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Xue L, Du R, Bi N, Xiao Q, Sun Y, Niu R, Tan Y, Chen L, Liu J, Wang T, Xiong L. Transplantation of human placental chorionic plate-derived mesenchymal stem cells for repair of neurological damage in neonatal hypoxic-ischemic encephalopathy. Neural Regen Res 2024; 19:2027-2035. [PMID: 38227532 DOI: 10.4103/1673-5374.390952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 09/18/2023] [Indexed: 01/17/2024] Open
Abstract
JOURNAL/nrgr/04.03/01300535-202409000-00035/figure1/v/2024-01-16T170235Z/r/image-tiff Neonatal hypoxic-ischemic encephalopathy is often associated with permanent cerebral palsy, neurosensory impairments, and cognitive deficits, and there is no effective treatment for complications related to hypoxic-ischemic encephalopathy. The therapeutic potential of human placental chorionic plate-derived mesenchymal stem cells for various diseases has been explored. However, the potential use of human placental chorionic plate-derived mesenchymal stem cells for the treatment of neonatal hypoxic-ischemic encephalopathy has not yet been investigated. In this study, we injected human placental chorionic plate-derived mesenchymal stem cells into the lateral ventricle of a neonatal hypoxic-ischemic encephalopathy rat model and observed significant improvements in both cognitive and motor function. Protein chip analysis showed that interleukin-3 expression was significantly elevated in neonatal hypoxic-ischemic encephalopathy model rats. Following transplantation of human placental chorionic plate-derived mesenchymal stem cells, interleukin-3 expression was downregulated. To further investigate the role of interleukin-3 in neonatal hypoxic-ischemic encephalopathy, we established an in vitro SH-SY5Y cell model of hypoxic-ischemic injury through oxygen-glucose deprivation and silenced interleukin-3 expression using small interfering RNA. We found that the activity and proliferation of SH-SY5Y cells subjected to oxygen-glucose deprivation were further suppressed by interleukin-3 knockdown. Furthermore, interleukin-3 knockout exacerbated neuronal damage and cognitive and motor function impairment in rat models of hypoxic-ischemic encephalopathy. The findings suggest that transplantation of hpcMSCs ameliorated behavioral impairments in a rat model of hypoxic-ischemic encephalopathy, and this effect was mediated by interleukin-3-dependent neurological function.
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Affiliation(s)
- Lulu Xue
- Transformation Research Laboratory, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou Province, China
- State Key Laboratory of Biotherapy, Sichuan University, Chengdu, Sichuan Province, China
| | - Ruolan Du
- Institute of Neurological Disease, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Ning Bi
- Department of Animal Zoology, Institute of Neuroscience, Kunming Medical University, Kunming, Yunnan Province, China
| | - Qiuxia Xiao
- Institute of Neurological Disease, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yifei Sun
- Institute of Neurological Disease, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Ruize Niu
- Department of Animal Zoology, Institute of Neuroscience, Kunming Medical University, Kunming, Yunnan Province, China
| | - Yaxin Tan
- Department of Pediatrics, the People's Liberation Army Rocket Force Characteristic Medical Center, Beijing, China
| | - Li Chen
- Institute of Neurological Disease, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Jia Liu
- Department of Animal Zoology, Institute of Neuroscience, Kunming Medical University, Kunming, Yunnan Province, China
| | - Tinghua Wang
- Transformation Research Laboratory, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou Province, China
- State Key Laboratory of Biotherapy, Sichuan University, Chengdu, Sichuan Province, China
- Institute of Neurological Disease, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Department of Animal Zoology, Institute of Neuroscience, Kunming Medical University, Kunming, Yunnan Province, China
| | - Liulin Xiong
- Transformation Research Laboratory, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou Province, China
- Department of Anesthesiology, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou Province, China
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Hashemi Bahramani M, Gharib A, Soeimani M, Rabiei M. Do cord blood CD34 cells stay the same or change after expansion: A comprehensive analysis of gene expression results before and after seven days of cell culture. Transfus Apher Sci 2023; 62:103748. [PMID: 37438246 DOI: 10.1016/j.transci.2023.103748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/30/2023] [Accepted: 06/06/2023] [Indexed: 07/14/2023]
Abstract
INTRODUCTION Hematopoietic stem cell transplantation is used to treat hematopoietic malignancies and bone marrow failure syndromes. Due to the difficulties of using these cells isolated from the bone marrow, an additional source for receiving essential hematopoietic cells is umbilical cord blood. But the main problem with using the umbilical cord is its insufficient blood volume. The ex-vivo reproductive system of hematopoietic stem cells can overcome this problem that has the ability for Transplantation and hematopoiesis in the long term. This study aimed to evaluate the expression profile of CD133 + umbilical cord blood microRNAs in different stages of hematopoietic stem cells before and after ex-vivo proliferation. MATERIALS AND METHODS The expression profile of 1034 types of microRNA of CD34 + hematopoietic stem cells of the umbilical cord was analyzed before and after ex vivo proliferation. After isolating CD34 + cells from the umbilical cord blood of normal-born babies using MACS (Magnetic-activated cell sorting) column, these cells were cultured in a Stem span culture medium containing SCF, FLT3, and TPO cytokines in 24-well plates. The expression profile of microRNAs was investigated on days 0 and 7 days after cultivation by the Real-Time PCR method. RESULTS The results showed that the production of two-thirds of the micro-RNAs was reduced during the proliferation process. The micro-RNA expression of hematopoietic stem cell proliferation was also lower. At the same time, micro-RNA expression related to differentiation was higher. CONCLUSION The observed reduction in miRNA expression may be attributed to enhanced differentiation through proliferation. Therefore, miRNAs appear to be a viable option for regulating the proliferation processes of Hematopoietic stem cell transplantation.
