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New Treatment For Blood Diseases Using Artificial Bone Marrow

By Stem Cell Treatment

January 12, 2014

Image Caption: Scanning electron microscopy of stem cells (yellow / green) in a scaffold structure (blue) serving as a basis for the artificial bone marrow. Credit: C. Lee-Thedieck/KIT

Rebekah Eliason for redOrbit.com Your Universe Online

An exciting breakthrough is offering hope for the treatment of blood diseases such as leukemia using artificial bone marrow.

Specialized cells, known as hematopoietic stem cells, located within bone marrow, continuously replace and supply new blood cells such as red blood cells and white blood cells. Traditionally a blood disease like leukemia is treated with bone marrow transplants that supply the patient with new hematopoietic stem cells. Researchers have now discovered a way to artificially reproduce hematopoietic stem cells.

Since not every leukemia patient can find a suitable transplant, there is a need for other forms of treatment. The lack of appropriate transplants could be solved by artificial reproduction of hematopoietic stem cells. Previously, reproduction of the cells has been impossible due to their inability to survive anywhere but in their natural environment. Hematopoietic stem cells are found in a special niche of the bone marrow. If the cells reside out of the bone marrow, the specialized properties are modified. Consequently, to effectively reproduce the cells, the stem cell niche environment must also be created.

In the microscopic environment of the stem cell niche, there are several specific properties of importance. Areas in the bone that house the stem cells are extremely porous like a sponge. Making things even more complex, the spongy tissue is also home to other cell types which exchange signal substances with the stem cells. Also, the space among the cells creates an environment ensuring stability along with a place for the cells to anchor. Furthermore, the stem cell niche supplies the cells with nutrients and oxygen.

Dr. Cornelia Lee-Thedieck is head of the Young Investigators Group Stem Cell-Material Interactions, which consists of scientitsts from the KIT Institute of Functional Interfaces (IFG), the Max Planck Institute for Intelligent Systems, Stuttgart and Tbingen University. The team was successful at artificially reproducing major properties of bone marrow at the laboratory.

Using synthetic polymers, the researchers were able to create a porous structure that simulated the spongy environment of the blood-forming bone marrow. Also, they were able to add protein building blocks which are similar to those found naturally in the environment of the bone marrow that enable cells to anchor. Finally, they added the other types of cells needed for exchanging signaling substances.

After the artificial bone marrow was created, the scientists placed hematopoietic stem cells that had been isolated from cord blood into it. For several days the cells were bred. Various analytical methods were then used to determine that cells were able to reproduce in the artificial bone marrow. When compared with standard cell cultivation methods, a larger number of stem cells in the artificial bone marrow retained their specific properties.

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New Treatment For Blood Diseases Using Artificial Bone Marrow

Start of stem-cell study offers hope to patients with spinal-cord injuries

By Stem Cell Doctors

CTVNews.ca Staff Published Friday, January 10, 2014 4:33PM EST Last Updated Friday, January 10, 2014 11:42PM EST

A team of doctors at the University of Calgary has, for the first time in North America, successfully performed a stem cell transplant in a spinal cord injury patient, a procedure that could offer a glimmer of hope to patients whose injuries have long been considered untreatable.

The doctors injected the neural stem cells into the spine of a 29-year-old paraplegic, who will now be monitored to determine whether implanting those cells is safe.

Later studies will look at whether it is possible to regenerate new tissue and repair the mans injury.

That is the goal, a cure, the University of Calgarys Dr. Steven Casha, who performed the procedure on Wednesday, told CTV News.

Stem cells have the potential to recreate lost tissue, he added, although that remains to be proven in humans with spinal cord injuries. The answer, he said, is a long way away.

The transplant is part of an ongoing clinical trial being conducted by StemCells Inc., which harvested the stem cells from the nervous system of a fetus. The company holds a patent on the cells.

Data from three patients in Europe who have already undergone a transplant suggests the procedure is safe.

