Regenerative medicine using stem cell therapy has grown in popularity in the past years because of the promising results it has shown for the management of conditions, injuries, and other issues.
By understanding the power of stem cells, the options available, and the reasons why some people are hesitant while others urge research forward, you can decide for yourself whether they are the appropriate treatment option for you.
What Are Stem Cells, and How Do They Help?
Stem cells are undifferentiated cells with the potential to become and create specialized cells. They function as a repair system for the body, contributing to the process of tissue regeneration while also supporting normal growth and development.
Stem cells have two crucial and unique abilities: pluripotency and self-renewal. Pluripotency is the ability to become any kind of cell needed, and self-renewal refers to the way they can replicate themselves indefinitely, providing a never-ending supply of undifferentiated cells.
Different Types of Stem Cells
There are three broad categories of stem cells: embryonic stem cells, adult stem cells, and induced pluripotent stem cells. Each option has diverse applications and unique characteristics.
Embryonic cells come from blastocyst-stage embryos, which are embryos that are from three to five days old. They usually derive from in vitro fertilization clinics. At this stage, the embryo contains an inner cell mass capable of creating all of the tissues that make up the human body. Embryonic cells are fertilized in a lab and donated with full consent. But due to ethical controversy, it is widely used in research only.
Adult stem cells are found in various tissues and organs throughout the adult human body. These stem cells are multipotent, so they can transform into a limited number of stem cells. Adult stem cells help maintain tissue homeostasis and repair and replace damaged cells.
Adult stem cells include:
Mesenchymal stem cells
Blood stem cells
Skin stem cells
Neural stem cells
Epithelial stem cells
Induced pluripotent stem cells are made by reprogramming certain adult stem cells into a pluripotent state with the use of genetic factors. These cells are similar to embryonic stem cells in the way they function.
Stem Cell Research: Why There’s Controversy
Using stem cells and performing stem cell research still poses challenges in ethics for some people, especially when turning to embryonic stem cells.
Concerns over when personhood begins make the use of embryonic stem cells more complex because there’s a worry about the moral status of embryos and whether they can be used or discarded.
It’s crucial to understand that the embryos that are used have never been in a woman’s body. They are embryos that fertility clinics would otherwise discard. Although the discarding of the embryos is not usually a controversy, the use of those same embryos for research creates controversy for some.
In this regard, induced pluripotent stem cells are more readily accepted because they don’t rely on embryos. Other issues can arise, however, when it comes to the actual process of researching stem cells. This includes oversight concerns as well as consent issues.
Arguments for Stem Cell Research
Because of the benefits that stem cell therapy offers, many scientists encourage research to improve treatments and learn more about how human bodies function.
Scientific Advancements
Stem cell research contributes to the understanding of cellular processes. This allows for the development of better treatment options, as well as a better comprehension of how some conditions form. Stem cells hold promise for the treatment of degenerative conditions like Parkinson’s disease, COPD, and Alzheimer’s.
Additionally, stem cell research offers the chance for scientists to understand how stem cells replace or repair damaged cells. This information would make it easier to provide targeted treatments that are more efficient and longer lasting.
Economic Boost
Using stem cells to create new therapies and medical technologies opens the door to the creation of new jobs and specializations. These advanced treatments can also help decrease medical costs, helping the economy in the long run.
Ethical Use of Discarded Embryos
Embryos that have been made via in vitro fertilization processes and have gone unused can serve a purpose instead of being discarded. Many argue that this is a better option than treating the embryos like medical waste.
Arguments Against Stem Cell Research
Those against stem cell research generally cite safety and ethical concerns centering on consent and exploitation problems.
Safety and Efficacy
Because stem cell therapies are still relatively new, there are worries about how effective they can be. The issue with this argument against stem cell research is that it fights against the very thing that would provide a definite answer as to whether stem cells are effective and safe: ongoing research.
Ethical Concerns
The ethical concerns mainly focus on the use of embryonic stem cells, including the worry about obtaining consent. In many instances, detractors suggest turning to induced pluripotent stem cells for research and avoiding embryonic cell use because of the ethical barriers that would slow the research down.