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Affiliation(s)
- Mohammad Hashemi Bahramani
- Department of Pathology and Laboratory Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atoosa Gharib
- Department of Pathology, Shahid Modarres Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Soeimani
- Department of Hematology and Cell Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran; Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahnaz Rabiei
- Department of Pathology and Laboratory Medicine, Imam Hossein Hospital, Madani Street, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Krasilnikova OA, Baranovskii DS, Lyundup AV, Shegay PV, Kaprin AD, Klabukov ID. Stem and Somatic Cell Monotherapy for the Treatment of Diabetic Foot Ulcers: Review of Clinical Studies and Mechanisms of Action. Stem Cell Rev Rep 2022; 18:1974-1985. [PMID: 35476187 DOI: 10.1007/s12015-022-10379-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2022] [Indexed: 02/06/2023]
Abstract
Diabetic foot ulcer (DFU) is one of the most severe complications of diabetes mellitus, often resulting in a limb amputation. A cell-based therapy is a highly promising approach for an effective DFU treatment. However, there is no consensus regarding the most effective cell type for DFU treatment. Various cell types contribute to chronic wound healing via different mechanisms. For example, application of keratinocytes can stimulate migration of native keratinocytes from the wound edge, while mesenchymal stem cells can correct limb ischemia. To assess the effectiveness of a certain cell type, it should be administered as a monotherapy without other substances and procedures that have additional therapeutic effects. In the present review, we described therapeutic effects of various cells and provided an overview of clinical studies in which stem and somatic cell-based therapy was administered as a monotherapy. Topical application of somatic cells contributes to DFU healing only, while injection of mesenchymal stem cells and mononuclear cells can break a pathophysiological chain leading from insufficient blood supply to DFU development. At the same time, the systemic use of mesenchymal stem cells carries greater risks. Undoubtedly, cell therapy is a potent tool for the treatment of DFU. However, it is vital to conduct further high-quality clinical research to determine the most effective cell type, dosage and way of administration for DFU treatment. Ischemia, neuropathy and neuro-ischemia are underlying factors of diabetic foot ulcer. Stem and somatic cells monotherapy can improve chronic wound healing via different mechanisms.
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Affiliation(s)
- O A Krasilnikova
- A. Tsyb Medical Radiological Research Center - branch of the National Medical Research Radiological Center, Obninsk, Russia
| | - D S Baranovskii
- A. Tsyb Medical Radiological Research Center - branch of the National Medical Research Radiological Center, Obninsk, Russia.,Research and Educational Resource Center for Cellular Technologies, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
| | - A V Lyundup
- Research and Educational Resource Center for Cellular Technologies, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
| | - P V Shegay
- Department of Regenerative Medicine, National Medical Research Radiological Center, Obninsk, Russia
| | - A D Kaprin
- Research and Educational Resource Center for Cellular Technologies, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia.,Department of Regenerative Medicine, National Medical Research Radiological Center, Obninsk, Russia
| | - I D Klabukov
- Research and Educational Resource Center for Cellular Technologies, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia. .,Department of Regenerative Medicine, National Medical Research Radiological Center, Obninsk, Russia. .,Obninsk Institute for Nuclear Power Engineering of the National Research Nuclear University MEPhI, Obninsk, Russia.
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Yunir E, Kurniawan F, Rezaprasga E, Wijaya IP, Suroyo I, Matondang S, Irawan C, Soewondo P. Autologous Bone-Marrow vs. Peripheral Blood Mononuclear Cells Therapy for Peripheral Artery Disease in Diabetic Patients. Int J Stem Cells 2021; 14:21-32. [PMID: 33377454 PMCID: PMC7904521 DOI: 10.15283/ijsc20088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 10/18/2020] [Accepted: 10/19/2020] [Indexed: 01/09/2023] Open
Abstract
Diabetes mellitus (DM) remains one of the most important risk factors for peripheral artery disease (PAD), with approximately 20% of DM patients older than 40 years old are affected with PAD. The current standard management for severe PAD is endovascular intervention with or without surgical bypass. Unfortunately, up to 40% of patients are unable to undergo these revascularization therapies due to excessive surgical risk or adverse vascular side effects. Stem cell therapy has emerged as a novel therapeutic strategy for these ‘no-option’ patients. Several types of stem cells are utilized for PAD therapy, including bone marrow mononuclear cells (BMMNC) and peripheral blood mononuclear cells (PBMNC). Many studies have reported the safety of BMMNC and PBMNC, as well as its efficacy in reducing ischemic pain, ulcer size, pain-free walking distance, ankle-brachial index (ABI), and transcutaneous oxygen pressure (TcPO2). However, the capacity to establish the efficacy of reducing major amputation rates, amputation free survival, and all-cause mortality is limited, as shown by several randomized placebo-controlled trials. The present literature review will focus on comparing safety and efficacy between BMMNC and PBMNC as cell-based management in diabetic patients with PAD who are not suitable for revascularization therapy.
