This article was written by YANG, Fujian Medical University
Review expert of this article: Professor Li Jing from the Affiliated Hospital of Jiangsu University
introduction
"Perinatal tissues such as the placenta and umbilical cord are rich sources of human stem cells, growth factors, extracellular matrix proteins, and have potential uses in a wide range of therapeutic applications and health improvements. This was recognized in a paper published in the journal Acta Biomaterialia, which also states: "Placental stem cells and their derivatives have unique biological properties, including pro-angiogenesis, anti-inflammatory, antifibrotic, antimicrobial, and immunomodulatory. "Today we take a closer look at why placenta/umbilical cord mesenchymal stem cells have great promise in improving health and treating diseases.
Placenta is usually discarded as medical waste after birth. However, with the development of cell technology, more clinical consensus has been formed: the "0-year-old" stem cells in the placental umbilical cord are easy to obtain, can be expanded in large quantities, are widely used, are suitable for a wide range of people, bring surprise changes to the treatment of a variety of diseases, and are ethical.
At present, a review published in the journal Acta Biomaterialia [1] shows that perinatal tissues, as a source of biomaterials and stem cells, have broad application prospects in the field of tissue engineering and regenerative medicine, and are expected to overcome the shortage of biological scaffolds and cell sources in clinical practice.
Placental and umbilical cord-derived stem cells:
Anti-inflammatory, anti-fibrotic, antibacterial and immune-modulating
Perinatal tissue, as the name suggests, refers to the placenta and fetal appendages (amniotic membranes, chorion, umbilical cord, etc.) and the abundant cell types contained therein. In recent years, perinatal tissues have gradually become a major research focus, among which various stem cell types such as hematopoietic stem cells and mesenchymal stem cells are representative. Hematopoietic stem cells are well known for the treatment of blood diseases, and in recent years, other non-hematopoietic stem cells in perinatal tissues, especially mesenchymal stem cells, have attracted increasing attention and are considered to have great therapeutic potential.
Image from Ref. [1]
Studies [1-2] have demonstrated that perinatal tissue-derived mesenchymal stem cells (MSCs) for regenerative medicine and tissue engineering have the following advantages:
1. Large amount and easy collection: In the past, MSCs were derived from bone marrow, adipose and other tissues, and the collection process was painful and may bring invasive harm to the donor, while perinatal tissue, as a kind of medical waste that is routinely discarded after delivery, can be easily obtained with non-invasive strategies without ethical issues.
2. Powerful immunomodulatory properties: Perinatal tissue-derived MSCs do not express human leukocyte antigen class II (HLA-DR) or co-stimulatory molecules required for T cell activation, are not immunogenic, are immunotolerant, and in addition, they have potent immunomodulatory properties.
3. Has a strong immunosuppressive ability and expresses adhesion molecules, which are important for homing of damaged tissues.
4. It has other unique biological properties, including pro-angiogenesis, anti-inflammatory, anti-fibrotic, antibacterial, etc.
Image from Ref. [1]
Placental and umbilical cord stem cells:
An important weapon for improving health
Based on their special biological properties, placental and umbilical cord-derived mesenchymal stem cells are considered to have promising prospects in improving health and disease treatment, including the regeneration of tissues such as the nervous system, heart disease, diabetes, liver, and the control of immune and inflammatory responses.
01. Infusion of umbilical cord/placental mesenchymal stem cells to improve nerve damage
The damage of neurological diseases is often permanent, and stem cells have the ability to self-renew and differentiate into other cell types, and the use of stem cell therapy for the treatment of neurological diseases is currently a research hotspot. Among them, cerebral palsy is one of the most disabling neurological diseases. A clinical trial on intrathecal injection of umbilical cord mesenchymal stem cells for cerebral palsy has shown [3] that umbilical cord mesenchymal stem cell injection is safe and even has the potential to improve clinical and imaging outcomes of cerebral palsy, which provides a new idea for the treatment of cerebral palsy.