In other instances, the worry of consent focuses on the risk of the potential exploitation of vulnerable populations. Those against the research note concern about the possibility of future coercion and other similar activities.
However, as with any other form of research, the scientific community imposes strict guidelines designed to protect against these concerns.
Focusing on the Potential of Regenerative Medicine
Living with chronic conditions that affect quality of life usually means relying on medications, invasive procedures, and therapies that might manage some symptoms but don’t get to the root of the problem.
On the other hand, stem cell research offers the potential to not only understand the causes of some of the most debilitating conditions and injuries, but also to provide therapy solutions to help manage symptoms.
The path to learning more about conditions like COPD or Parkinson’s is not easy, but embracing new and promising treatment options can open a way forward. By tackling some of the ethical concerns people have about stem cells head-on, lives may be able to improve for many people around the world.
Articular cartilage primarily consists of chondrocytes and extracellular matrix and has an essential role in the process of joint movement, including lubrication, shock absorption, and conduction. However, over time, damage to the articular cartilage caused by acute or repetitive trauma or disease of the joints – including osteoarthritis – often results in pain, lack of mobility, and reduced quality of life for an estimated 500 million people worldwide.
Current treatments to address articular cartilage defects include physiotherapy, medication, intra-articular injection, and intra-articular irrigation; none of these treatments are able to regenerate the new cartilage needed to correct the issue.
In recent years, mesenchymal stem cells (MSCs) have been found to be potential solutions for a number of diseases, including OA, specifically because of their ability to differentiate and produce a variety of cells. MSCs have also been found to be safe for use in humans and have demonstrated the ability to improve clinical symptoms such as pain, disability, and physical function.
Additionally, hyaluronic acid (HA) has demonstrated itself to be an important component of the synovial fluid by protecting joint cartilage by providing lubrication and acting as a shock absorber. However, in the presence of OA, HA concentration decreases and results in increased aggravation and joint damage to cartilage. Like MSCs, clinical studies have also demonstrated HA’s ability to relieve pain in patients with OA.
Specifically, 24 healthy canines were operated on to induce cartilage defect model before being randomly divided into 3 groups; each of these groups received a different treatment: bone marrow mesenchymal stem cells (MBSCs) plus HA, HA alone, or saline. After 28 weeks, Li et al. found that the canines treated with BMSCs plus HA (BMSC-HA) showed significant improvement in cartilage defects compared to those receiving just HA or just saline.
The authors also found that while BMSCs-HA demonstrated the most significant improvement in cartilage defect, treatment with HA alone also demonstrated improvements when compared to those receiving saline alone.
Li et al. also identified a number of important limitations of this study, including the limited level of cells and proteins; the repair of cartilage defects in this study was a dynamic process that limited the study to the terminal point of repair; and that this was a preliminary and non-blinded study, which could have affected the evaluation of ICRS macroscopic and histological score. Considering this, the authors call for further blinded and basic experiments as a way to further improve understanding.
As a result of this study, Li et al. concluded that both BMSCs-HA and HA alone could significantly promote new cartilage formation, with BMSCs-HA demonstrating a better way to repair cartilage defects in a canine model.
Systemic Lupus Erythematosus (SLE) is an autoimmune disease that causes inflammation to affect many different body systems including the joints, skin, kidneys, blood cells, brain, heart, and lungs.
Affecting over 5 million people worldwide, and associated with a wide range of symptoms, SLE is difficult to diagnose. Currently, there is no treatment to prevent or cure lupus and current therapeutic treatment options are only designed to treat and minimize the symptoms of the disease.
Considering their strong protective and immunomodulatory abilities, mesenchymal stem cells (MSCs) have been recognized as a potential treatment for various autoimmune diseases and inflammatory disorders, including SLE.
In this research article, Zhou et al. conducted a meta-analysis with the goal of assessing if MSCs are able to become a new treatment for SLE with good efficacy and safety.