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Affiliation(s)
- Em Yunir
- Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.,Metabolic Disorder, Cardiovascular, and Aging Cluster, Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Farid Kurniawan
- Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.,Metabolic Disorder, Cardiovascular, and Aging Cluster, Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Edo Rezaprasga
- Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.,Metabolic Disorder, Cardiovascular, and Aging Cluster, Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Ika Prasetya Wijaya
- Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Indrati Suroyo
- Department of Radiology, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Sahat Matondang
- Department of Radiology, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Cosphiadi Irawan
- Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Pradana Soewondo
- Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.,Metabolic Disorder, Cardiovascular, and Aging Cluster, Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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Abstract
INTRODUCTION Transplantation of the keratinocytes, fibroblasts, bone marrow, and adipose tissue-derived mesenchymal stem cells may improve chronic wound healing by delivery of different cytokines, chemokines, and growth factors, which play an essential role in wound healing. The purposes of this review were to check which cell lines are potentially beneficial in enhancement of wound healing and to describe the safety and efficacy of cell therapies in the clinical treatment of chronic wounds, as well as to summarize the pertinent literature and research progress in this field. METHODS PubMed search engine and ClinicalTrials.gov were used to analyze the available data on cell therapies applied in treatment of chronic wound. The analysis included 51 articles, assessing the use of keratinocytes (10), fibroblasts (7), keratinocytes and fibroblasts (10), bone marrow-derived cells (20), and adipose tissue cells (4). Studies on the cell-based products that are currently available on the market (Dermagraft, EpiDex, Apligraf, and HP802-247) were also included, with majority of reports found on fibroblasts and keratinocytes studies. RESULTS Cell-based therapies have a great potential to improve wound healing without major surgical procedures and donor-site morbidity. There is, however, a lack of guidelines on how the age of the patients, the general health conditions, and the coexistence of different diseases may affect the success of these therapies. Further studies are needed to determine the fate of transplanted cells and the number of cells required to obtain optimal effects and outcomes. CONCLUSIONS Despite many promising clinical trials on application of various stem cell-based therapies for treatment of chronic wounds, there is still a need for multicenter comparative studies assessing the dose response and the cell source response on the efficacy of chronic wound healing.
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Sihota R, Sen S, Mohanty S, Ahmad M, Ravi A, Gupta V, Bhatla N. Effect of intracameral human cord blood-derived stem cells on lasered rabbit trabecular meshwork. Int Ophthalmol 2019; 39:2757-2766. [PMID: 31140023 DOI: 10.1007/s10792-019-01120-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 05/22/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study aimed to investigate the effect of intracameral human cord blood stem cells on lasered rabbit trabecular meshwork. METHODS Immediately following diode laser application to the trabecular meshwork, human cord blood stem cells were injected intracamerally, in one eye of 12 albino rabbits. The other eye of ten rabbits was lasered controls and two eyes were normal controls. Rabbits were killed after 4, 8 and 12 weeks. RESULTS Lasered control rabbit eyes showed significant disruption of trabecular architecture, loss and pleomorphism of trabecular endothelial cells and progressive narrowing of trabecular spaces till 12 weeks. In contrast, lasered eyes, concurrently injected with human cord blood stem cells, showed relatively preserved endothelial cellularity and structure of the trabecular meshwork, at all time points. Human CD34- and CD44-positive cells were identified in 7/8 eyes treated with stem cells, at 4 and 8 weeks, and 2 of 3 at 12 weeks. Many PKH26-labeled human cord blood cells were visible throughout the trabecular area at 4 weeks. They gradually decreased in number by 8 weeks, and at 12 weeks, they appeared to be oriented along trabecular beams. CONCLUSIONS There was a relative preservation of cellularity and architecture of the trabecular meshwork in eyes injected with human cord blood stem cells, as compared to lasered control eyes up to 12 weeks, without significant inflammation. This suggests a probable role for such stem cells in eyes with glaucoma, having trabecular dysfunction.
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Affiliation(s)
- Ramanjit Sihota
- Glaucoma Research Facility and Clinical Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Seema Sen
- Ocular Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Sujata Mohanty
- Stem Cell Facility, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Mohammad Ahmad
- Ocular Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Alok Ravi
- Glaucoma Research Facility and Clinical Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Viney Gupta
- Glaucoma Research Facility and Clinical Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Neerja Bhatla
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, 110029, India
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Menéndez-Menéndez Y, Otero-Hernández J, Vega JA, Pérez-Basterrechea M, Pérez-López S, Álvarez-Viejo M, Ferrero-Gutiérrez A. The role of bone marrow mononuclear cell-conditioned medium in the proliferation and migration of human dermal fibroblasts. Cell Mol Biol Lett 2017; 22:29. [PMID: 29270201 PMCID: PMC5735620 DOI: 10.1186/s11658-017-0055-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 11/10/2017] [Indexed: 12/14/2022] Open
Abstract
Background Several recent studies have demonstrated the great potential of bone marrow cells in regenerative medicine, not only for their ability to differentiate to match a damaged cell type, but also because they synthesize and release various growth factors and cytokines. We examined the effect of bone marrow cell-conditioned medium in the healing process, especially in terms of fibroblast proliferation and migration. Methods These in vitro studies consisted of co-culture (without direct contact) of dermal fibroblasts with mononuclear bone marrow cells and the use of conditioned medium obtained from these cultures in a scratch wound model. Results Mononuclear cells were found to increase the proliferation of fibroblasts, and the conditioned medium showed a stimulatory effect on the migration of fibroblasts. Conclusion When considered together with the observed increase in growth factor levels in conditioned medium, it appears that these cells act through a paracrine mechanism.
