stem cell therapy ppt

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STEM CELL THERAPY

Presented by

Mrs. S.Jeyalakshmi, M Sc (N),

Asst. Professor


STEM CELLS

Stem cells are the body’s master cells

Primitive cells

Stem cells has the ability to renew themselves through mitotic cell division and differentiating into a diverse range of specialized cell types.


STEM CELLSRare

Stem cells that are found in bone marrow, peripheral blood, and cord blood are called “Hematopoietic Stem Cells”

These are building blocks of the blood and immune systems.


Cell differentiation


History of stem cells

• Stem cells themselves have actually been around for almost as long as life has been on earth. In essence all life evolved from stem cells of some kind.

• Stem cell field research developed from studies in the 1960s by Canadian scientists Ernest A. McCulloch and James E. Till .


• Forty-four years later, they have been honoured with the 2005 Albert Lasker award for Basic Medical Research, an award often referred to as "America's Nobel."


Drs. Ernest McCulloch (left) and James Till (Irma Council for the Canadian Medical Hall of Fame)


History of Human Stem Cell Research

• In 1968, the first bone marrow transplant was successfully used in treatment of SCID

• Since the 1970’s, bone marrow transplants have been used for treatment of immunodeficiencies and leukemias


Bone Marrow Stem Cells


History of Human Embryonic Cell Research

• 1954 – John Enders received a Nobel prize in Medicine for growing polio virus in human embryonic kidney cells


• In 1998, James Thomson (University of Wisconsin-Madison) isolated cells from the inner cell mass of the early embryo, and developed the first human embryonic stem cell lines.

History of Human Embryonic Stem Cell Research

In 1998, John Gearhart (Johns Hopkins University) derived human embryonic germ cells from cells in fetal gonadal tissue (primordial germ cells).

Pluripotent stem cell “lines” were developed from both sources


1998 – Mice cloned 1998 – Cows cloned

• 1952 – Briggs and King cloned tadpoles

• 1996 – The first mammal cloned from adult cells was Dolly, the sheep.

2000 – Pigs cloned

History of Somatic Cell Nuclear Transfer (Cloning)


History of Cloning

• 2001 – Cat cloned 2002 – Rabbits cloned 2003 – Mule cloned

“CC” Carbon Copy

2004 – Bull serial-cloned 2005 – Dog cloned


Kinds of Stem CellsStem cell

type Description Examples

Totipotent Each cell can develop into a new individual

Cells from early (1-3 days) embryos

Pluripotent Cells can form any (over 200) cell types

Some cells of blastocyst (5 to 14 days)

MultipotentCells differentiated, but can form a number of other tissues

Fetal tissue, cord blood, and adult stem cells


Types of Stem cells

1. Embryonic stem cells2. Adult stem cells


Embryonic stem cell

Derived from the inner cell mass

PluripotentCan develop into more than 200 different cellsDifferentiate into cells of the 3 germ cell layers

Because of their capacity of unlimited expansion and pluripotency – useful in regenerative medicine


Two Sources of Embryonic Stem Cells

1. Excess fertilized eggs from IVF (in-vitro fertilization) clinics

2. Therapeutic cloning (somatic cell nuclear transfer)


Excess fertilized eggs from IVF (in-vitro fertilization) clinics

Tens of thousands of frozen embryos are routinely destroyed when couples finish their treatment.

These surplus embryos can be used to produce stem cells.

Regenerative medical research aims to develop these cells into new, healthy tissue to heal severe illnesses.


Therapeutic cloning (somatic cell nuclear transfer)

The nucleus of a donated egg is removed and replaced with the nucleus of a mature, "somatic cell" (a skin cell, for example).

No sperm is involved in this process, and no embryo is created to be implanted in a woman’s womb.

The resulting stem cells can potentially develop into specialized cells that are useful for treating severe illnesses.


Tissue or adult stem cells

They produce cells specific to the tissue in which they are foundThey are relatively unspecializedHowever they are predetermined to give rise to specific cell types when they differentiateEg: haematopoietic, bone marrow, neural


Other types of stem cells

Umbilical cord blood stem cells• Cord blood that is taken from

the umbilical cord after the baby is born contains stem cells.

• Cord blood stem cells can grow a complete immune system of blood cells.