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This study divided 72 participants (4-14 years old) with spastic cerebral palsy equally into an experimental and control group. The experimental group received umbilical cord mesenchymal stem cell therapy, and the control group received sham surgery. Subjects were evaluated at follow-up at 1, 3, 6, and 12 months postoperatively, respectively. The results showed a significant increase in mean GMFM-66 scores, a significant decrease in MAS scores, and an increase in total PEDI scores, as well as significant improvements in areas such as friends and family, activity participation, and communication after 12 months of stem cell therapy. In addition, the experimental group significantly improved the patients' motor function after 6 months of stem cell injection compared to the control group, and this improvement continued until the end of follow-up.
Image from Ref. [3]
02. Umbilical cord mesenchymal stem cells are infused back to accelerate lung tissue regeneration
Various respiratory diseases seriously affect people's health and quality of life. Among them, the one that has impressed everyone recently is the new coronavirus. Previous studies have shown that the application of MSCs can inhibit the inflammatory response of the lungs and accelerate the regeneration of lung tissue. Results from a phase 1/2a clinical trial [4] showed that intravenous administration of umbilical cord mesenchymal stem cells (UC-MSCs) was associated with a significant improvement in survival, significantly improving patient survival and recovery time. UC-MSC treatment was associated with a significant decline in a series of inflammatory cytokines in the "cytokine storm" of COVID-19.
Image from Ref. [4]
03. Infusion of umbilical cord/placental mesenchymal stem cells to improve digestive diseases
As a non-specific inflammatory digestive disease, the cause of Crohn's disease is still unknown, and the treatment is difficult. Therefore, researchers are trying to use the powerful anti-inflammatory properties of MSCs to provide new ideas for the treatment of this disease. In a clinical study [5], 6-12 patients with moderate Crohn's disease were enrolled with placental mesenchymal stem cells at a dose of 1×10*6 cells/kg intravenously in the low-dose group and 4×10*6 cells/kg in the high-dose group on days 0 and 7. The results showed that no adverse events occurred during the trial period, and the related symptoms and indicators were improved, demonstrating the safety and efficacy of human placental mesenchymal stem cells in the treatment of Crohn's disease.
04. Infusion of umbilical cord/placental stem cells to improve aging
In 2016, the world's first placental stem cell treatment for Progeria made a breakthrough. After receiving placental mesenchymal stem cell therapy at Peking University Third Hospital, a 14-year-old girl with Progeria showed a significant improvement in her mental state, her rapidly aging body was relieved, her skin became smoother than before, and her hearing and liver function showed signs of improvement.
In addition to the direct use of mesenchymal stem cells from the placenta and umbilical cord, the use of exosomes derived from placenta and umbilical cord mesenchymal stem cells has become a new trend in the development of skin care products. In an investigative pilot study [7], the investigators found that after topical application of 5.0 ml of placental stem cell exosomes to the patient's face, the skin tone, saturation and clarity were improved to varying degrees, as well as the reduction of fine lines, pores, pigmentation, oil, etc., and the skin texture and vascularization were also improved.
brief summary
So far, researchers have demonstrated that placental and umbilical cord-derived cells and their secreted actives are able to improve healing and promote regeneration, mainly because of their anti-inflammatory, anti-fibrotic, immunomodulatory, and antimicrobial properties. Perinatal tissues such as the placenta and umbilical cord are rich reservoirs of stem cells and their derivatives, and in recent years, stem cells extracted from perinatal tissues such as the placenta and umbilical cord have been widely used in the biomedical field and have attracted widespread attention. The future use of cells in human perinatal tissues may usher in a new era.
Bibliography:
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[2] Torre P, Flores AI. Current Status and Future Prospects of Perinatal Stem Cells. Genes (Basel). 2020; 12(1):6. Published 2020 Dec 23. doi:10.3390/genes12010006
https://pubmed.ncbi.nlm.nih.gov/33374593/
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