Specifically, using predetermined criteria, the authors conducted a bibliographical search and statistical analysis to assess the efficacy and safety of MSCs for SLE. This search and analysis resulted in 10 studies comprising of 8 prospective or retrospective case series, including 231 SLE patients, and four randomized control trials (RCTs) with 47 patients with SLE in the case group and 37 patients with SLE in the control group, that fulfilled the inclusion criteria for this meta-analysis.
The authors found that all of the studies included as part of the meta-analysis of RCT and self-controlled studies with the exception of one indicated that MSC treatment of SLE can achieve better efficacy. Specific results of the RCT meta-analysis supporting this conclusion included lower proteinuria, increased serum albumin, and increased serum C3 at 3 months, lower SLEDAI values at 3 months and 6 months, and a lower rate of adverse events in the MSC group when compared to the control group.
Similar results were observed and reported from the meta-analysis of self-controlled studies. These results included MSC treatment significantly reducing proteinuria and the value of SLEDAI at 1 month, 2 months, 3 months, 4 months, 6 months, and 12 months. Further supporting evidence reported included improved values of SCR, BUN, C3, and C4.
While the results of this meta-analysis were overwhelmingly supportive of MSCs as a potential treatment option for SLE, the authors also noticed several limitations associated with their findings. These limitations included the small sample sizes of the included studies and the inconsistency of the severity of the patient’s disease.
Although more studies with larger sample sizes should be conducted to confirm these findings, Zhou et at. concluded that MSCs might be a good treatment agent for SLE in the clinic.
Chronic obstructive pulmonary disease (COPD) is a condition that affects about 12.5 million people in the United States. COPD can become progressively worse over time and affect your breathing.
Although lifestyle changes, oxygen therapy, and medications have traditionally served as the standard treatment choices, there is now another promising option for treating COPD, regenerative medicine, also known as stem cell therapy.
Understanding COPD: Symptoms and Causes
COPD is the umbrella term for several conditions that cause airflow blockages and other breathing-related issues. Chronic bronchitis and emphysema can both lead to COPD. Chronic bronchitis is the inflammation of your bronchial tubes’ lining, while emphysema destroys the air sacs at the ends of the smallest air passages.
Key Symptoms of COPD
Common symptoms of COPD are:
Chest tightness
Wheezing
Fatigue
Unintended weight loss
Shortness of breath
Chronic cough that produces clear, white, yellow, or green mucus
Swelling in feet and ankles
It’s common to experience exacerbations, which is when symptoms get significantly worse for days at a time. Many factors cause exacerbations, including exposure to air pollution, respiratory infections, and anything else that triggers inflammation.
Causes and Risk Factors
Those most likely to develop COPD are women and people who:
Are over 65.
Have experienced air pollution.
Had many respiratory infections during childhood.
One of the most prevalent causes of COPD is smoking. Smoking irritates your airways, triggering inflammation that narrows those airways. Because smoke also damages the cilia, they’re not able to effectively get rid of mucus or particles from the airways.
Another cause of COPD is alpha-1 antitrypsin (AAT) deficiency. This is an uncommon disorder that can cause emphysema. When you have AAT deficiency, you don’t have an enzyme that protects your lungs from inflammation. The deficiency makes it easier for your lungs to experience damage from irritating substances like dust and smoke.
The Current Treatments and Their Limitations
Current COPD treatments include the use of bronchodilators and steroids — as well as oxygen therapy — to minimize the symptoms of the condition.
Bronchodilators are medications that relax the muscles around the airways, helping you get better airflow. Some bronchodilators offer quick relief for acute episodes, while others are more appropriate for maintenance.
Steroids work together with bronchodilators to reduce airway inflammation. The problem with steroids is that they have significant side effects when used as a long-term treatment. Some of these side effects include weight gain, an increased risk of developing infections, and even bone loss.
Oxygen therapy is appropriate for people who have severe hypoxemia because it helps improve oxygen levels and relieve symptoms. Pulmonary rehabilitation programs are other options that combine exercise training with education to help patients understand the condition better.
