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Stem cells are biological building blocks..

Current status & Rationale

stem-cell therapy could fundamentally change medicine..

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Knowledge

Stem cells are biological building blocks, the starting point of human life. But without proper direction, they’re not very useful when it comes to treating disease. It is a cell which does not have a definite role yet. It can regenerate itself and is capable of self-renewing. This cell remains quiescent until activated. This kind of cell is found usually among different cells of an organ.

Deeper understanding of stem cell instruction could yield deeper understanding of the origins of specific diseases.

Only non-ESC have been used clinically so far. Bone marrow cells were first used successfully 4 decades ago, and cord blood stem cells in the past 10–15 years. These cells have been of benefit for blood disorders such as leukaemia, multiple myeloma and lymphoma; and disorders with defective genes such as severe combined immune deficiency.

Though stem-cell therapy could fundamentally change medicine, almost all treatments being developed were still in an experimental stage or under clinical trial, except for bone marrow derived Mesenchymal Stem Cells transplants.

Bone Marrow derived Mesenchymal Stem Cells

One of the most promising cellular sources is bone-marrow-derived mesenchymal stem cells (MSCs) also termed multipotent stromal cells. MSCs represent an autologous source and are abundant and non-tumorigenic. Additionally, MSCs possess the useful characteristics of homing and chemokine secretion.

The mechanisms by which transplanted MSCs influence diseases can be broadly classified as cellular replacement or paracrine secretion, with the latter subdivided into trophic factor secretion or immunomodulation by cytokines. Emerging research suggests that genetic manipulations before transplantation could enhance the therapeutic potential of MSCs. Such manipulation could turn the cells into a ‘Trojan horse’, to deliver specific proteins, or promote reprogramming of the MSCs into the neural lineage.

Bone Marrow derived Mesenchymal Stem Cells

One of the most promising cellular sources is bone-marrow-derived mesenchymal stem cells (MSCs) also termed multipotent stromal cells. MSCs represent an autologous source and are abundant and non-tumorigenic. Additionally, MSCs possess the useful characteristics of homing and chemokine secretion.

The mechanisms by which transplanted MSCs influence diseases can be broadly classified as cellular replacement or paracrine secretion, with the latter subdivided into trophic factor secretion or immunomodulation by cytokines. Emerging research suggests that genetic manipulations before transplantation could enhance the therapeutic potential of MSCs. Such manipulation could turn the cells into a ‘Trojan horse’, to deliver specific proteins, or promote reprogramming of the MSCs into the neural lineage.

Adipose tissue derived stem cells

Adipose tissue-derived stem cells (ADSC) are routinely isolated from the stromal vascular fraction (SVF) of homogenized adipose tissue. Similar to other types of mesenchymal stem cells (MSC), ADSC remain difficult to define due to the lack of definitive cellular markers. Still, many types of MSC, including ADSC, have been shown to reside in a perivascular location, and increasing evidence shows that both MSC and ADSC may in fact be vascular stem cells (VSC). Locally, these cells differentiate into smooth muscle and endothelial cells that are assembled into newly formed blood vessels during angiogenesis and neovasculogenesis.

Additionally, MSC or ADSC can also differentiate into tissue cells such as adipocytes in the adipose tissue. Systematically, MSC or ADSC are recruited to injury sites where they participate in the repair/regeneration of the injured tissue. Due to the vasculature’s dynamic capacity for growth and multipotential nature for diversification, VSC in tissue are individually at various stages and on different paths of differentiation. Therefore, when isolated and put in culture, these cells are expected to be heterogeneous in marker expression, renewal capacity, and differentiation potential. Although this heterogeneity of VSC does impose difficulties and cause confusions in basic science studies, its impact on the development of VSC as a therapeutic cell source has not been as apparent, as many preclinical and clinical trials have reported favorable outcomes. With this understanding, ADSC are generally defined as CD34+CD31- although loss of CD34 expression in culture is well documented. In adipose tissue, CD34 is localized to the intima and adventitia of blood vessels but not the media where cells expressing alpha-smooth muscle actin (SMA) exist.

