Regenerative Medicine Using Pregnancy-Specific Biological Substances (eBook)

Regenerative Medicine UsingPregnancy-Specific Biological Substances 2
Copyright Page 3
Introduction 4
Foreword 17
Preamble 19
Preface 20
Acknowledgments 22
Contents 24
Contributors 28
Part I Massive Wastage of Pregnancy SpecificBiological Substances 33
1: A Massive Wastage of the Global Resources 34
1.1 The Placenta 34
1.2 Amniotic Membranes 35
1.3 Amniotic Fluid 36
1.4 The Umbilical Cord 36
1.4.1 Wharton’s Jelly 36
1.4.2 Vessels 36
1.4.3 Epithelium 36
1.5 Umbilical Cord Blood 37
1.6 Factors Affecting Availability 37
References 38
Part II Basic Science and the Role of Placenta 40
2: Placenta as a Source of Stem Cells and as a Key Organ for Fetomaternal Tolerance 41
2.1 Placenta Structure 41
2.2 Embryological Development of the Placenta 42
2.3 Immunology of the Placenta 43
2.4 Possible Mechanisms Controlling Fetomaternal Tolerance 44
2.5 Placenta as a Source of Hematopoietic Stem Cells 46
2.6 Placenta as a Source of Nonhematopoietic Multipotent Stem and/or Progenitor Cells: In Vitro and In Vivo Studies 47
2.7 Conclusion 49
References 49
3: Placenta and Umbilical Cordin Traditional Chinese Medicine 54
3.1 History of the Medicinal Use of the Human Placenta 54
3.2 Preparation of the Human Placenta 54
3.3 Clinical Use of Human Placenta 55
3.4 Pharmacological Use of the Human Placenta 55
3.5 Adverse Effects of Human Placenta 56
3.6 Conclusion 56
References 56
Part III Use of Cord Blood in Biochemistry 57
4: Use of Umbilical Venous Blood on Assessing the Biochemical Variations of Acid–Base, Nutritional and Metabolic Parameters on Growth-Retarded Fetuses, in Comparison with Gestational Control Cases: A Study 58
4.1 Introduction 58
4.2 Materials and Methods 58
4.2.1 Population Under Study 58
4.2.1.1 Control Group 59
4.2.1.2 Pathological Group 59
4.2.2 Sampling Procedure 59
4.2.3 Analytical Methods 59
4.2.4 Statistics 60
4.3 Results 60
4.3.1 Gaseous and Acid–Base Parameters in Umbilical Venous Blood (Table 4.1, Fig. 4.1) 60
4.3.1.1 Control Population (n = 109) 60
4.3.1.2 Pathological Population 61
Severe Growth Retardation (n = 29) 61
Moderate Growth Retardation (n = 11) 62
4.3.2 Metabolic Parameters in Umbilical Venous Blood (Table 4.2, Fig. 4.2) 62
4.3.2.1 Control Population (n = 109) 62
4.3.2.2 Pathological Population 62
Severe Growth Retardation (n = 29) 62
Glucose 62
Lactate and Pyruvate 62
Free Fatty Acids 62
Ketone Bodies 62
Cholesterol 63
Moderate Growth Retardation (n = 11) 63
4.4 Discussion 65
4.5 Conclusion 66
References 67
Part IV Use of Cord Blood as Blood Substitute 69
5: Umbilical Cord Blood Transfusion and Its Therapeutic Potentialities 70
5.1 Introduction 70
5.2 Umbilical Cord Blood as a Source of Components in Transfusional Therapy 71
5.3 Human Umbilical Cord Blood Features 71
5.3.1 Hematologic Parameters of Newborn Blood 71
5.3.2 Newborn Hemoglobin 72
5.3.3 Coagulation Factor Features of Umbilical Cord Blood 72
5.3.4 Immunological Features of Umbilical Cord Blood 73
5.3.5 Erythrocyte Antigens and Antibodies 74
5.4 Hemocomponents from Umbilical Cord Blood 74
5.5 Stored Umbilical Cord Blood Features and Quality 75
5.6 Suggestion for Collection, Preparation, and Storage of Umbilical Cord Blood 76
5.7 Risk of Infectious Disease due to Allogeneic Umbilical Cord Blood Transfusion 76
5.8 Therapeutic Use of Umbilical Cord Blood Transfusion 77
