Niche science: The aging stem cell

Studies on stem cell aging are uncovering molecular mechanisms of regenerative decline, providing new insight into potential rejuvenating therapies.Studies on stem cell aging are uncovering molecular mechanisms of regenerative decline, providing new insight into potential rejuvenating therapies. Most human tissues retain an amazing ability to regenerate well into adulthood. Somatic stem cells are central to this ability, replacing damaged cells and thus keeping the body in a highly functional state. Yet this process does not continue unabated forever, as aging is accompanied by a loss of this regenerative capacity. Presently, studies in invertebrate and vertebrate model systems are advancing our understanding of regenerative decline and are identifying strategies for ‘rejuvenating’ therapies that have the potential to extend human health- and lifespan.The feasibility of rejuvenating interventions was demonstrated by classic studies in which exposure to a young systemic environment restored regenerative capacity of muscle stem cells in old mice.¹ Similar rejuvenation has now been demonstrated for the central nervous system, suggesting that such interventions have systemic potential² and raising the question of whether the lifespan of the organism could be extended by restoring the regenerative capacity of adult stem cells. This has already been demonstrated in flies, where improved intestinal stem cell function leads to enhanced longevity.³Such studies have inspired the burgeoning field of “stem cell aging.”^4,5 A recent symposium at the Buck Institute for Research on Aging in Novato, CA showcased the field, bringing together researchers interested in the biology of aging and experts in stem cell biology, and covering topics ranging from basic research in stem cell aging to the use of stem cells in clinical applications. Clear from the meeting is that new molecular insight into stem cell aging is emerging at a rapid pace, revealing both the promises and challenges of deploying stem cell therapies for age-related diseases. The key questions are starting to be answered.     

Participant understanding and recall of informed consent for induced pluripotent stem cell biobanking

The ability to generate human induced pluripotent stem cells (iPSCs) has opened new avenues for human disease modelling and therapy. The aim of our study was to determine research participants’ understanding of the information given when donating skin biopsies for the generation of patient-specific iPSCs. A customised 35-item questionnaire based on previous iPSC consent guidelines was sent to participants who had previously donated samples for iPSC research. The questionnaire asked pertinent demographic details, participants' motivation to take part in iPSC research and their attitudes towards related ethical issues. 234 participants were contacted with 141 (60.3 %) complete responses received. The median duration between recruitment and follow-up questioning was 313 days (range 10–573 days). The majority of participants (n = 129, 91.5 %) believed they understood what a stem cell was; however, only 22 (16.1 %) correctly answered questions related to basic stem cell properties. We found no statistically significant difference in responses from participants with different levels of education, or those with a health sciences background. The poor understanding amongst participants of iPSC research is unlikely to be unique to our study and may impact future research if not improved. As such, there is a need to develop an easily understood yet comprehensive consent process to ensure ongoing ethical progress of iPSC biobanking.     

Fraud and misconduct in science: the stem cell seduction

Scientific misconduct and fraud occur in science. The (anonymous) peer review process serves as goalkeeper of scientific quality rather than scientific integrity. In this brief paper we describe some limitations of the peer-review process. We describe the catastrophic facts of the ‘Woo-Suk Hwang fraud case’ and raise some ethical concerns about the issue. Finally, we pay attention to plagiarism, autoplagiarism and double publications. (Neth Heart J 2009;17:25-9.)     

The history and future prospective of haplo-identical stem cell transplantation

Initial attempts at haplo-identical transplantation with T-cell replete bone marrow (BM) were associated with a high transplant-related mortality (TRM), mainly caused by severe graft-versus-host disease (GvHD), and previous efforts to prevent GvHD by ex vivo T-cell depletion of haplo-identical BM were associated with a high risk of graft failure and other complications. Improvements in large-scale T-cell depletion techniques of haplo-identical peripheral mobilized stem cells (PBSC) have overcome the human leukocyte antigen (HLA) barrier by using megadose numbers of stem cells obtained by either highly purified CD34(+) selection or negative depletion of T cells. In addition, recent insights into the role of graft-facilitating and anti-leukemic alloreactive natural killer (NK) cells, the permanent availability of the haplo-identical donor post-transplant and continuous improvements in graft-engineering techniques for the generation of effector cells for post-transplant adoptive transfer, have facilitated the development of strategies to decrease regimen-related toxicity through the use of less intensive preparative regimens, prevent severe infections by rebuilding the immune system and decrease the risk of relapse by exploiting the alloreactivity of donor NK cells and other donor-derived effector cells.     

