7. Expectations: realistic and unrealistic

2021 ◽  
pp. 109-120
Author(s):  
Jonathan Slack

‘Expectations: realistic and unrealistic’ contemplates the goal of biomedical sciences to regenerate missing structures and to cure heart failure, diabetes, cancer, and neurodegeneration. The hype and controversy of human embryonic stem (ES) cells led the proponents of stem cell research to promise very rapid development of very radical cures. In reality progress will be slow. There are a number of lessons that we can learn from the development of haematopoietic stem cell transplantation (HSCT), which is one of the major applications of stem cell therapy in clinical practice.

Stem Cells ◽  
2008 ◽  
Vol 26 (10) ◽  
pp. 2644-2653 ◽  
Author(s):  
Satsuki Yamada ◽  
Timothy J. Nelson ◽  
Ruben J. Crespo-Diaz ◽  
Carmen Perez-Terzic ◽  
Xiao-Ke Liu ◽  
...  

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Iman Razeghian-Jahromi ◽  
Anthony G. Matta ◽  
Ronan Canitrot ◽  
Mohammad Javad Zibaeenezhad ◽  
Mahboobeh Razmkhah ◽  
...  

AbstractWhile existing remedies failed to fully address the consequences of heart failure, stem cell therapy has been introduced as a promising approach. The present review is a comprehensive appraisal of the impacts of using mesenchymal stem cells (MSCs) in clinical trials mainly conducted on ischemic cardiomyopathy. The benefits of MSC therapy for dysfunctional myocardium are likely attributed to numerous secreted paracrine factors and immunomodulatory effects. The positive outcomes associated with MSC therapy are scar size reduction, reverse remodeling, and angiogenesis. Also, a decreasing in the level of chronic inflammatory markers of heart failure progression like TNF-α is observed. The intense inflammatory reaction in the injured myocardial micro-environment predicts a poor response of scar tissue to MSC therapy. Subsequently, the interval delay between myocardial injury and MSC therapy is not yet determined. The optimal requested dose of cells ranges between 100 to 150 million cells. Allogenic MSCs have different advantages compared to autogenic cells and intra-myocardial injection is the preferred delivery route. The safety and efficacy of MSCs-based therapy have been confirmed in numerous studies, however several undefined parameters like route of administration, optimal timing, source of stem cells, and necessary dose are limiting the routine use of MSCs therapeutic approach in clinical practice. Lastly, pre-conditioning of MSCs and using of exosomes mediated MSCs or genetically modified MSCs may improve the overall therapeutic effect. Future prospective studies establishing a constant procedure for MSCs transplantation are required in order to apply MSC therapy in our daily clinical practice and subsequently improving the overall prognosis of ischemic heart failure patients.


2021 ◽  
pp. 90-108
Author(s):  
Jonathan Slack

‘Therapy using tissue-specific stem cells’ begins with haematopoietic stem cell transplantation (HSCT), which is considered the most important type of stem cell therapy. HSCT covers the transplantation of bone marrow and other types of transplant where the blood-forming stem cells of the graft come from non-marrow sources. It is used mostly for the treatment of leukaemias and lymphomas. Some genetic diseases of the blood have also been successfully treated using allogeneic HSCT. There are also other examples of cell therapy using tissue-specific stem cells, such as epidermal cells for the treatment of burns and limbal (corneal) stem cells for treatment of eye injuries.


Nano LIFE ◽  
2018 ◽  
Vol 08 (04) ◽  
pp. 1841008 ◽  
Author(s):  
Bing Hui Wang ◽  
Danny Liew ◽  
Kevin W. Huang ◽  
Li Huang ◽  
Wenjie Tang ◽  
...  

Cardiovascular disease remains the single highest global cause of death and a significant financial burden on the healthcare system. Despite the advances in medical treatments, the prevalence and mortality for heart failure remain unacceptably high. New approaches are urgently needed to reduce this burden and improve patient outcomes and quality of life. One such promising approach is stem cell therapy, including embryonic stem cells, bone marrow derived stem cells, induced pluripotent stem cells and mesenchymal stem cells. However, the cardiac microenvironment following myocardial infarction poses huge challenges with inflammation, adequate retention, engraftment and functional incorporation all crucial concerns. The lack of cardiac regeneration, cell viability and functional improvement has hindered the success of stem cell therapy in clinical settings. The use of biomaterial scaffolds in conjunction with stem cells has recently been shown to enhance the outcome of stem cell therapy for heart failure and myocardial infarction. This review outlines some of the current challenges in the treatment of heart failure and acute myocardial infarction through improving stem cell therapeutic strategies, as well as the prospect of suitable biomaterial scaffolds to enhance their efficacy and improve patient clinical outcomes.


