STEM CELL THERAPY

What Are Stem Cells?

Stem cells are the raw material from which all of the bodys mature, differentiated cells are made. Stem cells give rise to brain cells, nerve cells, heart cells, pancreatic cells, etc.
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Whats So Special About Stem Cells?

They have the potential to replace cell tissue that has been damaged or destroyed by severe illnesses. They can replicate themselves over and over for a very long time. Understanding how stem cells develop into healthy and diseased cells will assist the search for cures.

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Stem cells
 Rare  Primitive  Defined

cells

by their capacity to self renew as well as differentiate into one or more mature cell types. types.

Properties


Self renewal - the ability to go through numerous cycles of cell division while maintaining the undifferentiated state. Potency the capacity to differentiate into specialized cell types.

 Totipotent

stem cells -cells produced by the first few divisions of the cell . So can form any cell of the embryo as well as the placenta.

 Pluripotent

these cells differentiate into cells derived from the three germ cell layers.

 Eg:

embryonic stem cell, embryonic germ cell and embryonic carcinoma cells.

 Multipotent

these cells can produce cells of a closely related family of cells.

 Eg:

haematopoeitic stem cells, neural and mesenchymal stem cells

 Unipotent

these cells only produce one cell type., but have the property of self renewal which distinguishes them from the non stem cells.

 Two

broad types seen:

A embryonic stem cells B adult stem cells

Embyronic stem cell

Derived from the inner cell mass  Pluripotent  Can develop into more than 200 different cells  Differentiate into cells of the 3 germ cell layers  Because of their capacity of unlimited expansion and pluripotency useful in regenerative medicine


Embryonic Stem Cells:

Researchers extract stem cells from a 5-7 days old blastocyst. 5blastocyst. Stem cells can divide in culture to form more of their own kind, thereby creating a stem cell line. The research aims to induce these cells to generate healthy tissue needed by patients.

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Two Sources of Embryonic Stem Cells 1. Excess fertilized eggs from IVF (in-vitro (infertilization) clinics 2. Therapeutic cloning (somatic cell nuclear transfer)
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Tens of thousands of frozen embryos are routinely destroyed when couples finish their treatment.

These surplus embryos can be used to produce stem cells. Regenerative medical research aims to develop these cells into new, healthy tissue to heal severe illnesses.

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Somatic Cell Nuclear Transfer The nucleus of a donated egg is removed and replaced with the nucleus of a mature, "somatic cell" (a skin cell, for example). No sperm is involved in this process, and no embryo is created to be implanted in a woman s womb. The resulting stem cells can potentially develop into specialized cells that are useful for treating severe illnesses.
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Tissue or adult stem cells

They produce cells specific to the tissue in which they are found  They are relatively unspecialized  However they are predetermined to give rise to specific cell types when they differentiate  Eg: haematopoietic, bone marrow, neural


Umbilical cord blood stem cells

 It

has both mesenchymal blood cell and haematopoietic stem cells. st successful umbilical cord blood 1 transplantation in 1989 in a patient with Fanconis anaemia.

Haematopoeitic stem cells

from bone marrow in adults and umbilical cord blood  Option given to the parents regarding stem cell banking during antenatal visits  25% chance that sibling also can have a perfect match
 Derived

 

Blood is collected from umb cord immediately after delivery about 100100150cc The number of cells in 1 ml is 40,000 They are stored in blood banks at -196deg celsius in a state of suspended animation and restart their activity on thawing

Application of stem cells

cell research: 1. It provides an ideal model for the study of development of organisms 2. It replaces damaged cells of the body 3. It also aids in drug discovery
 Stem

 Regenerative

medicine

and  Therapeutic issues

Therapeutic applications of embryonal stem cells ES cell

The potential to form 200 or more cells.  Hence used in regenerative medicine in cases like cardiac failure, Parkinsons disease, diabetes.  These cells are being coaxed to differentiate into cardiomyocytes, neural stem cells, insulin producing cell and even germ cells.


Safety concern
 Potential

to form teratomas after transplantation Hence to produce pure differentiated cells.  Risk of transfer of xenopathogens

Immunological barriers
Rejection- mediated by class 1 MHC Rejectionand by antigen presenting cells harbouring the class 2 MHC antigen  Can be overcome by generating large MHC homozygous ES cell banks, and the production of patient specific ES cell via Somatic Cell Nuclear Transfer.


 ES

cells are used as models for developmental biology like early embryonic differentiation and understanding the pathogenesis of specific genetic diseases.

Stem cells and diseases

The best studied stem cells are the haematopoietic and the male germ cells.  Some of the prominent diseases treated include leukemia, anaemia, thallesemia and myelodysplastic syndrome.  Allogenic BMT is another well known procedure done.


Potential application of fetal stem cells

 1. 2.

3.

In the field of fetal medicine: Non invasive prenatal diagnosis Intrauterine stem cell transplantation Gene therapy

Ailments for which stem cells are being used now

     

Acute leukemias Chronic leukemias Myelodysplastic syndromes Marrow failure Myeloproliferative disorders Lymphoproliferative disorders

 Phagocyte

disorders  Inherited disorders like Lesch Nyhan syndrome, beta Thallesemia etc  Inherited platelet abnormalities  Inherited metabolic disorders like Mucopolysaccharidosis, Hurlers syndrome, Krabbe disease, Niemann- pick disease etc Niemann-

 Histocytic

disorders  Inherited erythrocyte abnormalities  Inherited immune system disorders like ataxia telangectesia, DiGeorge syndrome, SCID etc  Plasma cell disorder  Malignancies like neuroblastoma, Ewing sarcoma, Renal cell CA etc

Trials underway
Cardiac disease  Diabetes  Multiple Sclerosis  Muscular Dystrophy  Parkinsons disease  Spinal cord injury  Stroke


Future stem cell application

 Alzheimers  Lupus  Rheumatoid

Disease arthritis

 Research

is going on regarding the use of stem cells for male infertility in mouse  However the progeny has severe abnormalities

1.

2.

Also recent research suggests that oocyte can be generated from stem cells originating from Bone marrow- haematopoietic marrowstem cells Ovarian surface cells

Ethical issues
we trying to play GOD?  Is embryo a person?  Will stem cell research encourage embryo destruction and abortions?
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