Regenerative medicine on trial
Umbilical cord tissue is a rich source of mesenchymal stem cells (MSCs), which are being used to treat tissue injuries and degenerative diseases in FDA-approved clinical trials.
Ability to repair
Umbilical cord tissue, also known as Wharton’s Jelly, is rich in mesenchymal stem cells (MSCs). MSCs are a unique type of stem cell that differs from the hematopoietic stem cells (HSCs) found in bone marrow, mobilized peripheral blood and cord blood.
HSCs give rise to blood cells and have been used with success for more than 50 years to treat patients with leukemia, lymphoma, anemia, congenital gene deficiencies and many other disorders.
- MSCs give rise to structural tissues such as bone, cartilage and fat.
- MSCs are emerging as a promising therapeutic agent for tissue regeneration. They have unique qualities that make them suitable for tissue repair.
- MSCs can be expanded in the lab to generate millions of cells which may be used for different purposes at different times in a patient’s life.
- MSCs do not have to be HLA matched as closely with the recipient as do HSCs, so they can be more readily available for other family members.
Abundant in cord tissue
MSCs were initially isolated from bone marrow but are also found in adipose tissue, cord blood and placenta, and cord tissue. Although present in cord blood, the MSC count is very low and they can be difficult to isolate. On the other hand, cord tissue is an abundant source of MSCs. Differences in MSCs, depending on the source, have not been fully explored.
- Data exist which demonstrate stem cells, including MSCs, obtained from younger donors are more robust than those retrieved from older donors.¹
- These data suggest using stem cells isolated from newborn cord blood and tissue may represent a more vigorous stem cell source than those isolated from adult donors.
Most individuals will develop some form of organ dysfunction in their lifetime which will significantly impact their quality of life. Modern medicine focuses on treating the symptoms of organ failure since it has not been possible to regenerate healthy tissue in affected individuals. One exception is the rare possibility of an organ transplant, primarily from cadaveric donors, of which there are far too few. Regenerative medicine promises novel approaches to repair and/or restore normal healthy tissue which would represent a paradigm shift in the way disease is currently treated.
Facilitating tissue regeneration
Tissue regeneration is the desired outcome when organs have been damaged. One of the natural responses to tissue damage is stimulation of an inflammatory response which has some undesired effects.
- Activated immune cells that participate in the inflammatory response release chemicals that result in cell death and lead to the formation of scar tissue.
- The inflammatory process and scar tissue formation is counterproductive to tissue repair and regeneration.
MSCs have been shown in laboratory studies to significantly inhibit the inflammatory response and minimize scar formation. They appear to have protective effects that facilitate tissue repair and stimulate tissue-specific stem cells to generate new, healthy, functional cells and tissues.
Treating diseases with mesenchymal stem cells
MSC-mediated therapy has proven safe and effective in the treatment of various degenerative diseases and tissue injuries including:
- Graft-Versus-Host Disease
- Other immunological disorders
- Heart disease
- Osteogenesis Imperfecta
- Spinal cord injuries
Although the treatments are still experimental, early clinical trials have demonstrated conclusively that MSCs are safe when administered to patients. Evidence of beneficial effects has led to increased interest by treating physicians, resulting in an impressive number of FDA-approved clinical trials. Currently there are 268 clinical trials listed on the FDA web site, clinicaltrials.gov
, using MSC derived from any source. The following table summarizes 42 studies using MSC isolated from cord tissue (31) and cord blood (11).
¹ Aging alters tissue resident mesenchymal stem cell properties. Alt, EU, et. al. Stem Cell Res, 2012 Mar; 8(2): 215-25 SOURCES: ¹ Aging alters tissue resident mesenchymal stem cell properties. Alt, EU, et. al. Stem Cell Res, 2012 Mar; 8(2): 215-25