2002 ◽  
Vol 2 ◽  
pp. 1762-1773 ◽  
Author(s):  
Norio Nakatsuji ◽  
Hirofumi Suemori

Human embryonic stem (ES) cell lines have opened great potential and expectation for cell therapy and regenerative medicine. Monkey and human ES cell lines, which are very similar to each other, have been established from monkey blastocysts and surplus human blastocysts from fertility clinics.Nonhuman primate ES cell lines provide important research tools for basic and applicative research. Firstly, they provide wider aspects of investigation of the regulative mechanisms of stem cells and cell differentiation among primate species. Secondly, their usage does not need clearance or permission from the regulative rules in many countries that are associated with the ethical aspects of human ES cells, although human and nonhuman embryos and fetuses are very similar to each other. Lastly and most importantly, they are indispensable for animal models of cell therapy to test effectiveness, safety, and immunological reaction of the allogenic transplantation in a setting similar to the treatment of human diseases.So far, ES cell lines have been established from rhesus monkey (Macaca mulatta), common marmoset (Callithrix jacchus), and cynomolgus monkey (Macaca fascicularis), using blastocysts produced naturally or by in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). These cell lines seem to have very similar characteristics. They express alkaline phosphatase activity and stage-specific embryonic antigen (SSEA)-4 and, in most cases, SSEA-3. Their pluripotency was confirmed by the formation of embryoid bodies and differentiation into various cell types in culture and also by the formation of teratomas that contained many types of differentiated tissues including derivatives of three germ layers after transplantation into the severe combined immunodeficiency (SCID) mice.The noneffectiveness of the leukemia inhibitory factor (LIF) signal makes culture of primate and human ES cell lines prone to undergo spontaneous differentiation and thus it is difficult to maintain these stem cell colonies. Also, these ES cells are more susceptible to various stresses, causing difficulty with subculturing using enzymatic treatment and cloning from single cells. However, with various improvements in culture methods, it is now possible to maintain stable colonies of monkey ES cells using a serum-free medium and subculturing with trypsin treatment. Under such conditions, cynomolgus monkey ES cell lines can be maintained in an undifferentiated state with a normal karyotype and pluripotency even after prolonged periods of culture over 1 year. Such progress should facilitate many aspects of stem cell research using both nonhuman primate and human ES cell lines.


Cells ◽  
2019 ◽  
Vol 8 (1) ◽  
pp. 47 ◽  
Author(s):  
Giorgio Ottaviano ◽  
Robert Chiesa ◽  
Tobias Feuchtinger ◽  
Mark Vickers ◽  
Anne Dickinson ◽  
...  

Adverse outcomes following virus-associated disease in patients receiving allogeneic haematopoietic stem cell transplantation (HSCT) have encouraged strategies to control viral reactivation in immunosuppressed patients. However, despite timely treatment with antiviral medication, some viral infections remain refractory to treatment, which hampers outcomes after HSCT, and are responsible for a high proportion of transplant-related morbidity and mortality. Adoptive transfer of donor-derived lymphocytes aims to improve cellular immunity and to prevent or treat viral diseases after HSCT. Early reports described the feasibility of transferring nonspecific lymphocytes from donors, which led to the development of cell therapy approaches based on virus-specific T cells, allowing a targeted treatment of infections, while limiting adverse events such as graft versus host disease (GvHD). Both expansion and direct selection techniques have yielded comparable results in terms of efficacy (around 70–80%), but efficacy is difficult to predict for individual cases. Generating bespoke products for each donor–recipient pair can be expensive, and there remains the major obstacle of generating products from seronegative or poorly responsive donors. More recent studies have focused on the feasibility of collecting and infusing partially matched third-party virus-specific T cells, reporting response rates of 60–70%. Future development of this approach will involve the broadening of applicability to multiple viruses, the optimization and cost-control of manufacturing, larger multicentred efficacy trials, and finally the creation of cell banks that can provide prompt access to virus-specific cellular product. The aim of this review is to summarise present knowledge on adoptive T cell manufacturing, efficacy and potential future developments.


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