We have not been seeing significant complications or adverse eventsand there have been a couple of patients who havemade very small gains in functionthat appear to be hopeful and that is very interesting, Dr. Michael Fehlings, head of the spinal program at Toronto Western Hospital and the lead investigator for the trial at the University of Toronto, told CTV.

Fehlings cautioned that the results are very preliminary.

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Start of stem-cell study offers hope to patients with spinal-cord injuries

Artificial Bone Marrow Created By German Scientists, Could Be Used To Treat Leukemia Someday

By Stem Cell Doctors

Bone marrow nurtures both red blood cells and white blood cells, with healthy people producing more than 500 billion red- and-white blood cells every day. But when bone marrow is damaged by a disease like leukemia, or by radiation or chemotherapy drugs, the supply of blood cells drops, leaving a person at risk for fatal infections.

Leukemia and other types of bone-marrow diseases are often treated by transplanting healthy hematopoietic stem cells, which can develop into various kinds of blood cells, from another person. The donor cells can be taken from another persons bone marrow or bloodstream, or from preserved umbilical cords and placentas. But finding a matching donor can be difficult, and the amount of stem cells harvested from the donor may not always be enough to meet the needs of the patient.

One thing that doctors want to be able to do is to find a way to cultivate a bumper crop of stem cells. But blood stem cells thrive in a very specific environment inside bone marrow. And bone marrow has a very complex architecture, like a tiny sponge that contains many sizes of pores, and special docking proteins for stem cells.

"We assume that stem cells [do] not only notice the chemical composition of their surroundings., Karlsruhe Institute of Technology researcher and co-author of the study Cornelia Lee-Thedieck told German broadcaster Deutsche Welle. They can probably also feel if their environment is soft or hard, rough or smooth.

Lee-Thedieck and colleagues used a simple, porous polymer to mimic a sponge-like structure for the base of their artificial bone marrow. They added proteins similar to ones found in bone marrow to act as docking points for the blood stem cells, and added other cells to help ferry necessary molecular messages and materials back and forth.

When hematopoietic stem cells from cord blood were introduced to the artificial environment, they thrived much better than in standard 2-dimensional cell-culture systems. But the authors guess that it will be at least another 15 years before most patients will be able to benefit from this invention.

"Producing artificial bone marrow for culturing and multiplying blood stem cells is a potentially interesting application," Martin Bornhuser, a researcher from the University Hospital Dresden unaffiliated with the current paper, told DW. "It would make it possible to generate a sufficient number of stem cells from a small amount to transplant into an adult patient.

SOURCE: Raic et al. Biomimetic macroporous PEG hydrogels as 3D scaffolds for the multiplication of human hematopoietic stem and progenitor cells. Biomaterials 35: 929-940, January 2014.

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Artificial Bone Marrow Created By German Scientists, Could Be Used To Treat Leukemia Someday

Medical Board Suspends Oregon Doctor For Stem Cell Treatments …

By Stem Cell Medicine

Oregon Medical Board has issued a rare emergency suspension of a Eugene physicians license after the doctor conducted experimental stem cell treatments on patients.

The board considers Dr. Kenneth Welkers medical practice an immediate danger to the public.

Welker can appeal the suspension, issued Thursday. He did not return calls from The Associated Press on Friday, nor did the clinic at which hes employed, Oregon Optimal Health.

According to his online biography, Welker is a trained surgeon who quit his practice to pursue alternative medicine in 2007.

In May 2013, the boards suspension order says Welker injected processed stem cells into the spine of a 62-year-old woman, and was confused when she began to sweat and feel tingling in her extremities.

Stem cells, unlike other cells in the body, have two distinct characteristics. They can renew themselves through cell division, and they are not specialized in the way that muscle cells or brain cells are. Under certain conditions, they can be induced to transform into organ- or tissue-specific cells.

