อัพเดตเมื่อ: ม.ค. 18
STEM CELLS TREATMENT FOR KIDNEY PROBLEMS
Remarkable progress has been made to advance stem cell therapy as a potential treatment for kidney diseases: various kinds of stem cells can rebuild renal function in preclinical trials of acute and chronic kidney injury. (1)
EXHAUSTED KIDNEY STEM CELLS, EXHAUSTED KIDNEY FUNCTION The influence of aging and of the underlying disease itself on donor stem cell ability is a significant constraint of autologous treatment but deserves discussion for donor stem cell transplantation for therapies. Donor cells are usually derived from healthy, young donors. Mesenchymal stem cells from older kidney failure patients can be used to culture and inject back to the patient, but their therapeutic effects will decrease with age and disease. The complex disease pathological is known to effects mesenchymal stem cells function such that mesenchymal stem cells from and stage kidney disease or diabetic patients are likely to be effective therapeutically compared to that of mesenchymal stem cells from healthy donors. Several studies examined resident mesenchymal stromal cells (MSC) from the kidney part of the degenerate kidney. These kidney origin cells are not likely to be utilized for self-renewal as the population is exhausted over the course of the progression of chronic kidney disease. Mesenchymal stem cells of nonrenal origin such as adipose tissue, bone marrow, cord, placenta, and blood are the most studied cells in acute kidney injury and chronic kidney disease. In acute kidney injury, either created by toxic substances such as chemotherapy, by severe systemic infection, or by shock state make kidney shortage of blood supply, mesenchymal stem cells have shown regenerative and protective effects. In chronic kidney disease, multiple evidence supports that mesenchymal stem cell treatment can decrease fibrosis and kidney dysfunction. mesenchymal stem cells limited chronic kidney disease progression and decrease glomerular pathology in kidney disease from diabetes. A meta-analysis in 2015 reported that the injection of mesenchymal stem cells was the most efficient cell type in slowing the progression and development of chronic kidney disease. Increasing kidney function and improved kidney tissue fibrosis pathologies were the most changes observed after mesenchymal stem cell treatment. After kidney cells, damage induced by chemotherapy mesenchymal stem cells can improve kidney cell function. In addition, to decrease of renal structural abnormalities and reduce protein in the urine, kidney inflammation can also be improved by mesenchymal stem cells.
STEM CELL TREATMENT FOR LUNG PROBLEMS
Many lung problems still incurable and progressive to have significant morbidity and mortality. For example, emphysema, chronic obstructive pulmonary disease, or less common problems but such as cystic fibrosis, pulmonary fibrosis, pulmonary hypertension. Even though symptomatic care for these problems has improved, lung transplantation remains the single option for many patients. Additionally, lung transplantation is often a difficult choice since a five-year mortality of approximately 50% and many problems related to the required lifelong immunosuppression. Scientists believes that the failure of respiratory system stem cell repairing function may be the cause of chronic lung diseases such as emphysema.
MESENCHYMAL STEM CELLS TRANSPLANT
“THE REPAIRING EFFECTS”
The repairing abilities of mesenchymal stem cells to the lung in chronic lung disease models were mainly created by multiple paracrine factors (the important substances which cell need for repair) produced by transplant mesenchymal stem cells. These factors can decrease inflammation, induce immune modulation, enhance the permeability of gas exchange cells, and improve tissue repair. Even the few regenerated lung cells from exogenous mesenchymal stem cells also have contributed to functional restoration by replacing the damaged structures. (4)
STEM CELLS TREATMENT FOR COPD,
THE PROTECTION AND REGENERATION
Chronic Obstructive Pulmonary Disease is currently the fourth leading cause of death worldwide. Approximately 20% of patients with Chronic Obstructive Pulmonary Disease have emphysema which means the destruction of alveolar walls creating enlargement of air spaces. Patients usually die from progressive respiratory failure and even the advances in the treatment there remain no cure. Several studies have evaluated the role of stem cells on regenerating of the lung in mouse emphysema models. These studies utilized the transplantation of stem cells into emphysematous mice and reported that there were reduced emphysematous structural changes. Another study systemically delivered stem cells immediately the following irradiation to destroyed mouse lung. These data showed that stem cells can protect against the progression of emphysema. The potential mechanism is seeming through paracrine effects (stem cells produce the important substance that cells need for rejuvenate) resulting in reduce alveolar cell death after injury.
