Multiple sclerosis (MS) is a progressive auto-immune disease that affects the central nervous system (CNS). Currently, it is estimated that nearly 2 million people worldwide are affected by MS.
Characterized by the body attacking the myelin (the protective sheath that covers the nerve fibers), MS causes communication issues between the brain and the rest of the body. As the nerves continue to deteriorate, the condition can cause permanent damage.
Currently, there is no pharmaceutical treatment for MS, only medications that treat the symptoms of the condition.
In the field of regenerative medicine, mesenchymal stem cells (MSCs) have emerged as a candidate that could potentially treat a number of diseases, including MS. Specifically, MSCs have anti-inflammatory effects and have demonstrated the ability to differentiate in order to target the overactivity and self-antigen attacks observed in the development and progression of MS.
As part of this review, Alanazi et al. reviewed a number of clinical trials that have utilized MSCs isolated from a variety of sources, including peripheral blood, bone marrow (BM-MSCs), adipose tissue (AD-MSCs), umbilical cord (UCMSCs), and the placenta, in order to better understand their potential as a treatment option for MS.
An analysis of these clinical trials led the authors of this review to the consensus that MSCs appear effective in inhibiting CD4+ and CD8+ T cell activation, T regulatory cells, and macrophage switch into the auto-immune phenotype.
Further analysis of the specific MSCs used to treat MS by Alanazi et al. indicates that while BM-MSCs, AD-MSCs, and UCMSCs all demonstrate beneficial effects when applied to the treatment of MS, UCMSCs appear to be the best option.
According to the authors, UCMSCs demonstrate faster self-renewal than other MSCs, are able to differentiate into three germ layers, and can accumulate in damaged tissue or inflamed areas. Additionally, UCMSCs are also among the easiest MSCs to source, demonstrate a high concentration of MSCs, are safe and inexpensive, and are not associated with ethical issues.
Based on the information reviewed, Alanazi et al. recommend emphasizing the clinical utility of UCMSCs for regenerative medicine and immunotherapy, including for the treatment of MS.
Because of its ability to simultaneously activate multiple mechanisms, including paracrine, trophic, immunomodulatory, and differentiation, researchers consider mesenchymal stem cells to be an effective option for stem cell therapy.
After years of active research, bone marrow-derived MSCs (BM-MSCs) have been a prevalent source for MSC-based studies. There is also active research using MSCs from a variety of other sources, including adipose tissue, peripheral and umbilical cord blood, amniotic fluid, skin, dental pulp, synovium, umbilical cord tissue, placental complex, and endometrium.
As part of this review, Arutyunyan et al. review umbilical cord-derived MSCs (UC-MSCs) as a prospective source for MSC-based therapy. More specifically, the authors focus on the potential therapeutic benefits of Wharton’s jelly, the gelatinous substance found in the umbilical cord stroma; of particular interest to researchers is the presence of mesenchymal-derived cells, including stem cells, with the absence of capillaries.
When studied in vitro, researchers found UC-MSCs demonstrated the ability to differentiate into a wide range of cells, including chondrocytes, adipocytes, osteoblasts, odontoblast-like cells, dermal fibroblasts, smooth muscle cells, and somatostatin-producing cells, sweat gland cells, endothelial cells, neuroglia cells, and dopaminergic neurons.
While it’s well known that MSCs produce a variety of bioactive compounds that supply a paracrine mechanism for their therapeutic activity, researchers have learned that UC-MSCs secretomes differ significantly from MSCs from bone marrow and adipose. Specifically, the most significant difference is UC-MSCs’ nearly complete absence of synthesis of the main proangiogenic factor, VEGF-A. UC-MSCs also demonstrate increased production of antiangiogenic factors when compared to BM-MSCs and AT-MSCs.