In 1998, researchers discovered how to derive stem cells from human embryos, and in 2006, they determined how to induce some specialized adult cells to take on the genetic characteristics of stem cells. These are called induced pluripotent stem cells, or iPSC.

iPSC have long been used to treat cancers such as leukemia and lymphoma its what doctors are using when they do bone marrow transplants. The cells are being studied for everything from heart disease to diabetes, but its too soon to know if these approaches are safe or effective.

Advocates of alternative medicine have heaped praise on the possibility of using iPSC to treat a variety of maladies. Texas Gov. Rick Perry, for instance, had stem cells taken from fat in his own body, grown in a lab and then injected into his back and his bloodstream during a 2011 operation to fuse part of his spine.

But scientists have questioned the safety and wisdom of Perrys treatment, especially because it was not part of a clinical trial in which unproven therapies are tested in a way that helps protect patients and advances medical knowledge.

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Medical Board Suspends Oregon Doctor For Stem Cell Treatments ...

Stem cell replacement for frequent age-related blindness

By Stem Cell Treatment

Jan. 10, 2014 Age-related macular degeneration (AMD) is the most frequent cause of blindness. Scientists at the Department of Ophthalmology at the Bonn University Hospital and from the Neural Stem Cell Institute in New York (USA) have developed a method for using stem cells to replace cells in the eye destroyed by AMD. The implants survived in rabbit eyes for several weeks. Additional research is needed for clinical application. The results are now presented in the journal "Stem Cell Reports."

About four and a half million people in Germany suffer from age-related macular degeneration (AMD). It is associated with a gradual loss of visual acuity and the ability to read or drive a car can be lost. The center of the field of vision is blurry, as if covered by a veil. This is caused by damage to a cell layer under the retina, known as the retinal pigment epithelium (RPE). It coordinates the metabolism and function of the sensory cells in the eye. Inflammatory processes in this layer are associated with AMD and "metabolic waste" is less efficiently recycled. To date, there is no cure for AMD; treatments can only relieve the symptoms.

Scientists from the Bonn University Department of Ophthalmology, together with researchers in New York (USA), have now tested a new method in rabbits by which the damaged RPE cells in AMD may be replaced. The researchers implanted different RPEs which were obtained, among others, from stem cells from adult human donors. "These cells have now been used for the first time in research for transplantation purposes," says lead author Dr. Boris V. Stanzel from the Department of Ophthalmology at the University of Bonn. The discovery and characterization of the adult RPE stem cells was performed in the group of Prof. Sally Temple and Dr. Jeffrey Stern from the Neural Stem Cell Institute (NSCI) in New York, USA. Dr. Timothy Blenkinsop at NSCI pioneered methods to grow them to closely resemble true RPE.

Researchers in Bonn developed the implantation techniques

The implantation techniques for the new method were developed by researchers working with Dr. Stanzel from the Department of Ophthalmology at the University of Bonn. They allowed the stem cell derived RPE to grow on small polyester discs, thus yielding a thin cell layer. The researchers implanted this human RPE monolayer in rabbits under the retina. "Our research group developed special instruments to implant the replacement cells can under the retina," reports Dr. Stanzel. After four days, the researchers used tomographic methods to check whether the replacement cells had integrated into the surrounding cell layers. "The implanted cells were alive," reports the researcher at the Department of Ophthalmology at the University of Bonn. "That is a clear indication that they have joined with the surrounding cells." After one week, the implanted cell layer was still stable. Even after four weeks, tissue examinations showed that the transplant was intact.

A new approach for possible treatment of AMD

"The results from the experiments prove that retinal pigment epithelial cells obtained from adult stem cells have the potential to replace cells destroyed by age-related macular degeneration," summarizes Dr. Stanzel. Moreover, using the newly developed basic method, it will be possible in the future to test which stem cell lines are suitable for transplantation in the eye. "However, clinical application is still far away," says Dr. Stanzel. More research is needed.