By excluding the intima, which contains the CD34+CD31+ endothelial cells, and the media, which contains the CD34-CD31- smooth muscle cells, it leaves the adventitia as the only possible location for the CD34+ ADSC. In the capillary, CD34 and CD140b (a pericyte marker) are mutually exclusively expressed, thus suggesting that pericytes are not the CD34+ ADSC. Many other cellular markers for vascular cells, stem cells, and stem cell niche have also been investigated as possible ADSC markers. Particularly the best-known MSC marker STRO-1 has been found either expressed or not expressed in cultured ADSC. In the adipose tissue, STRO-1 appears to be expressed exclusively in the endothelium of certain but not all blood vessels, and thus not associated with the CD34+ ADSC. In conclusion, we believe that ADSC exist as CD34+CD31-CD104b-SMA- cells in the capillary and in the adventitia of larger vessels. In the capillary these cells coexist with pericytes and endothelial cells, both of which are possibly progenies of ADSC (or more precisely VSC). In the larger vessels, these ADSC or VSC exist as specialized fibroblasts (having stem cell properties) in the adventitia.

Blood Stem Cells

A small number of hematopoietic stem cells circulate in the bloodstream. These cells have the same properties as bone marrow stem cells and can be used as a substitute. The circulating blood stem cells can be obtained from drawn blood, a less-invasive procedure than collecting bone marrow cells. Because they are few in number, however, collecting enough of them can be difficult.

The mechanisms by which transplanted MSCs influence diseases can be broadly classified as cellular replacement or paracrine secretion, with the latter subdivided into trophic factor secretion or immunomodulation by cytokines. Emerging research suggests that genetic manipulations before transplantation could enhance the therapeutic potential of MSCs. Such manipulation could turn the cells into a ‘Trojan horse’, to deliver specific proteins, or promote reprogramming of the MSCs into the neural lineage.

Blood Stem Cells

A small number of hematopoietic stem cells circulate in the bloodstream. These cells have the same properties as bone marrow stem cells and can be used as a substitute. The circulating blood stem cells can be obtained from drawn blood, a less-invasive procedure than collecting bone marrow cells. Because they are few in number, however, collecting enough of them can be difficult.

The mechanisms by which transplanted MSCs influence diseases can be broadly classified as cellular replacement or paracrine secretion, with the latter subdivided into trophic factor secretion or immunomodulation by cytokines. Emerging research suggests that genetic manipulations before transplantation could enhance the therapeutic potential of MSCs. Such manipulation could turn the cells into a ‘Trojan horse’, to deliver specific proteins, or promote reprogramming of the MSCs into the neural lineage.

Umbilical Cord Blood Stem Cells

After a baby is born, the umbilical cord can be set aside and used as a source of stem cells. The umbilical cord blood is a rich source of stem cells that can be substituted for bone marrow stem cells.

Umbilical cord blood stem cells are rejected less often by the host tissue, possibly because they have not developed cell-surface molecules that can be recognized and attacked by the host’s immune system.

The mechanisms by which transplanted MSCs influence diseases can be broadly classified as cellular replacement or paracrine secretion, with the latter subdivided into trophic factor secretion or immunomodulation by cytokines. Emerging research suggests that genetic manipulations before transplantation could enhance the therapeutic potential of MSCs. Such manipulation could turn the cells into a ‘Trojan horse’, to deliver specific proteins, or promote reprogramming of the MSCs into the neural lineage.

Umbilical Cord tissue Stem Cells

Mesenchymal stem cells (MSCs) can be isolated from many tissues, such as bone marrow, adipose tissue, umbilical cord etc. However, umbilical cord tissue, especially the part known as “Wharton’s Jelly”, is also a source of mesenchymal stem cells. The umbilical cord is routinely discarded at parturition, thus the isolation of MSCs from this tissue raises no ethical controversy compared with the ethical concerns associated with embryonic stem cells. MSCs from this tissue have greater differentiation potential and faster rates of division compared to bone marrow-derived MSCs. The large volume of umbilical cord and ease of physical manipulation increases the yield of MSCs. Also, the capacity of MSCs cells to proliferate is known to decrease with the age of the donor. Due to the presence of placental barrier, umbilical cord MSCs have lower risk of bacterial and viral infections than those isolated from bone marrow, adipose tissue and peripheral blood.

