1
|
Panwar A. Thalassemia, biobanking infrastructures, and personalized stem cell therapies in Chennai. FRONTIERS IN SOCIOLOGY 2023; 8:1057220. [PMID: 37577128 PMCID: PMC10415100 DOI: 10.3389/fsoc.2023.1057220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 06/30/2023] [Indexed: 08/15/2023]
Abstract
Thalassemia and leukemia and related blood disorders are approved for blood stem cell transplants in India, for a stem cell transplant to be successful, the human leukocyte antigen (HLA) complex located on the arm of chromosome six must be a match between the cord blood donor and the recipient. In the quest to find an exact blood stem cell match for an individual, the HLA becomes the node at the center of community genetics where the HLA match is sought (not necessarily successful) in the extended family, the same caste, language, and ethnic (both national and the diaspora) groups. By considering thalassemia as a case study, how do we understand personalized stem cell therapies within biobanking infrastructures in Chennai? How do social categories get entwined with biological materials like cord blood?
Collapse
Affiliation(s)
- Amishi Panwar
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| |
Collapse
|
2
|
Panwar A. Amulets and Cord Blood: Understanding Banking and Regenerative Medicine in Chennai, India. Med Anthropol 2023; 42:121-135. [PMID: 36625669 PMCID: PMC9928429 DOI: 10.1080/01459740.2022.2159821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Umbilical cord blood stem cells can be extracted and collected in cord blood banks, potentially to be used for stem cell transplants in the case of blood and related disorders. But some women in Tamil Nadu store dried cord tissue in an amulet to protect their children from harm and to restore health when required. I trace the sakthi (power) of the amulet and its contents by following puberty rites, pre-delivery rituals and food consumed, which the pregnant mother embodies, eventually to be reproduced in an amulet. What makes the amulet and its contents medicine and a symbol of regeneration, just like cord blood stem cells? Why is the amulet a preferred mode of storing cord tissue in Chennai?
Collapse
Affiliation(s)
- Amishi Panwar
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK,CONTACT Amishi Panwar Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, BristolBS8 2PS, UK
| |
Collapse
|
3
|
Regenerative Medicine Therapies for Prevention of Abdominal Adhesions: A Scoping Review. J Surg Res 2022; 275:252-264. [DOI: 10.1016/j.jss.2022.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/26/2021] [Accepted: 02/08/2022] [Indexed: 01/02/2023]
|
4
|
Christakopoulos GE, DeFor TE, Hage S, Wagner JE, Linden MA, Brunstein C, Bejanyan N, Verneris MR, Smith AR. Phase I Dose-Finding, Safety, and Tolerability Trial of Romiplostim to Improve Platelet Recovery After UCB Transplantation. Transplant Cell Ther 2021; 27:497.e1-497.e6. [PMID: 33785364 DOI: 10.1016/j.jtct.2021.02.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/22/2020] [Accepted: 02/26/2021] [Indexed: 11/18/2022]
Abstract
Platelet recovery is delayed after umbilical cord blood transplant (UCBT). Romiplostim is a thrombopoietin receptor agonist that has the potential to improve platelet engraftment after UCBT. The purpose of this study was to determine the safety profile and maximum tolerated dose (MTD) of romiplostim and to investigate whether romiplostim accelerates platelet recovery post-UCBT. It was a single-center, dose-finding, safety and tolerability phase I trial of weekly romiplostim in 20 adult patients who failed to achieve an un-transfused platelet count of 20 × 109/L by day +28 post-UCBT. Romiplostim was administered at the assigned dose as 6 weekly injections beginning by day +42 post-UCBT. Four dose levels (4, 6, 8, and 10 µg/kg per dose) were evaluated. The MTD of romiplostim was determined by the continual reassessment method, with a goal to identify a dose level with desired toxicity rate of ≤20%. Median age of the patients was 59.5 years, and 60% were female. Eleven patients received nonmyeloablative (NMA) double UCBT, seven patients received myeloablative single UCBT, and two patients received NMA single UCBT. Two patients received 4 µg/kg per dose, two received 6 µg/kg per dose, four received 8 µg/kg per dose, and the remaining 12 received 10 µg/kg per dose. Only five patients completed the full six doses of treatment. Of the 15 patients who received fewer than six doses, 12 were due to a platelet count of >100 × 109/L, two were due to platelet count of >400 × 109/L, and one was due to right upper extremity edema without thrombosis. All romiplostim-treated patients achieved platelet engraftment to 20 × 109/L at a median of 45 days post-UCBT compared to 90% of controls at a median of 45 days (P = .08). Similarly, 90% of romiplostim-treated patients achieved platelet engraftment to 50 × 109/L at a median of 48 days compared to 75% of controls at a median of 52 days (P = .09). All dose levels were effective with low toxicity; therefore, the MTD of romiplostim was 10 µg/kg per dose, and romiplostim is a safe and potentially effective therapy to counter delayed platelet recovery post-UCBT.
Collapse
Affiliation(s)
| | - Todd E DeFor
- Biostatistics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Stefanie Hage
- Division of Pediatric Blood and Marrow Transplant & Cellular Therapy, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - John E Wagner
- Division of Pediatric Blood and Marrow Transplant & Cellular Therapy, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Michael A Linden
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Claudio Brunstein
- Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Nelli Bejanyan
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Michael R Verneris
- Division of Hematology, Oncology, and Bone Marrow Transplantation, Department of Pediatrics, University of Colorado, Aurora, Colorado
| | - Angela R Smith
- Division of Pediatric Blood and Marrow Transplant & Cellular Therapy, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota.
| |
Collapse
|
5
|
Antenatal predictors of stem cell content for successful umbilical cord blood donation. Arch Gynecol Obstet 2021; 304:377-384. [PMID: 33590333 PMCID: PMC8277615 DOI: 10.1007/s00404-021-05970-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 01/12/2021] [Indexed: 12/03/2022]
Abstract
Purpose The most important HLA-independent factor for the selection of cord blood units (CBU) for hematopoietic stem cell transplantation is the total nucleated cell (TNC) count over 150 × 107 as a surrogate marker for stem cell content. The purpose of this prospective study was to define prenatal clinical predictors for TNC count that would help to identify successful CBU donors before the onset of active labor. Methods This was a prospective analysis of 594 CBUs, collected from all eligible term singleton pregnancies at Basel University Hospital between 4/2015 and 9/2016 analyzing several maternal and fetal factors. The impact of these factors on TNC count (< 150 × 107 cells vs. ≥ 150 × 107 cells) of the CBUs was modeled in a multivariate analysis. Results A total of 114 (19.2%) CBUs had a TNC count of ≥ 150 × 107. In a ROC analysis there was no significant difference between the AUC of all prenatal factors (AUC 0.62) and estimated fetal birth weight by ultrasound alone (AUC 0.62). For women planning a trial of labor a recruitment cut-off at an estimated birth weight of 3300 g would allow 72.6% of all donors with sufficient TNC count to be recruited and 22.8% of all collected CBUs would have a sufficient TNC count for banking. For women planning for elective CS a cut-off of 3400 g would allow 71.4% of all donors with sufficient TNC count to be recruited and 22.7% of all collected CBUs would have sufficient TNC count for banking. Conclusion The estimated fetal birth weight within 2 weeks of delivery by ultrasound as single parameter can be considered at the time of recruitment to estimate the chances of a successful CBU donation.