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Stem cell replacement for frequent age-related blindness

Study: potentially life-saving blood stem cells regenerate in artificial bone marrow

By Stem Cell Treatment

A team of biochemists has engineered artificial bone marrow capable of hosting hematopoietic stem cells -- the potentially life-saving cells used in the treatment of leukemia -- for regeneration.

The work was carried out at the KIT Institute of Functional Interfaces (IFG), the Max Planck Institute for Intelligent Systems, Stuttgart and Tbingen University in Germany, where Cornelia Lee-Thedieck led a team in building a scaffold for stem cell regeneration.

Hematopoietic stem cells, which are derived from both blood and bone marrow, are known for their extraordinary regenerative properties -- they can differentiate into a whole series of specialised cells in the body and travel into the blood from the bone marrow. This makes it an excellent treatment for cancers of the blood, including leukemia and lymphoma where underdeveloped white blood cells multiply out of control. In these cases the patient's own supply of hematopoietic cells is destroyed and they are replenished via a bone marrow transplant from a matched donor. These are not in plentiful supply, so for years artificial bone marrow has been in development to help fill the need -- existing hematopoietic stem cells only replenish and thrive within the complex, porous structure of bone marrow and do not survive without it. If researchers could develop a suitable host, they could continually transplant cells onto that host to regenerate cells and meet demand.

"Multiplication of hematopoietic stem cells in vitro with current standard methods is limited and mostly insufficient for clinical applications of these cells," write the team in the journal Biomaterials. "They quickly lose their multipotency in culture because of the fast onset of differentiation. In contrast, HSCs efficiently self-renew in their natural microenvironment (their niche) in the bone marrow."

The team believes it has now created a potentially game-changing host that mimics that niche. They used synthetic polymers to build macroporous hydrogel scaffolds that mimic the spongy texture of bone marrow. Protein building blocks were then introduced, which would encourage introduced stem cells to stick to the scaffold. They had to introduce a number of other cells which importantly also thrive within bone marrow to exchange nutrients and oxygen.

To test the scaffold, stem cells from bone marrow and umbilical cord blood were introduced. It took a few days, but those from the cord blood began to multiply.

The authors concluded: "Co-culture in the pores of the three-dimensional hydrogel scaffold showed that the positive effect of MSCs on preservation of HSPC stemness was more pronounced in 3D than in standard 2D cell culture systems."

This is not the first time that artificial bone marrow has been attempted, however. Back in 2008 a team from the University of Michigan maintained that it had created a replica that could make red and white blood cells, and within which blood stem cells could replicate and produce B cells (important immune cells). In this instance, scaffolds were made from a transparent polymer using tiny spheres that were then dissolved to create pores the nutrients could pass through. It's unclear for how long the stem cells thrived, and Wired.co.uk has contacted the team to try and find out how the research has progressed and if the engineered bone marrow has continued to be effective.

If the research is successful going forward, it could mean the beginning of "blood farming", where artificial bone marrow is used to produce red and white blood cells and platelets to be banked for transfusions.

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Study: potentially life-saving blood stem cells regenerate in artificial bone marrow

A shift in stem cell research

By Stem Cell Treatment

Jan. 10, 2014

A team of engineers at the University of Wisconsin-Madison has created a process to improve the creation of synthetic neural stem cells for use in central nervous system research.

The process, outlined in a paper published in Stem Cells last month, will improve the state of the art in the creation of synthetic neural stem cells for use in central nervous system research.

Randolph Ashton

Human pluripotent stem cells have been used to reproduce nervous-system cells for use in the study and treatment of spinal cord injuries and of diseases such as Parkinson's and Huntington's.

Currently, most stem cells used in research have been cultured on mouse embryonic fibroblasts (MEFs), which require a high level of expertise to prepare. The expertise required has made scalability a problem, as there can be slight differences in the cells used from laboratory to laboratory, and the cells maintained on MEFs are also undesirable for clinical applications.

Removing the high level of required skill and thereby increasing the translatability of stem cell technology is one of the main reasons why Randolph Ashton, a UW-Madison assistant professor of biomedical engineering and co-author of the paper, wanted to create a new protocol.