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Affiliation(s)
- Yolanda Menéndez-Menéndez
- Unidad de Coordinación de Trasplantes, Terapia Celular y Medicina Regenerativa, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Jesús Otero-Hernández
- Unidad de Coordinación de Trasplantes, Terapia Celular y Medicina Regenerativa, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Jose Antonio Vega
- Departamento de Morfología y Biología Celular, Universidad de Oviedo, Oviedo, Spain.,Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Temuco, Chile
| | - Marcos Pérez-Basterrechea
- Unidad de Coordinación de Trasplantes, Terapia Celular y Medicina Regenerativa, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Silvia Pérez-López
- Unidad de Coordinación de Trasplantes, Terapia Celular y Medicina Regenerativa, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - María Álvarez-Viejo
- Unidad de Coordinación de Trasplantes, Terapia Celular y Medicina Regenerativa, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Amaia Ferrero-Gutiérrez
- Unidad de Coordinación de Trasplantes, Terapia Celular y Medicina Regenerativa, Hospital Universitario Central de Asturias, Oviedo, Spain
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Wehbe T, Chahine NA, Sissi S, Abou-Joaude I, Chalhoub L. Bone marrow derived stem cell therapy for type 2 diabetes mellitus. Stem Cell Investig 2016; 3:87. [PMID: 28066789 DOI: 10.21037/sci.2016.11.14] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 11/21/2016] [Indexed: 12/19/2022]
Abstract
In this study, 6 patients with type 2 diabetes (T2D) underwent autologous bone marrow mononuclear stem cell (BM-MNSC) infusion into the celiac and superior mesenteric arteries without pretreatment with any myeloablative or immune-suppressive therapy. Five of 6 (83%) showed normalization of their fasting glucose and the glycosylated hemoglobin (HbA1C) with significant reduction of their medication requirements. The HbA1C dropped on average 2.2 points. The three patients with diabetic complications showed improvement or stabilization and most patients reported improved energy and stamina. The durations of response varied between 6 months and 2 years. No patients had any significant adverse effects.
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Affiliation(s)
- Tarek Wehbe
- Hematology Department, the Lebanese Canadian and Notre Dame University Hospitals, Beirut, Lebanon
| | - Nassim Abi Chahine
- Neurosurgery Department, the Lebanese Canadian Hospital, Beirut, Lebanon
| | - Salam Sissi
- Endocrinology Department, Al-Saydet Hospital, Zgharta, Lebanon
| | - Isabelle Abou-Joaude
- Endocrinology Department, The Middle East and Notre Dame University Hospitals, Beirut, Lebanon
| | - Louis Chalhoub
- Endocrinology Department, the Lebanese Canadian Hospital, Beirut, Lebanon
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Pirzad Jahromi G, Shabanzadeh Pirsaraei A, Sadr SS, Kaka G, Jafari M, Seidi S, Charish J. Multipotent bone marrow stromal cell therapy promotes endogenous cell proliferation following ischemic stroke. Clin Exp Pharmacol Physiol 2016. [PMID: 26218989 DOI: 10.1111/1440-1681.12466] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Despite extensive research over the years, there still exists some debate as to what constitutes the optimal therapeutic strategy to promote recovery following stroke. Due to the complexity of injured brain pathophysiology, treatment approaches should ideally address numerous factors, ultimately aiming to promote tissue protection, axonal regrowth and functional recovery. This study extends the understanding of the effects of bone marrow stromal cell (BMSC) treatment following experimentally induced ischemic stroke in rats. Focal ischemic brain injury was experimentally induced in rats by placing a preformed clot into the middle cerebral artery. Animals were injected intravenously with BMSCs at 24 h after stroke and were killed 7 days post injury. When administered BMSCs following stroke, the neurological outcome was significantly improved relative to controls. There was an increase in the number of BMSCs labelled with BrdU present in the injured hemisphere of the brain compared to the non-injured side. Furthermore, administration of BMSCs also led to increases in astrocytosis, vascularization and endogenous proliferation. These findings provide insight into the mechanisms of action of BMSC treatment and further argue for the therapeutic potential of BMSCs as an effective treatment following cerebral stroke.
