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What are Stem Cells?
 
Stem cells have the remarkable potential to develop into many different cell types in the body during early life and growth. In addition, in many tissues they serve as a sort of internal repair system, dividing essentially without limit to replenish other cells as long as the person or animal is still alive. When a stem cell divides, each new cell has the potential either to remain a stem cell or become another type of cell with a more specialized function, such as a muscle cell, a red blood cell, or a brain cell.
 
Stem cells are distinguished from other cell types by two important characteristics. First, they are unspecialized cells capable of renewing themselves through cell division, sometimes after long periods of inactivity. Second, under certain physiologic or experimental conditions, they can be induced to become tissue- or organ-specific cells with special functions. In some organs, such as the gut and bone marrow, stem cells regularly divide to repair and replace worn out or damaged tissues. In other organs, however, such as the pancreas and the heart, stem cells only divide under special conditions.
 

"Stem Cell Basics: Introduction." Stem Cell Information. National Institutes of Health, U.S. Department of Health and Human Services, 2009. 5 February 2011. <http://stemcells.nih.gov/info/basics/basics1>.

"What is a stem cell?" Animation

 

What is Stem Cell Research?

Stem cell research is an emerging technology that examines the therapeutic use of undifferentiated cells in treating different disorders, injuries, and diseases.
 
Undifferentiated cells are cells that have not assumed a specific cell type yet.
 
 
 
Are All Stem Cells the Same?
No. There are many types of stem cells, but they can be classified into two basic groups:
 
1.     Adult stem cells repair and maintain healthiness of the tissue or organ in which they are found.
 
2.     Embryonic stem cells are found on the inner cell mass of a human blastocyst.
 
 
Somatic (Adult) Stem Cells
 
Recent research has proven that adult stem cells are located in many different tissues including the heart and brain which also proves that our bodies have an abundant supply. Adult stem cells can be obtained from a human body (located in the bone marrow, blood, muscle, heart, brain, liver, gut, skin, testis, ovarian epithelium, and teeth), an umbilical cord, body tissue of a placenta, and even fat cells. If scientists can control the differentiation of adult stem cells, these cells may have the potential to also be used for transplants.
 
Embryonic Stem Cells
 
Embryonic stem cells are taken from an early embryo. "Most embryonic stem cells are derived from embryos that develop from eggs that have been fertilized in vitro—in an in vitro fertilization clinic—and then donated for research purposes with informed consent of the donors. They are not derived from eggs fertilized in a woman's body."

"Stem Cell Basics: What are Embryonic Stem Cells?" Stem Cell Information. National Institutes of Health, U.S. Department of Health and Human Services, 2009. 5 February 2011. <http://stemcells.nih.gov/info/basics/basics3.asp>.

Please visit http://stemcells.nih.gov/info/basics/basics3.asp for more information.

Pros and Cons of Embryonic and Adult Stem Cells
  Advantages Disadvantages
Embryonic Stem Cells 1. Flexible—appear to have the potential to make any cell.                                            2. Immortal—one ES cell line can potentially provide an endless supply of cells with defined characteristics.                                           3. Availability—embryos from in vitro fertilization clinics. 1. Difficult to differentiate uniformly and homogeneously into a target tissue.
2. Immunogenic—ES cells from a random embryo donor are likely to be rejected after transplantation.
3. Tumorigenic—Capable of forming tumors or promoting tumor formation.
4. Destruction of developing human life.
 
Adult Stem Cells 1. Special adult-type stem cells from bone marrow and from umbilical cord have been isolated recently which appear to be as flexible as the embryonic type.
2. Already somewhat specialized—inducement may be simpler.
3. Recipients will not experience rejection.
4. Relative ease of procurement- some adult stem cells are easy to harvest (skin, muscle, marrow, fat), while others may be more difficult to obtain (brain stem cells).
5. Non-tumorigenic.
6. No harm done to the donor.
 
1. Limited quantity—can sometimes be difficult to obtain in large numbers.
2. Finite—may not live as long as ES cells in culture.
3. Less flexible (with the exception of #1 above)—may be more difficult to reprogram to form other tissue types.
 

http://www.stemcellresearchfacts.com/pros_cons.html

 

Potential Treatments

http://www.stemcellresearch.org/facts/asc-refs.pdf ~ http://www.stemcellresearch.org/facts/treatments.htm

 

"Scientists have found ways of developing these stem cells into most types of human cells. Researchers are confident that they will lead to treatments to many diseases: bone loss, broken bones, brain damage due to oxygen starvation, severe burns, cancer (some forms), diabetes, Lou Gehrig's disease, heart disease, hepatitis, incomplete bladder control, Huntington's, leukemia, lupus, muscular dystrophy, multiple sclerosis, osteoarthritis, Parkinson's, spinal cord injuries, and stroke! The Coalition for the Advancement of Medical Research estimates that stem cell research will  develop cures and/or new treatments for 100 million Americans who currently suffer from a wide variety of diseases and disorders."

Robinson, B.A. "Human Stem Cells: What are Stem Cells?" Religious Tolerance, 2009. 5 February 2011. <http://www.religioustolerance.org/res_stem1.htm>.