Rather than culturing stem cells on MEFs, the new process uses two simple chemical cocktails to accomplish the same task. The first mixture, developed by John D. MacArthur Professor of Medicine James Thomson in the Morgridge Institute for Research, is used to maintain the stem cells in the absence of MEFs. The second cocktail allows researchers to push the stem cells toward a neural fate with very high efficiency.

These chemical mixtures help to ensure the consistency of the entire process and give researchers a better understanding of what is driving the differentiation of the cells. "Once you remove some of the confounding factors, you have better control and more freedom and flexibility in terms of pushing the neural stem cells into what you want them to become," says Ashton.

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A shift in stem cell research

Stem Cells In Use – Learn Genetics

By Stem Cell Doctors

In 1968, doctors performed the first successful bone marrow transplant. Bone marrow contains somatic stem cells that can produce all of the different cell types that make up our blood. It is transplanted routinely to treat a variety of blood and bone marrow diseases, blood cancers, and immune disorders. More recently, stem cells from the blood stream (called peripheral blood stem cells) and umbilical cord stem cells have been used to treat some of the same blood-based diseases.

Leukemia is a cancer of white blood cells, or leukocytes. Like other blood cells, leukocytes develop from somatic stem cells. Mature leukocytes are released into the bloodstream, where they work to fight off infections in our bodies.

Leukemia results when leukocytes begin to grow and function abnormally, becoming cancerous. These abnormal cells cannot fight off infection, and they interfere with the functions of other organs.

Successful treatment for leukemia depends on getting rid of all the abnormal leukocytes in the patient, allowing healthy ones to grow in their place. One way to do this is through chemotherapy, which uses potent drugs to target and kill the abnormal cells. When chemotherapy alone can't eliminate them all, physicians sometimes turn to bone marrow transplants.

In a bone marrow transplant, the patient's bone marrow stem cells are replaced with those from a healthy, matching donor. To do this, all of the patient's existing bone marrow and abnormal leukocytes are first killed using a combination of chemotherapy and radiation. Next, a sample of donor bone marrow containing healthy stem cells is introduced into the patient's bloodstream.

If the transplant is successful, the stem cells will migrate into the patient's bone marrow and begin producing new, healthy leukocytes to replace the abnormal cells.

New evidence suggests that bone marrow stem cells may be able to differentiate into cell types that make up tissues outside of the blood, such as liver and muscle. Scientists are exploring new uses for these stem cells that go beyond diseases of the blood.

While most blood stem cells reside in the bone marrow, a small number are present in the bloodstream. These peripheral blood stem cells, or PBSCs, can be used just like bone marrow stem cells to treat leukemia, other cancers and various blood disorders.

Since they can be obtained from drawn blood, PBSCs are easier to collect than bone marrow stem cells, which must be extracted from within bones. This makes PBSCs a less invasive treatment option than bone marrow stem cells. PBSCs are sparse in the bloodstream, however, so collecting enough to perform a transplant can pose a challenge.

Newborn infants no longer need their umbilical cords, so they have traditionally been discarded as a by-product of the birth process. In recent years, however, the stem-cellrich blood found in the umbilical cord has proven useful in treating the same types of health problems as those treated using bone marrow stem cells and PBSCs.

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Stem Cells In Use - Learn Genetics

B.C. Women’s Hospital’s umbilical cord blood bank offers gift of life

By Stem Cell Doctors

North Vancouver resident Hector Walker owes his life to stem cells derived from the umbilical cord blood of a pair of wee strangers.

Walker, who is 62 and had leukemia, had no clue where his doctors at Vancouver General Hospital found the donor stem cells for his 2010 transplant. But hes grateful they did and thrilled that finding a match may become less cumbersome now that B.C. Womens Hospital will soon start asking expectant mothers to donate their newborn babies cord blood, a rich and versatile source of potentially healing stem cells.