UC-MSCs have recently demonstrated the ability to transfer their own mitochondria into mitochondrial DNA-depleted cells. This observation has broad implications for the therapeutic potential of UC-MSCs, primarily due to the failure of mitochondria as an initial event in many diseases. In this regard, the authors conclude that the transfer of mitochondria provides a rationale for the therapeutic use of UC-MSCs for ischemic injury or disease linked to mitochondrial dysfunction.
Arutyunyan et al. found recent animal model preclinical studies regarding the use of UC-MSCs for the treatment of different diseases demonstrated promising results. Additionally, clinical studies involving UC-MSCs demonstrated to be safe with no significant side effects other than fever.
While the authors point out concern with the lack of standardized protocols for the isolation and expansion of UC-MSCs and of uniform requirements for the final product. Despite these concerns, the authors also conclude that the results of clinical trials using UC-MSCs are encouraging, particularly for the treatment of autoimmune and endocrine diseases.
“Post-stroke” or “post-stroke period” refers to the period of time following a stroke. A stroke occurs when there is a sudden disruption of blood flow to a part of the brain, leading to brain cell damage and, potentially, the death of brain tissue. The severity and specific consequences of a stroke depend on various factors, such as the type of stroke (ischemic or hemorrhagic) and the location and size of the affected brain area.
The post-stroke period is a critical time for stroke survivors as they begin their recovery and rehabilitation journey. During this period, individuals may experience a range of physical, cognitive, emotional, and social challenges. The post-stroke phase can vary in duration and intensity depending on the extent of brain damage and the effectiveness of treatment and rehabilitation.
Some common aspects and challenges of the post-stroke period include:
Medical stabilization: In the immediate aftermath of a stroke, medical professionals focus on stabilizing the patient, preventing further damage, and addressing any potential complications.
Acute care and rehabilitation: Once the individual’s condition is stable, they may undergo rehabilitation, which may involve physical therapy, occupational therapy, speech therapy, and other specialized treatments to help restore lost functions and improve independence.
Physical recovery: Many stroke survivors experience weakness, paralysis, or difficulty with mobility. Physical therapy aims to help them regain strength, balance, and coordination.
Cognitive recovery: Depending on the area of the brain affected, stroke survivors may experience difficulties with memory, attention, language, and problem-solving. Cognitive rehabilitation can assist in addressing these issues.
Emotional and psychological support: Stroke can have significant emotional and psychological impacts. Depression, anxiety, and frustration are not uncommon during the post-stroke period.
Social reintegration: Stroke survivors may face challenges in reintegrating into their communities and resuming their daily activities. Support from family, friends, and support groups can be essential during this phase.
Long-term management: For some individuals, the effects of a stroke may be permanent, necessitating ongoing care and management of any residual disabilities or health issues.
The post-stroke period is highly individual, and recovery outcomes can vary widely from person to person. Early intervention, rehabilitation, and ongoing support play vital roles in improving the quality of life for stroke survivors.
Diagnosing a stroke typically involves a combination of clinical evaluation, medical history assessment, and imaging tests. Rapid and accurate diagnosis is crucial because time is of the essence when it comes to stroke treatment.
The faster a stroke is diagnosed and treated, the better the chances of minimizing brain damage and improving outcomes.
What Are The Different Types of Stroke?
There are two main types of strokes: ischemic stroke and hemorrhagic stroke. Each type has different underlying causes:
Ischemic Stroke:
Ischemic strokes account for about 85% of all strokes and occur when there is a blockage or narrowing of a blood vessel supplying blood to the brain. This blockage can be due to a blood clot (thrombus) that forms within a blood vessel in the brain (cerebral thrombosis) or elsewhere in the body and travels to the brain (cerebral embolism).
Common risk factors for ischemic stroke include atherosclerosis (the buildup of fatty deposits in the blood vessels), high blood pressure (hypertension), diabetes, high cholesterol levels, smoking, and certain heart conditions such as atrial fibrillation.
