analysis of murine and human BM cells did not show any clonal skewing caused by insertion of the Lenti/βAS3-FB vector in cells from primary and secondary transplanted mice. CONCLUSIONS We present here a complete protocol, thoroughly optimized to manufacture, characterize and establish safety of a FCP for gene therapy of SCD.
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Affiliation(s)
- Fabrizia Urbinati
- Department of Microbiology, Immunology and Molecular Genetics and the Eli & Edythe Broad Stem Cell Research Center, University of California, Los Angeles, California, USA
| | - Jennifer Wherley
- Department of Microbiology, Immunology and Molecular Genetics and the Eli & Edythe Broad Stem Cell Research Center, University of California, Los Angeles, California, USA
| | - Sabine Geiger
- Department of Microbiology, Immunology and Molecular Genetics and the Eli & Edythe Broad Stem Cell Research Center, University of California, Los Angeles, California, USA
| | - Beatriz Campo Fernandez
- Department of Microbiology, Immunology and Molecular Genetics and the Eli & Edythe Broad Stem Cell Research Center, University of California, Los Angeles, California, USA
| | - Michael L Kaufman
- Department of Microbiology, Immunology and Molecular Genetics and the Eli & Edythe Broad Stem Cell Research Center, University of California, Los Angeles, California, USA
| | - Aaron Cooper
- Department of Microbiology, Immunology and Molecular Genetics and the Eli & Edythe Broad Stem Cell Research Center, University of California, Los Angeles, California, USA
| | - Zulema Romero
- Department of Microbiology, Immunology and Molecular Genetics and the Eli & Edythe Broad Stem Cell Research Center, University of California, Los Angeles, California, USA
| | - Filippo Marchioni
- Department of Microbiology, Immunology and Molecular Genetics and the Eli & Edythe Broad Stem Cell Research Center, University of California, Los Angeles, California, USA
| | - Lilith Reeves
- Translational Core Laboratory, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | | | - Barbara Nowicki
- UCLA BM/Stem Cell Transplant Laboratory, University of California, Los Angeles, USA
| | - Elke Grassman
- Translational Trials Development and Support Labs, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Shivkumar Viswanathan
- Translational Trials Development and Support Labs, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Xiaoyan Wang
- Department of General Internal Medicine and Health Services Research, University of California, Los Angeles, USA
| | - Roger P Hollis
- Department of Microbiology, Immunology and Molecular Genetics and the Eli & Edythe Broad Stem Cell Research Center, University of California, Los Angeles, California, USA
| | - Donald B Kohn
- Department of Microbiology, Immunology and Molecular Genetics and the Eli & Edythe Broad Stem Cell Research Center, University of California, Los Angeles, California, USA.
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18
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Sordi V, Pellegrini S, Krampera M, Marchetti P, Pessina A, Ciardelli G, Fadini G, Pintus C, Pantè G, Piemonti L. Stem cells to restore insulin production and cure diabetes. Nutr Metab Cardiovasc Dis 2017; 27:583-600. [PMID: 28545927 DOI: 10.1016/j.numecd.2017.02.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/24/2017] [Accepted: 02/11/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND The advancement of knowledge in the field of regenerative medicine is increasing the therapeutic expectations of patients and clinicians on cell therapy approaches. Within these, stem cell therapies are often evoked as a possible therapeutic option for diabetes, already ongoing or possible in the near future. AIM The purpose of this document is to make a point of the situation on existing knowledge and therapies with stem cells to treat patients with diabetes by focusing on some of the aspects that most frequently raise curiosity and discussion in clinical practice and in the interaction with the patient. In fact, at present there are no clinically approved treatments based on the use of stem cells for the treatment of diabetes, but several therapeutic approaches have already been evaluated or are being evaluated in clinical trials. DATA SYNTHESIS It is possible to identify three large potential application fields: 1) the reconstruction of the β cell mass; 2) the immunomodulation in type 1 diabetes (T1D); 3) the treatment of complications. In this study we will limit the discussion to approaches that have the potential for clinical translation, deliberately omitting aspects of basic biology and preclinical data. Also, we intentionally omit the treatment of the complications that will be the subject of a future document. Finally, an overview of the Italian situation regarding the storage of cord blood cells for the therapy of diabetes will be given.
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Affiliation(s)
- V Sordi
- Diabetes Research Institute (DRI) - IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - S Pellegrini
- Diabetes Research Institute (DRI) - IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Krampera
- Stem Cell Research Laboratory, Section of Hematology, Department of Medicine, University of Verona, Italy
| | - P Marchetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - A Pessina
- CRC-StaMeTec (Mesenchymal Stem Cells for Cell Therapy), Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - G Ciardelli
- DIMEAS - Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - G Fadini
- Medicine Department (DIMED), University of Padua, Italy
| | - C Pintus
- Italian National Transplant Center (CNT), Italy
| | - G Pantè
- Italian Medicines Agency (AIFA), Italy
| | - L Piemonti
- Diabetes Research Institute (DRI) - IRCCS San Raffaele Scientific Institute, Milan, Italy.
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19
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Mousavi SH, Abroun S, Zarrabi M, Ahmadipanah M. The effect of maternal and infant factors on cord blood yield. Pediatr Blood Cancer 2017; 64. [PMID: 27905684 DOI: 10.1002/pbc.26381] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 11/05/2016] [Accepted: 11/07/2016] [Indexed: 11/11/2022]
Abstract
Umbilical cord blood (CB) can be used as an alternative hematopoietic stem cell source for transplantation in hematological malignancy and blood disorders. The success of transplantation is highly related to the levels of total nucleated cell and CD34+ cell counts. The evaluation of optimal conditions can decrease the rate of graft rejection due to low cell count and increases the quality of CB units (CBUs) in the blood bank and the success rate of engraftment. To this end, we review the maternal and infant parameters affecting the quality and quantity of CBUs.
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Affiliation(s)
- Seyed Hadi Mousavi
- Department of Hematology, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Abroun
- Department of Hematology, School of Medical Sciences, Tarbiat Modarres University, Tehran, Iran
| | - Morteza Zarrabi
- Royan Stem Cell Technology Institute, Cord Blood Bank, Tehran, Iran
| | - Mona Ahmadipanah
- Royan Stem Cell Technology Institute, Cord Blood Bank, Tehran, Iran
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20
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Paton MCB, McDonald CA, Allison BJ, Fahey MC, Jenkin G, Miller SL. Perinatal Brain Injury As a Consequence of Preterm Birth and Intrauterine Inflammation: Designing Targeted Stem Cell Therapies. Front Neurosci 2017; 11:200. [PMID: 28442989 PMCID: PMC5385368 DOI: 10.3389/fnins.2017.00200] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 03/24/2017] [Indexed: 12/20/2022] Open
Abstract
Chorioamnionitis is a major cause of preterm birth and brain injury. Bacterial invasion of the chorion and amnion, and/or the placenta, can lead to a fetal inflammatory response, which in turn has significant adverse consequences for the developing fetal brain. Accordingly, there is a strong causal link between chorioamnionitis, preterm brain injury and the pathogenesis of severe postnatal neurological deficits and cerebral palsy. Currently there are no treatments to protect or repair against brain injury in preterm infants born after pregnancy compromised by intrauterine infection. This review describes the injurious cascade of events in the preterm brain in response to a severe fetal inflammatory event. We will highlight specific periods of increased vulnerability, and the potential effects of therapeutic intervention with cell-based therapies. Many clinical trials are underway to investigate the efficacy of stem cells to treat patients with cerebral palsy. Stem cells, obtained from umbilical cord tissue and cord blood, normally discarded after birth, are emerging as a safe and potentially effective therapy. It is not yet known, however, which stem cell type(s) are the most efficacious for administration to preterm infants to treat brain injury-mediated inflammation. Individual stem cell populations found in cord blood and tissue, such as mesenchymal stem cells (MSCs) and endothelial progenitor cells (EPCs), have a number of potential benefits that may specifically target preterm inflammatory-induced brain injury. MSCs have strong immunomodulatory potential, protecting against global and local neuroinflammatory cascades triggered during infection to the fetus. EPCs have angiogenic and vascular reparative qualities that make them ideal for neurovascular repair. A combined therapy using both MSCs and EPCs to target inflammation and promote angiogenesis for re-establishment of vital vessel networks is a treatment concept that warrants further investigation.