At a news conference today, the biggest maternity hospital in the province will be named as a collection site for the new National Public Cord Blood Bank. It is the second hospital in the country to get that distinction (after Ottawa) and will serve as one of only four collection sites across the country.

Finding a bone marrow match was more of a problem for me because Im black. Even my brother wasnt a match, said Walker. Life is so unpredictable. People should understand they can save someones life by doing this.

The hospital was designated a collection site because so many babies are delivered there (7,000 annually) and the patient population is ethnically diverse.

Once a pilot phase of up to half a year is over, healthy, pregnant women giving birth at B.C. Womens will be able to donate the blood from the umbilical cords of their babies. Until now, most umbilical cords have been discarded, which is why Dr. Tanya Petraszko, a Canadian Blood Services (CBS) official, says: Our competition is the garbage can.

Canada has access to international sources but a public bank here should mean that Canadian doctors wont as often have to search the world for life-saving stem cells, especially for difficult-to-match, ethnically diverse patients like Walker (originally from Jamaica).

Because most registered blood and bone marrow donors are Caucasian, finding matches for minority groups is most challenging. In recent years, CBS has been trying to reach out to First Nations, Asian and other ethnic communities in a bid to boost that supply.

Only half of patients who need an unrelated stem cell transplant are able to find one and there are about 1,000 patients across Canada waiting for stem cell transplants. A stem cell transplant requires a DNA match between the donor and recipient, but cord blood cells are more adaptable so theres less chance of a rejection.

Canada is the last G8 country to establish a national bank. It was announced by federal and provincial governments nearly three years ago, after years of deliberations. Nearly $50 million was earmarked in start-up funds but CBS committed to forming a development group to raise another $12.5 million from philanthropic Canadians. (There is still $4 million left to raise).

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B.C. Women's Hospital's umbilical cord blood bank offers gift of life

Stem Cell Treatment for Arthritis

By Stem Cell Medicine

Stem Cell Treatment for Arthritis

Mesenchymal stem cells have been shown in recent studies to have significant effects on a variety of conditions including both rheumatoid arthritis and osteoarthritis. As the mechanisms behind these two forms of arthritic degeneration differ, the potential stem cell treatment for arthritis is likely to be administered differently and make use of a variety of properties of stem cells, such as their regenerative abilities, and the capacity for some stem cell types to help regulate immune function. Patients undergoing stem cell treatments for unrelated conditions have reported significant relief from their arthritis after such therapy even though this was not the reason for them obtaining treatment initially; these stories are anecdotal however, and do not constitute evidence for applying treatment more widely. Intravenous stem cell therapy using haematopoietic stem cells has been used extensively in veterinary medicine for a number of years. Often, stem cell treatment for arthritis in companion animals and race horses with signs of the condition (both rheumatoid and osteoarthritis) direct injections of stem cells into the damaged joint have proven effective at inhibiting the autoimmune attacks consistent with RA, reducing inflammation and pain in the joint, and supporting active tissue regeneration.

Stem Cell Treatment for Arthritis brings hope to millions suffering from arthritic conditions

The conditions under which stem cells are implanted appear to make all the difference between active regeneration and hypertrophy of joint tissue. Researchers are wary of the ad hoc use of stem cells for joint repair as it may be that the growth encouraged by stem cells may be adversely influenced by pre-existing pathology in an arthritis patients joints leading to exaggerated tissue growth that may further exacerbate the problems. Using a small number of chondrocytes alongside mesenchymal stem cells may make a significant difference in cultivating healthy cartilage repair without hypertrophy (excessive growth) occurring (Aung, et al, 2011).