Collapse
|
6
|
Zhou H, Nguyen L, Arnesano C, Ando Y, Raval M, Rodgers JT, Fraser S, Lu R, Shen K. Non-invasive Optical Biomarkers Distinguish and Track the Metabolic Status of Single Hematopoietic Stem Cells. iScience 2020; 23:100831. [PMID: 31982780 PMCID: PMC6994633 DOI: 10.1016/j.isci.2020.100831] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 12/11/2019] [Accepted: 01/07/2020] [Indexed: 12/28/2022] Open
Abstract
Metabolism is a key regulator of hematopoietic stem cell (HSC) functions. There is a lack of real-time, non-invasive approaches to evaluate metabolism in single HSCs. Using fluorescence lifetime imaging microscopy, we developed a set of metabolic optical biomarkers (MOBs) from the auto-fluorescent properties of metabolic coenzymes NAD(P)H and FAD. The MOBs revealed the enhanced glycolysis, low oxidative metabolism, and distinct mitochondrial localization of HSCs. Importantly, the fluorescence lifetime of enzyme-bound NAD(P)H (τbound) can non-invasively monitor the glycolytic/lactate dehydrogenase activity in single HSCs. As a proof of concept for metabolism-based cell sorting, we further identified HSCs within the Lineage-cKit+Sca1+ (KLS) hematopoietic stem/progenitor population using MOBs and a machine-learning algorithm. Moreover, we revealed the dynamic changes of MOBs, and the association of longer τbound with enhanced glycolysis under HSC stemness-maintaining conditions during HSC culture. Our work thus provides a new paradigm to identify and track the metabolism of single HSCs non-invasively and in real time. Metabolic optical biomarkers non-invasively distinguish HSCs from early progenitors NAD(P)H τbound reflects lactate dehydrogenase activity in single fresh/cultured HSCs pHi correlates with τbound in hematopoietic populations, with HSCs being the highest Optical biomarkers track metabolic changes and response to drugs in cultured HSCs
Collapse
Affiliation(s)
- Hao Zhou
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA
| | - Lisa Nguyen
- Department of Stem Cell Biology and Regenerative Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Cosimo Arnesano
- Translational Imaging Center, University of Southern California, Los Angeles, CA 90089, USA; Molecular and Computational Biology, University of Southern California, Los Angeles, CA 90089, USA
| | - Yuta Ando
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA
| | - Manmeet Raval
- Department of Stem Cell Biology and Regenerative Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Joseph T Rodgers
- Department of Stem Cell Biology and Regenerative Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Scott Fraser
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA; Department of Stem Cell Biology and Regenerative Medicine, University of Southern California, Los Angeles, CA 90033, USA; Translational Imaging Center, University of Southern California, Los Angeles, CA 90089, USA; Molecular and Computational Biology, University of Southern California, Los Angeles, CA 90089, USA
| | - Rong Lu
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA; Department of Stem Cell Biology and Regenerative Medicine, University of Southern California, Los Angeles, CA 90033, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA; Department of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Keyue Shen
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA; USC Stem Cell, University of Southern California, Los Angeles, CA 90033, USA.
| |
Collapse
|
7
|
Pagliuca S, Ruggeri A, Peffault de Latour R. Cord blood transplantation for bone marrow failure syndromes: state of art. Stem Cell Investig 2019; 6:39. [PMID: 32039261 DOI: 10.21037/sci.2019.10.04] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 10/16/2019] [Indexed: 12/20/2022]
Abstract
Hematopoietic stem cell transplantation (HSCT) and immunosuppressive therapy (IST) represent the milestones of the treatment algorithm for idiopathic and inherited bone marrow failure (BMF) disorders. However, patients lacking a suitable donor or failing IST still have a poor prognosis. Cord blood transplantation (CBT) has extended the possibility of HSCT for many patients in case of the absence of an eligible donor, and although in the last years, this procedure is less used in several hematological diseases, it remains an option for the treatment of patients with BMF syndromes. Nevertheless, optimization of conditioning regimen and cord blood unit selection is warranted to reduce the risk of graft failure and transplant-related mortality. This review summarizes the state of art of CBT in the field of BMF diseases, focusing on historical and recent issues in idiopathic aplastic anemia and inherited disorders.
Collapse
Affiliation(s)
- Simona Pagliuca
- Hematology and Transplantation Unit, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Annalisa Ruggeri
- Department of Pediatric Hematology and Oncology, IRCCS Ospedale Pediatrico Bambino Gesù, Roma, Italy.,Eurocord-Monacord, Hôpital Saint Louis, Paris, France.,Cellular Therapy and Immunobiology Working Party of EBMT, Leiden, The Netherlands
| | - Régis Peffault de Latour
- Hematology and Transplantation Unit, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Seshasubramanian V, Venugopal M, D S Kannan A, Naganathan C, Manisekar NK, Kumar YN, Narayan S, Periathiruvadi S. Application of high-throughput next-generation sequencing for HLA typing of DNA extracted from postprocessing cord blood units. HLA 2019; 94:141-146. [PMID: 31056847 DOI: 10.1111/tan.13565] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 04/24/2019] [Accepted: 05/02/2019] [Indexed: 01/05/2023]
Abstract
Cord blood has become an acceptable source of hematopoietic stem cells for transplantation. HLA plays a major role in hematopoietic stem cell transplantation (HSCT). Typing of cord blood samples for HLA alleles has been performed based on the serological and molecular methods. However, with the advent of next-generation sequencing technology, HLA typing becomes more accurate and unambiguous (upto intron level). Contamination of cord blood cells with erythropoietic cells poses a challenge in DNA extraction and downstream application. In the present study, DNA extracted from buffy coat of cord blood samples was typed for HLA-A, -B, -C, DRB1, and DQB1 alleles by Illumina miniseq and the sequences were aligned, phased, and mapped by MIA FORA software algorithms. Most frequent alleles found were HLA A*01:01:01 (17%), A*24:02:01 (15.1%), A*11:01:01 (13.6%), B*40:06:01 (10.7%), C*06:02:01 (17.7%), C*04:01:01 (14.2%), C*15:02:01 (11.4%), C*07:02:01 (10.7%), DRB1*07:01:01 (15.9%), DRB1*10:01:01 (10.2%), DQB1*06:01:01 (17.4%), DQB1*05:01:01 (12.4%), and DQB1*05:03:01 (10.4%). One null allele (A*24:11N), two novel alleles in B loci and three rare alleles (B*40:06:04, B*51:01:05, and C*01:44) were also identified in the present study. This study shows that high-throughput, unambiguous (third-field resolution) HLA typing can be performed on cord blood samples. In order to preserve the precious sample for future use, minimal amount of cord blood samples (postprocessing) could be used for HLA typing purpose.
Collapse
|
10
|
Park YB, Ha CW, Rhim JH, Lee HJ. Stem Cell Therapy for Articular Cartilage Repair: Review of the Entity of Cell Populations Used and the Result of the Clinical Application of Each Entity. Am J Sports Med 2018; 46:2540-2552. [PMID: 29023156 DOI: 10.1177/0363546517729152] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Following successful preclinical studies, stem cell therapy is emerging as a candidate for the treatment of articular cartilage lesions. Because stem cell therapy for cartilage repair in humans is at an early phase, confusion and errors are found in the literature regarding use of the term stem cell therapy in this field. PURPOSE To provide an overview of the outcomes of cartilage repair, elucidating the various cell populations used, and thus reduce confusion with regard to using the term stem cell therapy. STUDY DESIGN Systematic review. METHODS The authors systematically reviewed any studies on clinical application of mesenchymal stem cells (MSCs) in human subjects. A comprehensive search was performed in MEDLINE, EMBASE, the Cochrane Library, CINAHL, Web of Science, and Scopus for human studies that evaluated articular cartilage repair with cell populations containing MSCs. These studies were classified as using bone marrow-derived MSCs, adipose tissue-derived MSCs, peripheral blood-derived MSCs, synovium-derived MSCs, and umbilical cord blood-derived MSCs according to the entity of cell population used. RESULTS Forty-six clinical studies were identified to focus on cartilage repair with MSCs: 20 studies with bone marrow-derived MSCs, 21 studies with adipose tissue-derived MSCs, 3 studies with peripheral blood-derived MSCs, 1 study with synovium-derived MSCs, and 1 study with umbilical cord blood-derived MSCs. All clinical studies reported that cartilage treated with MSCs showed favorable clinical outcomes in terms of clinical scores or cartilage repair evaluated by MRI. However, most studies were limited to case reports and case series. Among these 46 clinical studies, 18 studies erroneously referred to adipose tissue-derived stromal vascular fractions as "adipose-derived MSCs," 2 studies referred to peripheral blood-derived progenitor cells as "peripheral blood-derived MSCs," and 1 study referred to bone marrow aspirate concentrate as "bone marrow-derived MSCs." CONCLUSION Limited evidence is available regarding clinical benefit of stem cell therapy for articular cartilage repair. Because the literature contains substantial errors in describing the therapeutic cells used, researchers need to be alert and observant of proper terms, especially regarding whether the cells used were stem cells or cell populations containing a small portion of stem cells, to prevent confusion in understanding the results of a given stem cell-based therapy.
Collapse
Affiliation(s)
- Yong-Beom Park
- Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Dongjak-gu, Seoul, Republic of Korea
| | - Chul-Won Ha
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Republic of Korea.,Stem Cell & Regenerative Medicine Research Institute, Samsung Medical Center, Gangnam-gu, Seoul, Republic of Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Gangnam-gu, Seoul, Republic of Korea
| | - Ji Heon Rhim
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Republic of Korea
| | - Han-Jun Lee
- Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Dongjak-gu, Seoul, Republic of Korea
| |
Collapse
|
11
|
Talkhoncheh MS, Subramaniam A, Magnusson M, Kumar P, Larsson J, Baudet A. Transient inhibition of NF-κB signaling enhances ex vivo propagation of human hematopoietic stem cells. Haematologica 2018; 103:1444-1450. [PMID: 29880606 PMCID: PMC6119158 DOI: 10.3324/haematol.2018.188466] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 05/17/2018] [Indexed: 01/15/2023] Open
Abstract
Despite extensive studies, defining culture conditions in which hematopoietic stem cells can be expanded ex vivo has been challenging. Here we show that chemical inhibition of the NF-κB signaling pathway leads to a significant improvement of hematopoietic stem cell function from ex vivo cultured human umbilical cord blood derived CD34+ cells. We found a distinct peak of activation of the NF-κB pathway shortly after cells were put in culture, and consequently inhibition of the pathway was both necessary and sufficient during the first 24 hours of culture where it reduced the levels of several pro-inflammatory cytokines. Taken together, NF-κB pathway inhibition facilitates propagation of hematopoietic stem cells in culture and may complement other strategies for hematopoietic stem cell expansion by relieving stress signals that are induced as an immediate response to culture initiation.
