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The NIH Website http://stemcells.nih.gov/info/basics provides excellent general information about stem cells. The “basics” summarized below have been slightly revised from the website content. INCELL has developed unique media products important to collection, culture and cryostorage of stem cells. These are offered as products and services to those individual patients who are interested in collecting and storing their stem cells for potential future use and to physicians who want to offer this specialty service to their patients. A new website “myEZ stemcells.com” is under construction as an up- to-date linked resource on stem cells, their future and current applications, and INCELL’s services and products in this area. Stem Cell Basics (http://stemcells.nih.gov/info/basics)
Personalized Medicine: Next Big Hope or Next Big Hype? http://www.pharmamanufacturing.com/articles/2005 Frequently Asked Questions (FAQs) on Stem Cells
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Stem cells and progenitor cells specific to a tissue are in very small numbers in all organ sites where there presence has been defined. Stem cells from blood are usually enriched by “calling up” cells from the bone marrow using specific growth factors. The patient is pre-treated, several days later blood is collected and the cells are separated from the blood plasma, then further purified using a variety of separation and purification methods. Cells from solid organ sites such as fat, skin, and bone marrow often need to be treated with enzymes or other agents that separate the cells from other cells and/or the cell matrix which holds them in place in the tissue. Although this is significant manipulation many of the techniques have been developed and improved over many years. What is becoming more clear are the cell-associated biomarkers that define what is an omnipotent, pluripotent, multipotent or progenitor cell from the various organ sites and what is universally or specifically applicable, if anything, to regulatory growth controls of specific cell types, tissues, or organ sites.
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Stem cells from umbilical cord blood - can these stem cells only be used for children? Would they be rejected by adults?
Stem cells from UCB could be transplanted into anyone who is an appropriate transplantation match (they would not necessarily be rejected by adult and rejection between unrelated donors is diminished in these cells compared to adult stem cells). However, the numbers of cells are too few for adults (unless they are pooled from multiple donors or expanded in culture), but there are enough cells for pediatric patients from the usual cord blood sample.
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Is it necessary to continue stem cell cloning now that stem cells from bone marrow seem to be pluripotent?
Our scientific knowledge is still very limited on all the ways that cells are regulated for growth and differentiation alone and with regard to all the details distinguishing use for cells of autologous (self) or allogeneic (other human) donors. There are no master banks of universal donor cells for all recipient patients who might need help. Clinical studies have not been done to show that all types of “replacement parts” can come from autologous marrow (unlikely in cases of certain diseases such as cancer and old age). Thus, we must continue the scientific work to get the answers and move forward. In my opinion, anything less is irresponsible, scientifically and medically unsound, unconscionable and unethical.
Medical Perspective Questions
We only have partial knowledge of how all these things work at the molecular, cell, tissue, organ and organism levels. Much more scientific work is needed. To understand all the regulatory pathways for various lineages of cell growth, differentiation, etc. we need to know the environmental and other conditions, as well as the cell-associated markers or receptors that characterize or control pluripotent, multipotent or progenitor cells from the various organ sites and what is universally applicable, if anything, and what is specific.
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What are some of the successful uses of autologous transplantation of adult bone marrow and other types of stem cells?
Bone marrow cells and mesenchymal stem cells have been used therapeutically to renew marrow and blood cells in patients who have cancer, and/or have been irradiated, and need a transplant to replace tumor cells and/or to be activated to fight the tumor cells during replacement, or who are transplanted after high dose chemotherapy or radiation therapy. The cells are also used to repair some bone or cartilage lesions during surgery, and have recently been used to repair heart muscle defects.
- Is there other evidence of success using stem cell therapy for congestive heart failure or other diseases (Parkinson's) or injuries (spinal cord)?
There have been reports of various types of cells being successfully used for treating heart failure, Parkinson’s and other injuries (e.g., spinal cord) in animal models and human patients. Results have been variable and complex, and often are apples and oranges compared to each other. However, specific protocols that would be reproducibly used clinically have yet to be agreed upon because more research work is needed in both pre-clinical and clinical studies.
Autologous stem or progenitor cells stored earlier by the recipient or obtained during a surgical procedure from the recipient have the least risk of rejection, provided they do not become contaminated during processing or handling so that the body recognizes them as foreign, rather than part of itself. If the cells can be re-programmed to be the “appropriate” cell type they have the highest probability for success
Stem cells of fetal, embryonic, or cord blood origin express lower amounts of antigens that might cause transplant rejection and therefore may be more suitable and require fewer immune suppression drugs in the patients who receive them compared to unrelated (allogeneic) cells or tissues (from other, unrelated people) or from animal (xenogeneic) cell or tissue donors.
- Would a universal donor or stored stem cell source offer more chance of being ready for any patient and thus improve outcomes or recovery?
Much more scientific work and well-designed comparative studies are needed to answer this question.
Much more scientific work and well-designed comparative studies are needed to answer this question because we still do not know everything about regulated and unregulated growth control. All therapies have risk-benefit ratios, and many suffering people might have longer lives and higher quality of life with treatment. If we understood all the regulatory mechanisms that define cell growth and regulation and could harness them for optimal use, then the potential benefits are staggering.
Yes, there is a potential that any donor cell source might contain tumor cells or cells with unregulated growth. Furthermore, it is known that as cell populations get older they are more prone to have mutated cells in the group. Much more scientific work and well-designed comparative studies are needed to answer this question. All therapies have risk-benefit ratios, and many suffering people might have longer lives and higher quality of life with treatment. If we understood all the regulatory mechanisms that define cell growth and regulation and could harness them for optimal use, then the potential benefits are staggering.