Clinical Applications of Blood-Derived and Marrow-Derived Stem Cells for Nonmalignant Diseases

Abstract

TEM CELLS ARE UNDIFFERENTIated cells that through replication have the capability of both self-renewal and differentiation into mature specialized cells. In broad terms, there are 2 types of stem cells, embryonic stem cells and adult stem cells. Human embryonic stem cells are isolated from a 50-to 150-cell, 4-to 5-dayold postfertilization blastocyst. Embryonic stem cells generate every specialized cell in the human body and, while capable of indefinite ex vivo proliferation, exist only transiently in vivo (during embryogenesis). Adult stem cells are located in tissues throughout the body and function as a reservoir to replace damaged or aging cells. Under physiologic conditions, adult stem cells are traditionally thought to be restricted in their differentiation to cell lineages of the organ system in which they are located. Embryonic stem cells have great promise and versatility but, compared with adult stem cells, are currently difficult to control due to their tendency to form tumors containing all types of tissue, ie, teratomas. Embryonic stem cell biology has been associated with ethical controversy, and feeder cellfree and xenogeneic-free culture methods approved by the US Food and Drug Administration are still being per-Author Affiliations are listed at the end of this article.

Hematopoietic SCT modulates gut inflammation in experimental inflammatory bowel disease

“…The rationale of these therapeutic approaches is to eradicate pathogenic cells responsible for the disease development while sparing the pluripotent blood stem cells from any ill effect and immune reset, that is, to generate new selftolerant lymphocytes after chemotherapy elimination of self or auto-reactive lymphocytes. 11,30 Despite the previous knowledge concerning the effects of chemotherapy and HSCT, the role of BM-derived cells in the intestine after transplantation is presently unclear. Both in animal models as well as in patients, it seems that BMCs are involved in the healing process after intestinal injury.…”

“…11,30 Therefore, these evidences suggest that SCT could be justified in some patients with IBD, which have already begun to be transplanted in some current trials, 42,43 thus raising the question of whether the cell transplantation or the intense immunosuppression was the critical event for patient recovery. In our study, both therapeutic approaches induced remission of the disease and, although we did not elucidate the exact mechanisms of action of the graft in the treatment of the IBD, we showed that in this model, the infusion of the graft was extremely important to reduce mortality.…”

“…5,7 Although current therapies are aimed at various elements of the immunoinflammatory cascade, no drug is, at present, curative, and a significant percentage of patients is refractory or intolerant to many pharmacological approaches and requires repeated surgery to combat complications of the disease. 8,9 Hematopoietic SCT (HSCT) for treatment of severe autoimmune diseases is being explored as therapy for various immune-mediated diseases, 10,11 as well as the utilization of high-dose chemotherapy without stem cell rescue. [12][13][14][15] Nevertheless, the exact immunological mechanisms by which BM cells (BMCs) or high-dose immunosuppression provide remission for those diseases, including IBD, is not yet clear.…”

A safety and feasibility study of cell therapy in dilated cardiomyopathy

“…In the clinical setting, cell therapies have been previously used in patients with ischemic heart disease, both in the acute and chronic stages. In most trials, the mononuclear fraction of bone marrow has been used, but a variety of cell types from bone marrow and skeletal myoblasts have also been delivered to patients (10)(11)(12)(13)(14)(15)(16)(17). Results have demonstrated excellent safety with encouraging signs of clinical improvement (10)(11)(12)(14)(15)(16)(17).…”

Mobilization and harvesting of PBPC in newly diagnosed type 1 diabetes mellitus

“…Autologous hematopoietic stem cell (HSC) transplantation is an established treatment for hematological malignancies, and recently has been employed to treat severe chronic autoimmune diseases (CAID), 1 including newly diagnosed type 1 diabetes mellitus (T1DM). 2 The objective of this modality of treatment in autoimmune diseases is the elimination of autoreactive clones of T cells to allow the regeneration of a 'new' immune system from the HSC infused.…”