Scientists Recreate Fully Functional Human Blood Vessels in Mice

Doctors transplant windpipe with stem cells

Comprehensive banking of sibling donor cord blood for children with malignant and nonmalignant disease.

Umbilical Cord Blood Injections test Aid Aging Brains

Sickle Cell Hopes Turn to Transplants

California Umbilical Cord Collection Program Moves Closer to Implementation

Scientists at the Harvard School of Medicine have developed fully functional blood vessels in mice by combining two types of progenitor cells including cord blood stem cells. It is hopeful that this work will lead to a non-surgical solution in the treatment of heart disease, ischemia (reduced blood flow) and wound healing. It also reduces the need to find compatible donor vessels. At this time, cell growth and differentiation in the laboratory took seven days to complete however scientists want to reduce that time to one – two days. They feel that this is necessary due to the need to act rapidly when treating heart conditions.

Harvard University Medical School Study. This procedure is

investigational and is available only in laboratory setting.

• After a severe collapse of her left lung, doctors give woman suffering from tuberculosis a windpipe with tissue grown from her own stem cells, eliminating the need for anti-rejection drugs.
• Rather than remove the entire left lung, a windpipe transplant was proposed instead.
• Scientists stripped off all the cells from a donor windpipe, leaving only a tube of connective tissue.
• Doctors then used the bone marrow's stem cells from a sample taken from her hip to create millions of cartilage and tissue cells to cover and line the windpipe.
• Results show that these stem cells created a functional, biological structure that can't be rejected.
• Cord blood stem cells are very similar in nature to the bone marrow stem cells that were used. Similar work is being done using cord blood stem cells in the field of tissue regeneration.

The Lancet, Volume 372, Issue 9655, Pages 2023 – 2030, 2008.

"Clinical transplantation of a tissue-engineered airway."
Paolo Macchiarini, Philipp Jungebluth, Tetsuhiko Go, M Adelaide Asnaghi, Louisa E Rees, Tristan A Cogan, Amanda Dodson, Jaume Martorell, Silvia Bellini, Pier Paolo Parnigotto, Sally C Dickinson, Anthony P Hollander, Sara Mantero, Maria Teresa Conconi, Martin A Birchall. The Lancet, Early Online Publication, 19 November 2008
doi:10.1016/S0140-6736(08)61598-6

• Researchers were able to ‘grow’ umbilical cord blood stem cells from existing cord blood samples. This is called cell expansion or cell amplification.
• 10 adult leukemia patients received one dose of expanded cord blood stem cells and one dose from an unrelated cord blood sample. The second sample had not been expanded.
• 20 adult leukemia patients received transplants using two cord blood samples that were not expanded. The study compared medical outcomes in the two groups.
• Engraftment occurred within 16 days in the 10 patients that were treated with the expanded units compared to 26 days in the 20 patients that received treatment with non-expanded double cord transplants. These results indicate that on average, patients who received the expanded cells achieved engraftment many days sooner, reducing the chance of infection.
• Researchers saw a mean 165-fold increase in the production of the cells that are most important for engraftment (CD34 cells); and a mean 650 fold increase in total nucleated cell counts.
• Additional clinical trials are underway with leukemia patients.

• Age-related decreases in brain function may be due to a reduction in the creation of brain cells and an increase in inflammation in the areas that produce cells.

• Animal studies show that treatment with umbilical cord stem cells can reduce inflammation in the brain and increase the production of neural cells.
• Further studies in humans are required to prove that cord blood stem cells can contribute to restoring some lost capacity in the aged brain.

• Epidermolysis Bullosa is a fatal genetic disease in which children lack a critical protein that allows the skin and the lining of the gastrointestinal system to be anchored to the body.
• A cord blood transplant was performed for a 2 year old boy using his sibling’s cord blood stem cells.
• Seven months after treatment, he is now producing the critical protein and is able to eat solid foods and has formed skin on his legs.
• Doctors say it may move his genetic disorder ‘off the incurable list’ for other patients.

• Sickle Cell disease is a genetic disorder affecting people of African American/ Canadian ancestry.
• Cord blood stem cells have been used to treat the disease. This article describes how a Utah Jazz Basketball star used one child’s cord blood to treat sickle cell disease in his other child. The treatment has been successful.

LINK TO ARTICLE

• Sickle Cell disease is a genetic disorder affecting people of African American/ Canadian ancestry.
• Cord blood stem cells have been used to treat the disease. Article #1 describes how a Utah Jazz Basketball star used one child’s cord blood to treat sickle cell disease in his other child. The treatment has been successful.
• A trial has been initiated to determine if transplanting blood stem cells from unrelated donors can help children with severe sickle cell disease.
• Children who qualify will receive a blood stem cell transplant from either bone marrow or umbilical cord blood to replace their own diseased cells.
• In a preliminary trial, about 10 patients experienced promising results after such transplants.

•  Umbilical cord-blood is rife with stem cells, which can be used to treat dozens of illnesses such as leukemia, diabetes, lymphoma and stroke.  But the lack of publicly banked samples makes it harder for patients to obtain a stem-cell match for use in therapy.
   
•  There are two main challenges that limit the availability of cord-blood stem cells.  Many parents find it costly to pay private companies to harvest and store their children's umbilical-cord blood.  Donating cord-blood to a public bank is difficult for parents to arrange.

It is generally estimated that the probability of receiving a stem cell transplant during a life time ranges between 1 / 2,700 to 1 / 200,000. This paper presents a mathematical estimation of the probability that in a lifetime (up to 70 years of age) receive a stem cell transplantation. They base their estimation on data accumulated from the following registries: The Center for International Blood and Marrow Transplant Research, the National Marrow Donor Program, the Bone Marrow Transplant Information Network and U.S. Hospital Discharge Database. They present four different scenarios and estimate the probability to receive stem cell transplant during a lifetime, if the current indications for transplant do not change:

However, the assumption that the indications for stem cell transplantation will not change may not be true. As the authors state: “Advances in HSCT (haematological stem cell transplantation) technology may lead to its use for indications, pharmacological developments may replace HSCT for some diseases, or both may occur: the effect of these advancements may increase, decrease or leave unchanged the lifetime probabilities estimated in this study.”
Another assumption that may change the estimates is the universal availability of stem cells. This is not currently the case. But: “However, these probabilities may be realized with increased number of donors and/or UCB (umbilical cord blood) units….. A bank with sufficient allogeneic UCB units could provide suitable transplants for most US patients in need, because of the possibility of using UBCs with 1 or 2 HLA mismatches…”