The efficiency of processing and isolation of mesenchymal stem cells from umbilical cord tissue is 100% versus 63% from umbilical cord blood.

Umbilical Cord tissue Stem Cells

Mesenchymal stem cells (MSCs) can be isolated from many tissues, such as bone marrow, adipose tissue, umbilical cord etc. However, umbilical cord tissue, especially the part known as “Wharton’s Jelly”, is also a source of mesenchymal stem cells. The umbilical cord is routinely discarded at parturition, thus the isolation of MSCs from this tissue raises no ethical controversy compared with the ethical concerns associated with embryonic stem cells. MSCs from this tissue have greater differentiation potential and faster rates of division compared to bone marrow-derived MSCs. The large volume of umbilical cord and ease of physical manipulation increases the yield of MSCs. Also, the capacity of MSCs cells to proliferate is known to decrease with the age of the donor. Due to the presence of placental barrier, umbilical cord MSCs have lower risk of bacterial and viral infections than those isolated from bone marrow, adipose tissue and peripheral blood.

The efficiency of processing and isolation of mesenchymal stem cells from umbilical cord tissue is 100% versus 63% from umbilical cord blood.

Dental Pulp derived Stem Cells

Dental pulp stem cells (DPSCs) can be found within the ‘‘cell rich zone’’ of dental pulp. Their embryonic origin, from neural crests, explains their multipotency and thus may have neurogenic potential that relates to the generation of neurons and their connections, that is, axon guidance. The stem cells found in dental pulp are mesenchymal stem cells. Dental pulp stem cells are excellent for regenerative medicine and tissue engineering applications

Tissue from the dental pulp is a source of neurotrophic factors capable of promoting neuronal survival and neurite outgrowth in vitro and in vivo. Nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), glialderived neurotrophic factor (GDNF), and CXCL12, also known as stromal cell-derived factor-1 (SDF-1), are expressed by dental pulp cells. These factors have also been implicated in axon guidance of the trigeminal ganglion (TG), which subserves sensation to the face and motor control to the masseter muscles of the jaw.

Research & Development is still in progress on Dental Pulp derived Stem Cells.

The efficiency of processing and isolation of mesenchymal stem cells from umbilical cord tissue is 100% versus 63% from umbilical cord blood.

FAQ'S

Stem cell therapy is the use of adult stem cells to treat certain diseases. The stem cells are derived from the patient’s own body tissue (bone marrow, adipose tissue, dental pulp, olfactory tissue). They are progenitor cells that lead to creation of new cells and are thus called as generative cells as well.

Mesenchymal stem cells, VSELs, other progenitor cells along with growth factors rejuvenate as well regenerate the functionally/ anatomically dead cells.

We use any one of following ways:

1- Patients own Bone marrow derived MNC

2- Patients own Adipose tissue derived Stromal cells

3-Lab Grown – Cord tissue Derived cultured Mscs, these cells are Used when patient’s own cells are limited in number or in diseases where patient’s own cells cannot be use

Bone marrow is a specific tissue found inside bones. Its main purpose is to produce stem cells, which give rise to the various blood cell types, especially the white blood cells, the red blood cells and the platelets. Each stem cell can further form millions of stem cells. Most stem cells are found in the bone marrow of the chest, hips, skull, upper arms and legs. If the stem cells develop into fully functional cells, they are released into the blood. A smaller number of undifferentiated stem cells are also found in the bloodstream.

Technique 1: Bone Marrow is harvested from lliac crest; approx 120 to 240 ml is harvested at one time. Fresh stem cells are isolated along with natural growth factors cells in sterile operating room. The sample is further processed to recover huge number of otherwise lost VSELS. The Final volume is brought to a 2-20 ml depending on route of administration. Growth factors are added.