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Affiliation(s)
- Madison C B Paton
- Neurodevelopment and Neuroprotection Research Group, The Ritchie Centre, Hudson Institute of Medical Research, Monash UniversityClayton, VIC, Australia.,Department of Obstetrics and Gynaecology, Monash Medical Centre, Monash UniversityClayton, VIC, Australia
| | - Courtney A McDonald
- Neurodevelopment and Neuroprotection Research Group, The Ritchie Centre, Hudson Institute of Medical Research, Monash UniversityClayton, VIC, Australia
| | - Beth J Allison
- Neurodevelopment and Neuroprotection Research Group, The Ritchie Centre, Hudson Institute of Medical Research, Monash UniversityClayton, VIC, Australia
| | - Michael C Fahey
- Neurodevelopment and Neuroprotection Research Group, The Ritchie Centre, Hudson Institute of Medical Research, Monash UniversityClayton, VIC, Australia.,Department of Paediatrics, Monash UniversityClayton, VIC, Australia
| | - Graham Jenkin
- Neurodevelopment and Neuroprotection Research Group, The Ritchie Centre, Hudson Institute of Medical Research, Monash UniversityClayton, VIC, Australia.,Department of Obstetrics and Gynaecology, Monash Medical Centre, Monash UniversityClayton, VIC, Australia
| | - Suzanne L Miller
- Neurodevelopment and Neuroprotection Research Group, The Ritchie Centre, Hudson Institute of Medical Research, Monash UniversityClayton, VIC, Australia.,Department of Obstetrics and Gynaecology, Monash Medical Centre, Monash UniversityClayton, VIC, Australia
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21
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Hütter G. The Safety of Allogeneic Stem Cell Transplantation. STEM CELLS IN CLINICAL APPLICATIONS 2017. [DOI: 10.1007/978-3-319-59165-0_1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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22
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Al-Deghaither SY. Impact of maternal and neonatal factors on parameters of hematopoietic potential in umbilical cord blood. Saudi Med J 2016; 36:704-12. [PMID: 25987113 PMCID: PMC4454905 DOI: 10.15537/smj.2015.6.11247] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Objectives: To determine characteristics of laboratory parameters of hematopoietic potential in umbilical cord blood and their association with maternal and neonatal factors. Methods: This prospective analysis was performed on 206 umbilical cord blood donations (50-200 ml) from King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia between January and September 2014. Samples were processed and analyzed for total nucleated cells (TNC’s), cluster designation (CD)45+, CD34+ counts, nucleated red blood cells (NRBCs) count, and viability testing. Results: Most of the study participants (63.6%) were on their first 3 deliveries and from women with age between 17 and 30 years (80.6%). The donated volume was 50.4-192.4 ml, TNCs ranged from 500.2×106 to 9430.3 ×106 cells, and CD34+ cells ranged from 1.25×106 to 12.82×106/unit. The volume was positively affected by bigger birth weight of the baby (p<0.0001), larger placenta (p=0.001), TNCs (p<0.0001), CD34+ (p<0.0001), NRBCs (p<0.0001), and viability (p=0.002). There were no statistically significant differences between baby boys and girls for laboratory variables. Conclusion: In the selection and identification of a possible donor of umbilical cord blood, several maternal and neonatal factors should be considered, as younger maternal age, neonatal birth weight >3300 grams, larger placental size, and first or second-born babies, were shown to be associated with higher TNCs, CD34+, CD45+, NRBCs, and viability.
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Affiliation(s)
- Sara Y Al-Deghaither
- Department of Clinical Laboratory Science, College of Applied Medical Sciences, King Saud University, PO Box 3160, Riyadh 12444, Kingdom of Saudi Arabia. E-mail.
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23
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Roura S, Pujal JM, Gálvez-Montón C, Bayes-Genis A. Quality and exploitation of umbilical cord blood for cell therapy: Are we beyond our capabilities? Dev Dyn 2016; 245:710-7. [PMID: 27043849 DOI: 10.1002/dvdy.24408] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/03/2016] [Accepted: 03/29/2016] [Indexed: 02/06/2023] Open
Abstract
There is increasing interest in identifying novel stem cell sources for application in emerging cell therapies. In this context, umbilical cord blood (UCB) shows great promise in multiple clinical settings. The number of UCB banks has therefore increased worldwide, with the objective of preserving potentially life-saving cells that are usually discarded after birth. After a rather long and costly processing procedure, the resultant UCB-derived cell products are cryopreserved until transplantation to patients. However, in many cases, only a small proportion of administered cells engraft successfully. Thus, can we do any better regarding current UCB-based therapeutic approaches? Here we discuss concerns about the use of UCB that are not critically pondered by researchers, clinicians, and banking services, including wasting samples with small volumes and the need for more reliable quality and functional controls to ensure the biological activity of stem cells and subsequent engraftment and treatment efficacy. Finally, we appeal for collaborative agreements between research institutions and UCB banks in order to redirect currently discarded small-volume UCB units for basic and clinical research purposes. Developmental Dynamics 245:710-717, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Santiago Roura
- Heart Failure and Cardiac Regeneration (ICREC) Research Program, Germans Trias i Pujol Health Science Research Institute, Can Ruti Campus, Crta.Can Ruti-Camí Escoles s/n, 08916, Badalona, Spain
- Center of Regenerative Medicine in Barcelona, c/ Dr. Aiguader 88, 08003, Barcelona, Spain
| | - Josep Maria Pujal
- Cell Processing Laboratory, Edifici Giroemprèn, Pic de Peguera 11, Parc Científic i Tecnològic Universitat de Girona, 17003, Girona, Spain
| | - Carolina Gálvez-Montón
- Heart Failure and Cardiac Regeneration (ICREC) Research Program, Germans Trias i Pujol Health Science Research Institute, Can Ruti Campus, Crta.Can Ruti-Camí Escoles s/n, 08916, Badalona, Spain
| | - Antoni Bayes-Genis
- Heart Failure and Cardiac Regeneration (ICREC) Research Program, Germans Trias i Pujol Health Science Research Institute, Can Ruti Campus, Crta.Can Ruti-Camí Escoles s/n, 08916, Badalona, Spain
- Cardiology Service, Germans Trias i Pujol University Hospital, Crta.Can Ruti-Camí Escoles s/n, 08916, Badalona, Spain
- Department of Medicine, Crta. Can Ruti-Camí Escoles s/n, Universitat Autònoma de Barcelona, 08916, Badalona, Spain
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Philip J, Kushwaha N, Chatterjee T, Mallhi RS. Optimizing cord blood collections: Assessing the role of maternal and neonatal factors. Asian J Transfus Sci 2015; 9:163-7. [PMID: 26420937 PMCID: PMC4562138 DOI: 10.4103/0973-6247.162714] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND As processing and cryopreservation of cord blood is time consuming and costly, it is essential to select units with optimal CD34+ cells, total nucleated cell (TNC) number and colony forming units (CFUs). These are the most important factors affecting outcome of UCB transplantation and are influenced by various maternal and neonatal factors. AIM AND OBJECTIVES To determine the maternal and neonatal factors affecting TNC and CD34+ cell counts in cord blood so as to aid in proper selection of cord blood units for cryopreservation. MATERIALS AND METHODS A total of 100 UCB units were collected from normal vaginal deliveries, processed and assessed for volume, TNC, CD34+ cell count and CFU-GM. These parameters were then analyzed to find out whether they correlated with maternal and neonatal characteristics such as mother's age, parity, gestational age, baby's birth weight, and sex. RESULTS The volume of CB collected significantly correlated with the TNC, CD34+ cell, and CFU-GM yields (P < 0.02). A heavier placenta (P < 0.05), and a heavier baby (P < 0.002) were associated with a significantly greater volume of CB whereas the age, parity of mother and the sex of the baby had no significant effect. CONCLUSION The only factors found to affect the TNC and CD34+ cell counts significantly were weight of the baby and placenta and the volume of cord blood collected. Since these factors are of prognostic significance, their analysis will aid in deciding which UCB unit should be processed and cryopreserved for UCB banking and subsequent transplantation.