Cryopreservation of cartilage cell and tissue for biobanking

Preservation of cell and tissue samples from endangered species is a part of biodiversity conservation strategy. Therefore, setting up proper cell and tissue cryopreservation methods is very important as these tissue samples and cells could be used to reintroduce the lost genes into the breeding pool by nuclear transfer. In this study, we investigated the effect of vitrification and slow freezing on cartilage cell and tissue viability for biobanking. Firstly, primary adult cartilage cells (ACCs) and fetal cartilage cells (FCC) were cryopreserved by vitrification and slow freezing. Cells were vitrified after a two-step equilibration in a solution composed of ethylene glycol (EG), Ficoll and sucrose. For slow freezing three different cooling rates (0.5, 1 and 2 °C/min) were tested in straws. Secondly, the tissues taken from articular cartilage were cryopreserved by vitrification and slow freezing (1 °C/min). The results revealed no significant difference between the viability ratios, proliferative activity and GAG synthesis of cartilage cells which were cryopreserved by using vitrification or slow freezing methods. Despite the significant decrease in the viability ratio of freeze–thawed cartilage tissues, cryopreservation did not prevent the establishment of primary cell cultures from cartilage tissues. The results revealed that the vitrification method could be recommended to cryopreserve cartilage tissue and cells from bovine to be used as alternative cell donor sources in nuclear transfer studies for biobanking as a part of biodiversity conservation strategy. Moreover, cartilage cell suspensions were successfully cryopreserved in straws by using a controlled-rate freezing machine in the present study.     

Stem cell tourism and future stem cell tourists: policy and ethical implications

Stem cell tourism is a small but growing part of the thriving global medical tourism marketplace. Much stem cell research remains at the experimental stage, with clinical trials still uncommon. However, there are over 700 clinics estimated to be operating in mostly developing countries--from Costa Rica and Argentina to China, India and Russia--that have lured many patients, mostly from industrialized countries, driven by desperation and hope, which in turn continue to fuel the growth of such tourism. While much research has focused on such dimensions as the promotions that allow such businesses to make their services known, media coverage, some patient research, and regulatory conditions for developing country clinics, little attention has been paid to the non-affected members of the general population, the future potential users of such services. This empirical study based on five focus group discussions with a diverse group of healthy adults in a Canadian city, explored participant views of patients who use stem cell tourism services, the likelihood they would avail themselves of such services if they were to suffer similar illnesses, and the conditions under which they might do so, and the impact that admonitions and advice from international expert bodies might have on their decisions. Our findings suggest that these healthy adults are sympathetic to the drivers of hope and desperation, and, despite cautions about research limitations, may seek such treatments themselves under similar conditions. These findings are discussed in the context of the policy and ethical issues raised by this form of medical tourism.     

Fetal stem cell transplantation: Past,present, and future

Since 1928, human fetal tissues and stem cells have been used worldwide to treat various conditions. Although the transplantation of the fetal midbrain substantia nigra and dopaminergic neurons in patients suffering from Parkinson's disease is particularly noteworthy, the history of other types of grafts, such as those of the fetal liver, thymus, and pancreas, should be addressed as there are many lessons to be learnt for future stem cell transplantation. This report describes previous practices and complications that led to current clinical trials of isolated fetal stem cells and embryonic stem(ES) cells. Moreover, strategies for transplantation are considered, with a particular focus on donor cells, cell processing, and the therapeutic cell niche, in addition to ethical issues associated with fetal origin. With the advent of autologous induced pluripotent stem cells and ES cells, clinical dependence on fetal transplantation is expected to gradually decline due to lasting ethical controversies, despite landmark achievements.     

Reduced-intensity stem cell transplantation for hematological malignancies: current status and the future

Reduced-intensity stem cell transplantation (RIST) has opened a new era for hematopoietic stem cell transplantation (HSCT). It was developed based on the knowledge that graft-versus-tumor (GVT) effect is the main anti-tumor effect in allogeneic HSCT. Because RIST is associated with less morbidity and mortality, it can be applied to many patients who could not undergo conventional HSCT. Experiences in the last decade clarified many issues related to RIST. For example, graft-versus-host disease (GVHD) in RIST may differ in character compared to conventional HSCT. Also, it is now known that intensity of conditioning is important in disease control, and the optimal regimens may be different for each disease or for each disease status. There are still many unsolved questions, and large prospective randomized trials are necessary to resolve these.     

Continuous renal replacement therapy in children post-hematopoietic stem cell transplantation: the present and the future

Allogeneic hematopoietic stem cell transplantation (HSCT) use has expanded markedly to treat different disorders like hematologic malignancies, immunodeficiency, and inborn errors of metabolism. However, it is commonly associated with complications that limit the benefit of this therapy. Acute renal failure occurs commonly after HSCT and results in increased risk of mortality. In many instances, children post-HSCT develop acute renal insufficiency in the context of other organ failure, necessitating intensive care unit admission for management. Recently, continuous renal replacement therapy (CRRT) has emerged as the favored modality of renal replacement therapy in the care of critically ill children who are hemodynamically unstable. Currently, CRRT is being utilized more often in the care of critically ill post- HSCT children to treat renal failure or to prevent fluid overload (FO). FO > 20% has been shown in many studies to be an independent risk of mortality in critically ill children and therefore, many clinicians will initiate this therapy due to FO even without overt renal failure. CRRT may be beneficial in disease processes as acute lung injury due to removal of fluid. CRRT results in improved oxygenation in post-HSCT children with acute lung injury and this improvement is sustained for at least 48 hours after initiation of this therapy. Survival in post-HSCT children requiring this therapy ranges from 17% to 45%, however, long term survival is still poor. This review will discuss current practice of CRRT in children post-HSCT, as well as future directions.