Induced pluripotent stem cells

Induced pluripotent stem cells are adult cells that have been genetically reprogrammed to an embryonic stem cell-like state


Properties of Stem cells

• Self renewal - the ability to go through numerous cycles of cell division while maintaining the undifferentiated state.

• Potency – the capacity to differentiate into specialized cell types.


Totipotent stem cells (Total)• Cells produced by the first few divisions of

the cell . So can form any cell of the embryo as well as the placenta.

• Total potential to differentiate into any adult cell type

• Total potential to form specialized tissue needed for embryonic development


Pluripotent (plural) • Potential to form most or all 210 differentiated

adult cell types• These cells differentiate into cells derived from

the three germ cell layers.

• Eg: embryonic stem cell, embryonic germ cell and embryonic carcinoma cells.


Multipotent (multiple)• Limited potential

• Forms only multiple adult cell types

• (These cells can produce cells of a closely related family of cells).

• Eg: haematopoeitic stem cells, neural and mesenchymal stem cells


• Unipotent – these cells only produce one cell type., but have the property of self renewal which distinguishes them from the non stem cells.


Resources of Stem cells

Umbilical Cord

Bone Marrow

Peripheral Blood

Amniotic Fluid

Adipose Tissue

Embryonic


Application of stem cells

A. Stem cell research:1. It provides an ideal model for the study

of development of organisms

2. It replaces damaged cells of the body

3. It also aids in drug discovery


B. Regenerative medicine

and

C. Therapeutic issues


Therapeutic applications of embryonal stem cells –ES cell

• The potential to form 200 or more cells.• Hence used in regenerative medicine in

cases like cardiac failure, Parkinsons disease, diabetes.

• These cells are being coaxed to differentiate into cardiomyocytes, neural stem cells, insulin producing cell and even germ cells.


Fetal stem cells

• Hematopoietic stem cell: - characterized by the presence of CD 34 Seen in the umbilical cord and fetal liver - Have a higher cloning efficiency and

generates more progenitors than adult bone marrow.

- They have a huge competitive engraftment advantage relative to the adult bone marrow.

- Fetal liver is now used to treat fetuses having X-Linked SCID.


• Haematopoietic stem cells used in patients whose haematopoietic system has to be replaced

They are used in 1.Providing a functional immune system in a person

with SCID.2.Replacing a defective blood system with a functional

one who has non malignant genetic disorder like sickle cell anaemia and thallasemia.

3.Restoring the haematopoietic system in cancer patients after treatment.


• Other fetal cells are • Mesenchymal stem cells-differentiate to

bone, fat and cartilage like the adult counterpart.

• Neural stem cell- they differentiate into neurons, astrocytes and oligodendrocytes. They are the main source of cells for degenerative CNS injury for replacement.

Eg: parkinson’s disease


Potential application of fetal stem cells

• In the field of fetal medicine:

1. Non invasive prenatal diagnosis

2. Intrauterine stem cell transplantation

3. Gene therapy


Cord blood stem cells

• Cord blood that is taken from the umbilical cord after the baby is born contains stem cells.

• Cord blood stem cells can grow a complete immune system of blood cells.


• Cord blood is rich in stem cells that are normal and free of malignancies.

• A typical cord blood collection has sufficient numbers of stem cells for engraftment in most recipients weighing up to 110 lb.

• Research for replicating stem cells, in vitro, is successfully being done to expand the volume.


Umbilical cord blood stem cells

• It has both mesenchymal blood cell and haematopoietic stem cells.

• 1st successful umbilical cord blood transplantation in 1989 in a patient with Fanconi’s anaemia.


Cord Blood Stem Cells have untapped potential

• Cord blood stem cells can be easily collected and stored• Long-term cryopreservation has no adverse effect• Clinical studies over the past 20 years demonstrate the

efficacy and safety of cord blood stem cells• Currently, cord blood-derived stem cells have clinically utility

in more than 70 diseases• Banking cells for future therapies has been validated by

science• Cord blood stem cells possess significant future potential

through expansion, gene therapy, and cell-specific therapies


Uses for cord blood stem cells

• Nearly 40 years ago, the first bone marrow transplant offered new hope for patients with leukemia.

• Since 1990, stem cell transplants are more prevalent than bone marrow transplants because of ease of collection.


• Today, umbilical cord blood, with its high concentration of “hematopoietic” stem cells, brings these types of transplantations into the 21st century.