5.8.1 Use of Cord Blood RBCsin Transfusion in Anemia Patients 78
5.9 Use of Umbilical Cord Blood Transfusion in Sickle Cell Anemia Patients 78
5.9.1 Use of Umbilical Cord Blood Transfusion in Patients with Malaria 78
5.9.2 Use of Umbilical Cord Blood Transfusion in Patients with Diabetes 79
5.9.3 Use of Umbilical Cord Blood Transfusion in Acute Ischemic Stroke Patients 79
5.10 Conclusions 79
References 80
6: Autologous Placental Blood Transfusion for the Therapy of Anemic Neonates 82
6.1 Background 82
6.2 Placental Blood Collection 82
6.3 Storage Stability 83
6.4 Microbial Contamination 84
6.5 Maternal Blood Contamination 86
6.6 Pharmacokinetics and Safety 86
6.7 Efficacy of Autologous Placental Blood in Avoiding Allogenous Blood Transfusions 86
6.8 Summary 88
References 88
7: Cord Blood: A Massive Waste of a Life-Saving Resource, a Perspective on Its Current and Potential Uses 91
7.1 Introduction 91
7.2 History of UCB Transplantation 91
7.3 Cord Blood Banking 91
7.4 Current State of the Art 92
7.5 Cord Blood Transplantation for Hemoglobinopathies 92
7.6 Double Cord Blood Transplants: Filling a Niche? 93
7.7 Biological Characteristics of UCB 93
7.8 CB Graft Characteristic, Engraftment, and Outcome 93
7.9 Potential Advantages and Disadvantages of UCB 94
7.10 Clinical Results 94
7.10.1 Related Donor CB Transplantation 94
7.10.2 Unrelated Donor CB Transplantation 94
7.11 Future Potential in Regenerative Medicine and Comparisons to Human Embryonic Stem Cells 95
7.12 Conclusions 96
References 96
8: Clinical Experience of Cord Blood Autologous Transfusion 98
8.1 Introduction 98
8.2 Concepts of Placental Transfusion 98
8.3 Concept of Stored Autologous Placental Transfusion 98
8.4 The Feasibility of Autologous Blood Collection and Safety 99
8.5 Risk of Autologous Cord Blood Transfusion 99
8.6 Stored Autologous Placental Transfusion for Anemia of Prematurity 99
8.7 Stored Autologous Placental Transfusion for Surgical Newborns 100
8.8 Autologous Cord Blood 100
8.9 Delayed Cord Clamping as Placental Transfusion 100
8.10 Definition of Delayed and Late Cord Clamping 100
8.10.1 Aim of Placental Transfusion 100
8.10.2 Magnitude of Placental Transfusion 101
8.10.3 Physiology of Placental Transfusion 101
8.10.4 Potential Benefits of Placental Transfusion 101
8.10.4.1 Preterm Infants 101
8.10.4.2 Term Infants 102
8.10.5 Potential Harms of Placental Transfusion 102
8.10.5.1 Preterm Infants 102
8.10.5.2 Term Infants 102
8.11 Milking of Umbilical Cord 102
8.11.1 Concept of Milking of the Umbilical Cord 103
8.12 Procedure of Umbilical Cord Milking 103
8.13 Potential Benefits of Milking of Umbilical Cord 103
8.14 Potential Harms of Milking of Umbilical Cord 103
8.15 Summary 104
References 104
9: Emergency Use of Human Cord Blood 107
9.1 Radiation Casualties of Fewer Than 100 109
9.2 Disproportionately More Radiation Victims 109
9.3 Blood for the Operating Rooms 110
9.4 1,000–10,000 Casualties 110
9.5 Source of Cord Blood 110
9.6 Back Up 110
9.7 72 Hours 110
9.8 Critical Issues 110
9.9 During the Emergency 110
9.10 Summary 111
References 111
10: Hemoglobin-Based Oxygen Carriers in Trauma Care: The US Multicenter Prehosptial Trial 113
10.1 Potential Role of Hemoglobin-Based Oxygen Carriers in Trauma Care 113
10.2 Clinical Evaluation of Modified Tetrameric Hemoglobin in Trauma Care: The First Multicenter Trial 113
10.3 Clinical Safety of Polymerized Hemoglobin in Trauma Care: The New Generation 115