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Affiliation(s)
- Gila Pirzad Jahromi
- Neuroscience Research Centre, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Alireza Shabanzadeh Pirsaraei
- Electrophysiology Research Centre, Neuroscience Institute, Tehran, Iran.,Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Genetics and Development Division, Toronto Western Research Institute, Toronto, ON, Canada
| | - Seyed Shahabeddin Sadr
- Electrophysiology Research Centre, Neuroscience Institute, Tehran, Iran.,Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Golamreza Kaka
- Neuroscience Research Centre, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mahvash Jafari
- Department of Biochemistry, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Sadegh Seidi
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Jason Charish
- Genetics and Development Division, Toronto Western Research Institute, Toronto, ON, Canada
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Mahadevaiah S, Robinson KG, Kharkar PM, Kiick KL, Akins RE. Decreasing matrix modulus of PEG hydrogels induces a vascular phenotype in human cord blood stem cells. Biomaterials 2015; 62:24-34. [PMID: 26016692 DOI: 10.1016/j.biomaterials.2015.05.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 05/04/2015] [Accepted: 05/14/2015] [Indexed: 01/12/2023]
Abstract
Adult and congenital cardiovascular diseases are significant health problems that are often managed using surgery. Bypass grafting is a principal therapy, but grafts fail at high rates due to hyperplasia, fibrosis, and atherosclerosis. Biocompatible, cellularized materials that attenuate these complications and encourage healthy microvascularization could reduce graft failure, but an improved understanding of biomaterial effects on human stem cells is needed to reach clinical utility. Our group investigates stem-cell-loaded biomaterials for placement along the adventitia of at-risk vessels and grafts. Here, the effects of substrate modulus on human CD34+ stem cells from umbilical cord blood were evaluated. Cells were isolated by immunomagnetic separation and encapsulated in 3, 4, and 6 weight% PEG hydrogels containing 0.032% gelatin and 0.0044% fibronectin. Gels reached moduli of 0.34, 4.5, and 9.1 kPa. Cell viability approached 100%. Cell morphologies appeared similar across gels, but proliferation was significantly lower in 6 wt% gels. Expression profiling using stem cell signaling arrays indicated enhanced self-renewal and differentiation into vascular endothelium among cells in the lower weight percent gels. Thus, modulus was associated with cell proliferation and function. Gels with moduli in the low kilopascal range may be useful in stimulating cell engraftment and microvascularization of graft adventitia.
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Affiliation(s)
- Shruthi Mahadevaiah
- Nemours - Alfred I. duPont Hospital for Children, Department of Biomedical Research, 1600 Rockland Road, Wilmington, DE 19803, United States; Nemours - Alfred I. duPont Hospital for Children, Critical Care Department, 1600 Rockland Road, Wilmington, DE 19803, United States
| | - Karyn G Robinson
- Nemours - Alfred I. duPont Hospital for Children, Department of Biomedical Research, 1600 Rockland Road, Wilmington, DE 19803, United States
| | - Prathamesh M Kharkar
- Department of Materials Science and Engineering, University of Delaware, 201 Du Pont Hall, Newark, DE 19716, United States
| | - Kristi L Kiick
- Department of Materials Science and Engineering, University of Delaware, 201 Du Pont Hall, Newark, DE 19716, United States
| | - Robert E Akins
- Nemours - Alfred I. duPont Hospital for Children, Department of Biomedical Research, 1600 Rockland Road, Wilmington, DE 19803, United States.
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11
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Preclinical and clinical evidence for stem cell therapies as treatment for diabetic wounds. Drug Discov Today 2015; 20:703-17. [PMID: 25603421 DOI: 10.1016/j.drudis.2015.01.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Revised: 12/10/2014] [Accepted: 01/12/2015] [Indexed: 01/07/2023]
Abstract
Diabetic wounds remain a global unsolved problem and the cost of diabetes-related amputations and diabetic wound treatment is approximately US$3 billion and US$9 billion per year, respectively. Diabetic foot ulcers (DFUs) occur in 15% of all patients with diabetes and precede 84% of all diabetes-related lower leg amputations. Currently, there is no satisfying treatment for these hard-to-heal-wounds. However, as we discuss here, experimental preclinical evidence for the successful use of adult stem cell therapies for diabetic wounds gives new hope for the development of effective treatments for use in the clinic.
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13
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Abd-Allah SH, Shalaby SM, Abd-Elbary E, Saleh AA, El-Magd MA. Human peripheral blood CD34+ cells attenuate oleic acid-induced acute lung injury in rats. Cytotherapy 2014; 17:443-53. [PMID: 25536864 DOI: 10.1016/j.jcyt.2014.11.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Revised: 10/24/2014] [Accepted: 11/06/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND AIMS Adult stem cell-based therapy is a promising novel approach for treatment of acute lung injury (ALI). In this study, we evaluated the therapeutic effect of isolated human peripheral blood CD34+ progenitor cells in an ALI rat model, induced by oleic acid (OA) injection. METHODS Seventy-five adult female rats were used in this study. Group A, control without treatment, and group B, control injected with phosphate-buffered saline, comprised 15 rats each; the remaining 45 rats were injected with OA to induce ALI and were further subdivided into 3 groups: group C (ALI group, 15 rats), group D (ALI and fibroblast group, 15 rats) and group E (ALI and CD34+ cell group, 15 rats). RESULTS CD34+ cells transplantation in rats with OA-induced lung injury improves the arterial PaO(2) and wet/dry ratio, reduces infiltration of inflammatory cells and decreases lung vascular permeability as determined by reduced intra-alveolar and interstitial patchy congestion and hemorrhage as well as decreased interstitial edema. Additionally, lung inflammation determined by expression of the pro-inflammatory mediators intercellular adhesion molecule 1 and tumor necrosis factor-α was attenuated in CD34+ cell-treated rats at 6, 24 and 48 h post-OA challenge compared with non-treated rats. Moreover, the expression of anti-inflammatory molecule interleukin-10 was up-regulated in the lung of OA-induced ALI rats after administration of CD34+ cells. The important finding was that human TNF-α-induced protein 6 (TSG-6) gene expression was significantly up-regulated in rats treated with CD34+ cells. CONCLUSIONS The freshly isolated human peripheral blood-derived CD34+ cells may be used as an important source of stem cells that improve ALI. The anti-inflammatory properties of CD34+ cells in the lung are explained, at least in part, by activation of CD34+ cells to express TSG-6.