A further study by Abedi (et al, 2010) appears to show that the use of scaffolding material alongside mesenchymal stem cell administration improves the healing process in induced articular cartilage defects in animal models (rabbits) in comparison to the stem cells alone. By encouraging differentiation into cartilage tissue types the almost universal progression of articular cartilage damage to osteoarthritis could, theoretically, be prevented using stem cell therapy. MSCs from osteoarthritis patients used in research has also led to the development of intelligent surfaces which can effectively prevent hypertrophy of such stem cells in the laboratory whilst facilitating cartilage regrowth (Petit, et al, 2011); further research in vitro is required to assess their use for therapeutic purposes however. A review of current research into synoviocytes and chondrogenesis has also highlighted a potential source of stem cells which may actively aid repair of avascular meniscal injuries that are otherwise unresponsive to treatment and commonly lead to osteoarthritis (Fox, et al, 2011).

Mesenchymal stem cells, which can differentiate into bone, cartilage, and a number of other cell types appear to hold great potential for easing osteoarthritis joint pain and possibly regenerating damaged tissue. However, MSC therapy alone is unlikely to address the systemic issue of autoimmune rheumatoid arthritis. Just as haematopoietic stem cells can help combat leukaemia, their use following myeloablation (the destruction of the bodys immune-forming cells in the bone marrow) looks promising for treatment of RA (Sykes, et al, 2005).

A study by Bhattacharya (et al, 2001) to test the safety of using umbilical cord blood for those with a variety of conditions found that the transfusions were well tolerated by all 62 of the patients and that the cord blood had the advantages of a higher oxygen carrying capacity, many growth factors and cytokines, and was also less likely to cause an immune reaction than adult whole blood transfusions. The study did not aim to assess the potential benefits of the stem cell treatment, only the safety of such procedures for those with rheumatoid arthritis, arthritis in the neck, ankylosing spondylitis, and systemic lupus erythematosus, amongst other conditions.

The ability to derive stem cells from patients themselves is also opening up a whole new realm of possible treatments which do not require the use of human embryonic stem cells or cord blood stem cells which are less readily available and mired in some ethical controversy. Autologous stem cell transplants are also advantageous as they do not trigger an immune response causing rejection of the material in the body; immunosuppressant drugs are, therefore, not necessary. Jorgensen (et al, 2004) stated that mesenchymal stem cells appeared to be good candidates for the regeneration of arthritic tissue and that more research was required to assess their viability. This research has been carried out in subsequent years by a whole host of scientists such as Mao (2005), Gonzlez (et al, 2009), and Tyndall (et al, 2010).

Some studies have looked at animal models with induced rheumatoid arthritis and their reaction to mesenchymal stem cell transplantation. Across a number of studies the effects have been positive, with the Th1-induced autoimmune response down-regulated by the stem cell treatment. Human adipose-derived mesenchymal stem cells also decreased inflammatory cytokines and chemokines in the mouse models and actively increased the production of antiinflammatory substance interleukin-10 in lymph nodes and joints. A, perhaps unexpected, benefit of human AD-MSCs was the de novo generation of antigen-specific CD4+CD25+FoxP3+ Treg cells, which were then able to suppress those immune system cells which react against the bodys own tissue.

According to Passweg and Tyndall (2007), more than a 1000 patients with autoimmune diseases have been treated with haematopoietic stem cells between 1996 and 2007. Most of these patients had Multiple Sclerosis, systemic lupus erythematosus, RA, or systemic sclerosis and many of those treated have enjoyed long-term disease-free remissions and immune reconstitution since treatment. Unfortunately, there remains a risk of treatment related mortality with such stem cell therapy as it relies on the destruction initially of the patients immune system in order to reset it with the infused stem cells and remove the autoimmune components. This temporarily opens the patients up to increased risks of infection which can be fatal. Improvements in patient care during the treatments have reduced this risk substantially, but it is still a major consideration, particularly for those otherwise doing well on conventional medications. Tyndall and Laar (2010) found that incomplete, low immunoablative intensity, early conditioning was related to patient relapse. This is most likely due to residual lesional effector cells; the patients faulty immune system effectively repopulated itself with self-reactive immune cells when only partially destroyed by initial myeloablative treatment.

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Stem Cell Treatment for Arthritis

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