Collapse
Affiliation(s)
| | | | - Mattias Magnusson
- Division of Molecular Medicine and Gene Therapy, Lund Stem Cell Center, Lund University, Sweden
| | - Praveen Kumar
- Division of Molecular Medicine and Gene Therapy, Lund Stem Cell Center, Lund University, Sweden
| | - Jonas Larsson
- Division of Molecular Medicine and Gene Therapy, Lund Stem Cell Center, Lund University, Sweden
| | - Aurélie Baudet
- Division of Molecular Medicine and Gene Therapy, Lund Stem Cell Center, Lund University, Sweden
| |
Collapse
|
12
|
Mehta RS, Olson A, Ponce DM, Shpall EJ. Unrelated Donor Cord Blood Transplantation for Hematologic Malignancies. Hematology 2018. [DOI: 10.1016/b978-0-323-35762-3.00107-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
13
|
Role of αβ T Cell Depletion in Prevention of Graft versus Host Disease. Biomedicines 2017; 5:biomedicines5030035. [PMID: 28672883 PMCID: PMC5618293 DOI: 10.3390/biomedicines5030035] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 06/15/2017] [Accepted: 06/18/2017] [Indexed: 12/18/2022] Open
Abstract
Graft versus host disease (GVHD) represents a major complication of allogeneic hematopoietic stem cell transplantation (allo HCT). Graft cellular manipulation has been used to mitigate the risk of GVHD. The αβ T cells are considered the primary culprit for causing GVHD therefore depletion of this T cell subset emerged as a promising cellular manipulation strategy to overcome the human leukocyte antigen (HLA) barrier of haploidentical (haplo) HCT. This approach is also being investigated in HLA-matched HCT. In several studies, αβ T cell depletion HCT has been performed without pharmacologic GVHD prophylaxis, thus unleashing favorable effect of donor’s natural killer cells (NK) and γδ T cells. This article will discuss the evolution of this method in clinical practice and the clinical outcome as described in different clinical trials.
Collapse
|
14
|
Genetic diversity of Umbilical Cord Blood Units for transplant of the National Center of Blood Transfusion (Mexico). REVISTA MÉDICA DEL HOSPITAL GENERAL DE MÉXICO 2017. [DOI: 10.1016/j.hgmx.2016.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
15
|
Zhang QS. Stem Cell Therapy for Fanconi Anemia. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1083:19-28. [DOI: 10.1007/5584_2017_67] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
|
16
|
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.
Collapse
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.
| |
Collapse
|
17
|
The HLA System in Transfusion Medicine and Transplantation. Transfus Med 2016. [DOI: 10.1002/9781119236504.ch16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
18
|
Chen S, Gao R, Kobayashi M, Yu H, Yao C, Kapur R, Yoder MC, Liu Y. Pharmacological inhibition of AKT activity in human CD34 + cells enhances their ability to engraft immunodeficient mice. Exp Hematol 2016; 45:74-84. [PMID: 27645691 DOI: 10.1016/j.exphem.2016.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 07/20/2016] [Accepted: 09/05/2016] [Indexed: 12/14/2022]
Abstract
Although practiced clinically for more than 40 years, the use of hematopoietic stem cell (HSC) transplantation remains limited by the inability to expand functional HSCs ex vivo. To determine the role of phosphoinositide 3-kinase (PI3K)/AKT signaling in human hematopoietic stem and progenitor cell (HSPC) maintenance, we examined the effect of genetic and pharmacological inhibition of AKT on human umbilical cord blood (UCB) CD34+ cells. We found that knock-down of AKT1 in human UCB CD34+ cells using short interfering RNAs targeting AKT1 enhances their quiescence and colony formation potential in vitro. We treated human UCB CD34+ cells with an AKT-specific inhibitor (AKTi) and performed both in vitro and in vivo stem and progenitor cell assays. We found that ex vivo treatment of human HSPCs maintains CD34 expression and enhances colony formation in serial replating assays. Moreover, pharmacological inhibition of AKT enhances the short-term repopulating potential of human UCB CD34+ cells in immunodeficient mice. Mechanistically, genetic and pharmacological inhibition of AKT activity promotes human HSPC quiescence. These preclinical results suggest a positive role for AKTi during ex vivo culture of human UCB HSPCs.
Collapse
Affiliation(s)
- Sisi Chen
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Rui Gao
- Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Michihiro Kobayashi
- Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Hao Yu
- Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Chonghua Yao
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Reuben Kapur
- Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Mervin C Yoder
- Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Yan Liu
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA.
| |
Collapse
|
19
|
Scholkmann F, Miscio G, Tarquini R, Bosi A, Rubino R, di Mauro L, Mazzoccoli G. The circadecadal rhythm of oscillation of umbilical cord blood parameters correlates with geomagnetic activity - An analysis of long-term measurements (1999-2011). Chronobiol Int 2016; 33:1136-1147. [PMID: 27409251 DOI: 10.1080/07420528.2016.1202264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Recently, we have shown that the contents of total nucleated cells (TNCs) and CD34+ hematopoietic stem and progenitor cells (CD34+ HSPCs) as well as the cord blood volume (CBV) in umbilical cord blood (UCB) show a circadecadal (~10 years) rhythm of oscillation. This observation was based on an analysis of 17,936 cord blood donations collected during 1999-2011. The aim of the present study was to investigate whether this circadecadal rhythm of oscillation in TNCs, CD34+ HSPCs and CBV is related to geomagnetic activity. For the analysis, the yearly averages of TNCs, CD34+ HSPCs and CBV in UCB were correlated with geomagnetic activity (Dcx index). Our analysis revealed that (i) all three UCB parameters were statistically significantly correlated with the level of geomagnetic activity, (ii) CBV showed a linear correlation with the Dcx index (r = 0.5290), (iii) the number of TNCs and CD34+ HSPCs were quadratic inversely correlated with the Dcx index (r = -0.5343 and r = -0.7749, respectively). Furthermore, (iv) CBV and the number of TNCs were not statistically significantly correlated with the number of either modest or intense geomagnetic storms per year, but (v) the number of CD34+ HSPCs was statistically significantly correlated with the number of modest (r = 0.9253) as well as intense (r = 0.8683) geomagnetic storms per year. In conclusion, our study suggests that UCB parameters correlate with the state of the geomagnetic field (GMF) modulated by solar activity. Possible biophysical mechanisms underlying this observation, as well as the outcome of these findings, are discussed.
Collapse
Affiliation(s)
- Felix Scholkmann
- a Research Office for Complex Physical and Biological Systems (ROCoS) , Zurich , Switzerland
| | - Giuseppe Miscio
- b Apulia Cord Blood Bank , IRCCS "Casa Sollievo della Sofferenza" , S. Giovanni Rotondo (FG) , Italy
| | - Roberto Tarquini
- c Department of Clinical and Experimental Medicine, School of Medicine , University of Florence , Florence , Italy.,d Interinstitutional Department for Continuity of Care of Empoli, School of Medicine , University of Florence , Florence , Italy
| | - Alberto Bosi
- e Department of Clinical and Experimental Medicine, Unit of Haematology, School of Medicine , University of Florence , Florence , Italy
| | - Rosa Rubino
- f Department of Medical Sciences, Division of Internal Medicine and Chronobiology Unit , IRCCS "Casa Sollievo della Sofferenza" , S. Giovanni Rotondo (FG) , Italy
| | - Lazzaro di Mauro
- b Apulia Cord Blood Bank , IRCCS "Casa Sollievo della Sofferenza" , S. Giovanni Rotondo (FG) , Italy
| | - Gianluigi Mazzoccoli
- f Department of Medical Sciences, Division of Internal Medicine and Chronobiology Unit , IRCCS "Casa Sollievo della Sofferenza" , S. Giovanni Rotondo (FG) , Italy
| |
Collapse
|
20
|
Abstract
Fanconi anemia (FA) is an inherited bone marrow failure syndrome characterized by congenital abnormalities and chromosomal breakages with the occurrence of hematological and solid malignancies. FA is the most common type of inherited bone marrow failure and poses tremendous challenges. FA patients are uniquely hypersensitive to hematopoietic stem cell transplantation (HSCT) conditioning agents due to the underling chromosomal instability. HSCT has shown important progress in the last years, especially after the introduction of fludarabine and the reduction of cyclophosphamide in the preparative regimen. For patients with HLA-identical-related donors HSCT should be performed as first-line therapy, for patients with alternative donors HSCT remains a therapy with increased morbidity and mortality.