10.4 Clinical Efficacy of Polymerized Hemoglobin in Trauma Care 116
10.4.1 Perioperative Applications: Reduce Allogeneic RBC Transfusions in Trauma Care 116
10.5 Perioperative Applications: Reduce Allogeneic RBC Transfusions During Initial 116
10.5.1 Resuscitation and Thereby Decrease ARDS and MOF 116
10.6 Acute Hemorrhagic Shock: When Stored RBCs are Unavailable in Trauma Care 119
10.7 Current Phase III US Multicenter Prehospital HBOC Trial 120
References 122
11: Placental Umbilical Cord Blood as a True Blood Substitute with an Edge 124
11.1 Background 124
11.2 Antigenic Difference of Adult RBC and Cord Blood RBC 125
11.3 Basic Immunological Characters of Cord Blood Constituents 126
11.4 Contemporary Experience with Allogeneic Cord Blood Transfusion as an Adult Blood Substitute 126
11.5 Other Impacts of Cord Blood Transfusion, i.e., Cell Therapy Potential on the Host 129
11.6 Special Advantages of Cord Blood Transfusion 129
References 130
Part V Immunotherapy Potential of FetalCell in Maternal System 133
12: Implications of Feto-maternal Cell Transfer in Normal Pregnancy 134
12.1 Introduction 134
12.2 Materno-fetal Cell Transfer and Its Implications on Immunity and Tolerance 134
12.3 Feto-maternal Cell Traffic and Its Use for Noninvasive Prenatal Diagnosis 136
12.4 Feto-maternal Cell Traffic and Its Long-Term Consequences 137
References 139
13: Early Reports on the Prognostic Implications and Immunotherapeutic Potentials of Cd34 Rich Cord Whole Blood Transfusion in Advanced Breast Cancer with Severe Anemia 142
13.1 Introduction 142
13.2 Materials and Methods 143
13.3 Result and Analysis 143
13.4 Discussion 153
13.5 Conclusion 156
References 157
Part VI Use of Placental Umbilical Cord Bloodin Neurology 158
14: Anti-inflammatory Effects of Human Cord Blood and Its Potential Implication in Neurological Disorders 159
14.1 Introduction 159
14.2 Inflammatory Response in Neurological Disorders and Brain Injury 159
14.3 Immunomodulatory Strategies for Therapy of CNS Disorders 159
14.4 Immunological Properties of HUCBCs 160
14.4.1 Phenotypical Characteristics of HUCBCs 160
14.4.2 Immunomodulatory Properties of HUCBCs 160
14.5 Experimental Evidence of Anti-inflammatory Properties of HUCBCs in Models of CNS Disorders 161
14.5.1 Site of Migration and Engraftment of Intravenously Transplanted HUCBCs 161
14.5.2 Modulation of Splenocyte Phenotype and Function by HUCBCs 162
14.5.3 Modulation of Brain Inflammatory Cells and Cytokines by HUCBCs 162
14.6 Conclusion 164
References 164
15: Transforming “Waste” into Gold: Identification of Novel Stem Cells Resources with Therapeutic Potential in Neuromuscular Disorders 167
15.1 Introduction 167
15.2 Umbilical Cord 167
15.3 Adipose Tissue 169
15.4 Conclusion 171
References 171
16: Human Umbilical Cord Blood Cells for Stroke 173
16.1 Introduction 173
16.2 The Characteristics of Human Umbilical Cord Blood Cells 175
16.3 From the Beginning to the Current Niche for HUCB in Neuroscience Focusing on In vitro Studies177
16.4 The Application of HUCB in Stroke Research Focusing on In vivo Studies 178
16.5 Disclosure statement 181
References 182
17: Placental Umbilical Cord Blood Transfusion for Stem Cell Therapy in Neurological Diseases 186
17.1 Introduction 186
17.2 Stem Cell Therapy in Neurological Diseases 186
17.3 Umbilical Cord Blood: An Alternative Source of Stem Cells 187