Surgery is the last recourse for people with severe COPD who don’t find any relief from medications or other options. For some people, a lung transplant is a viable choice. For others, the removal of damaged lung tissue can offer some relief from symptoms.
Limitations of Traditional Treatments
Although doctors have been providing these options for a long time, they have limitations. For instance, they may offer relief from symptoms, but they typically don’t address the underlying cause of the problem. Even after treatment, the damage to your airway passages and lungs remains.
The side effects of long-term use of these treatments can also be serious. Corticosteroids put a strain on your heart, cause muscle weakness, and can even impact wound healing, which can make them a challenging choice for long-term management of COPD.
More invasive procedures, like surgery, have significant risks. Additionally, there are limits to who can receive surgery for COPD because of the use of anesthesia.
Recent Advances in the Treatment of COPD
To help improve the quality of life of a patient with COPD, new treatment options are available. By working closely with your doctor, you can find the right choice for your unique needs.
Drug Therapy Innovations
The latest medications for those with COPD are new bronchodilators and anti-inflammatory medications that don’t cause the same side effects that may make you hesitate to try long-term drug treatments. The goal of these new medications is to offer longer-lasting support and reduce the flares you experience with COPD.
Inhaler Technologies
Your inhaler is an important part of a COPD treatment program, and the latest technologies allow for better drug delivery while also ensuring that the inhaling techniques are correct. All of this makes it easier to stick to using your inhaler regularly.
Stem Cell Therapy for COPD
A new potential treatment option for COPD is regenerative medicine, also known as stem cell therapy. This type of regenerative medicine uses stem cells to help your body heal itself so that it can regenerate damaged tissue for better lung function.
Mesenchymal stem cells (MSCs) can be isolated from various sources, such as bone marrow, adipose tissue, or umbilical cord blood. These cells have the ability to differentiate into different cell types and possess immunomodulatory and regenerative properties.
MSCs have shown promise as a potential therapeutic approach for chronic obstructive pulmonary disease (COPD). While there is currently no cure for COPD, MSC-based therapies have the potential to modulate the immune response, reduce inflammation, and promote tissue repair in the lungs.
When administered into the lungs, MSCs can release anti-inflammatory molecules, promote tissue regeneration, and interact with the immune system to suppress excessive inflammation.
Getting Treatment for COPD
If you have COPD, ensuring that you have the right treatment plan on your side is vital for your long-term recovery. If you have COPD and it is progressively worsening, and there are limited treatment options available, you may want to explore stem cell therapy as a potential avenue for slowing disease progression or improving lung function.
Regenerative medicine aims to enhance what your body already does naturally, helping it heal so that you improve your quality of life. Speak to a regenerative specialist on the options you may have with this new alternative therapy option.
Biomedical applications of mesenchymal stem cells (MSCs) in the field of regenerative medicine continue to evolve. Coupled with the rapid development of molecular biology and transplantation techniques, MSC applications have become a central focus of research surrounding regenerative medicine.
Since being discovered nearly 50 years ago, the understanding of various techniques for MSC extractions and the subsequent potential for differentiation has continued to advance.
This review, presented by Han et al., provides a brief overview of MSC extraction methods and their subsequent potential for differentiation and summarizes the future applications and challenges of various MSCs in the field of regenerative medicine.
It has now been well established that MSCs can be isolated from various tissues, including bone marrow, adipose, synovium, and human umbilical cord blood. The general process for MSC extraction involves the isolation of various tissues, digestion to obtain cells, culturing for three to five days, and continuous culturing of adherent cells to the desired passage.
Interestingly, the authors point out that rabbits are the most frequently used animal models for experiments involving cartilage or bone tissue regeneration. Considering this, the authors call for the surface markers of rabbit tissue-derived MSC to receive increased focus and further verification.