Hemorrhagic Stroke:
Hemorrhagic strokes occur when a blood vessel in the brain ruptures, causing bleeding into or around the brain tissue. The bleeding puts pressure on brain cells and can damage them.
The two main types of hemorrhagic stroke are intracerebral hemorrhage (bleeding within the brain) and subarachnoid hemorrhage (bleeding into the space between the brain and the thin tissues that cover it).
Hypertension is a significant risk factor for hemorrhagic stroke, as it can weaken blood vessel walls over time. Other risk factors include brain aneurysms, arteriovenous malformations (AVMs), and certain blood-thinning medications.
How Can I Avoid a Potential Stroke?
It’s important to note that certain lifestyle factors and medical conditions can increase the risk of stroke. These include:
How Do You Know If You Are Having or Have Had a Stroke?
If you suspect someone is having a stroke or experience symptoms yourself, it’s crucial to seek immediate medical attention as prompt treatment can minimize brain damage and improve outcomes. Remember, “FAST” is a simple way to remember the most common symptoms of a stroke:
F – Face drooping A – Arm weakness S – Speech difficulty T – Time to call emergency services.
Recognizing the symptoms of a stroke is crucial because immediate medical attention can greatly improve the chances of minimizing brain damage and improving outcomes. The symptoms of a stroke can vary depending on the type of stroke (ischemic or hemorrhagic) and the part of the brain affected.
Here are some common signs and symptoms of a stroke:
Sudden numbness or weakness: You may experience sudden numbness or weakness in the face, arm, or leg, typically affecting one side of the body. A common indicator is drooping on one side of the face when trying to smile.
Trouble speaking or understanding speech: You might have difficulty speaking coherently or understanding what others are saying. Your speech may become slurred or difficult to comprehend.
Confusion or trouble with comprehension: You may feel confused, disoriented, or have difficulty understanding simple instructions or questions.
Sudden severe headache: A sudden, severe headache that is different from any previous headaches you’ve experienced may be a warning sign of a stroke, especially if it’s accompanied by other symptoms.
Trouble with vision: You may experience sudden blurred or double vision or have trouble seeing out of one or both eyes.
Dizziness or loss of balance: You may feel dizzy, lightheaded, or have trouble maintaining your balance, leading to difficulty walking or coordination problems.
hemorrhagic strokes) to prevent further damage to the brain. Rehabilitation and support following a stroke are also essential for recovery and regaining function.
What Treatments Are There for Post Stroke Care?
Post-stroke care focuses on the rehabilitation and management of stroke survivors to improve their physical, cognitive, emotional, and social functioning. The specific treatments for post-stroke care depend on the individual’s needs and the extent of the stroke’s impact. Here are some common components of post-stroke care and treatments:
Physical therapy
Occupational therapy
Speech therapy
Cognitive rehabilitation
Emotional support and counseling
Medications
Pain management
Assistive devices
Nutritional support
Social and vocational support
Post-stroke care is often a multidisciplinary approach, involving a team of healthcare professionals working together to develop a personalized treatment plan. The goal is to maximize the individual’s functional recovery, promote independence, and enhance their overall quality of life after a stroke. As each stroke survivor’s situation is unique, the treatment plan will be tailored to their specific needs and abilities. Regular follow-up appointments and ongoing support are essential components of post-stroke care to monitor progress and adjust treatment as necessary.
Regenerative Medicine for Post Stroke Management
Regenerative medicine, also known as stem cell therapy, is a cutting-edge field of medicine that focuses on harnessing the regenerative capabilities of stem cells to treat various medical conditions and injuries, including post-stroke care.
Mesenchymal stem cells (MSCs) are unique cells that have the ability to differentiate into different cell types and self-renew, meaning they can produce more stem cells. MSCs are a type of adult stem cell found in various tissues, such as bone marrow and adipose (fat) tissue. They have the unique ability to differentiate into different cell types and secrete bioactive molecules that can promote tissue repair and modulate the immune response.