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Affiliation(s)
- Somia H Abd-Allah
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Sally M Shalaby
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Eman Abd-Elbary
- Department of Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ayman A Saleh
- Department of Animal Wealth Development, Genetics and Genetic Engineering, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafr El-Sheikh, Egypt
| | - Mohammed Abu El-Magd
- Department of Anatomy and Embryology, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafr El-Sheikh, Egypt.
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14
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Osawa H, Orii K, Terunuma H, Abraham SJ. Combining autologous peripheral blood mononuclear cells with fibroblast growth factor therapy along with stringent infection control leading to successful limb salvage in diabetic patient with chronic renal failure and severe toe gangrene. Int J Stem Cells 2014; 7:158-61. [PMID: 25473454 PMCID: PMC4249899 DOI: 10.15283/ijsc.2014.7.2.158] [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: 07/25/2014] [Indexed: 01/07/2023] Open
Abstract
Peripheral arterial disease (PAD) is a common complication of Diabetes Mellitus (DM) and often culminates in amputation of the affected foot. Pseudomonas aeruginosa infections associated with PAD are difficult to treat due to their multi-drug resistance. Herein we report a 38 year old male who reported with DM, chronic kidney disease (CKD) and rest pain of the right second toe in October 2011. He underwent percutaneous transluminal angioplasty (PTA) which was unsuccessful. The gangrene of the toes worsened and amputation of the right second toe was done. Bacteriological examination showed presence of P. aeruginosa which during the course of antibiotic therapy became multi-drug resistant. Gangrene and abscess of the foot worsened and amputation of the right third toe was performed. Then autologous peripheral blood mononuclear cell (PBMNC) therapy was performed but as infection control could not still be achieved, the fourth toe was amputated. A protocol of foot bath using carbonic water, local usage of antibiotics (Polymyxin-B), and basic fibroblast growth factor (b-FGF) spray was then employed after which the infection could be controlled and improvement in vascularity of the right foot could be observed in angiography. This combined approach after proper validation could be considered for similar cases.
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Affiliation(s)
- Hiroshi Osawa
- Shimada General Hospital, Division of Cardiovascular Surgery, Chiba
| | - Kouan Orii
- Shimada General Hospital, Division of Cardiovascular Surgery, Chiba
| | | | - Samuel Jk Abraham
- The Mary-Yoshio Translational Hexagon (MYTH), Nichi-In Centre for Regenerative Medicine (NCRM), Chennai, India ; Yamanashi University- School of Medicine, Chuo, Japan
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15
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Loeken MR. Opportunities and challenges for repair of macrovascular disease using circulating blood-derived progenitor cells. Diabetes Metab Res Rev 2014; 30:554-5. [PMID: 25315433 PMCID: PMC4222573 DOI: 10.1002/dmrr.2564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 04/29/2014] [Indexed: 11/11/2022]
Abstract
There are currently few solutions for diabetic vascular disease that involve repair of damaged tissues. The manuscript by Porat et al. in this issue, suggests a possible method to use a patient's own circulating blood cells to provide progenitors to repair damaged vascular tissues.
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Affiliation(s)
- Mary R Loeken
- Section on Islet and Regenerative Cell Biology, Joslin Diabetes Center, USA
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16
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Liu Y, Liu Y, Wang P, Tian H, Ai J, Liu Y, Zhou Y, Liu Z, Guo W, Yang S. Autologous bone marrow stem cell transplantation for the treatment of postoperative hand infection with a skin defect in diabetes mellitus: A case report. Oncol Lett 2014; 7:1857-1862. [PMID: 24932248 PMCID: PMC4049741 DOI: 10.3892/ol.2014.1998] [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: 08/28/2013] [Accepted: 02/07/2014] [Indexed: 02/05/2023] Open
Abstract
Among stem cells, autologous mesenchymal stem cells (MSCs) are ideal for transplantation by virtue of limited rejection reactions and marked proliferative ability. This study presents a novel method by which MSCs were harvested from the bone marrow of a patient who presented with severe post-traumatic infection and a non-healing skin defect in the hand, secondary to uncontrolled diabetes mellitus (DM). An autologous MSC suspension was injected into the persistent skin defect after stabilizing the blood glucose level and appropriate infection control. During the course of a regular 18-month postoperative follow-up, the patient exhibited immediate recovery with no transplant-associated complications, as well as no evidence of tumorigenicity. Thus, transplantation of autologous MSCs may play a role in the clinical application of stem cells, particularly for treatment of skin defects following surgery in cases of DM and for those caused by various other traumas.