Han et al. also discuss the differentiation potentials of MSC types, highlighting that bone marrow-derived MSCs display superior capabilities for differentiation into osteogenesis and chondrogenesis under standard differentiation protocols. They also point out that umbilical cord blood-derived MSCs (UCB-MSCs) demonstrate biological advantages relative to other adult sources, including their capability for longer culture times, larger-scale expansion, and higher anti-inflammatory effects. Considering that differentiation conditions vary based on the type of MSC, the authors highlight that it is becoming increasingly necessary to choose the desired MSC type according to the specific purpose being sought.
MSC-based regenerative medicine has been widely studied and applied to many aspects of the field. This review summarizes several reports concerning the latest preclinical and clinical trials of various MSC types for tissue engineering, most notably the reconstruction of fragile tissue associated with the musculoskeletal system, nervous system, myocardium, liver, cornea, trachea, and skin.
In order to improve the therapeutic effectiveness of MSCs, while also reducing the potential identified risks, the authors suggest reducing excessive cytokines, further exploring the immunomodulatory effects of MSCs, and establishing strict preclinical biosafety testing rules. Additionally, longer and larger controlled clinical trials are required to further determine the safety of MSCs.
While there have been tremendous advances in the field of regenerative medicine, especially as they relate to MSCs, Han et al. share a number of challenges that have to be overcome before the clinical application of MSC therapy, with the primary challenge being the implementation of a standardized method of isolation and culturing for MSCs.
The authors conclude this review by summarizing three distinct properties of MSCs that make them an optimal source of tissue regeneration: their immunoregulatory capacity, paracrine or autocrine functions that generate growth factors, and their ability to differentiate into target cells.
Liver disease accounts for nearly two million deaths annually and is responsible for 4% of all deaths (1 out of every 25 deaths worldwide); approximately two-thirds of all liver-related deaths occur in men.
Most forms of chronic liver disease result from viral infections, alcohol abuse, or metabolic disorders and eventually result in cirrhosis and liver failure. The only effective treatment for end-stage cirrhosis is liver transplantation. Unfortunately, considering organ shortages and the high cost associated with this type of medical procedure, liver transplants are not available in many countries.
Stem cell transplantation, specifically transplantation using mesenchymal stem cells (MSCs), has been increasingly used as a potential treatment strategy for a host of diseases, including for treating chronic liver disease.
As part of this review, Kang et al. discuss the therapeutic effects of MSCs in liver diseases to address questions regarding their efficacy and safety, evaluate recent advances in this area, and consider the potential risks and challenges in the use of MSC-based therapies for liver disease.
When considering the therapeutic effects of MSC therapy in chronic liver disease, the authors conclude that this treatment has shown to be effective, primarily due to their immunomodulation, differentiation, and antifibrotic properties exhibited by MSCs. The authors also point out that although the safety and therapeutic effects of MSC therapy have been observed in several clinical studies, to date the therapy has demonstrated only modest improvements in treating liver disease. Kang et al. attribute this modest improvement, in part, to the current limited feasibility of transplanted cells.
The authors provide a detailed review of the strategies that have been utilized to improve the effects of MSC transplantation, including tissue engineering, preconditioning, genetic engineering, and using extracellular vesicles as cell-free therapy, and summarize the future potential of each of these as ways to improve MSC transplantation.
Kang et al. also highlight several problems that must be considered and addressed before MSCs are fully accepted as clinical therapeutic treatment options for chronic liver disease; these problems include the potential for carcinogenesis and viral transmission. For example, previous animal studies have demonstrated a relationship between the development of sarcoma and the number of passages. While this has not been directly observed in clinical trials involving human MSCs, the follow-up period was too short to allow for observed evidence of this development. As a result, the authors call for a detailed study into the chromosomal integrity before MSC transplantation to ensure the safety of the procedure.
In addition to the potential for tumor cell growth, allotransplantation of MSC cells may involve the risk of viral transmission to the patients. As a result, the authors indicate that both MSC recipients and donors may need to be screened for the presence of specific viruses, including parvovirus B19, herpes simplex virus, and cytomegalovirus.
The authors conclude that the prospects of MSC-based cell therapy for treating chronic liver disease will be determined by standardizing the cell source, culture conditions, administration route, and the outcomes of future large-scale clinical trials.
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