Perinatal stem cells have been attracting attention globally in recent years due to their potential in regenerative medicine. These stem cells come in many forms, due to the wide variety of potential sources for these cells. Perinatal stem cells, for instance, may be umbilical cord-derived hematopoietic stem cells, amniotic epithelial cells, amniotic fluid stem cells, or chorionic mesenchymal stem cells. All sources, nonetheless are considered biological waste and are therefore usually discarded after delivery of babies.
Importantly, perinatal stem cells, despite their origin, tend to share a number of characteristics that make them beneficial in treating conditions. Additionally, unlike other sources of stem cells, retrieval of perinatal stem cells is noninvasive and does not require the ethical considerations that retrieval from other sources may involve. A recent review in Regenerative Medicine has highlighted the potential benefits of perinatal stem cells in therapeutic interventions.
In addition to the relatively easy collection and preparation of perinatal stem cells, these cells tend to be easily harvested and manipulated without harming either the mother or the baby. Upon collection, these stem cells exist in high volume and have greater ability to proliferate than other stem cell types such as bone marrow stem cells. Research has also shown that these cells tend not to lead to adverse immune reactions, though the mechanisms involved in their relationship to the immune system are not well understood.
Given their relative advantages over other stem cell types, perinatal stem cells are well poised to be used in cell-based therapies targeting a wide variety of conditions. Future research will help to define the precise role these cells can play in regenerative medicine and which conditions they may be most useful for.
Bone generally develops via one of two distinct mechanisms: intramembranous ossification and endochondral ossification. In the former case, mesenchymal progenitor cells directly differentiate into osteoblasts that form bone. In the latter case, the mesenchymal progenitor cells first create a matrix of cartilage that then acts as a template to enable the remodeling or development of bone tissue. This process of endochondral ossification is the predominant way that bone is generating during the healing process after bones are broken and fractures are endured. Using stem cells to facilitate this process can, therefore, be beneficial in non-healing bone fractures.
A new study published in Acta Biomaterialia has proposed that adipose tissue can be used in bone generation as a scaffold on which adipose mesenchymal stem cells can expand and allow for endochondral ossification. The researchers showed how adipose tissue could be used in this way, through what they termed Adiscaf, to successfully generate cartilage tissue and eventually bone tissue formation. The bone tissue that formed through this process contained bone marrow elements, further demonstrating the bone’s integrity and the promise of this procedure.
Compared to other strategies for building scaffolding, this strategy appeared successful because by using adipose tissue, the adipose stem cells were exposed to their native environment and therefore likely maintained functions they otherwise may not have. Not only will these findings help to solidify our understanding of how to nurture stem cells and enable them to differentiate in ways that can be therapeutically applicable, but they also specifically show how adipose tissue may be able to be used to generate a bone organ through endochondral ossification. Future research will likely help to clarify how these findings can be applied to patients to improve bone healing.
Adipose mesenchymal stromal cells, or adipose stem cells, were discovered in 2001 and have since been heavily researched for their potential use in plastic surgery. The abundance of research and the positive clinical findings have resulted in these cells being increasingly used in plastic surgery and have helped plastic surgery move to the forefront of regenerative medicine. A recent review has summarized research into adipose mesenchymal stromal cells and their applications in plastic surgery.
One of the things that make adipose mesenchymal stromal cells so valuable for plastic surgery is that these cells can overcome challenges observed with other stem cells. Much of the reason for the ability of adipose stem cells to provide better outcomes than other stem cell types are their regenerative properties. The stromal vascular fraction that includes all adipose tissue cells except the adipocytes is becoming used more and more for grafting and replacing fat grafting because of its great potential for tissue regeneration. In addition to grafting, adipose stem cells are showing promise in wound healing and recovery from tissue damage and scarring.
