Review Article :
Stem cells have a great potential to divide and
present in all multicellular organism throughout their life. It holds a wide
range of applications in novel therapies for the cure of many diseases and
injuries by using early embryonic cells as well as adult stem cells. In research, they provide the whole knowledge
of how humans develop from a cell. Understanding the phenomena of stem cells we
can use these cells for the specific purpose in treating diseases such as
modeling disease, cell-based therapies or drug screening. Adult as well as
embryonic stem cells collectively used to treat such problems for the benefits
of society. The power of plasticity in adult stem cells has yet determined. Use
of stem cells can carry various ethical impacts along with several
applications. Stem cells are defined as the
cells have the ability to divide into multiple cell lineages. They are the
versatile type of cells that can renew themselves and give rise to the
specialized type of cells. Stem cells are uncommitted until they receive signal
and develop into the specialized cell while other cells of the body like heart
and skin are used to transfer its function. Stem cells are present in our body
from the early stages to the end of life. Present in all multicellular organism
having the totipotancy to divide. Although the early embryonic stem cells
demonstrate totipotancy
while the adult stem cells possess multipotent. From years researches are finding
the way to use stem cells to replace cells and tissues that cause disease or
damage. In the last century, Pluripotent cells were
first isolated from a human embryo and grown in culture media [1]. Stem cell
holds a wide range of applications in novel therapies for the cure of many
diseases and injuries by making use of early embryonic cells as well as adult
stem cells. In Russia, one of the scientists proposed the term “stem cells” for the
very first time of scientific use. Stem cells have the ability to differentiate
into another form of body cells. A different disease can be cured by using novel
technologies of stem cells now a day [2]. A stem cell is an unspecialized
cell that can make identical copies of it and have the ability to differentiate
into various type cells and tissue in body. Stem cells are classified on two
types as Basis of potency · Totipotent · Pluripotent · Multipotent
· Oligopotent · Unipotent Basis
of their source · Embryonic
stem cell · Adult
stem cell · Pluripotent
stem cells Totipotent cells have
the ability to divide in all possible types of cells. Also the Pluripotent
cells can differentiate in all possible form of cells. Some cells can divide in
closely related family of cells as multipotent.
Oligopotent cells can divide only in little type of cells. While, Unipotent cells can
produce only their relevant type of cells. Some cells are derived from embryo
as embryonic stem cells also. In short the goal of stem cell is the repairing
in body cells and tissues that are damaged [3]. Gene
Therapy by stem cells Stem cells are present in the
embryo and early stages of the fetus, amniotic fluid, the
placenta, and umbilical cord. Stem cells have a great capability to increase
the rate of health. In research, they provide the whole knowledge to search how
to develop human from a cell. Understanding the phenomena of stem cells we can
use these cells for a specific purpose in treating diseases such as modeling
disease, cell-based therapies or drug screening. Stem cells are also used for transplant.
Now the scientist has the knowledge that stem cells are also present in brain
and heart. Stem cells are used to replace the cellular damaged cells by healthy
cells or regenerate the
organ. The innovative treatments of stem cells transplant was done at
Apollo hospital Ahmedabad and demonstrate steady growth. No surgery involved in
the transplantation of stem cells in patients and donor. This can be done by
blood transfusion. The stem cells delivered in the patients and regenerate or
replace the damage inpatient. These cells can be taken by the own body of
patients which are healthy cells or by the other person known as the donor. The
International Society for Stem Cell Research has
developed some guidelines that help us in regarding stem cells treatment. Most
of the clinical trials are generally concerned with the monogenic disordered.
There are many diseases which can be cured by using stem cells given below: Parkinson Parkinson is a disease
of the nervous system in which the successive injury to neurons of midbrain
occurs. In which the motor sign becomes rigid and tremor due to the successive
injury in neurons in basal ganglia also occur in the caudate nucleus and
putamen which results in nervous disordered. An amino acid named as Levodopa
works by being converted to dopamine in the brain can improve the symptoms.
This amino acid is one of the drugs used to handle the symptoms of this disease
at all stages [4]. The main symptoms are as: · Unconscious twinkling and
temblor · Decelerate
movements · Balance
issues and standing problems · Contraction
and tighten of limbs Causes:
However, the main causes of this disease remain
unclear yet. About 15 percent of these patients have a family history. These
families can be caused by a mutation in genes or by the alteration of genes
that have not been identified [3]. Today stem cells gene therapy is
supposed as a novel treatment and different disease can be cured by using stem
cells. For this purpose, several forms of cells are studied such as; Embryonic
stem cells: The most common example of the embryonic
stem cells found within an early-stage embryo. Then, the damaged cells are
replaced in disease or wound, mainly used to treat the neuron damaged cell;
replace neurons damaged by the spinal cord injury, Parkinson disease or other neurological diseases. Mesenchymal
cells: Mesenchymal stem cells
are of various forms of cells, including cartilage, muscles cells and
adipocytes (fat cells which give rise to marrow adipose tissue). Some scientist
injected mesenchymal cells in some patients and noticed important improvements
and with no side effects. Fetal
neural stem cells: Neural Stem Cells
(NSCs) are multipotent cells that can give rise to various cell types in the
Central System (CNS), including neurons, astrocytes, and oligodendrocytes.