Collapse
|
21
|
Abstract
Umbilical cord blood banks use two methods to store frozen umbilical cord blood (UCB): red cell reduction (RCR) or plasma depletion (PD). The RCR method centrifuges cord blood in hetastarch or albumin to isolate 21 ml of cord blood containing mostly white blood cells, adds 4 ml of 50% dimethyl sulfoxide (DMSO), and then freezes the resulting 25 ml of cell suspension. The PD method removes plasma, saves all the cells, and freezes the cells in 10% DMSO. PD UCB units are cheaper to process but more expensive to store and somewhat more troublesome to thaw. However, when properly thawed and washed, PD UCB units have as many or more total nucleated cells (TNCs), CD34(+) cells, and colony-forming units (CFU) than RCR units. Two studies suggest that PD units have 20-25% more TNCs, MNCs, and CD34(+) cells, as well as two to three times more CFU than RCR units. Higher TNC, CD34(+), and CFU counts predict engraftment rate with faster neutrophil and platelet recovery. PD units have high engraftment rates with low mortality and high disease-free survival, comparable with clinical results of treatments with RCR units. One recent series of studies suggests that PD units are more effective for treating thalassemia with 2-year survival rates of 88%, disease-free survival rates of 74%, and 100% cure rate for children under age 7, compared to only 61% overall survival and 23% disease-free survival rate in thalassemic children treated with RCR units. These findings suggest that PD units not only have more TNCs, CD34(+) cells, and CFU than RCR units but also have high engraftment rates and may be more effective for treating certain conditions such as β-thalassemia.
Collapse
Affiliation(s)
- Wise Young
- Department of Cell Biology and Neuroscience, Rutgers, State University of New Jersey, Piscataway, NJ, USA
| |
Collapse
|
22
|
Abou-Zied AM, Soliman RH, Hefila SM, Imam SA. Biochemical and Parasitological Studies on the Effect of hUCB-Selected CD34(+) Progenitor/Stem Cells in Mice Infected with Schistosoma mansoni. Int J Stem Cells 2014; 7:98-107. [PMID: 25473447 PMCID: PMC4249909 DOI: 10.15283/ijsc.2014.7.2.98] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2014] [Indexed: 01/20/2023] Open
Abstract
Background and Objectives: Placenta and blood that remained in the umbilical cord is routinely available as a discarded tissue after deliveries and it is free of any legal, moral, ethical or religious objections, providing a high number of multipotent CD34+ progenitor and stem cells. Using ex vivo isolated CD34+ cells from human umbilical cord blood (hUCB) have emerged as promising candidates to treat various diseases, including exogenous pathogenic infections. We have expanded to build a rational approach to study the effect of CD34+ cells after damaged liver tissues by the devastating human parasitic flatworm Schistosoma mansoni. Methods and Results: Experimental studies were conducted in the Department of Zoology, Faculty of Science and Departments of Parasitology and Physiology, Faculty of Medicine, SCU, Egypt. We have studied the impact of ex vivo preparation of CD34+ cells from hUCB on S. mansoni-induced liver fibrosis de novo, and treated for shorter and longer periods in vivo. Ova count, ALT and albumin were measured at specific time interval and histopathological examination of liver was conducted to confirm the biochemical results. The data obtained were statistically analyzed by ANOVA between groups. It was found that the administration of CD34+ cells have modestly reduced liver damage; reduced the S. mansoni infection associated elevation in serum levels of ALT; significantly improved serum levels of albumin and reduced egg granuloma diameter in the livers. Conclusions: We demonstrated that CD34+ cells can markedly ameliorated liver fibrosis in vivo and may be beneficial for therapy to recover organ structure and/or function of S. mansoni-infected mice.
Collapse
Affiliation(s)
- Akram M Abou-Zied
- Department of Zoology, Genetics Division, Faculty of Science, Suez Canal University, Ismailia, Egypt
| | - Rasha H Soliman
- Department of Parasitology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | | | - Samir A Imam
- Department of Zoology, Genetics Division, Faculty of Science, Suez Canal University, Ismailia, Egypt
| |
Collapse
|
23
|
Tang BL, Zhu XY, Zheng CC, Liu HL, Geng LQ, Wang XB, Ding KY, Yao W, Tong J, Song KD, Zhang L, Qiang P, Sun ZM. Successful early unmanipulated haploidentical transplantation with reduced-intensity conditioning for primary graft failure after cord blood transplantation in hematologic malignancy patients. Bone Marrow Transplant 2014; 50:248-52. [PMID: 25365067 DOI: 10.1038/bmt.2014.250] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 09/01/2014] [Accepted: 09/17/2014] [Indexed: 11/09/2022]
Abstract
Primary graft failure (pGF) is a frequent complication following cord blood transplantation (CBT). For those patients who will not experience autologous recovery, salvage transplantation should be performed as early as possible. However, standardized treatment protocols for pGF, such as the optimal stem cell source, preparative regimen and the ideal time for salvage transplantation, have yet to be determined. Therefore, we analyzed 17 hematologic malignancy patients who received unmanipulated haploidentical peripheral blood (PB) and BM transplantation with reduced-intensity conditioning (RIC) as a salvage therapy for pGF after CBT. The median interval between the two transplantations was 38 days. The RIC regimen for salvage transplantation consisted of fludarabine, antithymocyte globulin, CY and low-dose TBI. The neutrophil and plt engraftments were achieved in 14 (82.4%) and 13 (76.4%) patients, respectively. The cumulative incidences of grades II-IV and grades III-IV aGVHD were 35.3% and 17.6%, respectively. The cumulative incidence of chronic GVHD was 29.4%. After a median follow-up of 43 months, 10 of 17 patients remained alive in CR. The cumulative incidence of TRM at 180 days was 29.4%. The probability of 3-year OS and leukemia-free survival was 57.5%. Our results show that unmanipulated haploidentical PB and BM transplantation under a RIC regimen is an effective treatment for pGF after CBT.
Collapse
Affiliation(s)
- B L Tang
- Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - X Y Zhu
- Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - C C Zheng
- Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - H L Liu
- Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - L Q Geng
- Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - X B Wang
- Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - K Y Ding
- Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - W Yao
- Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - J Tong
- Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - K D Song
- Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - L Zhang
- Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - P Qiang
- Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - Z M Sun
- Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| |
Collapse
|
24
|
Yao Y, Song Q, Chu Y, Gong H, Li N, Hu Q, Xu X. Infusion of allogeneic umbilical cord blood hematopoietic stem cells in patients with chemotherapy-related myelosuppression. Exp Ther Med 2014; 8:1946-1950. [PMID: 25371761 PMCID: PMC4218683 DOI: 10.3892/etm.2014.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 09/29/2014] [Indexed: 11/05/2022] Open
Abstract
Chemotherapy-induced myelosuppression is one of the main problems in the treatment of cancer. In the present study, the effects of allogeneic umbilical cord blood hematopoietic stem cell (UCB-HSC) infusion were investigated on the treatment of chemotherapy-related myelosuppression. In total, 65 patients (male, 42; female, 23) diagnosed with chemotherapy-related myelosuppression were included in the study. The majority of the patients were classified with stage II myelosupression at enrolment, and an average concentration of 7.07×109/l UCB-HSCs were transfused through the peripheral vein. The minimum values of the white blood cell (WBC) count, hemoglobin (Hb) level, platelet (PLT) count and Karnofsky performance status (KPS) scores were recorded prior to and between days 7 and 14 following UCB-HSC infusion. When assessing the overall data, the results revealed that the mean WBC and PLT counts increased significantly following UCB-HSC infusion. However, the subgroup analyses based on gender and KPS score revealed that UCB-HSC infusion was more successful in male patients and those with a higher KPS score. Spearman's correlation analysis revealed a linear correlation between the number of transfused UCB-HSCs and the changes in the WBC and PLT counts following treatment. In conclusion, the results indicated that peripheral vein infusion of non-human leukocyte antigen matched UCB-HSCs can markedly improve chemotherapy-related myelosuppression in a safe and effective manner.
