What is stem cell?

  • Body “MASTER” cells in human body.
  • Capable of SELF RENEWAL –> make more stem cells –> to replenish and repair tissue
  • Capable of DIFFERENTIATION –> different types of cells.

What are stem cells therapies?

  • The treatment of various disorders, non-serious to life threatening, by using stem cells.

Mesenchymal Stem Cell (MSC) & Its Role in Stem Cell Therapy

Mesenchymal Stem Cell (MSC)

  • In year 2006, human MSCs are defined by the International Society for Cellular Therapy (ISCT) as below: –
  1. Plastic adherent.
  2. Possess specific surface markers (CD105+, CD73+, CD90+, CD45-, CD34-, CD14-, CD11b-, CD79a-, CD19- and HLA-DR-).
  3. Capable of differentiating into: –

    • osteoblasts (bone cells)
    • adipocytes (fat cells)
    • chondroblasts (cartilage)

Where can we find MSC?

Mesenchymal stem cells (MSC) are multipotent stem cells that could differentiate into multiple lineages including osteogenic (bone cells), adipogenic (fat cells), chondrogenic (cartilage) and neurogenic (nerve cells).

The most common sources of MSC in the body are bone marrow, umbilical cord, adipose tissues, dental pulp, and peripheral blood.

Multipotency of MSC

MSCs vs Other Types of Stem Cells

MSCs vs Other types of Stem Cells

Does not involve the ethical issues

As MSCs can be sourced from the aforementioned tissues in an adult.

Less immunogenic

Did not express immunogenic markers –> lowered the risk of rejection (by the host’s immune system) and complications of transplantation.

Immunomodulatory property

MSC possesses immunomodulatory properties.
Have been shown to reduce inflammatory markers in several studies.

Homing ability

Upon receiving “SIGNALS”, MSCs can migrate to, and engraft in the tissue and followed by exerting their local and regenerative functional effects.

MSC Therapeutic Applications

Potential MSC Therapies:

  • Graft versus Host Disease (following transplantation)
  • Tissue/ organ repair (Bone, cartilages, cardiac and brain)
  • Diabetes
  • Ageing-related
  • Weakness

Clinical Trials with MSC (1)

MSC vs aGvHD/HSC transplantation

(6 years old kid;acute lymphoblastic leukemia (ALL); skin GvHD at Day14 following HSC transplantation)

  *MSCs-FFM: MSC-Frankfurt am Main

Clinical Trials with MSC (2)

MSC vs aGvHD/HSC transplantation

(23 yrs old male;Acute myeloid leukemia (AML); gut GvHD )

Clinical Trials with MSC (3)

MSC vs Osteoarthritis

Clinical Trials with MSC (4)

MSC vs Diabetic foot ulcer

(57 yrs old female;Type 2 diabetes mellitus;Diabetic foot ulcer)

Clinical Trials with MSC (5)

MSC vs Aging Frailty

Aging frailty:

  • Characterized by decreased physical and immunological functioning.
  • Associated with stem cell depletion.
  • Randomized, double-blinded study
  • Patients with frailty (n=30, mean age 75.5 ± 7.3 yrs old)
  • Intravenous injection of allo-hMSCs (100 or 200 million cells)
  • Research findings:

 

–> After 1 month: No adverse effects

–> After 6 months:

 

√ 6-min walk test, short physical performance exam, and forced expiratory volume in 1   second test ­↑

√ Female sexual quality of life questionnaire ­↑

√ Inflammation marker (TNF-a) ↓

Challenges of MSC Therapeutic Applications

SAFETY

  • Ethical approval
  • Standard

 

→ cGMP stem cell production laboratory

  • Regulation and Law Enforcement

 

→ National Pharmaceutical Regulatory Agency (NPRA)

→ Medical Review & Ethics Committee (MREC)

→ Institutional Review Board

Challenges of MSC Therapeutic Applications

EFFICACY

Therapeutic effects
The Sciences