Using umbilical cord blood for regenerative therapy: Proof or promise?

Abstract

The identification of nonhematopoietic progenitor cells in cord blood has spawned great interest in using cord blood cells for new indications in regenerative therapy.Many preclinical studies demonstrated improvement in reperfusion and markers of organ recovery using cord blood-derived cells in a range of animal models. Initial results heralded increasing clinical interest regarding the use of cord blood for regenerative therapy. Initial clinical studies were largely uncontrolled feasibility studies that were case series and reported on small numbers of patients. The emergence of controlled studies has been slower, although multiple controlled studies have been conducted in patients with cerebral palsy and type I diabetes. Heterogeneity in the cellular product, patients, study design, and the timing of outcome measurements remains barriers to meta-analysis and a clearer understanding of efficacy. Controlled studies of modest size have been reported for a range of additional conditions. The conduct of controlled clinical trials to evaluate potential new uses of cord blood for regenerative therapy remains essential. None of the indications studied to date can be regarded as proven. Moreover, consistency in outcome reporting in terms of the instruments used and the time points for assessment after therapy are needed, including longer follow-up of study participants. Frequent and careful evaluation of the evidence will allow cord blood banks, health care providers, and patients to assess potential new options in the use of cord blood for regenerative therapy. K E Y W O R D S clinical trial, cord blood, regenerative therapy

Migration Inhibitory Factor in Conditioned Medium from Human Umbilical Cord Blood-Derived Mesenchymal Stromal Cells Stimulates Hair Growth

“…Umbilical cord blood (UCB) is an attractive source of mesenchymal stromal cells because of its abundance and relative ease of collection. Some studies have demonstrated that primitive human umbilical cord blood-derived MSCs (hUCB-MSCs) have biological advantages over bone marrow or adipose tissue, which suggests that hUCB-MSCs are a useful model for clinical applications of cell therapies [ 18 , 19 ]. Furthermore, hUCB-MSCs cultured with specific substances produce growth factors and regulatory factors that have paracrine effects on surrounding cells.…”

The law and problematic marketing by private umbilical cord blood banks

“…Umbilical cord blood is a rich source of stem cells that can be used in treatments for blood and immune system disorders. It is also used for research into novel therapies not yet ready for clinical application [1,2]. The use of the stem cells in these applications depends on individuals banking their cord blood in either public, private, or public-private hybrid banks.…”

“…The Supreme Court of Canada has addressed the legal meaning of a general impression in the context of Quebec's Consumer Protection Act, a provincial statute that is largely based on the Competition Act. In Richard v. Time, Inc, the Supreme Court held that assessing a general impression requires "describing the general impression that the representation is likely to convey to a "credulous" and inexperienced consumer; and [2] determining whether that general impression is true to reality" [59].…”

Human Amnion-Derived Mesenchymal Stromal Cells in Cirrhotic Patients with Refractory Ascites: A Possible Anti-Inflammatory Therapy for Preventing Spontaneous Bacterial Peritonitis

“…Even if the autologous bone marrow and adipose tissue-derived mesenchymal stromal cells (BM-MSCs and AT-MSCs, respectively) are the most prevalent well-accepted cells in clinical trials [17,18], the invasiveness of collecting samples in both procedures has led scientists to find other sources of MSCs. For example, extraembryonic tissues, such as placenta [19], amniotic membrane [20][21][22], and umbilical cord [23][24][25], which are usually intended as discards of childbirth, have recently been considered new emerging sources. MSCs isolated from human term amnion (hA-MSCs) meet all the release minimal criteria [26,27] but, compared with MSCs isolated from bone marrow, the placental-derived MSCs have been reported to proliferate faster and more robustly during expansion in in vitro cultures [18].…”