These stem cells improve the conditions of patients and no tumors found. Up
till now, there is no stem cells therapy or transplant therapy for Parkinsons disease. But
we are making huge trials in this regard. Alzheimer:
Alzheimer is the
commonest cause of premature senility. It is a chronic neurodegenerative
disease. It usually starts slowly but worse over time. So, at an old age when a
person has some other age-related disease such as heart disease or kidney
failure, it becomes difficult to manage once someone develops this disease [5]. Complications of the decline in
the brain function are what lead to death. A number of stem cells are being
used in the treatment of this disease, discuss below: Neural
stem cells: Neural stem cells can be developing into
a number of body cells such as neurons, astrocytes, and oligodendrocytes. Some
scientist injected neural cells and some glial cells in two groups of mouse and
observed the improvements. No improvement was noticed in these two groups, the
cognitive ability is the same but there is a significant difference in that
mouse which does not receive any kind of injection of cells. Mesenchymal
stem cells: Lee at al. performed an experiment on
Alzheimer mice by injecting mesenchymal stem cells derived from the human
umbilical cord and observed the significant changes in oxidative stress,
learning, and memory in mice were returned [6]. Recently, a number of clinical trials have
been `done that are based on amyloid cascade hypothesis but it gives
disappointed results. The failure of this therapy gives us the idea of disease
model and necessities of cell therapy. Multiple
sclerosis: A severe form of disease-causing damage
to the brain and spinal cord progressively to sheaths of newer cells. It causes
muscle metabolism and insight vision with severe fatigue. Commonly early signs of multiple
sclerosis (MS) include; · Sight
problems · Pain · Weakness
or fatty cells · Anxiety
· Digestive
issues · Sexual
disability · Arteries
problems The early signs or symptoms of
multiple sclerosis normally begin at teenage to 40 years of life. Only about 2%
to 5% of all people diagnosed with MS have symptoms before 18 [7]. Recent clinical trials shows that patients
treated with nonmyeloablative
Hemapoietic Stem Cell Transplantation (HSCT) performed better than those patients
that are treated with Disease
Modifying Treatment (DMT). Research shows that significant number of people
that are treated with (HSCT) progressive better condition and are able to slow
disease when compare with (DMT) treated patients [1]. Liver
disease: Cirrhosis causes liver
injury and it does not perform its function in a proper way. The main causes
are alcohol consumption, HBV, HCV, and non-alcoholic fatty liver diseases. This
damage is treated by the replacement of healthy liver cell tissue by the
damaged cells. Stem cells transplantation is now the best treatment for cirrhosis
disease. A number of stem cells are capable for the diagnoses of cirrhosis such
as embryonic stem cells, annex stem cells etc. different types of treatment
have been done in this respect. In 2006, an experiment was performed in which
CD34 cells were injected in at least five patients and results found
that balance in bilirubin and albumin level, improvement in patients with no
side effect. Later in 2006, the patient was
injected with bone
marrow mononuclear stem cells and it improves the patients albumin level.
