INTRODUCING!!! STEM CELL THERAPY;
THE NEW WAVE IN MEDICINE
Deep down, you might have heard or pondered about Stem Cell Therapy.
Well let’s take it slowly and really look at this latest medical innovation and see why it is termed the new wave in Medicine.
What are Stem Cells?
Stem cells are a class of undifferentiated cells that are able to differentiate into specialized cell types. Stem cells are the foundation for every organ and tissue in your body, and can replicate rapidly.
Stem cells play a huge part in the body’s healing process, and the introduction of new stem cells has always showed great promise in the treatment of many conditions.
It wasn’t until we found out where and how to isolate these cells that we started using them for transplants.
Although a person’s own stem cells are always 100 percent compatible, there are risks in using someone else’s stem cells, especially if the donor and recipient are not immediately related.
The relatively recent discovery of stem cells in the umbilical cord’s blood has proven advantageous over acquiring stem cells from other sources. Researchers are currently conducting clinical trials with stem cells, adding to the growing list of 80 diseases which they can treat.There are many different types of stem cells that come from different places in the body or are formed at different times in our lives.
These include embryonic stem cells that exist only at the earliest stages of development and various types of tissue-specific (or adult) stem cells that appear during fetal development and remain in our bodies throughout life.
All stem cells can self-renew (make copies of themselves) and differentiate (develop into more specialized cells).
Commonly, stem cells come from two main sources:
- Embryos formed during the blastocyst phase of embryological development (embryonic stem cells) and
- Adult tissue (adult stem cells).
Both types are generally characterized by their potency, or potential to differentiate into different cell types (such as skin, muscle, bone, etc.).
Embryonic stem cells
Embryonic stem cells are obtained from the inner cell mass of the blastocyst, a mainly hollow ball of cells that, in the human, forms three to five days after an egg cell is fertilized by a sperm.
A human blastocyst is about the size of the dot above this “i.”
In normal development, the cells inside the inner cell mass will give rise to the more specialized cells that give rise to the entire body—all of our tissues and organs.
However, when scientists extract the inner cell mass and grow these cells in special laboratory conditions, they retain the properties of embryonic stem cells.
Embryonic stem cells are pluripotent, meaning they can give rise to every cell type in the fully formed body, but not the placenta and umbilical cord.
Human embryonic stem cells have been derived primarily from blastocysts created by in vitro fertilization (IVF) for assisted reproduction that were no longer needed.
Adult stem cells
Adult or somatic stem cells exist throughout the body after embryonic development and are found inside different types of tissue and are more specialized than embryonic stem cells.
These stem cells have been found in tissues such as the brain, bone marrow, blood, blood vessels, skeletal muscles, skin, and the liver. They remain in a quiescent or non-dividing state for years until activated by disease or tissue injury.
Adult stem cells can divide or self-renew indefinitely, enabling them to generate a range of cell types from the originating organ or even regenerates the entire original organ.
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Stem cells are categorized by their potential to differentiate into other types of cells. Embryonic stem cells are the most potent since they must become every type of cell in the body. The full classification includes:
- Totipotent – the ability to differentiate into all possible cell types. Examples are the zygote formed at egg fertilization and the first few cells that result from the division of the zygote.
- Pluripotent – the ability to differentiate into almost all cell types. Examples include embryonic stem cells and cells that are derived from the mesoderm, endoderm, and ectoderm germ layers that are formed in the beginning stages of embryonic stem cell differentiation.
- Multipotent – the ability to differentiate into a closely related family of cells. Examples include hematopoietic (adult) stem cells that can become red and white blood cells or platelets.
- Oligopotent – the ability to differentiate into a few cells. Examples include (adult) lymphoid or myeloid stem cells.
- Unipotent – the ability to only produce cells of their own type, but have the property of self-renewal required to be labeled a stem cell. Examples include (adult) muscle stem cells.
Embryonic stem cells are considered pluripotent instead of totipotent because they do not have the ability to become part of the extra-embryonic membranes or the placenta.
Identification of stem cells
Although there is not complete agreement among scientists of how to identify stem cells, most tests are based on making sure that stem cells are undifferentiated and capable of self-renewal.
One way to identify stem cells in a lab, and the standard procedure for testing bone marrow or hematopoietic stem cell (HSC), is by transplanting one cell to save an individual without HSCs. If the stem cell produces new blood and immune cells, it demonstrates its potency.
Clonogenic assays (a laboratory procedure) can also be employed in vitro to test whether single cells can differentiate and self-renew. Researchers may also inspect cells under a microscope to see if they are healthy and undifferentiated or they may examine chromosomes.
To test whether human embryonic stem cells are pluripotent, scientists allow the cells to differentiate spontaneously in cell culture, manipulate the cells so they will differentiate to form specific cell types, or inject the cells into an immunosuppressed mouse to test for the formation of a teratoma (a benign tumor containing a mixture of differentiated cells).