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Affiliation(s)
- Yihong Liu
- Department of Endocrinology and Metabolism, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China ; Diabetic Centre of Control and Prevention, The People's Liberation Army 520 Hospital, Mianyang, Sichuan 621000, P.R. China
| | - Yuchen Liu
- Diabetic Centre of Control and Prevention, The People's Liberation Army 520 Hospital, Mianyang, Sichuan 621000, P.R. China
| | - Pujie Wang
- Diabetic Centre of Control and Prevention, The People's Liberation Army 520 Hospital, Mianyang, Sichuan 621000, P.R. China
| | - Haoming Tian
- Department of Endocrinology and Metabolism, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Jianzhong Ai
- Core Facility of Genetically Engineered Mice, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Yangbo Liu
- Diabetic Centre of Control and Prevention, The People's Liberation Army 520 Hospital, Mianyang, Sichuan 621000, P.R. China
| | - Yi Zhou
- Diabetic Centre of Control and Prevention, The People's Liberation Army 520 Hospital, Mianyang, Sichuan 621000, P.R. China
| | - Zhongwen Liu
- Diabetic Centre of Control and Prevention, The People's Liberation Army 520 Hospital, Mianyang, Sichuan 621000, P.R. China
| | - Wenjun Guo
- Diabetic Centre of Control and Prevention, The People's Liberation Army 520 Hospital, Mianyang, Sichuan 621000, P.R. China
| | - Shenke Yang
- Diabetic Centre of Control and Prevention, The People's Liberation Army 520 Hospital, Mianyang, Sichuan 621000, P.R. China
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17
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Chen L, Huang H, Sharma HS, Zuo H, Sanberg PR. Cell transplantation as a pain therapy targets both analgesia and neural repair. Cell Transplant 2013; 22 Suppl 1:S11-9. [PMID: 23992823 DOI: 10.3727/096368913x672091] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Cell transplantation is a potentially powerful approach for the alleviation of chronic pain. The strategy of cell transplantation for the treatment of pain is focused on cell-based analgesia and neural repair. (1) Adrenal medullary chromaffin cells and the PC12 cell line have been used to treat cancer pain and neuropathic pain in both animal models and human cases. As biological or living minipumps, these cells produce and secrete pain-reducing neuroactive substances if administered directly into the spinal subarachnoid space. (2) Cell implantation for pain neurorestorative therapy is a new concept and an emerging research field for pain control along with neural repair. Possible neurorestorative mechanisms include neuroprotective, neurotrophic, neuroreparative, neuroregenerative, neuromodulation, or neuroconstructive interventions, as well as immunomodulation and enhancing the microcirculation. These factors may ultimately restore the damaged or irritated condition of the lesioned nerves. The growing preclinical and clinical data show that neural stem/progenitor cells, olfactory ensheathing cells, mesenchymal stromal cells, and CD34(+) cells have the capacity to manage intractable pain and improve neurological functions. Cell delivery routes include local, intrathecal, or intravascular implants. Although these strategies are still in their infancy phase for pain neurorestoratology, cell-based therapies could open up new avenues for the relief of pain. In this review, these aspects are critically analyzed based on our own investigations. This manuscript is published as part of the International Association of Neurorestoratology (IANR) supplement issue of Cell Transplantation.
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18
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Abu Kasim NH, Govindasamy V, Gnanasegaran N, Musa S, Pradeep PJ, Srijaya TC, Aziz ZACA. Unique molecular signatures influencing the biological function and fate of post-natal stem cells isolated from different sources. J Tissue Eng Regen Med 2012; 9:E252-66. [PMID: 23229816 DOI: 10.1002/term.1663] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Revised: 09/04/2012] [Accepted: 10/31/2012] [Indexed: 12/21/2022]
Abstract
The discovery of mesenchymal stem cells (MSCs) from a myriad of tissues has triggered the initiative of establishing tailor-made stem cells for disease-specific therapy. Nevertheless, lack of understanding on the inherent differential propensities of these cells may restrict their clinical outcome. Therefore, a comprehensive study was done to compare the proliferation, differentiation, expression of cell surface markers and gene profiling of stem cells isolated from different sources, viz. bone marrow, Wharton's jelly, adipose tissue and dental pulp. We found that although all MSCs were phenotypically similar to each other, Wharton's jelly (WJ) MSCs and dental pulp stem cells (DPSCs) were highly proliferative as compared to bone marrow (BM) MSCs and adipose tissue (AD) MSCs. Moreover, indistinguishable cell surface characteristics and differentiation capacity were confirmed to be similar among all cell types. Based on gene expression profiling, we postulate that BM-MSCs constitutively expressed genes related to inflammation and immunodulation, whereas genes implicated in tissue development were highly expressed in AD-MSCs. Furthermore, the transcriptome profiling of WJ-MSCs and DPSCs revealed an inherent bias towards the neuro-ectoderm lineage. Based on our findings, we believe that there is no unique master mesenchymal stem cell that is appropriate to treat all target diseases. More precisely, MSCs from different sources exhibit distinct and unique gene expression signatures that make them competent to give rise to specific lineages rather than others. Therefore, stem cells should be subjected to rigorous characterization and utmost vigilance needs to be adopted in order to choose the best cellular source for a particular disease.
