Stem cell therapies for the lysosomal storage diseases - the quintessential neurodegenerative diseases

As a novel neurotherapeutic strategy, stem cell transplantation has received considerable attention. However, little focus of this attention has been devoted to the probabilities of success of stem cell therapies for specific neurological disorders. Given the complexities of the cellular organization of the nervous system and the manner in which it is assembled during development, it seems unlikely that a cellular replacement strategy will succeed for any but the simplest of neurological disorders in the near future. A general strategy for stem cell transplantation to prevent or minimize neurological disorders is much more likely to succeed. The lysosomal storage diseases represent the quintessential neurodegenerative diseases for which preventative stem cell transplantation will both likely succeed and set the stage for therapeutic approaches to other neurodegenerative diseases.     

LeuT: A prokaryotic stepping stone on the way to a eukaryotic neurotransmitter transporter structure

Ion-coupled secondary transport is utilized by a broad range of integral membrane proteins to catalyze the energetically unfavorable movement of solute molecules across a lipid bilayer. Members of the solute carrier 6 (SLC6) family, present in both prokaryotes and eukaryotes, are sodium-coupled symporters that play crucial roles in processes as diverse as nutrient uptake and neurotransmitter clearance. The crystal structure of LeuT, a bacterial member of this family, provided the first atomic-level glimpse into overall architecture, pinpointed the substrate and sodium binding sites and implicated candidate helices and residues in the “gating” conformational changes that accompany ion binding and release. The structure is consistent with a wealth of elegant biochemical data on the eukaryotic counterparts and has for the first time permitted the construction of accurate homology models that can be directly tested experimentally. Sequence identity is especially high near the substrate and sodium binding sites and, thus, molecular insights within these regions have been substantial. However, there are several topics relevant to transport mechanism, inhibition, and regulation that structure/functions studies of LeuT cannot adequately address, suggesting the need for a eukaryotic transporter crystal structure.     

Herbgenomics: A stepping stone for research into herbal medicine

From the prehistoric era until the publishing of the Compendium of Materia Medica and the first scientific Nobel Prize in the Chinese mainland for Tu's discovery on anti-malarial tablets, each milestone and stepping stone in the developmental history of herbal medicine involved intrepid exploration, bold hypothesis formulation, and cautious verification. After thousands of years of discovery and development, herbal research has entered a new era—the era of herbgenomics. Herbgenomics combines herbal and genomic research, bridging the gap between traditional herbal medicine and cutting-edge omics studies. Therefore, it provides a general picture of the genetic background of traditional herbs, enabling researchers to investigate the mechanisms underlying the prevention and treatment of human diseases from an omics perspective.     

Stem cell separation: A bottleneck in stem cell therapy

The substantial progress in embryonic stem cell (ESC) research could lead to new possibilities in the treatment of various diseases. Currently, applications of ESC for cell therapy are impeded by the presence of potentially teratoma-forming undifferentiated ESC. Thus, a selective and quantitative removal of undifferentiated ESC from a pool of differentiated and undifferentiated cells is essential before cell therapy. We evaluated the highly selective magnetic activated cell sorting (MACS) method for the quantitative removal of undifferentiated ESC. We found that the clearance rates for undifferentiated ESC decreased with decreasing amount of undifferentiated ESC in the cell pool. Using a simplified model calculation we could predict that, assuming an initial purity of 60%, an estimated 31 steps are required to achieve less than 10^–1 cell per 10⁹ cells. Thus, a log clearance rate of 10, which would be necessary for a therapeutically application, is hard to achieve. Our work clearly indicates that the current MACS technology is insufficient to meet the purification needs for cell therapy.     

Convergence to genetically uniform state in stepping stone models of population genetics

We investigate continuous time stepping stone models. Extending the models treated in population genetics, we consider the system described by the following infinite dimensional stochastic differential equation, $$dx_k (t) = a_k (x_k )dB_k + \left\{ {\sum\limits_{j \in S} {q_{k,jXj} } } \right\}dt, k \in S$$ which contains the effects of random sampling drift and a kind of stochastic fluctuation in selection. We obtain a necessary and sufficient condition for the system to converge to a genetically uniform state.     

Diagnostic laboratory parasitology--a stepping stone to medical research in tropical Africa.