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Affiliation(s)
- Joseph Philip
- Department of Transfusion Medicine, AFMC, Pune, Maharashtra, India
| | - Neerja Kushwaha
- Department of Transfusion Medicine, AFMC, Pune, Maharashtra, India
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Impact of umbilical cord blood-derived mesenchymal stem cells on cardiovascular research. BIOMED RESEARCH INTERNATIONAL 2015; 2015:975302. [PMID: 25861654 PMCID: PMC4377460 DOI: 10.1155/2015/975302] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 01/11/2015] [Indexed: 01/06/2023]
Abstract
Over the years, cell therapy has become an exciting opportunity to treat human diseases. Early enthusiasm using adult stem cell sources has been tempered in light of preliminary benefits in patients. Considerable efforts have been dedicated, therefore, to explore alternative cells such as those extracted from umbilical cord blood (UCB). In line, UCB banking has become a popular possibility to preserve potentially life-saving cells that are usually discarded after birth, and the number of UCB banks has grown worldwide. Thus, a brief overview on the categories of UCB banks as well as the properties, challenges, and impact of UCB-derived mesenchymal stem cells (MSCs) on the area of cardiovascular research is presented. Taken together, the experience recounted here shows that UCBMSCs are envisioned as attractive therapeutic candidates against human disorders arising and/or progressing with vascular deficit.
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Dulugiac M, Horeanga I, Torcatoru A, Bardas A, Matei G, Zarnescu O. Factors which can influence the quality related to cell viability of the umbilical cord blood units. Transfus Apher Sci 2014; 51:90-8. [PMID: 25219638 DOI: 10.1016/j.transci.2014.08.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 08/22/2014] [Accepted: 08/25/2014] [Indexed: 11/29/2022]
Abstract
Cell viability is an important indicator for the quality of umbilical cord blood (UCB) units that can influence the transplant final outcome. Thus, it is particularly important to identify the factors that may affect the cell quality during the banking process. The present study is a first attempt to correlate the impact of exogenous factors (time from collection to processing, collected UCB volume) and endogenous factors (TNCC--total nucleated cell count, CD34(+)cell count) on cell viability assessed before UCB units cryopreservation within a banking standardized process. Three thousand UCB units collected in 35 ml CPDA containing bags were processed by HES sedimentation within 48 h. TNCC, CD34(+) cell counts and total cell viability were determined after processing. Cell viability of 94.37 ± 4.67%, TNCC of 73.17 ± 36.73 × 10(7) and CD34(+)cell count of 2.61 ± 2.29 × 10(6) was obtained after processing of units with UCB collected volume of 80.23 ± 28.52 ml. A significant negative correlation was found between cell viability and the time from collection to processing (r = -0.7228; P < 0.0001). The cell viability decreasing rate of 20.54%, 15.18% and 3-10% were achieved for units with collected UCB volume <40 ml, (40-80 ml) and >80 ml, to 48 h versus 12 h. There were no differences considering cell viability for the UCB units with similar collected UCB volume that had various CD34(+)cell count or TNCC (P > 0.05). The extension of the time from collection to processing of UCB units can reduce the quality by decreasing cell viability. The cell viability decreasing rate owing to the time influence is determined by the collected UCB volume being inversely proportional to it. Endogenous factors do not affect the cell viability.
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Affiliation(s)
- Magda Dulugiac
- Regina Maria Central Stem Cells Bank, 5B Ion Ionescu de la Brad, 13811, Bucharest, Romania; Faculty of Biology, University of Bucharest, Splaiul Independentei 91-95, R-050095, Bucharest, Romania
| | - Ionela Horeanga
- Regina Maria Central Stem Cells Bank, 5B Ion Ionescu de la Brad, 13811, Bucharest, Romania
| | - Andrei Torcatoru
- Regina Maria Central Stem Cells Bank, 5B Ion Ionescu de la Brad, 13811, Bucharest, Romania
| | - Alexandru Bardas
- Regina Maria Central Stem Cells Bank, 5B Ion Ionescu de la Brad, 13811, Bucharest, Romania
| | - Georgiana Matei
- Regina Maria Central Stem Cells Bank, 5B Ion Ionescu de la Brad, 13811, Bucharest, Romania
| | - Otilia Zarnescu
- Faculty of Biology, University of Bucharest, Splaiul Independentei 91-95, R-050095, Bucharest, Romania.
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Purtill D, Smith K, Devlin S, Meagher R, Tonon J, Lubin M, Ponce DM, Giralt S, Kernan NA, Scaradavou A, Stevens CE, Barker JN. Dominant unit CD34+ cell dose predicts engraftment after double-unit cord blood transplantation and is influenced by bank practice. Blood 2014; 124:2905-12. [PMID: 25185264 PMCID: PMC4224191 DOI: 10.1182/blood-2014-03-566216] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 06/25/2014] [Indexed: 01/09/2023] Open
Abstract
We investigated the unit characteristics associated with engraftment after double-unit cord blood (CB) transplantation (dCBT) and whether these could be reliably identified during unit selection. Cumulative incidence of neutrophil engraftment in 129 myeloablative dCBT recipients was 95% (95% confidence interval: 90-98%). When precryopreservation characteristics were analyzed, the dominant unit CD34(+) cell dose was the only characteristic independently associated with engraftment (hazard ratio, 1.43; P = .002). When postthaw characteristics were also included, only dominant unit infused viable CD34(+) cell dose independently predicted engraftment (hazard ratio, 1.95; P < .001). We then examined the determinants of infused viable CD34(+) cell dose (precryopreservation count, postthaw recovery, and postthaw viability) in 402 units thawed at our center. This revealed close correlation between precryopreservation and postthaw CD34(+) cell counts (r(2) = 0.73). Median CD34(+) cell recovery was 101%, although it ranged from 12% to 1480%. Notably, units from non-Netcord Foundation for the Accreditation of Cellular Therapy (Netcord-FACT)-accredited banks were more likely to have low recovery (P < .001). Furthermore, although median postthaw CD34(+) cell viability was 92%, 33 (8%) units had <75% viable CD34(+) cells. Units from non-Netcord-FACT-accredited banks and units with cryovolumes other than 24.5 to 26.0 mL were more likely to have poor postthaw viability. Precryopreservation CD34(+) cell dose and banking practices should be incorporated into CB unit selection.