17.4 Therapeutic Uses of Human Placental Umbilical Cord Blood Transfusion in Neurology 189
17.5 Conclusion 190
References 190
Part VII Use of Placental Umbilical Cord BloodSerum in Ophthalmology 192
18: Umbilical Cord and Its Blood: A Perspective on Its Current and Potential Use in Ophthalmology 193
18.1 Introduction 193
18.2 Rationale of Serum Therapy in Ophthalmology 193
18.3 History of Serum Use in Ophthalmology 194
18.4 Introduction of Umbilical Cord Serum in Ophthalmology 194
18.5 Preparation of Umbilical Cord Serum Eye Drops 195
18.6 Safety and Stability 196
18.7 Application of Umbilical Cord Serum Eye Drops in Ophthalmology 196
18.7.1 Persistent Corneal Epithelial Defects 196
18.7.2 Dry Eye Syndrome 196
18.7.3 Ocular Complications of GVHD 197
18.7.4 Neurotrophic Keratitis 198
18.7.5 Miscellaneous 198
18.8 Complications and Considerations 198
18.9 Future Application 199
References 200
Part VIII Use of Placental Umbilical Cordin Cardiovascular Surgery 202
19: Umbilical Vein Grafts for Lower Limb Revascularization 203
19.1 Operative Technique 206
19.2 Results 208
19.3 Complications 209
19.3.1 Thrombosis 209
19.3.2 Infection 211
19.3.3 Aneurysms 211
19.3.4 Intimal Hyperplasia 211
19.4 Summary 211
References 212
Part IX Use of Cord Blood in CardiovascularMedicne 213
20: Cord Blood Stem Cells in Angiogenesis 214
20.1 Endothelial Progenitor Cells (EPC) 214
20.2 Angiogenesis in Acute Myocardial Infarction (MI) 214
20.3 Angiogenesis in Retinal and Chordial Abnormalities 215
20.4 Conclusion 215
References 216
21: Endothelial Progenitor Cells from Cord Blood: Magic Bullets Against Ischemia? 218
21.1 EPCs: A Concept, a Marker, or an Identity? 218
21.1.1 1997: “The Year of the Contact” the First Definition of EPCs218
21.1.2 Revisiting the Concept and the Definition: The Heterogeneous EPCs’ Nature 218
21.1.3 The Search for a Common Progenitor of EPCs and HPCs. But Does It Really Exist? 219
21.2 EPCs “At Work”: Multiple Ways to Promote Blood Vessel Formation 220
21.2.1 Some Important Definitions 220
21.2.2 EPCs as “Builders” of New Blood Vessels into Ischemic Tissues 220
21.2.3 EPCs as “Organizers” of Novel Blood Vessel Development 220
21.3 Cord-Blood-Derived EPCs to Promote Angiogenesis: Why and How? 221
21.3.1 Newborn Versus Adult EPCs: Advantages, Disadvantages, and Possible Escapes 221
21.3.2 In Vivo Studies 222
21.3.3 The Perspectives 223
References 223
22: Therapeutic Potential of Placental Umbilical Cord Blood in Cardiology 227
22.1 Introduction 227
22.1.1 Possible Cellular Source for Cardiac Stem Cell Therapy 227
22.1.2 Allograftable Cellular Source 227
22.1.3 Lineage of Stem Cells in Placental Umbilical Cord Blood 228
22.1.4 Cardiomyogenic Transdifferentiation Potential In Vitro 228
22.1.5 Effect of UCB-Derived Stem Cell in Cardiology In Vivo 230
22.1.6 Limitations and Future of UCBMSCs in Cardiology 231
References 231
23: Stem Cell Therapy for Heart Failure Using Cord Blood 233
23.1 Introduction 233
23.2 Inhibition of Inflammatory Cascade by Mesenchymal Stem Cells 233
23.3 Inhibition of Death/Repair 234
23.4 Currently Stem Cell Therapy Helps Heart Patients: Just Not That Well 235
23.5 How to Increase Stem Cell Efficacy? 238
23.6 Making Stem Cells Home Better 238
23.7 Revitalize Stem Cells 239
23.8 Use Stem Cell Combinations 240
23.9 Cardiovascular Regenerative Cell Therapy Using UCB-Derived HSC 240
23.10 Cardiac Angiogenesis Using UCB-Derived HSCs 241
23.11 Conclusion 241