• Cord blood stem cells have been used to treat more than 45 malignant and genetic diseases. Leukemia is the most common.


Potential future uses for stem cells

• Current research shows great promise for the treatment of heart disease, liver disease, diabetes, stroke, multiple sclerosis, Alzheimer’s disease, Parkinson’s disease, spinal cord injury, and systemic lupus.


• Stored cord blood stem cells from a child is the perfect match for that child. This allows for an autologous transplant if needed, with no risk of Graft-vs- Host Disease(GVHD). GVHD is where the body rejects the donor’s stem cells and may prevent engraftment from occurring.

• Cord blood stem cells are a close match for siblings or family members in case of need, with low risk of GVHD.


Making a decision to collect your baby’s cord blood stem cells.

• Yes, if there is a family history of malignant, benign or inherited disorders.

• Yes, even in the absence of “health risk factors”, as there are potential benefits to your family in the future.

• Yes, if the costs are affordable and this is something of value to you.

• Yes, it is the one chance to collect them.


Collecting cord blood stem cells

• This blood is collected by the physician after the baby is born and the cord is cut.

• It takes less than 5 minutes and there is no pain, harm or risk to mother or newborn.

• This cord blood containing the stem cells, is sent to a “Cord Blood Bank” either private or public where it is processed and the stem cells are preserved in liquid nitrogen.


Haematopoeitic stem cells

• Derived from bone marrow in adults and umbilical cord blood

• Option given to the parents regarding stem cell banking during antenatal visits

• 25% chance that sibling also can have a perfect match


• Blood is collected from umbilical cord immediately after delivery about 100-150cc

• The number of cells in 1 ml is 40,000

• They are stored in blood banks at 196deg celsius in a state of suspended animation and restart their activity on thawing


Advantages over bone marrow cells

1. High rate of engraftment2. More tolerant to tissue matches3. Less severe GVHD4. Rarely contaminated with latent virus5. Easy to collect, not painful6. Superior proliferative capacity7. Greater immunological naievity8. Unlimited supply9. Lower cost


Ailments for which stem cells are being used now

• Acute leukemias• Chronic leukemias • Myelodysplastic

syndromes• Marrow failure• Myeloproliferative

disorders• Lymphoproliferative

disorders


• Phagocyte disorders• Inherited disorders like Lesch Nyhan

syndrome, beta Thallesemia etc• Inherited platelet abnormalities • Inherited metabolic disorders like

Mucopolysaccharidosis, Hurler’s syndrome, Krabbe disease, Niemann- pick disease etc


• Histocytic disorders

• Inherited erythrocyte abnormalities

• Inherited immune system disorders like ataxia telangectesia, DiGeorge syndrome, SCID etc

• Plasma cell disorder

• Malignancies like neuroblastoma, Ewing sarcoma, Renal cell CA etc


Trials underway

• Cardiac disease• Diabetes• Multiple Sclerosis• Muscular Dystrophy• Parkinson’s disease• Spinal cord injury• Stroke


Future stem cell application

• Alzheimer’s Disease

• Lupus

• Rheumatoid arthritis


• Research is going on regarding the use of stem cells for male infertility in mouse

• However the progeny has severe abnormalities

• Also recent research suggests that oocyte can be generated from stem cells originating from

1.Bone marrow- haematopoietic stem cells

2.Ovarian surface cells


Ethical issues

• Are we trying to play GOD?

• Is embryo a person?

• Will stem cell research encourage embryo destruction and abortions?


Guidelines for stem cell research in India

• Compulsory registration of the existing cell lines to be registered under specific apex bodies in the field

• Genetic research dealing with human egg or sperm and genetic engineering and then transfer of human blastocysts will not be allowed


• Research and therapy using fetal/placental stem cell will be allowed

• Termination of pregnancy cannot be sought for donating fetal tissue for therapeutic or financial benefits


• All the umbilical cord blood banks should be registered with Drug Controller General of India

• Research into human cloning is not to be done


• These guidelines are aimed to encourage development of sound research and therapy, prevent any misuse of human embryos and fetuses and protect patients from fraudulent treatments in the name of stem cell research.

stem cell therapy ppt

Documents

excess fertilized

complete immune

embryonic

bone marrow

stem cell

adult bone

specialized

haematopoietic