STEM CELLS TREATMENT FOR ASTHMA
The study, published in the foundation of American societies for experimental biology, reported that the mesenchymal stem cells can effectively decrease inflammation, reversed signs of airway remodeling, and completely repair airway/lung fibrosis and airway hypersensitivity. These cells were special on their own as they were able to efficiently reverse the scarring tissue that creates lung dysfunction and difficulty in breathing. They concluded that this may provide a new stand-alone treatment or an additional treatment for groups of asthma patients. (3)
STEM CELL TREATMENT FOR LIVER PROBLEMS
The past 20 years have shown an explosion of clinical and research applications of stem cells, changing the field of regenerative medicine. Stem cell transplantation has already been used to treat patients with liver disease, cancer, and other types of chronic diseases. Actually, stem cell-based treatment is effective in various diseases and creates new insights into the therapy of liver disease. A number of clinical trials have shown the effectivity profiles of stem cell transplantation in patients with liver disease, including liver failure, liver cirrhosis, mechanisms, and efficacy of stem cell treatment.
THERAPEUTIC EFFECTS, OF STEM CELLS HOW DOES IT WORK? From their ability for multiple rounds of self-renewal and ability to change into many different types of cells, stem cells play an important role in numerous biological phenomena including anti-inflammation, immune modulation, anti-cell death, new blood vessel genesis, promotion of tissue repair, and production of growth factors. Mesenchymal stem cells are the most common stem cell source for fundamental and clinical research given the lack of ethical constraints related to their usage and availability
STEM CELL TREATMENT FOR LIVER REGENERATION Until now, there have been numerous clinical trials on stem cell treatment liver disease, showing its side effects and efficiency features. Moreover, there were 139 clinical studies, including 27 ongoing clinical studies, on the association between liver disease and stem cell transplantation. The prior trial indicated that mesenchymal stem cell transplantation can constitute an effective treatment for liver disease. In a multicenter, randomized, open-label, phase 2 trial, autologous mesenchymal stem, cells safely improved liver function and enhance the quantification of tissue adhesion following liver biopsy in participants with alcoholic cirrhosis. Another open-label, paired, controlled study from China shown that injection of umbilical cord-derived mesenchymal stem cells also increased liver function and decrease fluid accumulation in the abdomen from late state liver disease, in patients with chronic hepatitis B. Mesenchymal stem cells transplantation was also reported to increase liver function in chronic liver disease patients with autoimmune diseases. Moreover, studies related animal models of acute liver failure have reported strong proof pointing to the success of mesenchymal stem cells transplantation in enhancing liver function, stop liver cell death, and increase liver cells production in animal models of acute liver failure, suggesting that mesenchymal stem cells transplantation may be benefits to treat liver failure. In 2012, Shi and team experiment with a case-control study to measure the efficacy and safety of umbilical cord mesenchymal stem cell transplantation in chronic liver disease patients with acute-on-chronic liver failure; and found increased survival rates, together with decrease end-stage liver disease scores and improve liver function. Another study on mesenchymal stem cell transplantation for the treatment of acute on top chronic liver failure patients also receive the same results, in which the treatment improves the 24 weeks survival rate, increase liver function, and reduce the chance of severe infections. Furthermore, a recent systematic review and meta-analysis of mesenchymal stem cell transplantation in acute on top chronic liver disease patients, which reported that the treatment remarkable decrease mortality rates, without increasing the incidence of severe complications. There were also no differences in the chance of severe complications such as brain edema, liver-kidney syndrome, gastrointestinal bleeding between the standard medical treatment, and the mesenchymal stem cell treatment group.