References 242
24: Human Umbilical Cord Blood Mononuclear Cells in the Treatment of Acute Myocardial Infarction 249
24.1 Introduction 249
References 257
Part X Use of Placental Umbilical Cord Bloodin Other Subspecialitiesof Regeneration Medicine 259
25: Umbilical Cord-Derived Mesenchymal Stem Cells 260
25.1 Characteristics of UCB-Derived Mesenchymal Stem Cells 261
25.2 Another Source of Fetal MSC: Placental Tissues and Umbilical Cord 262
25.3 Prospects for the Clinical Utilization of UCB-MSC 262
References 263
26: Cord Blood Stem Cell Expansion Ex Vivo: Current Status and Future Strategies 265
26.1 Introduction 265
26.1.1 Types of Stem Cells 265
26.1.2 Hematopoietic Stem Cells 265
26.1.3 Cord Blood Hematopoietic Stem Cells (CB HSCs) 266
26.2 Strategy for Ex Vivo CB HSC Expansion 266
26.2.1 The Problems for Large Ex Vivo Expansion of HSCs 266
26.2.2 Culture Systems for Stem Cell Expansion 266
26.3 Cellular Basis for CB HSC Expansion 267
26.3.1 The Mechanisms Underlying Feeder Cells Supporting HSC Expansion Ex Vivo 268
26.3.2 Manipulation of Feeder Cells for Ex Vivo HSC Expansion 269
26.3.3 The Choice of HSC Subsets for Ex Vivo Expansion 270
26.3.4 Cell Culture Condition and CB HSC Expansion 270
26.3.5 The Factors That Determine the Success and Failure of CB HSC Transplantation 271
26.4 Molecular Basis for CB HSC Expansion 271
26.4.1 Transcription Factors That Contribute to Stem Cell Expansion 272
26.4.2 Signal Transduction Pathways That Govern Stem Cell Fate and Expansion 272
26.4.3 Growth Factors and Cytokines That Regulate CB HSC Expansion 273
26.4.4 Proteins That Promote CB HSC Expansion 274
26.4.5 Small Molecules That Enhance CB HSC Expansion 274
26.5 Concluding Remarks 275
References 275
27: Embryonic-Like Stem Cells and the Importance of Human Umbilical Cord Blood for Regenerative Medicine 280
27.1 Introduction 280
27.2 The Rise of Umbilical Cord Stem Cells to Prominence 280
27.3 Over 20,000 Transplants Achieved 281
27.4 Cord-Derived Transplants Leave the Hematology Clinic 282
27.5 Research Leads the Way in Developing Cord-Related Stem Cells 283
27.6 Cord Blood Banking –A Controversial but Necessary Choice 285
27.7 Conclusion 288
References 289
Suggested Readings 290
28: Use of Non-hematopoietic Stem Cells of Fetal Origin from Cord Blood, Umbilical Cord, and Placenta in Regeneration Medicine 291
28.1 Introduction 291
28.2 Non-hematopoietic Cord Blood Stem Cells 292
28.2.1 Tissue Specific Monopotent Stem Cells in Cord Blood? 292
28.2.2 Unrestricted Somatic Stem Cells (USSC) 292
28.2.3 Cord Blood Mesenchymal Stromal Cells (MSC) 293
28.2.4 Cord Blood Endothelial Progenitors 294
28.2.5 Embryonic-Like Stem Cells in Cord Blood 294
28.2.6 Cord Blood Stem Cells – Many Categories of Stem Cells with Different Characteristics or Different Approaches to Charac 295
28.3 Umbilical Cord Stromal Cells 295
28.4 Placental Stem Cells 296
28.4.1 Mesenchymal Stromal Cells from Amniotic and Chorionic Regions 296
28.4.2 Amniotic Epithelial Cells 297
28.5 Possible Clinical Applications of Non-hematopoietic Fetal Stem Cells 297
28.6 Conclusion 299
References 299
29: Animal Studies of Cord Blood and Regeneration 304
29.1 Cord Blood Transplants: History 304
29.2 Studies in the Regenerative Use of Cord Blood 307
29.3 Conclusion 309
References 309
30: Immune Privilege of Cord Blood 313
30.1 Introduction 313
30.2 Cord Blood Hematopoietic Cells 314