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Affiliation(s)
- Duncan Purtill
- Adult Bone Marrow Transplantation Service, Department of Medicine
| | | | - Sean Devlin
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
| | | | | | - Marissa Lubin
- Adult Bone Marrow Transplantation Service, Department of Medicine
| | - Doris M Ponce
- Adult Bone Marrow Transplantation Service, Department of Medicine, Weill Cornell Medical College, New York, NY; and
| | - Sergio Giralt
- Adult Bone Marrow Transplantation Service, Department of Medicine, Weill Cornell Medical College, New York, NY; and
| | - Nancy A Kernan
- Bone Marrow Transplantation Service, Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Andromachi Scaradavou
- Bone Marrow Transplantation Service, Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Cladd E Stevens
- Adult Bone Marrow Transplantation Service, Department of Medicine
| | - Juliet N Barker
- Adult Bone Marrow Transplantation Service, Department of Medicine, Weill Cornell Medical College, New York, NY; and
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Cayer MP, Girard M, Fournier D, Delage G, Thibault L. Antimicrobial activity in cord blood units: occurrence and levels of antibiotics. Transfusion 2014; 54:2505-13. [PMID: 24724982 DOI: 10.1111/trf.12655] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 02/17/2014] [Accepted: 02/18/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Antibiotic prophylaxis treatment at delivery is highly recommended for reducing the risk of infection for mothers positive for group B streptococcus. It is therefore expected that some cord blood (CB) products will contain residual antibiotics. This study aimed to determine the incidence and level of β-lactam antibiotics in CB products. STUDY DESIGN AND METHODS The antimicrobial activity of 60 CB plasma by-products was evaluated using disk diffusion assays on 10 bacteria species. Plasma samples showing antimicrobial activity were either treated with β-lactamase enzyme to inhibit β-lactam antibiotics or heated to 56°C for 30 minutes to inhibit complement proteins. β-Lactam antibiotic concentrations were determined by comparison with a standard curve obtained with known concentrations of antibiotics. RESULTS Antimicrobial activity against mostly Gram-positive microorganisms was observed in 33% of CB units. The β-lactamase enzyme abolished the antimicrobial activity in the majority of these CB products. Up to 5 μg/mL penicillin and 14 μg/mL ampicillin were measured in these products. CONCLUSION Approximately one-third of CB products contain significant amounts of plasma with residual antibiotics, which can affect the survival and growth of bacterial contaminants when performing the sterility test and potentially lead to false-negative results. Additional work is required to better understand whether residual antibiotics in CB affect penicillin-allergic patients.
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Clark P, Trickett A, Saffo S, Stark D. Effects of cryopreservation on microbial-contaminated cord blood. Transfusion 2013; 54:532-40. [PMID: 23808601 DOI: 10.1111/trf.12323] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 05/12/2013] [Accepted: 05/20/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cord blood units (CBUs) are associated with significant risk of exposure to microbial contamination during collection and processing; however, the survival of bacteria within a CBU is poorly understood. This study aimed to determine whether contaminating organisms in CBU survive the cryopreservation, frozen storage, and subsequent thawing conditions before infusion. STUDY DESIGN AND METHODS A total of 134 CBUs rejected from banking due to known contamination were thawed and rescreened using blood culture bottles (BacT/ALERT, bioMérieux). An additional 61 fresh CBUs were deliberately spiked with a range of microbial organisms and evaluated both before freeze and after thaw. RESULTS Microbial contaminants were detected after thaw in 63% of stored contaminated CBUs and 85% of spiked CBUs. Postthaw organism detection in spiked cord blood (CB) was higher in adult culture bottles (80%) than pediatric culture bottles (61%). Twenty percent of spiked organisms, particularly Bacillus subtilis, Escherichia coli, Clostridium sporogenes, and Propionibacterium acnes, were not detected in prefreeze samples but were detectable after thaw. CONCLUSIONS This study demonstrates that the majority of contaminating organisms isolated in a prefreeze sample of CB have the ability to survive cryopreservation, frozen storage, and thawing. Further, CBUs reported as microbial free may contain microbial contamination, which could result in transplantation of contaminated CB and be potentially deleterious to a patient.
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Affiliation(s)
- Pamela Clark
- Sydney Cord Blood Bank, Sydney Children's Hospital, Randwick, NSW, Australia; University of New South Wales, Sydney, NSW, Australia; BMT Laboratory, SEALS, Prince of Wales Hospital, Randwick, NSW, Australia; Division of Microbiology, SydPath, St. Vincent's Hospital, Darlinghurst, NSW, Australia
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Anagnostakis I, Papassavas AC, Michalopoulos E, Chatzistamatiou T, Andriopoulou S, Tsakris A, Stavropoulos-Giokas C. Successful short-term cryopreservation of volume-reduced cord blood units in a cryogenic mechanical freezer: effects on cell recovery, viability, and clonogenic potential. Transfusion 2013; 54:211-23. [DOI: 10.1111/trf.12239] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 03/28/2013] [Accepted: 04/02/2013] [Indexed: 12/13/2022]
Affiliation(s)
- Ioannis Anagnostakis
- Hellenic Cord Blood Bank; Foundation for Biomedical Research; Academy of Athens
- Department of Immunology and National Tissue Typing Center; “G. Gennimatas” General Hospital
- Department of Microbiology; Medical School; University of Athens; Athens Greece
| | - Andreas C. Papassavas
- Hellenic Cord Blood Bank; Foundation for Biomedical Research; Academy of Athens
- Department of Immunology and National Tissue Typing Center; “G. Gennimatas” General Hospital
- Department of Microbiology; Medical School; University of Athens; Athens Greece
| | - Efstathios Michalopoulos
- Hellenic Cord Blood Bank; Foundation for Biomedical Research; Academy of Athens
- Department of Immunology and National Tissue Typing Center; “G. Gennimatas” General Hospital
- Department of Microbiology; Medical School; University of Athens; Athens Greece
| | - Theofanis Chatzistamatiou
- Hellenic Cord Blood Bank; Foundation for Biomedical Research; Academy of Athens
- Department of Immunology and National Tissue Typing Center; “G. Gennimatas” General Hospital
- Department of Microbiology; Medical School; University of Athens; Athens Greece
| | - Sofia Andriopoulou
- Hellenic Cord Blood Bank; Foundation for Biomedical Research; Academy of Athens
- Department of Immunology and National Tissue Typing Center; “G. Gennimatas” General Hospital
- Department of Microbiology; Medical School; University of Athens; Athens Greece
| | - Athanassios Tsakris
- Hellenic Cord Blood Bank; Foundation for Biomedical Research; Academy of Athens
- Department of Immunology and National Tissue Typing Center; “G. Gennimatas” General Hospital
- Department of Microbiology; Medical School; University of Athens; Athens Greece
| | - Catherine Stavropoulos-Giokas
- Hellenic Cord Blood Bank; Foundation for Biomedical Research; Academy of Athens
- Department of Immunology and National Tissue Typing Center; “G. Gennimatas” General Hospital
- Department of Microbiology; Medical School; University of Athens; Athens Greece
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Tokan RS, Arsan S, Erdeve O, Solaz N, Avcı A, Ulkar SE, Gülyapar E, Ustünyurt Z, Bıyıklı Z, Kemahlı S. Comparison of stored umbilical cord blood and adult donor blood: transfusion feasibility. Turk J Haematol 2012; 29:233-41. [PMID: 24744666 PMCID: PMC3986747 DOI: 10.5505/tjh.2012.94547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 01/30/2012] [Indexed: 11/18/2022] Open
Abstract
Objective: This study aimed to compare the storage properties of red blood cell (RBC) concentrates of umbilical cordblood (UCB) and adult donor blood (ADB), and to evaluate the feasibility of UCB-RBC concentrate as an autologoussource for blood transfusion in very low birth weight (VLBW) preterm neonates. Material and Methods: In all, 30 newborn (10 preterm, 20 full term) UCB and 31 ADB units were collected.RBC concentrates were stored and compared with regard to pH, potassium (K+), 2,3-biphosphoglycerate (2-3-BPG),adenosine tri-phosphate (ATP), plasma Hb, and bacterial contamination on d 1, 21, and 35 of storage. Results: The K+ level increased with time and differed significantly between storage d 1 and 21, and between storaged 1 and 35 in both the UCB and ADB units. Initial and d 21 K+ levels were higher in the UCB units than in the ADBunits. The 2,3-BPG level did not differ significantly between the UCB-PRC and ADB-PRC samples. After 35 d of storageboth UCB-PRC and ADB-PRC samples exhibited significant differences from the initial free Hb, intracellular ATP, andpH values. Significant differences in intracellular ATP and pH were also observed between the UCB-PRC and ADB-PRCsamples. Conclusion: The volume of harvested and prepared UCB-PRC can be used for some of the blood transfusions requiredduring the neonatal period and thus may decrease the number of allogeneic transfusions, especially in preterm newborns.The hematological and biochemical changes that occurred in UCB during storage were comparable with those observedin ADB, and do not pose a risk to the immature metabolism of neonates. UCB-RPC prepared and stored under standardconditions can be a safe alternative RBC source for transfusions in VLBW newborns.