Further study shows that the same types of stem cells were injected in 10 male
patients, decrease their bilirubin level and increase the albumin level [8]. The
stem cells transplantation and therapy have done many improvements in cirrhosis
disease. Some patients may die in this treatment of some radiotherapy and
neurological problems. Mohammad Nejad et.al has shown injection of autologous
mesenchyma cells in phase trials. In another group of same study, three out of
four patients, significantly improve their liver function while one of the
patients died due to nephropathy that caused hepatorenal syndrome
type 1 [9]. Asthma:
Another health care contributes to the major portion
of asthma. About 10 percent of patients are suffering from severe asthma having
inhaling problem with the inefficiency of lungs. Stem cells are now used to
cure asthma by performing different trials. In 2010, mesenchymal cells were
injected into the mouse as the asthma model. This is one of the major
contributions towards asthma patients for their cure. Mesenchymal cells show
effective results. In result of all these studies, the immunomodulatory
capacities of stem cell can be effective in immune based diseases. In near
future stem cells differentiation can form a promising therapy in organ and
tissue defect. Diabetes Extensiveness of diabetes is
increasing all over the world rapidly. The increase in hunger and more intakes
of fluids are the major symptoms of diabetes. Insulin is produced in the liver
cells and secreted in the pancreas, it breakdown the glucose in the blood. The
abnormal working of insulin is the main cause of diabetes. Recently, the
insulin has been generated by the stem cells of a mouse but these cells have
short cell life. It was published in 2000. Several forms of stem cells are
used in the therapy of diabetes such as embryonic stem cells, mesenchymal stem
cells, skin fibroblast
cells and many other types of cells. It is one of major disease prevailed
vastly that it is supposed in the year 2030, there are about 366 million people
suffered from this. The only treatment of diabetes is transplantation of pancreatic
islet cell but it is limited to organ presence as a donor [10]. Stem cells are placed to cure
diabetes now a day. Different types of stem cells being used and worked
wonderfully as; Embryonic
stem cells: In 2002, first-time insulin-producing cells
were made from mouse embryonic cells to cure the diabetic patient. Different
other experiments were performed over and over to get a more precise form to
produce insulin. Mesenchymal
cells: Mesenchymal cells show immunomodulation
in laboratory and clinical studies through myocard. But limited performance it
was unable for the cell metabolism of a patient to treat diabetes. Mesenchymal Stem Cells
(MSC) is one of the best method to treat both type1 and type2 diabetes
mellitus. MSC are responsible for reducing the blood glucose level by different
mechanisms. Most clinical trials in 2017, an
experiment is done, in this some people are treated with bone-marrow BM-MSC and
compare with people treated with Bone-Marrow Mononuclear Cells (BM-MNC). Ten
people received BM-MSC under control condition for 12 months and ten received
BM-MNC served same procedure. BM-MSC group shows only a significant reduction
in daily requirements of insulin on the other hand the group treated with
BM-MNC shows significant reduction in daily insulin requirements and also
increased production of C-peptides in 12 months. Sepsis Stem cells can modulate their
inflammatory response to infection and show unclear pathophysiology. Stem cells
can also be used for the treatment of sepsis due to inflammatory and reduction
way of action [11]. Human Embryonic Stem Cell: It
was reported that human embryonic cells significantly worked to decrease
inflammation and produce interferon and Tumor Necrosis Factor
(TNF) cells. In mice, ACE+cells have the ability to decrease the risk of sepsis
[12]. Mesenchymal Stem Cells: Firstly
scientist injects E.coli endotoxin in the lungs of mice than after 4 hours;
they directly inject mesenchymal cells into the lungs of mice. However, mice
show less effect and more survival [13]. In 2007 at Emory University a
mice divided into 4 groups received Escherchia-coli endotoxin in peritoneum.
The first group injected with BMDMSC, second group with endotoxin and BMDMSC,
third with endotoxin and mouse lung fibroblasts and one of the last with only
endotoxin. It was concluded that BMDMSC effects due to chemo attractants in
lung of mice stem cells. Respiratory
diseases Chronic
Obstructive Pulmonary Disease (COPD): It is the
airway obstruction disease having the symptoms of a cough and sputum. 210
people suffered from COPD in the report of the World Health Organization
(WHO). In 2030, maybe it will be the third major disease to cause death in
patients [14]. Emphysema model of rats scientists in China 2008, injected
mesenchymal cells from male rats to female rats. It was concluded that some
rats to produce improved results. Y chromosome was detected present in the
recipient lungs containing mesenchymal cells [15]. A trial has been performed
in patients of adult human mesenchyma cells having acute myocardial infection.
The patients who received MSC injection show different responses as forced
expiratory volume in 1 second and improved forced vital capacity. Stem cells can work wonder in the
treatment of several diseases as a miracle. They are performing a huge range of
experiments to perform their research for the cure of such diseases. It forms
revolutionary changes in medicine, degenerative diseases, and cancer. New
discoveries are forming day by day. Adult as well as embryonic stem cells
collectively used to treat such problems for the benefits of society. The
potential plasticity of adult stem cells has yet determined. Use of stem cells
can carry various ethical impacts along with several applications. However,
stem cells are not treated as the first discovery of human to treat while it
has to be considered [16]. However the Human Stem Cells (HSC)
can raises several ethical issues regarding its treatment and political
controversies over its use. There are ethical problems to produce Pluripotent induced stem
cells from the reprogramming of somatic cells regarding its research in
embryonic stem cells. Clinical trials, downstream research and consent to donate
material therapies on HSC are a major ethical concern. Scientific challenges
are used to ensure the ethical and policy issue on the research and treatment
of these stem cells in appropriate manner. Formation of tumor, uneven
behavior of cells, immunological reactions and long-term unknown health side
effects are the major risks of stem cells therapy. Thus appropriate preclinical trials
should be established on animals model as well as in human study of similar
cell based interventions also. If Pluripotent derived stem cells are
manipulated in vitro there should be higher proof of principle and safety
requirements in its treatment. In all clinical research, these trials should
follow ethical principles that balance its risks and benefits. Stem cells are used in different
fields for the treatment of diseases. They have great potential to divide and
regenerate. Several forms of these cells can be used to treat various diseases.