Research with stem cells
Scientists and researchers are interested in stem cells for several reasons. Although stem cells do not serve any one function, many have the capacity to serve any function after they are instructed to specialize. Every cell in the body, for example, is derived from first few stem cells formed in the early stages of embryological development. Therefore, stem cells extracted from embryos can be induced to become any desired cell type. This property makes stem cells powerful enough to regenerate damaged tissue under the right conditions.
Organ and tissue regeneration
Tissue regeneration is probably the most important possible application of stem cell research. Currently, organs must be donated and transplanted, but the demand for organs far exceeds supply. Stem cells could potentially be used to grow a particular type of tissue or organ if directed to differentiate in a certain way. Stem cells that lie just beneath the skin, for example, have been used to engineer new skin tissue that can be grafted on to burn victims.
Cardiovascular disease treatment
The scientists extracted vascular precursor cells derived from human-induced pluripotent stem cells from one group of adults with type 1 diabetes as well as from another group of “healthy” adults. They were then implanted onto the surface of the brains of the mice.
Within two weeks of implanting the stem cells, networks of blood-perfused vessels had been formed – they lasted for 280 days. These new blood vessels were as good as the adjacent natural ones.
The authors explained that using stem cells to repair or regenerate blood vessels could eventually help treat human patients with cardiovascular and vascular diseases.
Brain disease treatment
Additionally, replacement cells and tissues may be used to treat brain disease such as Parkinson’s and Alzheimer’s by replenishing damaged tissue, bringing back the specialized brain cells that keep unneeded muscles from moving. Embryonic stem cells have recently been directed to differentiate into these types of cells, and so treatments are promising.
Cell deficiency therapy
Healthy heart cells developed in a laboratory may one day be transplanted into patients with heart disease, repopulating the heart with healthy tissue. Similarly, people with type I diabetes may receive pancreatic cells to replace the insulin-producing cells that have been lost or destroyed by the patient’s own immune system. The only current therapy is a pancreatic transplant, and it is unlikely to occur due to a small supply of pancreases available for transplant.
Blood disease treatments
Adult hematopoietic stem cells found in blood and bone marrow have been used for years to treat diseases such as leukemia, sickle cell anemia, and other immunodeficiencies. These cells are capable of producing all blood cell types, such as red blood cells that carry oxygen to white blood cells that fight disease. Difficulties arise in the extraction of these cells through the use of invasive bone marrow transplants. However hematopoietic stem cells have also been found in the umbilical cord and placenta. This has led some scientists to call for an umbilical cord blood bank to make these powerful cells more easily obtainable and to decrease the chances of a body’s rejecting therapy.
Why are stem cells useful?
- Stem cells have several uses including:
- Research – to help us understand the basic biology of how living things workand what happens in different types of cell during disease.
- Therapy – to replace lost or damaged cells that our bodies can’t replace naturally.
Stem cell research
- Research is looking to better understand the properties of stem cells so that we can:
- Understand how our bodies grow and develop
- Find ways of using stem cells to replace cells or tissues?that have been damaged or lost.
- We can use stem cells to study how cells become specialised for specific functions in the body, and what happens when this process goes wrong in disease.
- If we understand stem cell development, we may be able to replicate this process to create new cells, tissues and organs?.
- We can grow tissue and organ structures from stem cells, which can then be studied to find out how they function and how they are affected by different drugs?.
Stem cell therapy
- Cells, tissues and organs can sometimes be permanently damaged or lost by disease, injury and genetic conditions?.
- Stem cells may be one way of generating new cells that can then be transplanted into the body to replace those that are damaged or lost.
- Adult stem cells are currently used to treat some conditions, for example:
- Blood stem cells are used to provide a source of healthy blood cells for people with some blood conditions, such as thalassaemia, and cancer patients who have lost their own blood stem cells during treatment.
- Skin stem cells can be used to generate new skin for people with severe burns.
- Age-related macular degeneration (AMD) is an example of a disease where stem cells could be used as a new form of treatment in the future:
- Some people with age-related macular degeneration lose their sight because cells in the retina?of the eye called retinal pigment epithelium (RPE) cells stop working.
- Scientists are using induced pluripotent stem cells to produce new RPE cells in the lab that can then be put into a patient’s eye to replace the damaged cells.
- Stem cells could be used to generate new organs for use in transplants:
- Currently, damaged organs can be replaced by obtaining healthy organs from a donor, however donated organs may be ‘rejected’ by the body as the immune system sees it as something that is foreign.
- Induced pluripotent stem cells generated from the patient themselves could be used to grow new organs that would have a lower risk of being rejected.
How do you generate induced pluripotent stem cells?
- Signals in the body tell a cell what type of specialised cell it should be by switching some genes?on and some genes off.