STEM CELL TREATMENT FOR PREMATURE MENOPAUSE AND RESTORE FERTILITY
The data from a new trial name Rejuvenation of premature ovarian failure with stem cells (Rose) report that, in the two patient who has completed the treatment with stem cells transplantation to date, serum estrogen levels have increased as soon as 3 months after the injection, and the rejuvenate effect has lasted for at least one year. Their menopausal symptoms have been decreased, and six months after the injection of the mesenchymal stem cells. Ultrasound imaging of treated patients shows a significant size enhance in the treated ovaries compared to the untreated one. So far, the patients have well tolerated with treatment, no side effects. The ovaries produce hormones and eggs typically until menopause in the early fifties when they stop working. About 1 percent of women have primary ovary insufficiency, and some are as young as in their teenage. With primary ovary insufficiency (the condition that the ovary stop produces hormone without reasons), the ovaries stop working and the women start menopause. They lose the ability to ovulate and menstruate and they may be at enhanced risk for menopausal symptoms including night sweets, hot flushes, vaginal dryness, and mood swings, and for osteoporosis-related fracture, cardiovascular disease, and earlier cognitive function decline. (6)
STEM CELLS TREATMENT FOR MEN HEALTH
Novel clinical study results show that stem cells can restore sufficient erectile function to allow impotent men to have sexual intercourse. In recent years a number of groups have worked to develop stem cell treatment as a therapy for erectile dysfunction problems, Results reported at the European Association of Urology conference in London manifest that 8 out of 21 have successfully return sexual function without the use of other medicines, injections, or implants. None of the 21 men reported significant adverse effects over the study period, or in the following year. After isolating the stem cells, they were injected into the muscles of the penis. No overnight stay in the hospital required. Within 6 months of the treatment, 8 out of the 21 patients shown that they had regained sufficient erectile function to achieve the sexual activity. This improvement has been stayed for a year, indicating that this therapeutic method may have long-term potential. Using the generally-accepted questionnaire to estimate erectile function, the whole group of 21 patients shown that their score had improved from 6 before the stem cell transplantation surgery, to 12 after 6 months. (7)
STEM CELLS TREATMENT FOR ERECTILE DYSFUNCTION IN DIABETES PATIENT
Erectile dysfunction is common in diabetic patients from multifactorial such as neurological, vascular, and hormonal changes. The first reported clinical study of stem cell treatment in diabetic men with erectile dysfunction showed a reasonable increase in penile rigidity after intra-penile muscle injection of umbilical cord blood stem cells. While penile rigidity has stayed for more than 6 months. In other trial on the use of stem cells in men with erectile dysfunction following prostate surgery, showed that intra-penile injection of mesenchymal stem cells appeared to be safe and improved the erectile function for a period of 6 months.
Reference: 1.Julia Marcheque ,Benedetta Bussolati ,Marie Csete Laura Perin,” Concise Reviews: Stem Cells and Kidney Regeneration: An Update “Stem cells translational medicine Received May 24, 2018 2.Viranuj Sueblinvong, MD1 and Daniel J. Weiss, M.D., PhD” Stem Cells and Cell Therapy Approaches in Lung Biology and Diseases” Transl Res. 2010 September; 156(3): 188–205 3.Monash University” Unique stem cells as a potential asthma treatment “June 28, 2017 4.Zhongwei Sun, Feng Li, Xin Zhou, Kian Fan Chung,Wen Wang” Stem cell therapies for chronic obstructive pulmonary disease: current status of pre-clinical studies and clinical trials” J Thorac Dis. 2018 Feb; 10(2): 1084–1098. 5.Dong-Bo Wu, En-Qiang Chen, and Hong Tang “Stem cell transplantation for the treatment of end-stage liver disease” World J Hepatol. 2018 Dec 27; 10(12): 907–910. 6.EndrocrineSociety.org “Stem cell therapy may help reverse effects of premature menopause, restore fertility” Chicago, IL March 18, 2018 7.European Association of Urology – press release” Stem cells shown to restore erection capability in men with erectile dysfunction “