30.3 Immune Modulation by Hematopoietic Stem Cells 314
30.4 Mesenchymal Stem Cells in Cord Blood 315
30.5 Non-Stem Cell Components of Cord Blood Are Hypoimmunogenic 316
30.6 Immune Effectors in Cord Blood 317
30.7 Clinical Safety of Cord Blood Transplants Without Immune Suppression 317
30.8 Why No GVHD? 318
30.9 Therapeutic Efficacy 318
30.10 Conclusions 319
References 320
31: Combination Cellular Therapy for Regenerative Medicine: The Stem Cell Niche 326
31.1 Introduction 326
31.2 Cellular Content of CB Products 326
31.3 Mesenchymal Stem Cells (MSCs) 327
31.3.1 Immunologic Properties of MSCs 328
31.4 The Stem Cell Niche 329
31.5 Ex Vivo Expansion of Cord Blood Cells on MSC 329
31.6 Summary 330
References 331
32: Use of Cord Blood in Regenerative Medicine 333
32.1 Introduction 333
32.2 Regenerative Medicine Applications 333
32.3 Preclinical Studies 334
32.3.1 Heart Disease 334
32.3.2 Juvenile Diabetes 334
32.3.3 Neurological Diseases and Injuries 335
32.3.4 Epithelial Tissue Applications 336
32.4 Current Clinical Trials with CB Stem Cells 337
32.5 Diabetes 337
32.6 Cerebral Palsy 337
32.7 Traumatic Brain Injury 337
32.8 Hearing Loss 337
32.9 Conclusions 338
References 338
Part XI Cord Blood Collection Variabilityand Banking 341
33: Comparisons Between Related and Unrelated Cord Blood Collection and/or Banking for Transplantation or Research: The UK NHS Blood and Transplant Experience 342
33.1 Introduction 342
33.2 Cord Blood Collection and Banking Practices in NHSBT and Licensing Requirements 343
33.2.1 The NHS Cord Blood Bank in London for Unrelated Donations 343
33.2.1.1 Banking and Transplantation of Unrelated Units 343
33.2.1.2 Cord Blood Units Unsuitable for Banking 345
33.2.1.3 Transplanted Units, Geographical Distribution, and Transplant Outcomes 345
33.2.2 The Collection and Use of Designated or Directed Cord Blood Units for Transplantation 346
33.2.2.1 Eligibility for Designated Cord Blood Donation 346
33.2.2.2 Informed Written Consent 346
33.2.2.3 The Human Tissue Authority’s Requirements for Designated Cord Blood Donations 346
33.2.2.4 Mandatory Screening 347
33.2.2.5 Designated Cord Blood Collection and Transport to NHSBT 347
33.2.2.6 HLA Typing, Including Pre-implantation Studies 347
33.2.2.7 Designated Cord Blood Processing and Storage 347
33.2.2.8 Reporting to the Referring Clinicians 348
33.2.2.9 Storage Policy 348
33.2.2.10 Designated Cord Blood Issue for Transplantation and Transplant Outcomes 348
33.2.2.11 Breakdown of Collections by Patient Disorder 348
33.2.2.12 Characteristics of Designated Cord Blood Collections 349
33.2.2.13 Microbiology Results 349
33.2.2.14 Transplant Characteristics 349
33.2.3 General Observations on the DCB Program and Comparisons with the Unrelated UCB Program 349
33.2.4 Cord Blood Units for Research 351
References 353
34: Donor and Collection-Related Variables Affecting Product Quality in Ex utero Cord Blood Banking 357
34.1 Donor-Related Variables 357
34.2 Collection-Related Variables 359
References 360
35: Cord Blood as a Source of Hematopoietic Progenitors for Transplantation 362
35.1 Introduction 362
35.2 Characterization of Cord Blood Hematopoietic Progenitors 362
35.3 Factors Influencing Umbilical Cord Blood Hematopoietic Content 363
35.3.1 Influence of Mode of Collection 363
35.3.2 Influence of Obstetric Factors 364
35.4 Unrelated Cord Blood Banking 366
35.4.1 UCB Donor Selection 366
35.4.2 UCB Collection 366