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Affiliation(s)
- Rola Sahyoun Tokan
- Ankara University, Faculty of Medicine, Department of Pediatrics, Ankara, Turkey
| | - Saadet Arsan
- Ankara University, Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Omer Erdeve
- Ankara University, Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Nuri Solaz
- Ankara University, Faculty of Medicine, Serpil Akdağ Blood Center, Ankara, Turkey
| | - Aslıhan Avcı
- Ankara University, Faculty of Medicine, Department of Biochemistry, Ankara, Turkey
| | - Serenay Elgün Ulkar
- Ankara University, Faculty of Medicine, Department of Biochemistry, Ankara, Turkey
| | - Elif Gülyapar
- Dr. Zekai Tahir Burak Women's Hospital, Ankara, Turkey
| | | | - Zeynep Bıyıklı
- Ankara University, Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
| | - Sabri Kemahlı
- Ankara University, Faculty of Medicine, Serpil Akdağ Blood Center, Ankara, Turkey
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Clark P, Trickett A, Stark D, Vowels M. Factors affecting microbial contamination rate of cord blood collected for transplantation. Transfusion 2012; 52:1770-7. [PMID: 22211719 DOI: 10.1111/j.1537-2995.2011.03507.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Collection and processing of cord blood (CB) is associated with significant risk of microbial contamination and hence relevant standards mandate microbial screening of the final product. This study aimed to determine the contamination rate and associated risk factors during 14 years of banking at the Sydney Cord Blood Bank. STUDY DESIGN AND METHODS CB was collected and processed using a closed system and tested for contamination using blood culture bottles (BacT/ALERT, bioMérieux) incubated for a minimum of 5 days. Four microbial screening methods were used with different combinations of inoculated bottles (adult or pediatric) and associated sample volumes (10 or 1 mL). RESULTS Of 13,344 CB units screened, 537 (4.0%) tested positive for contamination, with Bacteroides spp. (20.9%), Staphylococcus spp. (18.6%), and Propionibacterium spp. (13.7%) being the most common isolates. The contamination rate reduced from 10% in 1997 to 1.1% in 2009. Multivariate analysis demonstrated the following variables were independently associated with higher contamination rates: vaginal delivery, collection by obstetric staff, and use of an anaerobic bottle in addition to an aerobic bottle (which facilitated a larger sample inoculation volume than pediatric bottles). CONCLUSIONS This study demonstrates that contamination rates of CB collected for transplantation can be substantially reduced by collection after cesarean delivery and utilizing trained CB collection staff. These data also indicate that the common practice of testing using a pediatric (aerobic) bottle with its attendant small volume of the final CB product may be suboptimal for sensitive detection of contaminating anaerobic microbes.
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Affiliation(s)
- Pamela Clark
- Sydney Cord Blood Bank, Sydney Children's Hospital, Randwick, NSW, Australia.
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Chasovskyi K, Fedevych O, Vorobiova G, Zhovnir V, Maksimenko A, Boychenko O, Lysak Y, Cohen G, Yemets I. Arterial switch operation in the first hours of life using autologous umbilical cord blood. Ann Thorac Surg 2012; 93:1571-6. [PMID: 22459547 DOI: 10.1016/j.athoracsur.2012.01.104] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 01/23/2012] [Accepted: 01/31/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND In this study, we analyzed our clinical experience performing the arterial switch operation in the first hours of life using autologous umbilical cord blood transfusion (AUCBT). The safety and efficiency of AUCBT was assessed and compared with surgery with the use of homologous blood transfusion. METHODS Between September 2009 and February 2011, 61 neonates underwent ASO at our institution. Patients were enrolled and allocated to two groups with different modalities of management strategies for neonates with dextrotransposition of the great arteries. RESULTS The groups were similar in diagnoses, birth weight, cardiopulmonary bypass protocol, and surgical technique, excepting timing of surgery and blood management strategy. Preoperative mean hematocrit did not differ significantly between the groups (45% versus 45%). Mean hematocrit was significantly lower in the study group than in the control group during cardiopulmonary bypass (24% versus 31%). The hematocrit progressively increased in the study group to 38% on the first postoperative day. Serum lactate levels were higher in the study group till the second day after surgery. There were no significant differences in postoperative clinical profiles. There were no hospital deaths and no AUCBT-related side effects in our study. CONCLUSIONS The arterial switch operation can be performed in the first hours of life with AUCBT. Therefore, AUCBT is a safe and an efficient alternative to homologous blood in neonatal open heart surgery. During the study, we also identified positive economic effects associated with this approach.
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Affiliation(s)
- Kyrylo Chasovskyi
- Department of Perfusiology, Ukrainian Children's Cardiac Center, Kyiv, Ukraine.