Collapse
Affiliation(s)
- Yi Yao
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Qibin Song
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Yuxin Chu
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Hongyun Gong
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Na Li
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Qinyong Hu
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Xiaotao Xu
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| |
Collapse
|
25
|
Tipnis S, Viswanathan C. Umbilical cord matrix derived mesenchymal stem cells can change the cord blood transplant scenario. Int J Stem Cells 2014; 3:103-18. [PMID: 24855548 DOI: 10.15283/ijsc.2010.3.2.103] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2010] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The field of Umbilical cord blood (UCB) hematopoietic stem cell transplantation has had an amazing run since 1988. UCB is being increasing used in related and unrelated transplant settings. A major hurdle, however, in the use of UCB is its low cell dose, which is largely responsible for an elevated risk of graft failure and significantly delayed neutrophils and platelet engraftment. Strategies to increase CD34(+) HSC/HPC dose are under development as a direct correlation has been shown between these counts and time for engraftment. One strategy includes the ex vivo expansion of UCB derived CD34(+) cells. METHODS AND RESULTS We show that the umbilical cord derived mesenchymal stem cells (UCMSCs) can be used as supporting cells for ex vivo expansion of CD34(+) cells using low concentrations of cytokine cocktail. The UCMSCs release the cytokines required for maintenance and proliferation of CD34(+) cells in the ex vivo culture conditions. More than 25 fold increase in total nucleated cell count (TNC) and more than 20 fold increase in CD34(+) cell count has been obtained using this co-culture system. CONCLUSIONS UCMSCs from both, autologous and allogeneic origin can be used for expansion of UCB derived CD34(+) cells. The ease of availability and immunoprivileged nature of UCMSCs further holds promise in their use in an allogeneic transplant setting.
Collapse
Affiliation(s)
- Shabari Tipnis
- Regenerative Medicine, Reliance Life Sciences Pvt Ltd, Dhirubhai Ambani Life Sciences Centre, R-282, TTC area of MIDC, Thane Belapur road, Rabale, Navi Mumbai -400701, Maharashtra, India
| | - Chandra Viswanathan
- Regenerative Medicine, Reliance Life Sciences Pvt Ltd, Dhirubhai Ambani Life Sciences Centre, R-282, TTC area of MIDC, Thane Belapur road, Rabale, Navi Mumbai -400701, Maharashtra, India
| |
Collapse
|
26
|
Wikell H, Ponandai-Srinivasan S, Mattsson J, Gertow J, Uhlin M. Cord blood graft composition impacts the clinical outcome of allogeneic stem cell transplantation. Transpl Infect Dis 2014; 16:203-12. [DOI: 10.1111/tid.12182] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 06/05/2013] [Accepted: 07/15/2013] [Indexed: 11/28/2022]
Affiliation(s)
- H. Wikell
- Division of Therapeutic Immunology; Karolinska Institutet; Stockholm Sweden
- Department of Clinical Immunology and Transfusion Science; Karolinska University Hospital; Stockholm Sweden
| | | | - J. Mattsson
- Division of Therapeutic Immunology; Karolinska Institutet; Stockholm Sweden
- Center for Allogeneic Stem Cell Transplantation; Karolinska University Hospital; Stockholm Sweden
| | - J. Gertow
- Division of Therapeutic Immunology; Karolinska Institutet; Stockholm Sweden
- Center for Allogeneic Stem Cell Transplantation; Karolinska University Hospital; Stockholm Sweden
| | - M. Uhlin
- Division of Therapeutic Immunology; Karolinska Institutet; Stockholm Sweden
- Center for Allogeneic Stem Cell Transplantation; Karolinska University Hospital; Stockholm Sweden
| |
Collapse
|
27
|
Maurer AM, Gezer A. Promoting Effects of Heparin on ex vivo Expansion of Megakaryocytopoiesis from Human Cord Blood CD34+ Cells. ACTA ACUST UNITED AC 2013; 40:344-50. [PMID: 24273488 DOI: 10.1159/000355519] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 09/10/2013] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Transfusion of ex vivo expanded megakaryocytes (MKs) has been proposed to sustain platelet recovery after cord blood (CB) hematopoietic stem cell transplantation. In this study, we investigated the effects of heparin on ex vivo colony forming unit-megakaryocytes (CFU-MKs) and MKs expansion from CB CD34+ cells. METHODS CB CD34+ cells were stimulated by a combination of thrombopoietin (TPO), stem cell factor (SCF), Flt3-Ligand (FL), IL-6, and IL-11 supplemented with autologous serum and heparin during 14 days. Expanded cells were analyzed by flow cytometry and cultured in a CFU-MK assay. RESULTS Compared to control cultures, the 5-factor combination with heparin induced significantly (p ≤ 0.05) higher numbers of: CFU-MKs and CD41+ cells on days 7 and 14; CD41+ cells displaying hyperploidy levels (≥8N) on day 14; platelets on day 14. The culture-derived platelets were activated upon collagen stimulation. CONCLUSION Heparin can significantly enhance the stimulating effects of a combination of TPO, SCF, FL, IL-6, and IL-11 supplemented with autologous serum on CFU-MK, MK, and platelet production from CB CD34+ cells. This expansion system could represent a promising method to generate CFU-MKs and MKs cells for transfusion to sustain platelet reconstitution following CB transplantation.
Collapse
Affiliation(s)
- Anne-Marie Maurer
- Department of Hematology, School of Medicine, Marmara University, Istanbul, Turkey
| | | |
Collapse
|
28
|
Ebens CL, Maillard I. Notch signaling in hematopoietic cell transplantation and T cell alloimmunity. Blood Rev 2013; 27:269-77. [PMID: 24050990 DOI: 10.1016/j.blre.2013.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Notch signaling can regulate both hematopoietic progenitors and alloimmune T cells in the setting of allogeneic bone marrow or hematopoietic cell transplantation (allo-HCT). Ex vivo culture of multipotent blood progenitors with immobilized Delta-like ligands induces supraphysiological Notch signals and can markedly enhance progenitor expansion. Infusion of Notch-expanded progenitors shortened myelosuppression in preclinical and early clinical studies, while accelerating T cell reconstitution in preclinical models. Notch also plays an essential role in vivo to regulate pathogenic alloimmune T cells that mediate graft-versus-host disease (GVHD), the most severe complication of allo-HCT. In mouse allo-HCT models, Notch inhibition in donor-derived T cells or transient blockade of Delta-like ligands after transplantation profoundly decreased GVHD incidence and severity, without causing global immunosuppression. These findings identify Notch in T cells as an attractive therapeutic target to control GVHD. In this review, we discuss these contrasting functions of Notch signaling with high translational significance in allo-HCT patients.
Collapse
Affiliation(s)
- Christen L Ebens
- Life Sciences Institute, University of Michigan, Ann Arbor, MI, USA; Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | | |
Collapse
|
29
|
Cobellis L, Castaldi MA, Trabucco E, Imparato G, Perricone F, Frega V, Signoriello G, Colacurci N. Cord blood unit bankability can be predicted by prenatal sonographic parameters. Eur J Obstet Gynecol Reprod Biol 2013; 170:391-5. [PMID: 23958574 DOI: 10.1016/j.ejogrb.2013.07.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 04/26/2013] [Accepted: 07/12/2013] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To identify possible sonographic prenatal parameters and postnatal parameters in order to obtain more bankable cord blood units (CBUs) containing a high number of primitive progenitor cells, allowing CBUs to be used as a source of haematopoietic progenitors for clinical transplantation. STUDY DESIGN Prospective study undertaken in the Department of Gynaecology, Obstetrics and Reproductive Science, Second University of Naples, Italy. In total, 219 unrelated CBU donors were enrolled. Ultrasound parameters (biparietal diameter, head circumference, abdominal circumference, femur length, estimation of fetal weight, umbilical artery pulsatility index), collected at hospital admission, together with birth weight and placental weight, were correlated with bankable CBU parameters (CBU volume, total nucleated cell count, CD34+ cell count). RESULTS Femur length and abdominal circumference correlated positively with bankable CBUs. Receiver operating curve analysis showed that these parameters can identify bankable CBUs. CONCLUSIONS This is the first prospective study to show the relationship between ultrasonographic fetal parameters at term and the possibility of obtaining high-quality CBUs. As such, cord blood banking could be improved worldwide by performing low-cost ultrasonographic scans.