In the context of post-stroke care, MSC therapy aims to harness the regenerative and immunomodulatory properties of these stem cells to potentially enhance neurological recovery and reduce post-stroke complications.
Several preclinical studies and early-phase clinical trials have investigated the safety and potential benefits of MSC therapy for stroke. Here are some potential ways MSCs might exert beneficial effects in post-stroke patients:
Neuroprotection: MSCs have been shown to secrete factors that protect neurons from further damage and promote cell survival in animal models of stroke.
Anti-inflammatory effects: After a stroke, inflammation in the brain can exacerbate damage. MSCs can modulate the immune response, reducing harmful inflammation and promoting a more favorable environment for recovery.
Angiogenesis: MSCs can support the formation of new blood vessels (angiogenesis) in damaged brain tissue, improving blood flow and oxygen supply to the affected areas.
Neuroplasticity: MSCs may help enhance brain plasticity, which is the brain’s ability to reorganize and form new neural connections, potentially aiding recovery and functional improvements.
If you or someone you know is interested in exploring this alternative medicine, work with a regenerative medicine specialist who can help provide detailed information about the options available to them.
Researchers continue to tout the potential of mesenchymal stem cells (MSCs) as an evolving approach for the repair of damaged tissue or lost cells.
Specifically, the ability of MSCs to differentiate and secrete beneficial factors and vesicles is believed to play the most influential role in the regeneration of injured tissues and cells affected by various diseases.
Recently, research into the regenerative potential of MSCs has focused on the extracellular vesicles (EVs) secreted by MSCs as an emerging and potential non-cellular therapeutic approach for healing or repairing injured or damaged tissue.
MSC-derived EVs (MSC-EVs), or cell-free therapies, in contrast to treatments based on whole cells, are easier to manage and safer due to lower amounts of membrane-bound proteins such as MHC molecules and their inability to directly form tumors.
In this review, Keshtkar et al. discuss and describe the extracellular vesicles released by MSCs and their therapeutic potential for addressing different disease models.
These EVs are membrane-packed vesicles that are secreted by a variety of cell types and found in a variety of physiological fluids. In addition to MSCs, EVs are also secreted by T cells, B cells, dendritic cells, platelets, mast cells, epithelial cells, endothelial cells, neuronal cells, cancerous cells, and embryonic cells. EVs are also found in urine, blood, breast milk, saliva, cerebrospinal fluid, synovial fluid, and amniotic fluid.
EVs have repeatedly demonstrated that they perform an important role in cell-to-cell communication and have been implicated in a number of important processes, including the immune response, homeostasis maintenance, coagulation, and inflammation.
Several studies have explored the use of MSC- EVs as therapeutic treatment options for kidney disease, liver disease, cardiovascular disease, and neurological disease. The authors of this review report the beneficial therapeutic effects of MSC-EVs in each of the disease models listed above, which include a significant reduction in inflammation, improved angiogenesis, reduced oxidative stress, the suppression of fibrosis, and increased cell proliferation.
Keshtkar et al. conclude that EVs can be easily isolated from MSCs of various origins and can be transferred to target cells to introduce therapeutic effects that include the regeneration of tissue and suppression of inflammation. Additionally, the authors point out that EVs could be an effective, safe therapeutic option.
Considering the potential therapeutic benefits of MSC-EV regenerative therapy, the authors suggest standardizing methods for EV isolation, characterization, and administration as ways to provide safe, effective, and powerful new therapies based on MSC-EVs.
Kidney disease, also known as renal disease or nephropathy, refers to a condition in which the kidneys are damaged or unable to function properly. The kidneys play a crucial role in filtering waste products, excess fluid, and toxins from the blood, while also maintaining the body’s electrolyte balance and producing important hormones. When kidney disease occurs, these vital functions are compromised, leading to a range of complications.
What Causes Kidney Disease?