These cells can also play its role in medicine and treatment of diseases as
cancer also with the degenerative properties. It also possesses a wide range of
potential plasticity. Cells based therapies and drug screening can
also be done by the use of these stem cells. In research, they also provide a
whole knowledge of how humans develop from a cell. References 1. Ilic D, Devito L, Miere C and
Codognotto S. Human embryonic and induced pluripotent stem cells in clinical
trials (2015) British Medical Bulletin 116: 19-27. https://doi.org/10.1093/bmb/ldv045 2. Larijani B, Esfahani EN, Amini P,
Nikbin B, Alimoghaddam K, et al. Stem cell therapy in treatment of different
diseases (2012) Acta Medica Iranica 50: 79-96. 3. Kobold S, Guhr A, Kurtz A and
Löser P. Human embryonic and induced pluripotent stem cell research trends complementation
and diversification of the field (2015) Stem Cell Reports 4: 914-925. https://doi.org/10.1016/j.stemcr.2015.03.002 4. Davies EL, Lei K, Seidel CW,
Kroesen AE, McKinney SA, et al. Embryonic origin of adult stem cells required
for tissue homeostasis and regeneration (2017) ELife 6: 1-35. https://doi.org/10.7554/eLife.21052 5. Nayak A, Prakash S, Kanani A and
Bhargav P. Function of stem cells and their future roles in healthcare (2014)
Int J Pharmacy Tech 6: 2852-2895. https://doi.org/10.12968/bjon.2006.15.2.20372 6. Ding D, Mao D, Li K, Wang X, Qin
W, et al. Precise and long-term tracking of adipose-derived stem cells and
their regenerative capacity via superb bright and stable organic nanodots
(2014) ACS Nano 8: 12620-12631. https://doi.org/10.1021/nn505554y 7. Akutsu H, Cowan CA and Melton D. Human
embryonic stem cells (2006) Methods in Enzymology 418: 78-92. https://doi.org/10.1016/S0076-6879(06)18005-2 8. Greely HT. Moving human embryonic
stem cells from legislature to lab: Remaining legal and ethical questions
(2006) PLoS Medicine 3: 571-575. https://doi.org/10.1371/journal.pmed.0030143 9. Cogle CR, Guthrie SM, Sanders RC,
Allen WL, Scott EW, et al. An overview of stem cell research and regulatory
issues (2003) Mayo Clinic Proceedings 78: 993-1003. https://doi.org/10.4065/78.8.993 10. Van
Pham P. Adipose stem cells in the clinic (2014) Biomedical Res Therapy 1: 11. https://doi.org/10.7603/s40730-014-0011-8 11. Hellstrom
WJG, DeLay KJ, and Abdel-Mageed AB. Can adipose-derived stem cells be used in
the treatment of urethral stricture disease? (2016) European Urology 70: 1042-1043.
https://doi.org/10.1016/j.eururo.2016.05.027 12. Master
Z, McDonald M, Paciulli D and Longstaff H. A primer on ethics education for
stem cell and biomedical scientists (2016) Current Stem Cell Reports 2: 336-348. https://doi.org/10.1007/s40778-016-0064-2 13. Leite
M. Stem cell research in brazil: A difficult launch cell (2006) Analysis 124:
1107-1109. https://doi.org/10.1016/j.cell.2006.03.003 14. Banja
JD. Ethical considerations in stem cell research on neurologic and orthopedic
conditions (2015) PM R 7: 66-75. https://doi.org/10.1016/j.pmrj.2014.10.016 15. Siegel
AW. Temporal restrictions and the impasse on human embryonic stem-cell research
(2004) Lancet 364: 215-218. https://doi.org/10.1016/S0140-6736(04)16638-5 16. Minuth
WW, Denk L and Gruber M. Search for chemically defined culture medium to assist
initial regeneration of diseased renal parenchyma after stem/progenitor cell
implantation (2013) Int J Stem Cell Res Transplantation 1: 8-15. https://doi.org/10.19070/2328-3548-130002 Iqbal RK, Institute
of Molecular Biology and Biotechnology, Bahauddin Zakariya University, Multan,
Pakistan,
E-mail: Khalid.Iqbal@bzu.edu.pk Stem cell, Gene therapy, Health science,
Clinical trialsRole of Stem Cells in Health Science and Medicine
Rimsha Imam, Aqsa Saeed and Rana Khalid Iqbal
Abstract
Full-Text
Introduction
Stem cell
Future
aspects
Risks
and benefits in stem cells clinical trials
Conclusion
*Corresponding
author
Citation
Imam R, Saeed A and Iqbal RK. Role of stem cells in health science and
medicine (2019) Pharmacovigil and Pharmacoepi 2: 9-12 Keywords