Collapse
Affiliation(s)
- L Cobellis
- Department of the Woman, the Child and General and Specialized Surgery, Second University of Naples, Naples, Italy
| | | | | | | | | | | | | | | |
Collapse
|
30
|
Terzic A, Nelson TJ. Regenerative medicine primer. Mayo Clin Proc 2013; 88:766-75. [PMID: 23809322 DOI: 10.1016/j.mayocp.2013.04.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 04/12/2013] [Accepted: 04/16/2013] [Indexed: 01/14/2023]
Abstract
The pandemic of chronic diseases, compounded by the scarcity of usable donor organs, mandates radical innovation to address the growing unmet needs of individuals and populations. Beyond life-extending measures that are often the last available option, regenerative strategies offer transformative solutions in treating degenerative conditions. By leveraging newfound knowledge of the intimate processes fundamental to organogenesis and healing, the emerging regenerative armamentarium aims to boost the aptitude of human tissues for self-renewal. Regenerative technologies strive to promote, augment, and reestablish native repair processes, restituting organ structure and function. Multimodal regenerative approaches incorporate transplant of healthy tissues into damaged environments, prompt the body to enact a regenerative response in damaged tissues, and use tissue engineering to manufacture new tissue. Stem cells and their products have a unique aptitude to form specialized tissues and promote repair signaling, providing active ingredients of regenerative regimens. Concomitantly, advances in materials science and biotechnology have unlocked additional prospects for growing tissue grafts and engineering organs. Translation of regenerative principles into practice is feasible and safe in the clinical setting. Regenerative medicine and surgery are, thus, poised to transit from proof-of-principle studies toward clinical validation and, ultimately, standardization, paving the way for next-generation individualized management algorithms.
Collapse
Affiliation(s)
- Andre Terzic
- Mayo Clinic Center for Regenerative Medicine, Mayo Clinic, Rochester, MN; Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN; Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN; Department of Medical Genetics, Mayo Clinic, Rochester, MN.
| | | |
Collapse
|
31
|
Parco S, Vascotto F, Visconti P. Public banking of umbilical cord blood or storage in a private bank: testing social and ethical policy in northeastern Italy. J Blood Med 2013; 4:23-9. [PMID: 23610532 PMCID: PMC3628527 DOI: 10.2147/jbm.s41532] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background In northeastern Italy, according to Italian legislation, authorized public facilities can accept the donation and preservation of cord blood stem cells (CB-SC). Attitudes and knowledge in pregnant women differs between the local and immigrant (non-European Union [EU]) population. In this study we assessed the choices that pregnant women have with respect to the public and private harvesting system and the main reasons driving their decisions. We examined the ethnic origin of the families and compared tests for syphilis screening and leukocyte (WBC) counts in the CB-SC bags that are required for validation of the collection. Methods Out of a population of 3450 pregnant patients at the Institute for Maternal and Child Health of Trieste, northeast Italy, 772 women agreed to cord blood harvesting and the associated lab tests. Of these, 221 women (28.6%) were from immigrant families of non-EU countries. Their ethnic affiliation was recorded, and tests were performed for syphilis screening and for nucleated red blood cell (NRBC) interference with the WBC count in CB-SC bags to assess cellularity and to determine if storage was appropriate. Results Of the 772 pregnant women, 648 (84.0%) accessed the public collection system, which is free of charge, and 124 (15.0%) accessed the private fee-based system. One woman from the non-EU group opted for the private fee-based system. Of the 3450 pregnant women screened for syphilis at the Institute for Maternal and Child Health, the Treponema pallidum hemagglutination (TPHA) and Venereal Disease Research Laboratory (VDRL) tests were the main tests performed (66.0% of total cases) because many gynecologists in the public harvesting system apply the Italian regulations of the 1988 Decree, while the private system requires tests on syphilis and leaves the option to the lab physicians to select the best determination method. We found that the chemiluminescence method was more specific (97.0%) than the TPHA (83.0%) and nontreponemal rapid plasma reagin VDRL (75.0%) tests (P < 0.05, χ2 test). The specificity link between the two automatic methods versus microscopes for WBC dosing and NRBC interference was r2 = 0.08 (ADVIA 120) and r2 = 0.94 (XE-2100). The public system does not include human T-cell lymphotropic virus testing; this is reserved for the population from endemic zones. Conclusion In northeastern Italy current legislation prevents the establishment of private fee-based banks for storage of CB-SC. The cryopreservation, for future autologous personal or family use, is possible only by sending to foreign private banks, with a further fee of €300. These regulations confirm that Italian legislation tries to increase the anonymous allogenic donations and the number of CB-CS bags stored in the free-cost public system, that are available to anyone with therapeutic needs. Private banking is used almost exclusively by the wealthier local population. In the public system, many physicians continue to use older Italian laws regarding syphilis diagnosis, and NRBC interference on WBC count may have an impact on cord blood harvesting. Our findings suggest that in the EU there is no consensus policy on donor management. The value of storage for potential use within the family is useful only with collaboration between the public and the private systems.
Collapse
Affiliation(s)
- Sergio Parco
- Institute for Maternal and Child Health, Trieste, Italy
| | | | | |
Collapse
|
32
|
Proteomic Profiling of Ex Vivo Expanded CD34-Positive Haematopoetic Cells Derived from Umbilical Cord Blood. Stem Cells Int 2013; 2013:245695. [PMID: 23606859 PMCID: PMC3622389 DOI: 10.1155/2013/245695] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 01/25/2013] [Accepted: 02/07/2013] [Indexed: 11/17/2022] Open
Abstract
Ex vivo expansion of haematopoetic cells by application of specific cytokines is one approach to overcome boundaries in cord blood transplantation due to limited numbers of haematopoetic stem cells. While many protocols describe an effective increase of total cell numbers and the amount of CD34-positive cells, it still remains unclear if and how the procedure actually affects the cells' properties. In the presented publications, CD34-positive cells were isolated from cord blood and expanded for up to 7 days in media supplemented with stem cell factor (SCF), thrombopoietin (THPO), interleukin 6 (IL-6), and fms-related tyrosine kinase 3 ligand (FLT3lg). At days 3 and 7, expanded cells were harvested and analyzed by flow cytometry and quantitative proteomics. 2970 proteins were identified, whereof proteomic analysis showed 440 proteins significantly changed in abundance during ex vivo expansion. Despite the fact that haematopoetic cells still expressed CD34 on the surface after 3 days, major changes in regard to the protein profile were observed, while further expansion showed less effect on the proteome level. Enrichment analysis of biological processes clearly showed a proteomic change toward a protein biosynthesis phenotype already within the first three days of expression.
Collapse
|
33
|
Abstract
Haplotype-mismatched transplantation offers a unique opportunity to treat patients without a suitable matched related or unrelated donor. Indeed, related haplo-donors are usually extremely motivated, immediately available, and can provide additional stem or immune cells when required, a most important feature in the context of high-risk malignancies. Immunomagneticallly selected CD34(+) stem cell grafts enable rapid and sustained trilineage engraftment. However, the associated delay in immune reconstitution results in significant risk for severe infectious complications and malignant relapse. The infusion of T lymphocytes selectively depleted of their anti-host reactive components represents a most interesting approach to accelerate post-transplant T-cell recovery. Such a strategy relies on ex vivo donor cell activation against host antigens and their selective elimination. Immunotoxins and magnetic beads could target antigens such as CD25 with impressive results. Photodepletion of alloreactive T cells represents an appealing alternative to both eliminate anti-host immune T cells and spare resting T cells to fight infections. Interestingly, regulatory T cells can be retained after such treatment, and have been found to transform non-regulatory into regulatory T cells, a finding that may be of utmost importance in both prevention and control of graft-versus-host disease (GVHD). Efforts to promote efficient antigen presentation and selective allodepletion promise to accelerate immune reconstitution without GVHD and to address the most crucial issues in haplo-mismatched and other types of transplants.