Kidney disease can affect people of all ages and backgrounds. Kidney disease can have various causes, and understanding these underlying factors is crucial in managing the condition effectively. There are several primary causes of kidney disease:
Diabetes: Diabetes is a leading cause of kidney disease. High blood sugar levels can damage the blood vessels in the kidneys over time, impairing their ability to function properly. This condition, known as diabetic nephropathy, can progress to chronic kidney disease and ultimately lead to kidney failure.
Hypertension (High Blood Pressure): Uncontrolled high blood pressure puts excessive strain on the blood vessels in the kidneys, leading to their damage. Over time, this can result in chronic kidney disease. Conversely, kidney disease can also cause hypertension, creating a harmful cycle.
Glomerulonephritis: Glomerulonephritis refers to inflammation of the glomeruli, which are tiny filters in the kidneys responsible for removing waste from the blood. This inflammation can be triggered by infections, autoimmune disorders, or certain medications, leading to kidney damage and impaired function.
Polycystic Kidney Disease (PKD): PKD is a genetic disorder characterized by the growth of fluid-filled cysts in the kidneys. These cysts gradually enlarge and interfere with kidney function, ultimately leading to kidney failure.
Urinary Tract Obstruction: Kidney disease can also result from obstructions in the urinary tract, such as kidney stones, tumors, or an enlarged prostate gland. These blockages can disrupt the normal flow of urine, causing kidney damage and infection.
Infections: Severe or recurrent kidney infections, such as pyelonephritis, can cause inflammation and scarring of the kidneys. If left untreated, these infections can lead to chronic kidney disease.
Medications and Toxins: Certain medications and toxins can damage the kidneys if used improperly or in excessive amounts. Examples include nonsteroidal anti-inflammatory drugs (NSAIDs), certain antibiotics, and illicit drugs.
It’s important to note that some individuals may have a combination of risk factors that contribute to kidney disease. Additionally, early detection, regular monitoring, and proper management of these underlying causes can significantly slow the progression of kidney disease and help preserve kidney function.
What Are the Symptoms?
The symptoms of kidney disease may vary depending on the stage and underlying cause but often include fatigue, swelling in the legs and ankles, frequent urination, foamy or bloody urine, persistent itching, and high blood pressure. However, in the early stages, kidney disease may be asymptomatic, making early detection and regular screening crucial, especially for individuals with risk factors.
If you suspect that you have kidney disease, it is crucial to take immediate action and seek medical attention. If kidney disease is diagnosed, it is vital to follow the advice and treatment plan provided by your healthcare professional.
Kidney disease requires ongoing monitoring to assess kidney function, evaluate the progression of the disease, and adjust treatment if necessary. Your healthcare professional will schedule regular follow-up appointments to review your progress, conduct further tests as needed, and make any necessary adjustments to your treatment plan.
Coping with a chronic condition like kidney disease can be emotionally challenging. Consider reaching out to friends, family, or support groups who can provide encouragement, share experiences, and offer practical advice. Support from others who understand the journey can be invaluable.
Left untreated, kidney disease can lead to serious complications such as fluid retention, electrolyte imbalances, anemia, bone disorders, cardiovascular problems, and ultimately kidney failure. In end-stage renal disease, patients may require dialysis or a kidney transplant to sustain life.
What are Kidney Disease Treatments?
Management of kidney disease involves a combination of lifestyle modifications, medication, and, in some cases, medical procedures. Treatment aims to slow the progression of the disease, control symptoms, and prevent complications. Lifestyle changes may include maintaining a healthy diet with controlled salt and protein intake, staying adequately hydrated, exercising regularly, managing blood pressure and blood sugar levels, and avoiding smoking and excessive alcohol consumption.
Regenerative Medicine for Kidney Disease
Regenerative medicine holds great potential for the treatment of kidney disease. It involves the use of mesenchymal stem cells (MSCs) to stimulate the regeneration and repair of damaged kidney tissue.