Unlike some other stem cells types that are more challenging to harvest, adipose stem cells can be relatively easily retrieved by performing liposuction, which requires only local anesthesia and can be completed without causing scarring. Now that the potential of adipose stem cells is being realized, the authors of the recent review suggest that new protocols should be developed and solidified to help define how exactly these cells can reliably be used in regenerative medicine generally – and in plastic surgery specifically. As more research is conducted and clinical applications are observed through case studies, these protocols will evolve, and our ability to use adipose stem cells to treat patients will improve and expand.
Spinal cord injury is the second leading cause of paralysis in the United States. When the spinal cord is severely injured, nerve cells in the spinal cord are damaged or destroyed. Also, a sort of scar forms in the affected area, which prevents nerve signals from traveling between the brain and the extremities. Consequently, people who sustain spinal cord injuries suffer from paralysis. The degree of paralysis depends on the location of the spinal cord injury; injuries higher on the spinal cord such as the neck or upper back area can lead to paralysis of all four limbs, for example. In almost all cases, the paralysis is permanent once it occurs, because nerve cells in the spinal cord do not regenerate.
Because spinal cord injuries are common and the consequences are usually permanent, researchers have been aggressively and tirelessly researching ways to treat this condition. One approach is to try to form new nerve cells in the spinal cord using stem cells. Mesenchymal stem cells can become new nerve cells given the right set of circumstances. Unfortunately, simply injecting mesenchymal stem cells into patients with severe spinal cord injuries cannot reverse paralysis. On the other hand, using exosomes from mesenchymal stem cells may be the push that stem cells need to become nerve cells in the spinal cord.
Exosomes are tiny packets of cellular material released by stem cells. They contain a variety of potentially beneficial substances; perhaps the most important in cell regeneration is micro RNA (miRNA). miRNA can cause complex changes in cells that simple drugs, proteins, or even regular RNA cannot. Researchers cannot easily deliver miRNA to where it is needed in the body, but exosomes taken from stem cells can deliver miRNA right where it needs to be.
Researchers collected human mesenchymal stem cells and placed them in an environment that would cause them to become nerve cells. But instead of simply using the stem cells directly, they instead collected the exosomes from those stem cells. Those exosomes could then be used to prompt mesenchymal stem cells to become nerve cells. Simply put, the exosomes drove the process more efficiently than the stem cells alone.
What does this all mean? Exosomes taken from the mesenchymal stem cells could eventually be used to treat spinal cord injury. Those special exosomes would magnify the nerve cell-creating effect, perhaps restoring nerve cell function to a damaged spinal cord. Considerable research needs to be done before this possibility becomes a clinical reality, but this knowledge helps researchers design targeted experiments in the future.
A couple of weeks ago, scientists published findings showing that implanting human stem cells that are embedded within the engineered tissue can lead to the recovery of sensory perception in rats. The recovery of sensory perception is also accompanied by healing within the spinal cord and the ability to walk independently. The stem cells used in this experiment were collected from the membrane lining the mouth.
These results help demonstrate the potential for stem cells to help with spinal cord injuries but also point to the utility of combining stem cells with other factors to enhance their therapeutic effects. In this case, the researchers used a 3-dimensional scaffold to enable stem cells to attach and to stabilize them in the spinal cord. By adding growth factors, such as human thrombin and fibrinogen to the engineered tissue scaffolding, the researchers also increased the chances that attached stem cells would grow and differentiate.
The researchers compared the effects of their stem cell implants in paraplegic rats with the effects of adding no stem cells. Whereas the control rats who did not receive stem cells did not experience any improvement in mobility or sensation, 42% of the rats that did receive stem cells became better at supporting their weight on their hind limbs and at walking.
While these results are pre-clinical and do not apply directly to humans, the researchers conclude that further research is warranted. Given the positive impact of stem cells on the spinal cord in animals, it is reasonable to assume that stem cells may also benefit the human spinal cord. Further research will help clarify whether these stem cells can be adequately used to help treat patients with paraplegia.
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