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Bárcena A, Muench MO, Kapidzic M, Gormley M, Goldfien GA, Fisher SJ. Human placenta and chorion: potential additional sources of hematopoietic stem cells for transplantation. Transfusion 2012; 51 Suppl 4:94S-105S. [PMID: 22074633 DOI: 10.1111/j.1537-2995.2011.03372.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hematopoietic stem cell (HSC) transplantation is an essential element of medical therapy, leading to cures of previously incurable hematological and nonhematological diseases. Many patients do not find matched donors in a timely manner, which has driven efforts to find alternative pools of transplantable HSCs. The use of umbilical cord blood (UCB) as a source of transplantable HSCs began more than two decades ago. However, the use of UCB as a reliable source of HSCs for transplantation still faces crucial challenges: the number of HSCs present in a unit of UCB is usually sufficient for younger children but not for adults, and the persistent delayed engraftment often seen can result in high rates of infection and mortality. STUDY DESIGN AND METHODS We propose a new approach to a solution of these problems: a potential increase of the limited number of UCB-HSCs available by harvesting HSCs contained in the placenta and the fetal chorionic membrane available at birth. RESULTS We investigated the presence of hematopoietic progenitors and HSCs in human placenta and chorion at different gestational ages. The characterization of these cells was performed by flow cytometry and immunolocalization, and their functional status was investigated by transplanting them into immunodeficient mice. CONCLUSION HSCs are present in extraembryonic tissues and could be banked in conjunction to the UCB-HSCs. This novel approach could have a large impact on the field of HSC banking and, more crucially, on the outcome of patients undergoing this treatment by greatly improving the use of life-saving hematopoietic transplants.
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Affiliation(s)
- Alicia Bárcena
- The Ely and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, Center of Reproductive Sciences, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, California 94143-0665, USA.
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De Schauwer C, Meyer E, Cornillie P, De Vliegher S, van de Walle GR, Hoogewijs M, Declercq H, Govaere J, Demeyere K, Cornelissen M, Van Soom A. Optimization of the Isolation, Culture, and Characterization of Equine Umbilical Cord Blood Mesenchymal Stromal Cells. Tissue Eng Part C Methods 2011; 17:1061-70. [DOI: 10.1089/ten.tec.2011.0052] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Catharina De Schauwer
- Department of Reproduction, Obstetrics and Herd Health, Ghent University, Merelbeke, Belgium
| | - Evelyne Meyer
- Laboratory of Biochemistry, Ghent University, Merelbeke, Belgium
| | | | - Sarne De Vliegher
- Department of Reproduction, Obstetrics and Herd Health, Ghent University, Merelbeke, Belgium
| | - Gerlinde R. van de Walle
- Department of Comparative Physiology and Biometrics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Maarten Hoogewijs
- Department of Reproduction, Obstetrics and Herd Health, Ghent University, Merelbeke, Belgium
| | - Heidi Declercq
- Department of Basic Medical Sciences, Faculty of Medicine, Ghent University, Ghent, Belgium
| | - Jan Govaere
- Department of Reproduction, Obstetrics and Herd Health, Ghent University, Merelbeke, Belgium
| | - Kristel Demeyere
- Laboratory of Biochemistry, Ghent University, Merelbeke, Belgium
| | - Maria Cornelissen
- Department of Basic Medical Sciences, Faculty of Medicine, Ghent University, Ghent, Belgium
| | - Ann Van Soom
- Department of Reproduction, Obstetrics and Herd Health, Ghent University, Merelbeke, Belgium
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Pope B, Mitsakos K, Bilgin A, Hokin B, Grant R. Predicting overall viability of cord blood harvests. Transfusion 2011; 52:1079-85. [DOI: 10.1111/j.1537-2995.2011.03386.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Is there a role for autologous/placental red blood cell transfusions in the anemia of prematurity? Transfus Med Rev 2010; 24:125-9. [PMID: 20303035 DOI: 10.1016/j.tmrv.2009.11.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Because most extremely preterm infants with birth weight less than 1000 g need red blood cell transfusions, many attempts have been made to collect, process, and store placental blood (ie, umbilical cord blood) for autologous transfusions. Although it is feasible to do this, multiple problems in doing so including insufficient volumes collected, clotting, hemolysis, bacterial contamination, failure to significantly supplant need for allogeneic transfusions, and high costs have led many to question whether, on balance, autologous/placental red blood cell transfusion offers clinically significant benefits.
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Serikov V, Hounshell C, Larkin S, Green W, Ikeda H, Walters MC, Kuypers FA. Human term placenta as a source of hematopoietic cells. Exp Biol Med (Maywood) 2009; 234:813-23. [PMID: 19429852 DOI: 10.3181/0809-bc-262] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The main barrier to a broader clinical application of umbilical cord blood (UCB) transplantation is its limiting cellular content. Thus, the discovery of hematopoietic progenitor cells in murine placental tissue led us investigate whether the human placenta contains hematopoietic cells, sites of hematopoiesis, and to develop a procedure of processing and storing placental hematopoietic cells for transplantation. Here we show that the human placenta contains large numbers of CD34-expressing hematopoietic cells, with the potential to provide a cellular yield several-fold greater than that of a typical UCB harvest. Cells from fresh or cryopreserved placental tissue generated erythroid and myeloid colonies in culture, and also produced lymphoid cells after transplantation in immunodeficient mice. These results suggest that human placenta could become an important new source of hematopoietic cells for allogeneic transplantation.
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Affiliation(s)
- Vladimir Serikov
- Children's Hospital Oakland Research Institute, Oakland, CA 94609, USA
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40
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Flores AI, McKenna DH, Montalbán MA, De la Cruz J, Wagner JE, Bornstein R. Consistency of the initial cell acquisition procedure is critical to the standardization of CD34+ cell enumeration by flow cytometry: results of a pairwise analysis of umbilical cord blood units and cryopreserved aliquots. Transfusion 2009; 49:636-47. [PMID: 19055702 DOI: 10.1111/j.1537-2995.2008.02035.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The CD34+ cell content is a predictive factor for engraftment and survival after umbilical cord blood (UCB) transplantation. The high variability in the CD34 assay results in different recommended cell doses for infusion across transplant centers and also limits the clinical utility of the CD34+ cell counts provided by cord blood banks (CBBs). This bi-institutional study was intended to understand the sources of this variability. STUDY DESIGN AND METHODS The level of CD34 agreement between the University of Minnesota (UM) and the Madrid CBB (MCBB) was evaluated on 50 UCB units before and after cryopreservation. Two cryopreserved vials per unit were thawed and processed at both laboratories. Dual-platform ISHAGE-based flow cytometry was used for CD34 enumeration. RESULTS Postthaw nucleated cell recoveries were similar. However, whereas CD34+ cell enumeration before freezing was 0.35 +/- 0.22 percent, the results after thawing were 0.98 +/- 0.65 and 0.57 +/- 0.39 percent at UM and MCBB, respectively. Bland-Altman plots analysis ruled out the interchangeability of MCBB and UM CD34 values. Differences in the initial cell acquisition settings accounted for most of the CD34 discrepancy, which was no longer present after normalization of the forward scatter threshold for cell acquisition. CONCLUSIONS The standardization of CD34+ cell enumeration by flow cytometry is strongly reliant on a consistent initial cell acquisition procedure. The interlaboratory variation can be minimized by using frozen cell aliquots as reference samples. Both requisites should be considered for CD34 testing and UCB unit selection by regulatory institutions involved with cord blood banking and transplantation.