Stem cells can be grown into any cell...

    

What are the unique properties of all stem cells?

"Stem cells differ from other kinds of cells in the body. All stem cells—regardless of their source—have three general properties: they are capable of dividing and renewing themselves for long periods; they are unspecialized; and they can give rise to specialized cell types.

One of the fundamental properties of a stem cell is that it does not have any tissue-specific structures that allow it to perform specialized functions. A stem cell cannot work with its neighbors to pump blood through the body (like a heart muscle cell); it cannot carry molecules of oxygen through the bloodstream (like a red blood cell); and it cannot fire electrochemical signals to other cells that allow the body to move or speak (like a nerve cell). However, unspecialized stem cells can give rise to specialized cells, including heart muscle cells, blood cells, or nerve cells.

Stem cells are capable of dividing and renewing themselves for long periods. Unlike muscle cells, blood cells, or nerve cells—which do not normally replicate themselves—stem cells may replicate many times. When cells replicate themselves many times over it is called proliferation. A starting population of stem cells that proliferates for many months in the laboratory can yield millions of cells. If the resulting cells continue to be unspecialized, like the parent stem cells, the cells are said to be capable of long-term self-renewal."

Amniotic Fluid Derived Stem Cells

The Shady Side of Embryonic Stem Cell Therapy

Can I Grow A New Brain?

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15 Different Stem Cell Treatments

A summary of cell-based therapies being tried now in people with spinal cord injury around the world...

 
1. Olfactory (nasal) Mucosa Autografts:  
•   In 2001, Australia reported that nasal mucosa transplantation to injured spinal cords stimulates regeneration in rats after spinal cord injury. Dr. Carlos Lima and his colleagues in Lisbon, Portugal, have transplanted nasal muce recovering some function. Unfortunately, to date, there has not been a publication of the results so that we do not know what proportion of the people recover function, to what extent, and for how long. It is also unclear to me how many people have received this procedure but it is probably over 3 dozen.

2. Adult Olfactory Ensheating Cell Autografts:
   Dr. Mckay-Sims and his colleagues in Brisbane, Australia, have managed to grow olfactory ensheathing glia from the nasal mucosa of two patients and transplanted these about 15 million of these cells into their spinal cords. The study is still in its "double-blind" phase and we do not know whether there has been recovery of function or not. In some ways, this is the most desirable of all the options both from a scientific and clinical point of view. The cells were grown from the nasal mucosa and have been identified in culture as olfactory ensheathing glia. Because the cells come from the same person, there should be less risk of immune rejection of the cells.

3. Fetal Olfactory Ensheathing Glial Transplants:
•   The cells are injected into the spinal cord above and below the injury site without cutting or removing part of the spinal cord.
•   The cells are obtained from aborted fetuses and therefore are not genetically matched to the person receiving it. Although there is some evidence suggesting that fetal tissues are not rejected as adult tissues, it is likely that these transplants will be rejected from the spinal cord at some point, perhaps 3-4 months after transplantation.
•   In Beijing, Dr. Hongyun Huang is transplanting fetal olfactory ensheathing glia into the spinal cord of people who are 1-32 years after injury. Over 500 people with spinal cord injury and perhaps another 200 people with other conditions (such as ALS and MS) have received these transplants. Reports of earlier results in the first 171 patients that received such transplants indicate an average of 4-8 dermatomes of sensory recovery and 1-2 motor levels of improvement. To my knowledge, there has been three mortalities in the series, all in people more than 3 months after surgery and from unrelated causes.
•   Animal studies suggest that olfactory ensheathing glia will migrate from the injection site into the injury site and surrounding cord, change the environment of the injury site, and promote regeneration of axons. Unfortunately, only about 10% of the patients who have been transplanted week hospitalization.

4. Bone Marrow Stem Cell Auto-Grafts (Adult):
•   Dr. Tarcisio Barros at the University of Sao Paulo in Brazil has transplanted bone marrow mesenchymal
stem cells into the spinal cord of about 30 patients with chronic spinal cord injury. Some evidence from animal studies indicate that bone marrow contain stem cells and that these cells can be persuaded to produce neurons in culture. The cells were apparently injected through the vascular system into the blood vessels of the spinal cord. Dr. Barros has reported some initial promising results in terms of somatosensory evoked potential improvement in the patients. It is not clear how much motor improvement the patients are getting. Because the cells are auto grafts, they are not likely to be rejected.
•   Dr. Zhang at the Henan People's Provincial Hospital in Zhengzhou, China said that he has transplanted bone marrow
stem cells to dozens of people with spinal cord injury. The results are not clear but they are looking for ways to improve the results. In January 2005, they have transplanted bone marrow stem cells into over 180 patients with strokes and spinal cord injury. They grow the cells, sort them for those that are CD-43 positive, and then transplant them into the spinal cord.
•   There is a group of surgeons in Nanjing (China) that have transplanted bone marrow
stem cells into 90 patients with amyotrophic lateral sclerosis (ALS). These cells were apparently directly transplanted into the brain and spinal cord.
•   There are also several reports of bone marrow
stem cell
transplants being used in Italy to treat patients with amyotrophic lateral sclerosis.