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Affiliation(s)
- Noor Hayaty Abu Kasim
- Department of Conservative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Vijayendran Govindasamy
- Hygieia Innovation Sdn. Bhd, Lot 1G-2G, Lanai Complex No.2, Persiaran Seri Perdana, Percint 10, Federal Territory of Putrajaya, Malaysia.,Department of Children's Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Nareshwaran Gnanasegaran
- Regenerative Dentistry Research Group (ReDReG), Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Sabri Musa
- Department of Children's Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Regenerative Dentistry Research Group (ReDReG), Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Padmaja Jayaprasad Pradeep
- Oral Cancer Research and Coordinating Centre (OCRCC), Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Zeti Adura Che Ab Aziz
- Department of Conservative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
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19
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Botti C, Maione C, Coppola A, Sica V, Cobellis G. Autologous bone marrow cell therapy for peripheral arterial disease. STEM CELLS AND CLONING-ADVANCES AND APPLICATIONS 2012; 5:5-14. [PMID: 24198534 PMCID: PMC3781761 DOI: 10.2147/sccaa.s28121] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Inadequate blood supply to tissues caused by obstruction of arterioles and/or capillaries results in ischemic injuries – these injuries can range from mild (eg, leg ischemia) to severe conditions (eg, myocardial infarction, stroke). Surgical and/or endovascular procedures provide cutting-edge treatment for patients with vascular disorders; however, a high percentage of patients are currently not treatable, owing to high operative risk or unfavorable vascular involvement. Therapeutic angiogenesis has recently emerged as a promising new therapy, promoting the formation of new blood vessels by the introduction of bone marrow–derived stem and progenitor cells. These cells participate in the development of new blood vessels, the enlargement of existing blood vessels, and sprouting new capillaries from existing blood vessels, providing evidence of the therapeutic utility of these cells in ischemic tissues. In this review, the authors describe peripheral arterial disease, an ischemic condition affecting the lower extremities, summarizing different aspects of vascular regeneration and discussing which and how stem cells restore the blood flow. The authors also present an overview of encouraging results from early-phase clinical trials using stem cells to treat peripheral arterial disease. The authors believe that additional research initiatives should be undertaken to better identify the nature of stem cells and that an intensive cooperation between laboratory and clinical investigators is needed to optimize the design of cell therapy trials and to maximize their scientific rigor. Only this will allow the results of these investigations to develop best clinical practices. Additionally, although a number of stem cell therapies exist, many treatments are performed outside international and national regulations and many clinical trials have been not registered on databases such as ClinicalTrials.gov or EudraCT. Therefore, more rigorous clinical trials are required to confirm the first hopeful results and to address the challenging issues.
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Affiliation(s)
- C Botti
- Department of General Pathology, Second University of Naples, Naples, Italy
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20
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Benoit E, O'Donnell TF, Patel AN. Safety and efficacy of autologous cell therapy in critical limb ischemia: a systematic review. Cell Transplant 2012; 22:545-62. [PMID: 22490340 DOI: 10.3727/096368912x636777] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Researchers have accumulated a decade of experience with autologous cell therapy in the treatment of critical limb ischemia (CLI). We conducted a systematic review of clinical trials in the literature to determine the safety and efficacy of cell therapy in CLI. We searched the literature for clinical trials of autologous cell therapy in CLI, including observational series of five or more patients to accrue a large pool of patients for safety analysis. Safety analysis included evaluation of death, cancer, unregulated angiogenesis, and procedural adverse events such as bleeding. Efficacy analysis included the clinical endpoints amputation and death as well as functional and surrogate endpoints. We identified 45 clinical trials, including seven RCTs, and 1,272 patients who received cell therapy. The overall adverse event rate was low (4.2%). Cell therapy patients did not have a higher mortality rate than control patients and demonstrated no increase in cancer incidence when analyzed against population rates. With regard to efficacy, cell therapy patients had a significantly lower amputation rate than control patients (OR 0.36, p = 0.0004). Cell therapy also demonstrated efficacy in a variety of functional and surrogate outcomes. Clinical trials differed in the proportion of patients with risk factors for clinical outcomes, and these influenced rates of amputation and death. Cell therapy presents a favorable safety profile with a low adverse event rate and no increase in severe events such as mortality and cancer and treatment with cell therapy decreases the risk of amputation. Cell therapy has a positive benefit-to-risk ratio in CLI and may be a valuable treatment option, particularly for those challenging patients who cannot undergo arterial reconstruction.
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Affiliation(s)
- Eric Benoit
- Department of Surgery, Tufts Medical Center, Boston, MA, USA
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21
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Rodriguez JP, Murphy MP, Hong S, Madrigal M, March KL, Minev B, Harman RJ, Chen CS, Timmons RB, Marleau AM, Riordan NH. Autologous stromal vascular fraction therapy for rheumatoid arthritis: rationale and clinical safety. Int Arch Med 2012; 5:5. [PMID: 22313603 PMCID: PMC3296619 DOI: 10.1186/1755-7682-5-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Accepted: 02/08/2012] [Indexed: 02/08/2023] Open
Abstract
Advancements in rheumatoid arthritis (RA) treatment protocols and introduction of targeted biological therapies have markedly improved patient outcomes, despite this, up to 50% of patients still fail to achieve a significant clinical response. In veterinary medicine, stem cell therapy in the form of autologous stromal vascular fraction (SVF) is an accepted therapeutic modality for degenerative conditions with 80% improvement and no serious treatment associated adverse events reported. Clinical translation of SVF therapy relies on confirmation of veterinary findings in targeted patient populations. Here we describe the rationale and preclinical data supporting the use of autologous SVF in treatment of RA, as well as provide 1, 3, 6, and 13 month safety outcomes in 13 RA patients treated with this approach.
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