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Affiliation(s)
- Ana I Flores
- Madrid Cord Blood Bank and the Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
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41
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Singh K, Srivastava A, Mathur N, Kumar S, Kumar L, Mukhopadhyay A, Konchupillai V. Evaluation of four methods for processing human cord blood and subsequent study of the expansion of progenitor stem cells isolated using the best method. Cytotherapy 2009; 11:768-77. [DOI: 10.3109/14653240902824740] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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42
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Lecchi L, Perego L, Garcea F, Ratti I, Brasca M, Dotti D, Cimoni S, Pezzali I, Celeste T, Giovanelli S, Butti B, De Fazio N, Lopa R, Rebulla P. Ten-year quality control of a semiautomated procedure of cord blood unit volume reduction. Transfusion 2008; 49:563-9. [PMID: 19040412 DOI: 10.1111/j.1537-2995.2008.02013.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Volume reduction of cord blood units decreases the cost of cryogenic storage. This study reports the analysis of a 10-year quality control program of a semiautomated cord blood volume reduction procedure. STUDY DESIGN AND METHODS Cord blood was collected in a plastic bag containing 29 mL citrate-phosphate-dextrose, centrifuged at 2124 x g for 12 minutes, and processed with a semiautomated device. The procedure was aimed at removing most red blood cells and plasma and concentrating hematopoietic progenitors in the buffy coat (BC), thus reducing the unit volume and saving cryogenic space. Finally, the BC was cryopreserved with an equal volume of 20 percent dimethyl sulfoxide. Total nucleated cells (TNCs) were counted before and after processing in the 4311 units banked from 1998 through 2007, whereas CD34+ cells and colony-forming units-granulocyte-macrophage (CFU-GM) were counted in 420 random units from 2001 through 2007. RESULTS Mean postvolume reduction annual recoveries of TNCs, CD34+ cells, and CFU-GM ranged from 82.8 +/- 12.3 (standard deviation) to 91.4 +/- 6.4 percent, from 87.8 +/- 14.1 to 95.2 +/- 23.8 percent, and from 101.5 +/- 51.4 to 117.8 +/- 59.5 percent, respectively. Very strong correlations were found (r > 0.87) between postprocessing versus preprocessing TNCs, CD34+ cells, and CFU-GM; a moderate correlation between initial TNC count and unit's volume (r = 0.51); and no correlation between TNC percentage of recovery in the BC and initial unit's volume. The latter data indicate that most TNCs concentrate in the BC. CONCLUSIONS The semiautomated procedure of cord blood unit volume reduction used in this study provides high and stable cellular recoveries during several years of routine cord blood banking.
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Affiliation(s)
- Lucilla Lecchi
- Center of Transfusion Medicine, Cellular Therapy and Cryobiology, IRCCS Fondazione Ospedale Policlinico, Mangiagalli e Regina Elena, Milan, Italy.
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Papassavas AC, Gioka V, Chatzistamatiou T, Kokkinos T, Anagnostakis I, Gecka G, Redoukas I, Paterakis G, Stavropoulos-Giokas C. A strategy of splitting individual high volume cord blood units into two half subunits prior to processing increases the recovery of cells and facilitates ex vivo expansion of the infused haematopoietic progenitor cells in adults. Int J Lab Hematol 2008; 30:124-32. [PMID: 18333844 DOI: 10.1111/j.1751-553x.2007.00906.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study was designed to maximize the recovery of the desirable cell populations contained in the cord blood (CB) freezing bag, in order to optimize donor selection for adolescents and adults. To evaluate this hypothesis, high volume CB units (CBUs) were categorized into three volume collection groups (120-139, 140-159 and >or=160 ml) and were randomly split before volume reduction into two half low volume CBUs; (a) and (b). Using the SEPAX Cell Processing System, all CBUs were standardized to 26 ml. In 128 high volume split CBUs, the WBC, mononuclear cell and CD34+ cell recoveries were significantly higher (P
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Affiliation(s)
- A C Papassavas
- Hellenic Cord Blood Bank, Foundation for Biomedical Research, Academy of Athens, Athens, Greece.
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Fleming KK, Longmire EK, Hubel A. Numerical characterization of diffusion-based extraction in cell-laden flow through a microfluidic channel. J Biomech Eng 2007; 129:703-11. [PMID: 17887896 DOI: 10.1115/1.2768373] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cells are routinely cryopreserved in dimethyl sulfoxide (DMSO), a cryoprotective agent, for medical applications. Infusion of a DMSO-laden cell suspension results in adverse patient reactions, but current DMSO extraction processes result in significant cell losses. A diffusion-based numerical model was employed to characterize DMSO extraction in fully developed channel flow containing a wash stream flowing parallel to a DMSO-laden cell suspension. DMSO was allowed to diffuse across cell membranes as well as across the channel depth. A variety of cases were considered with the ultimate goal of characterizing the optimal geometry and flow conditions to process clinical volumes of cell suspension in a reasonable time (2-3 ml/min). The results were dependent on four dimensionless parameters: depth fraction of the DMSO-laden stream, Peclet number, cell volume fraction in the DMSO-laden stream, and cell membrane permeability parameter. Smaller depth fractions led to faster DMSO extraction but channel widths that were not practical. Higher Peclet numbers led to longer channels but smaller widths. For the Peclet values and channel depths considered (>or=500 microm) and appropriate permeability values, diffusion across cell membranes was significantly faster than diffusion across the channel depth. Cell volume fraction influenced the cross-stream diffusion of DMSO by limiting the fluid volume fraction available in the contaminant stream but did not play a significant role in channel geometry or operating requirements. The model was validated against preliminary experiments in which DMSO was extracted from suspensions of B-lymphoblast cells. The model results suggest that a channel device with practical dimensions can remove a sufficient level of contaminant within a mesoscale volume of cells in the required time.
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Affiliation(s)
- K K Fleming
- Department of Mechanical Engineering, University of Minnesota, 1100 Mechanical Engineering, 111 Church Street, Minneapolis, Minnesota 55455, USA
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45
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Fleming KK, Hubel A. Cryopreservation of Hematopoietic Stem Cells: Emerging Science, Technology and Issues. Transfus Med Hemother 2007. [DOI: 10.1159/000104213] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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46
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George TJ, Sugrue MW, George SN, Wingard JR. Factors associated with parameters of engraftment potential of umbilical cord blood. Transfusion 2006; 46:1803-12. [PMID: 17002638 DOI: 10.1111/j.1537-2995.2006.00971.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Umbilical cord blood (UCB) is an acceptable source of hematopoietic cells for transplantation with success being associated with the nucleated cell count (NCC), CD34+ cells, and colony-forming unit-granulocyte-macrophage (CFU-GM) content infused. A total of 1033 UCB samples with neonatal and paternal characteristics that might influence hematopoietic content were examined. STUDY DESIGN AND METHODS UCB samples were screened, processed, and reevaluated for the above cell counts. These parameters of engraftment potential were analyzed for associations with neonatal and parental characteristics. RESULTS Postprocessed NCCs (median, 6.53 x 10(8)+/- 2.80 x 10(8) SD; mean 7.30 x 10(8)), CD34+ counts (median, 2.02 x 10(6) +/- 2.20 x 10(6) SD; mean, 2.65 x 10(6); r = 0.66; p < 0.001), and CFU-GM content (median, 2.65 x 10(5) +/- 3.16 x 10(5) SD; mean, 3.54 x 10(5); r = 0.61; p < 0.001) all were strongly interrelated. Both initial volume (median, 77.5 +/- 26.2 mL SD; mean, 81.9 mL) and initial NCC (median, 9.75 x 10(8) +/- 4.88 x 10(8) SD; mean, 10.9 x 10(8)) correlated well with postprocessed NCC (r = 0.60; r = 0.90; p < 0.01), CD34+ count (r = 0.40; r = 0.63; p < 0.01), and CFU-GM content (r = 0.38; r = 0.59; p < 0.01), with a stronger relationship seen with initial NCC. Infant birth weight (specifically, >3000 g), but not sex, gestational age, or cytomegalovirus status correlated strongly with collection volume and UCB cell counts. Units from minority volunteers contained relatively smaller volumes and hematopoietic content. CONCLUSION UCB banks should emphasize selecting the heaviest infants and processing large-volume units with high NCCs to optimize hematopoietic potential. Minority recruitment should be encouraged with consideration given to inherent racial differences in cell counts. There does not appear to be a significant relationship between other neonatal and parental characteristics and that of engraftment potential.
