Cells for New life

For doctors

Dear Doctor!

In this section of our site you can find information about the treatment of diseases using fetal stem cells: summary of fetal stem cells types, their differences from other types of stem cells, fetal stem cells treatment guidelines, indications and contraindications, methods of treatment, including the most effective ways of cells administration, as well as treatment results of patients with various diseases.

The list of diseases that can be cured using stem cells is presented in the section "Diseases" of our site using the International Classification of Diseases, publication 10.

Fetal cells are different from other types of stem cells in several very important parameters.

1. Fetal cells are progenitor, i.e. these are the cells that have already had advance differentiation and its further development will be the basis for the formation of extremely specialized tissues - kidney, liver, muscle, heart, brain, spinal cord, etc.

What does it means in terms of regenerative medicine? First of all, the doctor can with high performance use fetal cells for treatment of target organ, such as liver cirrhosis - fetal hepatoblasts, ischemic insult - fetal neuroblasts, Duchenne myopathy - fetal myoblasts. In this case, no interference with the biology of the cells does not occur, because the fetal cells are ready for use after a minimum of manipulation by their isolation from the fetal allograft tissues. For comparison - to get therapeutic effect of hematopoietic stem cells from umbilical blood or bone marrow, firstly cells must be isolated and multiplied (umbilical blood contains only about 2%, bone marrow - about 5% of stem cells capable to differentiate in normal conditions only in red blood cells: erythrocytes, leucocytes, lymphocytes or platelets), to carry out in vitro directed differentiation into cells of target organs (such as neurons), clear cell culture from not differentiated cells impurities and only then administrating to the patient (e.g., ischemic stroke). In this sequence of operations very negative point presents - the direct intervention into the cellular genome during directed differentiation, which can significantly change the biology of the further development of stem cells in the patient's body. As a result, doctor can get not only the lack of therapeutic effect, but also completely unpredictable complications. With fetal cells such negative point does not happen, they are ready for treatment of the patient without any additional manipulation.

2. The number of stem cells. Today the most common methods of treatment are associated with the use of autologous bone marrow cells or umbilical cord blood cells. Unfortunately, many laboratories and biotechnological cord blood banks do not maintain their prior multiplication and do not consider stem cell dose required to achieve a therapeutic effect.

Let us analyze how much hematopoietic stem cells can be obtained from umbilical cord blood and bone marrow. The volume of blood, which can be collected from the placenta, is not more than 100 ml, the volume of a cell suspension of bone marrow - 20 ml. Maximum content of hematopoietic stem cells in cord blood and bone marrow are respectively 1.6% and 5.0%. Clinical trials in oncology have shown that with a patient's body weight of 10 kg potential transplants for cell transplantation can be all cord blood samples, with a body weight of 35 kg - 67%, and only 25% of the samples can provide an efficient transplant for patients weighing 50 - 70 kg. Please note that we are talking about the administration of ALL the cells of cord blood to ONE patient, but not the cells contained in a SINGLE vial of 1.2 ml!

At volume of 72 ml of umbilical cord blood the number of stem cells in it will make only 1.1 × 105. Authoritative researchers (Lickliter, 2000; Sharp, 2000) are sure that this amount is sufficient for transplantation to children, but too small for an adult transplantation, whose optimal for administration is 7-10 × 106 CD34-positive cells per 1 kg of body weight - in average of 7 × 108 per patient. From these calculations, it follows that a single sample of cord blood contains 700 times less than required stem cells for transplantation to one adult patient.
With regard to the bone marrow cells, almost in 1998 Gluckman showed that the minimal amount of CD34 + cells even for autologous transplantation is 2 × 106/kg body weight. Therefore, when a patient weight is 75 kg the substance of the cells in vitro for his treatment should be 15 × 107. It is impossible to get such a cell number without using multiplication of cells!
How much hematopoietic stem cells can be obtained from fetal material? Fetal liver in the early stages of development is the blood-forming organ and contains a lot of the earliest hematopoietic cells. The number of hematopoietic stem cells, which can be taken from it, reaches 10 × 1010.

3. Is the treatment with fetal cells safe from the point of view of the possible cancer development? Of course, yes - fetal cells do not cause cancer. The 40-year-old experience of their use in medicine of USSR, Russia and Ukraine proves that. Many famous politicians, actors and athletes received fetal cells, and for four decades of such a treatment there were no one case of cancer.

Why is the question of stem cells ability to cause cancer so acute in modern regenerative medicine? Why does this aspect raise concerns of physicians and patients fear before the stem cell treatment? The answer is simple - stem cells can actually turn into cancer cells. But it naturally happens only with embryonic stem cells and can occur after manipulations with cellular genome at directed differentiation or creating so-called induced pluripotent stem cells.
Physician should clearly understand which particular stem cells and why exactly are able to cause cancer. To do this, we need to understand what is embryonic stem cells. Embryonic (not fetal!) stem cells appear in the earliest stages of human embryonic development. 5 days after egg fertilization inside the blastocyst there is a division of cells on 2 types. The first - trophectoblast cells in their further development form placenta, the second - so-called inner cell mass from which embryo will be developed in further. Therefore, these cells have been called embryonic stem cells. There are 5-6 such cells and only they have the ability to transform into all cell types of the human body. It is this ability that served as the basis for the creation of such cell lines. Any cells of the human body can be obtained from such a line. However, in an experiment on immunodeficient mice, administration of such cells in 100% of cases caused the development of cancerous tumor - teratocarcinoma. This is how information that stem cells cause cancer happened and spread. But only embryonic stem cells naturally transform into cancer cells.

How much time do embryonic stem cells exist in the development process of the human body? Only 1-2 days. Then the differentiation with tissues formation of future organs, reproduction and spatial formation organ germ (provisory organs - liver, heart, lungs, etc.) occurs. At the 4th month of development the embryo becomes fetus - not only the primary organs, but also the blood circulation system appear. Since the heartbeat emergence a human embryo is called not an embryo, but fetus. In this period of development there aren’t any embryonic stem cells, and accordingly there is no risk of cancerous tumor developing.

Once again we pay your attention to the fact that fetal cells are not actually stem by definition. Stem cell - is one from which several different types (species) of tissue can form, like a tree trunk from which numerous branches grow. Fetal progenitor cell has already differentiated and can give a development to only one specialized type of tissue: fetal lung cells – to lungs, fetal heart cells - myocard, fetal kidney cells - to kidneys. Thus, fetal progenitor cell cannot turn into a cancer cell because all the genes responsible for the endless reproduction has been already closed in its genome, and genes that control the process of differentiation into specialized tissues are opened.

Watch for this section updates of our website. The following information - principles of treatment with fetal cells, indications and contraindications, methods of treatment, the most effective ways of fetal cells administration in various diseases, as well as the results of treatment of patients with various diseases - will soon be provided to your attention.