Collapse
Affiliation(s)
- Jean-Philippe Bastien
- Division of Hematology and Stem Cell Transplantation, Maisonneuve-Rosemont Hospital Research Center, Department of Medicine, Université de Montréal, Montreal, Canada
| | | | | |
Collapse
|
34
|
Mehrishi J, Bakács T. A novel method of CD34+ cell separation from umbilical cord blood. Transfusion 2013; 53:2675-80. [DOI: 10.1111/trf.12123] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Revised: 11/06/2012] [Accepted: 12/10/2012] [Indexed: 12/22/2022]
Affiliation(s)
- J.N. Mehrishi
- University of Cambridge; Cambridge UK
- Department of Probability; Alfréd Rényi Mathematical Institute of The Hungarian Academy of Sciences; 1053 Budapest Hungary
| | - Tibor Bakács
- University of Cambridge; Cambridge UK
- Department of Probability; Alfréd Rényi Mathematical Institute of The Hungarian Academy of Sciences; 1053 Budapest Hungary
| |
Collapse
|
35
|
Sun LX, Li YQ, Song XN, Jiang J, Chang YJ. A direct comparison of expression profiles of adhesion molecules on naïve T cells between cord blood and steady-state bone marrow grafts of healthy donors. Transplant Proc 2013; 45:415-9. [PMID: 23375331 DOI: 10.1016/j.transproceed.2012.05.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 02/17/2012] [Accepted: 05/04/2012] [Indexed: 11/18/2022]
Abstract
INTRODUCTION We compared the profiles of adhesion molecule expression on naïve T cells between umbilical cord blood (UCB) and steady-state bone marrow (SS-BM) grafts. METHODS The expressions of 4 adhesion molecules, including very late antigen 4 (VLA-4), intercellular adhesion molecule-1 (ICAM-1), L-selectin, and lymophocyte function-associated antigen-1 (LFA-1) on naïve T cells in UCB (n = 25) and SS-BM (n = 10) were analyzed using flow cytometry. RESULTS The expressions of ICAM-1 and L-selectin on CD4(+) T cells and CD8(+) T cells in UCB were significantly lower than those on SS-BM (P < .05 for all). The expressions of VLA-4 and LFA-1 on CD8(+) T cells in UCB were significantly lower than those of SS-BM (P = .002 and .047, respectively). Compared with SS-BM, we observed lower expression of ICAM-1 on naïve CD4(+) and CD8(+) T cells in UCB (P < .001 for all). The percentages of interferon (IFN)-γ positive cells among naïve CD4(+) and CD8(+) T-cell subsets were significantly lower in UCB, leading to ready polarization of naïve UCB T cells from a Th1 to Th2 phenotype versus those on SS-BM. CONCLUSIONS Our results among UCB suggested lower intensities of ICAM-1 expression on naïve T cells and their easier polarization from Th1 to Th2 elements.
Collapse
Affiliation(s)
- L-X Sun
- Department of Hematology, Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, China.
| | | | | | | | | |
Collapse
|
36
|
When one is better than two. Cytotherapy 2013; 15:139. [PMID: 23321324 DOI: 10.1016/j.jcyt.2012.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
37
|
Papewalis C, Topolar D, Götz B, Schönberger S, Dilloo D. Mesenchymal stem cells as cellular immunotherapeutics in allogeneic hematopoietic stem cell transplantation. ADVANCES IN BIOCHEMICAL ENGINEERING/BIOTECHNOLOGY 2013; 130:131-62. [PMID: 23455489 DOI: 10.1007/10_2012_158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative treatment option in hematopoietic disorders, immunodeficiencies and leukemia. To date graft-versus-host disease (GvHD) represents a life-threatening complication even if associated with beneficial antileukemic reactivity. GvHD is the clinical manifestation of donor cells reacting against host tissue. Because of their ability to facilitate endogenous repair and to attenuate inflammation, MSC have evolved as a highly attractive cellular therapeutic in allo-HSCT. Here we report on the clinical experience in the use of MSC to enhance engraftment and prevent and treat acute and chronic GvHD. In early clinical trials, MSC have shown considerable benefit in the setting of manifest GvHD. These encouraging results warrant further exploration.
Collapse
Affiliation(s)
- Claudia Papewalis
- Department of Pediatric Hematology and Oncology, Center for Pediatrics, University Hospital, Friedrich-Wilhelm University, Bonn, Germany
| | | | | | | | | |
Collapse
|
38
|
Abstract
PURPOSE OF REVIEW In recent years, stem cell therapy has been investigated as a promising approach for the treatment of stress urinary incontinence (SUI). This article reviews the biology of stem cells and their applications as a cell-based treatment for SUI. The current status and future direction of this forefront research in urinary incontinence are also examined. RECENT FINDINGS During the past decade, adult stem cells have been studied as a potential cell-based approach for the treatment of SUI. The results of current preclinical and clinical studies are presented. These studies demonstrated the improvement in histologic and functional outcomes with stem cell therapies for SUI. Adult stem cells may augment sphincter regeneration and also release trophic factors, promoting vessel and nerve integration into the generated tissues. So far, the findings of the clinical trials are less impressive than the results obtained with animal studies. SUMMARY Although stem cell therapy holds much promise for SUI, the clinical applications in patients have been slow to materialize. This challenge, together with the currently limited data on basic science studies and clinical trials, will undoubtedly stimulate new investigations in the near future.
Collapse
|
39
|
Aversa F, Martelli MF, Velardi A. Haploidentical Hematopoietic Stem Cell Transplantation With a Megadose T-Cell–Depleted Graft: Harnessing Natural and Adaptive Immunity. Semin Oncol 2012. [DOI: 10.1053/j.seminoncol.2012.09.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
40
|
Mizer JC, Ichim TE, Alexandrescu DT, Dasanu CA, Ramos F, Turner A, Woods EJ, Bogin V, Murphy MP, Koos D, Patel AN. Exogenous endothelial cells as accelerators of hematopoietic reconstitution. J Transl Med 2012; 10:231. [PMID: 23171397 PMCID: PMC3543295 DOI: 10.1186/1479-5876-10-231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 10/04/2012] [Indexed: 01/25/2023] Open
Abstract
Despite the successes of recombinant hematopoietic-stimulatory factors at accelerating bone marrow reconstitution and shortening the neutropenic period post-transplantation, significant challenges remain such as cost, inability to reconstitute thrombocytic lineages, and lack of efficacy in conditions such as aplastic anemia. A possible means of accelerating hematopoietic reconstitution would be administration of cells capable of secreting hematopoietic growth factors. Advantages of this approach would include: a) ability to regulate secretion of cytokines based on biological need; b) long term, localized production of growth factors, alleviating need for systemic administration of factors that possess unintended adverse effects; and c) potential to actively repair the hematopoietic stem cell niche. Here we overview the field of hematopoietic growth factors, discuss previous experiences with mesenchymal stem cells (MSC) in accelerating hematopoiesis, and conclude by putting forth the rationale of utilizing exogenous endothelial cells as a novel cellular therapy for acceleration of hematopoietic recovery.
Collapse
|
41
|
Oevermann L, Lang P, Feuchtinger T, Schumm M, Teltschik HM, Schlegel P, Handgretinger R. Immune reconstitution and strategies for rebuilding the immune system after haploidentical stem cell transplantation. Ann N Y Acad Sci 2012; 1266:161-70. [PMID: 22901267 DOI: 10.1111/j.1749-6632.2012.06606.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Haploidentical hematopoietic stem cell transplantation is a curative alternative option for patients without an otherwise suitable stem cell donor. In order to prevent graft-versus-host disease (GvHD), different in vitro and in vivo T cell-depletion strategies have been developed. A delayed immune reconstitution is common to all these strategies, and an impaired immune function after haploidentical transplantation with subsequent infections is a major cause of deaths in these patients. In addition to in vitro and in vivo T cell-depletion methods, posttransplant strategies to rapidly rebuild the immune system have been introduced in order to improve the outcome. Advances in in vitro and in vivo T cell-depletion methods, and adoptive transfer of immune cells of the innate and specific immune system, will contribute to reduce the risk of GvHD, lethal infections, and the risk of relapse of the underlying malignant disease.
Collapse
Affiliation(s)
- Lena Oevermann
- Department of Hematology/Oncology, Children's University Hospital, Tübingen, Germany
| | | | | | | | | | | | | |
Collapse
|
42
|
Stavropoulos-Giokas C, Dinou A, Papassavas A. The Role of HLA in Cord Blood Transplantation. BONE MARROW RESEARCH 2012; 2012:485160. [PMID: 23097706 PMCID: PMC3477523 DOI: 10.1155/2012/485160] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 09/12/2012] [Indexed: 01/09/2023]
Abstract
In recent years, umbilical cord blood (CB), a rich source of hematopoietic stem cells (HSC), has been used successfully as an alternative HSC source to treat a variety of hematologic, immunologic, genetic, and oncologic disorders. CB has several advantages, including prompt availability of the transplant, decrease of graft versus host disease (GVHD) and better long-term immune recovery, resulting in a similar long-term survival. Studies have shown that some degree of HLA mismatches is acceptable. This review is intended to outline the main aspects of HLA matching in different settings (related, pediatric, adult, or double-unit HSCT), its effect on transplantation outcome and the role of HLA in donor selection.