35.4.3 Volume Reduction 367
35.4.4 Cryopreservation and Storage of the Cord Blood Unit 367
35.4.5 Biological Controls 367
35.4.6 Release of Cord Blood Unit to Transplant Center 368
35.5 UCB Transplantation Outcomes 368
35.5.1 Allogeneic Transplantation 368
35.5.1.1 Pediatric Studies 368
Related Donor Transplantation 368
Unrelated Donor Cord Blood Transplantation 368
35.5.1.2 Adults 369
35.5.2 Autologous Transplantation 369
References 369
Part XII Clinical Use of Amniotic Fluid 373
36: Amniotic Fluid and Placenta Stem Cells 374
36.1 Introduction 374
36.2 Amniotic Fluid and Placenta in Developmental Biology 374
36.3 Isolation and Characterization of Progenitor Cells 375
36.4 Differentiation of Amniotic Fluid- and Placenta-Derived Progenitor Cells 375
36.4.1 Adipocytes 376
36.4.2 Osteocytes 376
36.4.3 Endothelial Cells 376
36.4.4 Hepatocytes 376
36.4.5 Myocytes 377
36.4.6 Neuronal Cells 377
36.4.7 Renal Cells 377
36.5 In Vivo Behavior of Amniotic Fluid Stem Cells 378
36.6 Amniotic Fluid and Placenta for Cell Therapy 378
36.7 Conclusion 379
References 379
37: Use of Amniotic Membrane, Amniotic Fluid, and Placental Dressing in Advanced Burn Patients 381
37.1 Introduction 381
37.2 Materials and Methods 381
37.3 Results and Analysis 382
37.4 Discussion 387
37.4.1 Amniotic Epithelial Cells 388
37.4.2 Mesenchymal Stromal Cells from Amniotic and Chorionic Regions 388
37.4.3 Placental Tissue and the Umbilical Cord is an Important Source of Fetal Mesenchymal Stem Cell 389
37.4.4 Feto-Maternal Cell Traffic in Pregnancy and Its Long-Term Consequences 389
37.5 Conclusion 391
References 391
38: Clinical Use of Amniotic Fluid in Osteoarthritis: A Source of Cell Therapy 393
38.1 Introduction 393
38.2 Materials and Method 394
38.3 Result and Analysis 395
38.4 Discussion 398
38.5 Differentiation of Amniotic Fluid- and Placenta-Derived Progenitor Cells 399
38.6 New Horizon for Offering a Cure (Repair) for Osteoarthritis with Simple Cell Therapy 400
38.7 Conclusion 400
References 401
Part XIII Clinical Issue of Aborted Human Tissue 402
39: A Study and Follow-up (1999–2009) of Human Fetal Neuronal Tissue Transplants at a Heterotopic Site Outside the Brain in Cases of Advanced Idiopathic Parkinsonism 403
39.1 Introduction 403
39.2 Fetal Tissue Used to Treat Diseases and Defects 404
39.3 Materials and Methods 406
39.4 Result and Analysis 407
39.5 Histological Analysis 417
39.6 Mini-Mental State Examination (MMSE) 424
39.7 Study of the Mood of the Transplant Patient (e.g., HADS) 425
39.8 Secondary Advantages of Neuronal Tissue Transplantation in the Present Study 428
39.9 Improvement of Aches and Pain with Fetal Neuronal Tissue Transplantation 429
39.10 Weight Gain and Sense of Well-Being with Fetal Tissue Transplantation 430
39.11 Discussion 431
39.12 Summary and Conclusions 433
References 434
Part XIV Ethics 436
40: Ethical Issues Surrounding Umbilical Cord Blood Donation and Banking 437
40.1 Introduction 437
40.1.1 Rational for UCB Collection and Storage 437
40.1.2 Clinical Evidence Regarding UCB Transplantation 438
40.1.3 Establishment of UCB Banks 438
40.2 Ethical Issues 439
40.2.1 Ethical Issues Concerning UCB Collection 439
40.2.2 Social-Justice Concerns for UCB Public Donation 441
40.2.3 Ethical Issues Concerning UCB Private Banking 442
40.2.4 A Role for Umbilical Cord Blood Stem Cells in Regenerative Medicine 443
40.3 Conclusion 444
References 444
Index 447