MSC therapy has shown promising potential for the treatment of kidney diseases. MSCs are a type of adult stem cell that can be isolated from various sources, including bone marrow, adipose tissue, and umbilical cord tissue.
In the context of kidney disease, stem cells have been studied for their regenerative and immunomodulatory properties. They have the ability to differentiate into different cell types, including kidney cells, and can also release various growth factors and cytokines that promote tissue repair and modulate the immune response. Here are some key points regarding the potential of MSC therapy for kidney disease:
Acute Kidney Injury (AKI): MSC therapy has been investigated as a potential treatment for AKI, a sudden loss of kidney function. Studies have shown that MSCs can enhance kidney repair, reduce inflammation, and improve kidney function in animal models of AKI. Clinical trials are underway to evaluate the safety and efficacy of MSC therapy for AKI in humans.
Chronic Kidney Disease (CKD): MSC therapy holds promise for the treatment of CKD, a progressive loss of kidney function over time. MSCs have been shown to have beneficial effects on renal fibrosis, inflammation, and oxidative stress, which are key factors in CKD progression. Preclinical studies have demonstrated that MSCs can ameliorate kidney damage and improve kidney function in animal models of CKD.
Immune modulation: MSCs possess immunomodulatory properties, which can be advantageous in kidney diseases with an immune component, such as autoimmune kidney diseases (e.g., lupus nephritis). MSCs can suppress abnormal immune responses, reduce inflammation, and promote tissue repair, thereby potentially mitigating the immune-mediated damage to the kidneys.
Safety and Delivery: MSC therapy has been generally considered safe, with no significant adverse effects reported in studies. Delivery methods vary but may include intravenous infusion or direct injection into the renal tissue during surgical procedures.
Kidney disease is a condition characterized by impaired kidney function, which can arise from various causes. Early detection, regular monitoring, and appropriate management are essential to slow the progression of the disease, maintain kidney function, and prevent complications. It is important for individuals with risk factors or concerning symptoms to seek medical attention for proper evaluation and treatment.
Mesenchymal stem cells (MSCs) isolated from a wide variety of tissues and organs have demonstrated immunomodulatory, anti-inflammatory, and regenerative properties that contribute to a host of regenerative and immunomodulatory activities, including tissue homeostasis and tissue repair. The most frequently studied and reported sources of MSCs are those collected from bone marrow and adipose tissue.
In this review, Krawczenkjo and Klimczak focus on MSCs derived from adipose tissue (AT-MSCs) and their secretome in regeneration processes.
Adipose tissue is the most commonly used source of MSCs, primarily because it is easily accessible and is often a byproduct of cosmetic and medical procedures. Like most MSCs, AT-MSCs are able to differentiate into adipocytes, chondrocytes, and osteoblasts; they are also able to differentiate into neural cells, skeletal myocytes, cardiomyocytes, smooth muscle cells, hepatocytes, endocrine cells, and endothelial cells.
In addition, AT-MSCs secrete a broad spectrum of biologically active factors that serve as essential components involved in the therapeutic effects of MSCs, including the ability to stimulate cell proliferation, new blood vessel formation, and immunomodulatory properties; these factors include cytokines, lipid mediators, hormones, exosomes, microvesicles, and miRNA.
Preclinical and clinical studies on AT-MSCs in tissue regeneration were demonstrated to contribute to wound healing, muscle damage, nerve regeneration, bone regeneration, and lung tissue regeneration.
Evaluating these studies, Krawczenko and Aleksandra Klimczak conclude that AT-MSCs and their secretome are promising and powerful therapeutic tools in regenerative medicine, primarily due to their unique properties in supporting angiogenesis.
The results obtained by the preclinical and clinical studies evaluated for this review suggest that the ability of AT-MSCs and their derivatives, including EVs and CM, to deliver a wide range of bioactive molecules could be considered as factors supporting enhanced tissue repair and regeneration.
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