- To generate induced pluripotent stem cells, scientists re-introduce the signals that normally tell stem cells to stay as stem cells in the early embryo. These switch off any genes that tell the cell to be specialised, and switch on genes that tell the cell to be a stem cell.
Your body has many different types of cells (more than 200 to be more exact) each geared towards specific functions.
Stem cells have potential
Your cells didn’t start out knowing how to come together to form your bones, heart or blood; they begun with more of a blank slate. These completely undifferentiated cells can be found during gestation, or the time the baby is in the womb, and are called embryonic stem cells. These early stage stem cells are master cells that have the potential to become any type of cell in the body.
Stem cells proliferate
To recap, we have certain types of stem cells that can become a variety of different cells—they are like the renaissance men of cells—but there is one more thing that makes stem cells special. This has to do with how they replicate themselves.
The body has two ways to create more cells. The first is cell division; it’s where a cell replicates within its membrane before dividing into two identical cells. Cells do this as needed for regeneration.
The other way the body creates more cells is through its stem cells, and stem cells do things a little differently. They undergo what is called asymmetric division, forming not one but two daughter cells: one cell often an exact replica of itself, a new stem cell with a relatively clean slate, and another stem cell that is ready to turn into a specific type of cell. This trait is known as self-renewal and allows stem cells to proliferate, or reproduce rapidly.
Stem cells are regenerative
Different cells have different life cycles, and many are constantly regenerating, but when damage occurs and the body needs to come up with a new supply of cells to heal itself, it relies on the stem cell’s ability to quickly create more cells to repair the wound. Herein lays the potential for the introduction of new stem cells to enhance or be the driving factor in the healing process.
Scientists first found ways to use stem cells in bone marrow, and following this discovery, the first stem cell transplant was performed in 1956 via bone marrow between identical twins. It resulted in the complete remission of the one twin’s leukemia.
Stem cells need to match
The immune system has a way to identify foreign cells; it’s what allows the body to defend itself. So although transplants were proving successful after the first in 1956, they were limited to twins because their shared genetic makeup made them 100 percent compatible. This took a turn in 1958, when scientists discovered a protein present on the surface of almost all cells that lets the body know if the cell is one of its own cells or a foreign cell. In 1973, we finally learned enough about these compatibility markers (called human leukocyte antigens or HLAs) to perform the first unrelated bone marrow transplant.
The proteins stem from three HLA genes, and you inherit one HLA from each parent, or half your HLA markers from your mother and half from your father. This gives siblings a 25 percent chance of being a perfect match, a 50 percent chance of being a partial match and another one-in-four chance of not being a match at all. Unfortunately, about seven out 10 patients who need a transplant don’t have a suitable donor in their family. They can either rely on their own stem cells, isolated before treatment or previously preserved, or try to find a match through a public donor.
An HLA match helps ensure the body accepts the new cell and the transplant is successful. It also reduces the risk of graft-versus-host disease (GVHD), which is when the transplanted cells attack the recipient’s body. Unfortunately, GVHD can also be deadly.
Not all adult stem cells are equal
Further advancements were made in 1978, when stem cells were discovered in cord blood and in 1988, when cord blood stem cells were first used in a transplant. Stem cells extracted from the umbilical cord blood or tissue has since been shown to be more advantageous than those extracted from other sources such as bone marrow. In many ways, this is because stem cells from the umbilical cord can be considered naïve and immature compared to stem cells from other sources. Cord stem cells haven’t been exposed to disease or environmental pollutants, and they are more accepting of foreign cells. In this case, inexperience makes them stronger.
Stem cells (center ones) can develop into any cell type. They are valuable as research tools and might, in the future, be used to treat a wide range of diseases. Credit: Judith Stoffer
Potential for use
Stem cell research is improving by leaps and bounds. These may soon become the basis for treating diseases such as Parkinson’s disease, diabetes, heart failure, cerebral palsy, heart disease and host of other chronic ailments.
Stem cells may also be used for screening new drugs and toxins and understanding birth defects without subjecting human volunteers to the toxins and drugs.
How can stem cells treat disease?
When most people think about stem cells treating disease they think of a stem cell transplant.
In a stem cell transplant, embryonic stem cells are first specialized into the necessary adult cell type. Then, those mature cells replace tissue that is damaged by disease or injury. This type of treatment could be used to:
- replace neurons damaged by spinal cord injury, stroke, Alzheimer’s disease, Parkinson’s disease or other neurological problems;
- produce insulin that could treat people with diabetes and heart muscle cells that could repair damage after a heart attack; or
- replace virtually any tissue or organ that is injured or diseased.
But embryonic stem cell-based therapies can do much more.
- Studying how stem cells develop into heart muscle cells could provide clues about how we could induce heart muscle to repair itself after a heart attack.
- The cells could be used to study disease, identify new drugs, or screen drugs for toxic side effects.
Any of these would have a significant impact on human health without transplanting a single cell.
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