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Affiliation(s)
- Thomas J George
- University of Florida, College of Medicine, Gainesville, Florida, USA.
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47
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Fleming KK, Hubel A. Cryopreservation of hematopoietic and non-hematopoietic stem cells. Transfus Apher Sci 2006; 34:309-15. [PMID: 16829201 DOI: 10.1016/j.transci.2005.11.012] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2005] [Accepted: 11/23/2005] [Indexed: 11/19/2022]
Abstract
Recent studies illustrate the potential for improving the cryopreservation of stem cells. Reduced DMSO concentrations in the cryopreservation medium, post thaw washing of cells and increased cell concentration have been actively studied. Standardization of cell processing has led to the study of liquid storage prior to cryopreservation, validation of mechanical (uncontrolled rate freezing) freezing, and cryopreservation bag failure. Finally, the need for the systematic study and optimization of preservation processes has not been fulfilled. As the sources and applications of stem cells (hematopoietic and non-hematopoietic) continue to be developed, the need for effective preservation methods will only grow.
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Affiliation(s)
- K K Fleming
- Department of Mechanical Engineering, University of Minnesota, 1100 Mechanical Engineering, 111 Church Street SE, Minneapolis, MN 55455, USA
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48
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Wagner E, Duval M, Dalle JH, Morin H, Bizier S, Champagne J, Champagne MA. Assessment of cord blood unit characteristics on the day of transplant: comparison with data issued by cord blood banks. Transfusion 2006; 46:1190-8. [PMID: 16836567 DOI: 10.1111/j.1537-2995.2006.00870.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Selection of a cord blood (CB) unit for allogeneic transplantation relies on graft characterization results provided by cord blood banks (CBBs). The goal was to compare the graft characterization results obtained upon thawing and washing to those provided by CBBs at selection. STUDY DESIGN AND METHODS With tests that assess CB graft characteristics known to impact engraftment, CB units have been analyzed after thaw and before infusion. Our results were compared to data provided by CBBs to determine the impact on engraftment and assess how CBB-supplied information can affect future CB unit selection. RESULTS Variability was noted as to the type of information provided by the different CBBs. Also, variability was found between the information provided by CBBs and the graft characterization results obtained upon thawing and washing. In some cases, CB measures known to be predictive of engraftment were found much lower than reported by CBBs. Only the total nucleated cell count, which is the main CB graft selection criterion besides HLA matching, correlated favorably. CONCLUSIONS Our data reveal a high degree of variability in graft characteristics provided by CBBs and often poor correlation with results obtained on thawed and washed CB units. We suggest that standardized laboratory procedures aimed at graft characterization should be used by both CBBs and transplant centers to avoid unacceptable discrepancies.
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Affiliation(s)
- Eric Wagner
- Division of Hematology-Oncology, CHU Sainte-Justine, Université de Montréal, Montréal, Québec, Canada
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49
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Meyer TPH, Hofmann B, Zaisserer J, Jacobs VR, Fuchs B, Rapp S, Weinauer F, Burkhart J. Analysis and cryopreservation of hematopoietic stem and progenitor cells from umbilical cord blood. Cytotherapy 2006; 8:265-76. [PMID: 16793735 DOI: 10.1080/14653240600735685] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Umbilical cord blood (UCB) is an important source of hematopoietic stem and progenitor cells (HSC/HPC) for the reconstitution of the hematopoietic system after clinical transplantation. Cryopreservation of these cells is critical for UCB banking and transplantation as well as for research applications by providing readily available specimens. The objective of this study was to optimize cryopreservation conditions for CD34+ HSC/HPC from UCB. METHODS Cryopreservation of CD34+ HSC/HPC from UCB after mononuclear cell (MNC) preparation was tested in a research-scale setup. Experimental variations were concentration of the cryoprotectant, the protein additive and cell concentration. In addition, protocols involving slow, serial addition and removal of DMSO were compared with standard protocols (fast addition and removal of DMSO) in order to avoid osmotic stress for the cryopreserved cells. Viability and recoveries of MNC, CD34+ cells and total colony-forming units (CFU) were calculated as read-outs. In addition, sterility testing of the collected UCB units before further processing was performed. RESULTS The optimal conditions for cryopreservation of CD34+ HPC in MNC preparations were 10% DMSO and 2% human albumin at high cell concentrations (5 x 10(7) MNC/mL) with fast addition and removal of DMSO. After cryopreservation using a computer-controlled freezer, high viabilities (89%) and recoveries for CD34+ cells (89%) as well as for CFU (88%) were observed. Microbial contamination of the collected UCB samples was reduced to a rate of 6.4%. DISCUSSION Optimized cryopreservation conditions were developed for UCB MNC in respect of the composition of the cryosolution. In addition, our results showed that fast addition of DMSO is essential for improved cryopreservation and post-thaw quality assessment results, whereas the speed of DMSO removal after thawing has little influence on the recoveries of CD34+ cells and CFU.
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Affiliation(s)
- T P H Meyer
- Blood Donor Service, Bavarian Red Cross, Herzon-Heinrich-Strasse 4, 80336 Munich, Germany
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50
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Kamble R, Pant S, Selby GB, Kharfan-Dabaja MA, Sethi S, Kratochvil K, Kohrt N, Ozer H. Microbial contamination of hematopoietic progenitor cell grafts-incidence, clinical outcome, and cost-effectiveness: an analysis of 735 grafts. Transfusion 2005; 45:874-8. [PMID: 15934984 DOI: 10.1111/j.1537-2995.2005.04178.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Screening of progenitor cell grafts (marrow, peripheral blood, and cord blood) for microbial contamination is required by the standards of AABB. Clinical sequelae from infusion of these contaminated grafts, however, is uncommon. STUDY DESIGN AND METHODS A retrospective analysis of 735 consecutive marrow and peripheral blood progenitor cell harvests between 1998 and 2003 was performed. Analysis included incidence, clinical outcome, and cost outcomes of positive blood cultures and antibiotic therapy. RESULTS Thirty-three of 735 (4.5%) harvests were contaminated. The incidence of microbial contamination varied with the source of the graft (4 of 26 [15%] were cord blood, 8 of 177 [4.5%] were marrow, and 21 of 532 [3.9%] were peripheral blood). Coagulase-negative Staphylococcus (n=22) and Propionibacterium acnes (n=8) were most frequently isolated. Potentially pathogenic organisms were isolated in 6 of 735 (0.81%) grafts (methicillin-sensitive Staphylococcus aureus, 4; methicillin-resistant S. aureus, 1; and Enterobacter cloacae, 1). The estimated total cost of surveillance was approximately $81,585. The cost of vancomycin therapy in 4 patients who received prophylactic antibiotic therapy was approximately $10,000. No adverse sequelae followed infusion of contaminated grafts. CONCLUSION Clinical sequelae following infusion of microbially contaminated progenitor cells is extremely rare. Prophylactic empiric antibiotics may be unnecessary. Routine microbial surveillance of progenitor cell grafts is a low-yield procedure.
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Affiliation(s)
- Rammurti Kamble
- Section of Hematology-Oncology and Bone Marrow Transplantation, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.
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