Technique 2: Adipose tissue. Using manual technique, 40 to 200 cc of fat is removed from abdomen. The fat is gently harvested to keep cells alive, using a medical procedure (not liposuction) blood and tumescent fluid layer is removed. Wash fat with saline and add human grade enzymes separating fat from stromal cells. Dissolve fat by massaging for 10min and allow standing for 20mins. The sample is then processed in Centrifuge 1000xg to get a pellet of stromal cells.

These cells are further bio-activated with laser to potentiate their effect. Approx 40-60 ml of the bone marrow is taken into the lab for expansion. The sample is cultured for mesenchymal stem cells in Serum free Media for maximum 3 passages.

Typically, three to five treatments are given. Treatments are given over a period of 6 months to one year.

Treatment is as per different protocols varying weekly /fortnightly/monthly, depending on the patient’s condition and the doctor’s recommendation for the particular individual.

In some cases patients have to stay in India for 1- 2 months, get 3- 5 shots on weekly/fortnightly basis.

Alternatively, patient visits India monthly or once in two months to take 3-5 shots

 

Between 3 to 8 hours, depending upon the condition of the individual patient.

There are not any known contraindications for other therapies during stem cell treatment. Typically, a doctor will review what other treatments and medication the patient is already taking.

Patients have not reported any side effects other than discomfort at the injection site and in some cases mild headaches.

Panel of our specialized doctors review the patient’s medical records.  It will then take 2 to 3 days to review the records and get back to the patient. Then the patient is scheduled for the next earliest available appointment. The process of scheduling takes 2 to 3 weeks, from the time of the initial contact to the date of the first treatment.

No. Bone marrow /adipose collection and stem cell implantation are outpatient procedures and are done as a day care.

According to several religious denominations, adult stem cells from Bone Marrow are not encumbered by any ethical or moral dilemmas. Those ethical issues, which apply to fetal and embryonic stem cells, do not apply to adult stem cells. The Catholic Church and other institutions have issued papers which actually encourage research and the use of adult stem cells in the treatment of human disease, as an ethically acceptable alternative to the use of fetal and embryonic stem cells.

Typically no. A doctor will review the patient’s condition and make recommendations if needed.

There may be specific nutritional supplements that may enhance the potential benefits of stem cell therapy. Such prescriptions will be made on an individual basis, depending on each patient’s particular evaluation.

Alcohol consumption and cigarette smoking can both be detrimental to new progenitor stem cells. It is highly advisable that people do not smoke or drink 2 weeks prior to and after treatment.

It is simple to obtain information and to get a medical evaluation. Feel free to contact us and be assured we will be completely honest with the possibilities of your success with our treatment.

This is a justified concern if a therapy involves embryonic stem cells. Because embryonic stem cells actually do divide at an extremely  fast rate, they have been shown to have cancer-causing potential in animals and humans. However, therapies with autologous bone marrow stem cell have no risk of developing cancer.

General tests for medical fitness include complete heamogram, serum creatinine, blood sugar, ECG and Xray chest for patients aged above 40 yrs.

Specific to disease for evaluation of disease, eligibility for treatment, prognosis and monitoring progress.

 

We have seen significant benefits varying between 40-60% depending on duration of the disease, age of the patient. Unfortunately, it’s impossible beforehand to give any prognosis and forecasts about the treatment outcomes with precise accuracy as in every case the patient’s dynamics is very individual and depends on number of factors.

Umbilical cord blood is an excellent source of hematopoietic/Mesenchymal stem cells. The success in cord blood transplantation has been demonstrated in more than 10,000 cases worldwide so far. These cases have been predominantly for hematopoietic \ mesenchymal transplantation in-patient suffering from various types of genetic disorders and in which no use of atutologous stem cells.

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The website contains no medical advice. All statements and opinions provided by the website are for educational and informational purposes. ||The treatment centres associated with Revita lifesciences provide surgical procedure only and are not involved in use or manufacture of any investigational drug ||Revita does not claim that any application or potential application, using autologous stem cells are approved by the FDA. We do not claim that these procedures work for any listed nor unlisted condition, intended or implied.||It’s important for potential patients to do their own research based on the options we present so that one can make an informed decision. Any decision to participate in experimental protocol is completely voluntary ||

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