Collapse
Affiliation(s)
- Catherine Stavropoulos-Giokas
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens (BRFAA), 4 Soranou Efessiou Street, 115 27 Athens, Greece
| | - Amalia Dinou
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens (BRFAA), 4 Soranou Efessiou Street, 115 27 Athens, Greece
| | - Andreas Papassavas
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens (BRFAA), 4 Soranou Efessiou Street, 115 27 Athens, Greece
| |
Collapse
|
43
|
Van Zant G, Liang Y. Concise review: hematopoietic stem cell aging, life span, and transplantation. Stem Cells Transl Med 2012. [PMID: 23197871 DOI: 10.5966/sctm.2012-0033] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Self-renewal and multilineage differentiation of stem cells are keys to the lifelong homeostatic maintenance of tissues and organs. Hematopoietic aging, characterized by immunosenescence, proinflammation, and anemia, is attributed to age-associated changes in the number and function of hematopoietic stem cells (HSCs) and their microenvironmental niche. Genetic variants and factors regulating stem cell aging are correlatively or causatively associated with overall organismal aging and longevity. Translational use of HSCs for transplantation and gene therapy demands effective methods for stem cell expansion. Targeting the molecular pathways involved in HSC self-renewal, proliferation, and homing has led to enhanced expansion and engraftment of stem cells upon transplantation. HSC transplantation is less effective in elderly people, even though this is the demographic with the greatest need for this form of treatment. Thus, understanding the biological changes in the aging of stem cells as well as local and systematic environments will improve the efficacy of aged stem cells for regenerative medicine and ultimately facilitate improved health and life spans.
Collapse
Affiliation(s)
- Gary Van Zant
- Department of Internal Medicine, University of Kentucky, Lexington, KY, USA
| | | |
Collapse
|
44
|
Handgretinger R. Alternative donor HSCT in refractory acquired aplastic anemia: the time has come. Pediatr Transplant 2012; 16:513-4. [PMID: 22646164 DOI: 10.1111/j.1399-3046.2012.01734.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
45
|
Broder SM, Ponsaran RS, Goldenberg AJ. US public cord blood banking practices: recruitment, donation, and the timing of consent. Transfusion 2012; 53:679-87. [PMID: 22803637 DOI: 10.1111/j.1537-2995.2012.03785.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cord blood has moved rapidly from an experimental stem cell source to an accepted and important source of hematopoietic stem cells. There has been no comprehensive assessment of US public cord blood banking practices since the Institute of Medicine study in 2005. STUDY DESIGN AND METHODS Of 34 US public cord blood banks identified, 16 participated in our qualitative survey of public cord blood banking practices. Participants took part in in-depth telephone interviews in which they were asked structured and open-ended questions regarding recruitment, donation, and the informed consent process at these banks. RESULTS Thirteen of 16 participants reported a variably high percentage of women who consented to public cord blood donation. Fifteen banks offered donor registration at the time of hospital admission for labor and delivery. Seven obtained full informed consent and medical history during early labor and eight conducted some form of phased consent and/or phased medical screening and history. Nine participants identified initial selection of the collection site location as the chief mode by which they recruited minority donors. CONCLUSION Since 2005, more public banks offer cord blood donor registration at the time of admission for labor and delivery. That and the targeted location of cord blood collection sites are the main methods used to increase access to donation and HLA diversity of banked units. Currently, the ability to collect and process donations, rather than donor willingness, is the major barrier to public cord blood banking.
Collapse
Affiliation(s)
- Sherri M Broder
- Department of Bioethics and Center for Genetic Research Ethics and Law, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
| | | | | |
Collapse
|
46
|
Rapid expansion of human hematopoietic stem cells by automated control of inhibitory feedback signaling. Cell Stem Cell 2012; 10:218-29. [PMID: 22305571 DOI: 10.1016/j.stem.2012.01.003] [Citation(s) in RCA: 191] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Revised: 12/15/2011] [Accepted: 01/06/2012] [Indexed: 12/28/2022]
Abstract
Clinical hematopoietic transplantation outcomes are strongly correlated with the numbers of cells infused. Anticipated novel therapeutic implementations of hematopoietic stem cells (HSCs) and their derivatives further increase interest in strategies to expand HSCs ex vivo. A fundamental limitation in all HSC-driven culture systems is the rapid generation of differentiating cells and their secreted inhibitory feedback signals. Herein we describe an integrated computational and experimental strategy that enables a tunable reduction in the global levels and impact of paracrine signaling factors in an automated closed-system process by employing a controlled fed-batch media dilution approach. Application of this system to human cord blood cells yielded a rapid (12-day) 11-fold increase of HSCs with self-renewing, multilineage repopulating ability. These results highlight the marked improvements that control of feedback signaling can offer primary stem cell culture and demonstrate a clinically relevant rapid and relatively low culture volume strategy for ex vivo HSC expansion.
Collapse
|
47
|
Cui X, Chopp M, Shehadah A, Zacharek A, Kuzmin-Nichols N, Sanberg CD, Dai J, Zhang C, Ueno Y, Roberts C, Chen J. Therapeutic benefit of treatment of stroke with simvastatin and human umbilical cord blood cells: neurogenesis, synaptic plasticity, and axon growth. Cell Transplant 2012; 21:845-56. [PMID: 22405262 DOI: 10.3727/096368911x627417] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The therapeutic efficacy of cell-based therapy after stroke can be enhanced by making the host brain tissue more receptive to the administered cells, which thereby facilitates brain plasticity. We hypothesized that simvastatin increases human umbilical cord blood cell (HUCBC) migration into the ischemic brain and promotes brain plasticity and neurological functional outcome after stroke. Rats were subjected to 2-h middle cerebral artery occlusion (MCAo) and administered subtherapeutic doses of simvastatin (0.5 mg/kg, gavaged daily for 7 days), HUCBCs (1 × 10(6), one time injection via tail vein), or combination simvastatin with HUCBCs starting at 24 h after stroke. Combination treatment of stroke showed an interactive effect in improvement of neurological outcome compared with simvastatin or HUCBC monotherapy groups. In addition, combination treatment significantly increased brain-derived neurotrophic factor/TrkB expression and the number of engrafted HUCBCs in the ischemic brain compared with HUCBC monotherapy. The number of engrafted HUCBCs was significantly correlated with functional outcome (modified neurological severity score). Combination treatment significantly increased neurogenesis and synaptic plasticity in the ischemic brain, and promoted neuroblast migration in cultured subventricular zone explants. Using primary cultured neurons (PCNs), we found that combination treatment enhanced neurite outgrowth compared with nontreatment control, simvastatin or HUCBC supernatant monotherapy. Inhibition of TrkB significantly attenuated combination treatment-induced neurite outgrowth. Our data indicate that combination simvastatin and HUCBC treatment of stroke increases BDNF/TrkB expression, enhances HUCBC migration into the ischemic brain, amplifies endogenous neurogenesis, synaptic plasticity and axonal growth, and thereby improves functional outcome after stroke.
Collapse
Affiliation(s)
- Xu Cui
- Department of Neurology, Henry Ford Hospital, Detroit, MI 48202, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Choo SY. The HLA System in Transfusion Medicine and Transplantation. Transfus Med 2011. [DOI: 10.1002/9781444398748.ch16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
49
|
Stem-cell Therapy for Peripheral Arterial Occlusive Disease. Eur J Vasc Endovasc Surg 2011; 42:667-75. [DOI: 10.1016/j.ejvs.2011.06.026] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Accepted: 06/15/2011] [Indexed: 11/17/2022]
|
50
|
Arno A, Smith AH, Blit PH, Shehab MA, Gauglitz GG, Jeschke MG. Stem Cell Therapy: A New Treatment for Burns? Pharmaceuticals (Basel) 2011; 4:1355-1380. [PMID: 27721328 PMCID: PMC4060129 DOI: 10.3390/ph4101355] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Revised: 09/21/2011] [Accepted: 10/10/2011] [Indexed: 12/12/2022] Open
Abstract
Stem cell therapy has emerged as a promising new approach in almost every medicine specialty. This vast, heterogeneous family of cells are now both naturally (embryonic and adult stem cells) or artificially obtained (induced pluripotent stem cells or iPSCs) and their fates have become increasingly controllable, thanks to ongoing research in this passionate new field. We are at the beginning of a new era in medicine, with multiple applications for stem cell therapy, not only as a monotherapy, but also as an adjunct to other strategies, such as organ transplantation or standard drug treatment. Regrettably, serious preclinical concerns remain and differentiation, cell fusion, senescence and signalling crosstalk with growth factors and biomaterials are still challenges for this promising multidisciplinary therapeutic modality. Severe burns have several indications for stem cell therapy, including enhancement of wound healing, replacement of damaged skin and perfect skin regeneration - incorporating skin appendages and reduced fibrosis -, as well as systemic effects, such as inflammation, hypermetabolism and immunosuppression. The aim of this review is to describe well established characteristics of stem cells and to delineate new advances in the stem cell field, in the context of burn injury and wound healing.
Collapse
Affiliation(s)
- Anna Arno
- Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
- Plastic Surgery Department and Burn Unit, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Alexandra H Smith
- Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Patrick H Blit
- Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Mohammed Al Shehab
- Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Gerd G Gauglitz
- Department of Dermatology and Allergology, Ludwig Maximilians University, Geschwister-Scholl-Platz 1, 80539, Munich, Germany
| | - Marc G Jeschke
- Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.
| |
Collapse
|