5. Fetal Olfactory Ensheathing Glia and Neural Stem Cell Transplants:
•   Dr. Samuiel Rabinovich and his colleagues in Novosibirsk have transplanted a mixture of olfactory ensheathing glia and neural stem cells into the spinal cord of patients with chronic injuries. These cells are apparently cultured from olfactory bulbs obtained from aborted fetuses. They report improvements in motor and sensory function in the patients. These results were published recently. It is not clear what cells were being injected.

6. Fetal Spinal Cord Transplants:
•   In the United States (Russia and Sweden as well), probably over 200 patients have received various fetal spinal cord transplants into the injury site. The results have been published in a few papers but most of the studies suggest modest recovery of function.

7. Adult Schwann Cell Auto-Grafts:
•   Timothy Volmer transplanted Schwann cells grown from peripheral nerves into two patients with multiple sclerosis. Dr. Volmer has moved to Barrows Neurological Institute in Phoenix, Arizona. A recent email suggested that he has finally re-organized his team and will be starting his clinical trials again. The trial at Yale University was funded by the Myelin Project.

8. Fetal Schwann Cell Transplants:
•   In Kunming, China, neurosurgeons there have transplanted fetal Schwann cells from aborted fetuses into about 90 patients with chronic spinal cord injury. They are reporting some improvement in function although there is some skepticism by visiting clinicians that these improvements are due to the transplants or to decompressive surgery.

9. Porcine Fetal Neural Stem Cell Transplants:
•   At the Washington University in St. Louis and Albany Medical Center, 10 patients have received transplants of neural stem cells obtained from fetal pig brains. This was in a clinical trial sponsored by Diacrin. The cells are apparently grown from pig brain, treated with antibodies to reduce the likelihood of immune rejection, and then transplanted into the spinal cord. The results of this trial have not yet been reported.

10. Human Fetal Neural Stem Cell Transplants:
•   I have met several doctors in China (Beijing and Guangzhou) who have grown human fetal neural stem cells from aborted fetuses and transplanted these into the spinal cords of people with acute or chronic spinal cord injury. Apparently, these patients have not gotten much recovery and most of these centers are no longer transplanting these cells.

11. Adult Activated Macrophage Auto-Grafts:
•   The company Proneuron carried out two phase 1 trials in Israel and in Europe in patients that are within 2-3 weeks after spinal cord injury. The cells were obtained from the blood of the patients, cultured and activated on skin, and then transplanted into the spinal cord exposed by laminectomy. This trial has started in the United States at three centers: Craig Hospital in Denver, Kessler Rehabilitation Institute in New Jersey, and Mt. Sinai Hospital in New York.

12. Adult Peripheral Nerve Auto-Grafts:
•   Dr. Carl Kao, a neurosurgeon who operates in Quito, Ecuador, has transplanted peripheral nerves of about 600 patients over the past 10-15 years. He also places omentum on the spinal cord which apparently is causing epidural cyst formations in some patients. The peripheral nerves should contain Schwann cells.
•   Dr. Henreich Cheng, a neurosurgeon in Taiwan, has used peripheral nerves to bridge transected spinal cords and treated with several growth factors including basic fibroblast growth factor. In 1995, he published a widely recognized paper with Lars Olson, reporting that axons will grow across the transection site and restore function. Since returning to Taiwan, he has apparently carried out this procedure in some patients. He has not yet published the results.


13. Activated Macrophage Autografts:
•   In 1998, Michal Schwartz reported that activated macrophages improves neurological recovery of rats after spinal cord injury.
•   An Israeli company called Proneuron initiated a phase 1 clinical trial to assess this treatment in patients within 3 weeks after injury. Melissa Holly was the first patient to undergo this therapy about 3 years ago. She showed substantial improvement. Perhaps a quarter of the patients who received the treatment showed improvement. A new phase 2 clinical trial is about ready to start.

14. Omentum Transplant:
•   The omentum is a part of the vascular tissue that surrounds the stomach and intestines. It's job is too carry blood to and food from the gut.
•   In the 1980's, Dr. Harry Goldsmith began transposing omentum to the spinal cord of animals. Dr. Goldsmith and colleagues transferred the omentum to many patients over the past two decades.
•   In addition, Dr. Carl Kao does omentum transplant.

15. Umbilical Cord Blood Transplants:
•   There was a news report from Korea of a woman who recovered motor function after having received an umbilical cord blood stem cell transplant. The cells came from an umbilical cord blood bank, matched with the recipient, and then cultured to select for certain cells. The results have not yet been published.
•   There are persistent news reports that Biomark International, a company that was shut down by the FDA and has now moved to London, has infused umbilical cord blood cells into hundreds of patients, some of whom may have spinal cord injury.
•   There are also reports that of umbilical cord blood cell transplants being done in Mexico.

Young, Wise. "A summary of cell-based therapies being tried now in people with spinal cord injury around the world ." CareCure Community. 16 July 2004. Web. 20 April 2007. http://sci.rutgers.edu/forum/showthread.php?t=19719.


 

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Stem cell treatment improves mobility after spinal cord injury: 5/11/2005

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