African countries can concentrate mainly on operational and problem-solving type of medical research using as a basis routine diagnostic laboratory parasitology which can be elevated to research level by incorporating all relevant techniques backed by statistically-based programming. Because of high incidence of parasitic infections and the peculiar host-parasite relationship, co-operation between all departments of any major hospital will be required to deal with the diseases due to them. Longitudinal studies on some parasites will enable generalisation and specific views to be formed on some infections. Multiplicity and wide variety of available techniques offer several research possibilities of clinico-pathological and epidemiological significance. Routine laboratory-based research offers the right environment for training various types of laboratory workers from technicians to medical parasitologists, through on-the-job training on techniques, investigative studies and research, backed by formal lectures and practicals at various levels. Trainee medical parasitologists can obtain higher degrees locally or abroad. The research can be organised around micro and mini research units. This approach is cost-beneficial because it minimises administrative difficulties and so avoids wastage. The results can be used to monitor impact of national development on parasitic infection prevalence and to formulate a policy on parasitic disease management.     

Stem cell therapy in stroke: designing clinical trials

Stroke is a common and disabling condition that represents a potentially attractive target for regenerative therapy. Stem cells from a wide range of origins have been investigated in studies using animal models of stroke, with evidence that neural or mesenchymal cells migrate to the site of ischemic injury after intravascular or intraparenchymal delivery, and that a proportion of cells survive and differentiate into cells with characteristics of neurons or glia. In some studies there is evidence of electrical function of transplanted cells. Some studies report improvements in neurological function with cell implantation even when undertaken up to 30 days after the stroke is induced. Few clinical trials have been undertaken to date, with two studies of a teratocarcinoma-derived cell line delivered by direct brain injection, and two of bone-marrow derived mesenchymal stem cells delivered intravascularly. Ongoing trials of other cell lines are exploring safety. There are considerable difficulties in designing future efficacy trials, some being generic to the field of regenerative treatment in stroke, and some that are specific to stem cells or their mode of delivery.     

Stem cell therapy independent of stemness

Mesenchymal stem cell (MSC) therapy is entering a new era shifting the focus from initial feasibility study to optimization of therapeutic efficacy. However, how MSC therapy facilitates tissue regeneration remains incompletely characterized. Consistent with the emerging notion that secretion of multiple growth factors/cytokines (trophic factors) by MSC provides the underlying tissue regenerative mechanism, the recent study by Bai et al demonstrated a critical therapeutic role of MSC-derived hepatocyte growth factor (HGF) in two animal models of multiple sclerosis (MS), which is a progressive autoimmune disorder caused by damage to the myelin sheath and loss of oligodendrocytes. Although current MS therapies are directed toward attenuation of the immune response, robust repair of myelin sheath likely requires a regenerative approach focusing on long-term replacement of the lost oligodendrocytes. This approach appears feasible because adult organs contain various populations of multipotent resident stem/progenitor cells that may be activated by MSC trophic factors as demonstrated by Bai et al This commentary highlights and discusses the major findings of their studies, emphasizing the anti-inflammatory function and trophic cross-talk mechanisms mediated by HGF and other MSC-derived trophic factors in sustaining the treatment benefits. Identification of multiple functionally synergistic trophic factors, such as HGF and vascular endothelial growth factor, can eventually lead to the development of efficacious cell-free therapeutic regimens targeting a broad spectrum of degenerative conditions.     

Stem cell therapy for retinal diseases

In this review, we discuss about current knowledge about stem cell(SC) therapy in the treatment of retinal degeneration. Both human embryonic stem cell and induced pluripotent stem cell has been growth in culture for a long time, and started to be explored in the treatment of blinding conditions. The Food and Drug Administration, recently, has granted clinical trials using SC retinal therapy to treat complex disorders, as Stargardt’s dystrophy, and patients with geographic atrophy, providing good outcomes. This study ’s intent is to overview the critical regeneration of the subretinal anatomy through retinal pigment epithelium transplantation, with the goal of reestablish important pathways from the retina to the occipital cortex of the brain, as well as the differentiation from pluripotent quiescent SC to adult retina, and its relationship with a primary retinal injury, different techniques of transplantation, management of immune rejection and tumorigenicity, its potential application in improving patients’ vision, and, finally, approaching future directions and challenges for the treatment of several conditions.     

Stem cell and cellular therapy developments

Recent discoveries on human and non-human stem cells have prompted the development of several studies aimed at the translation of laboratory evidences into novel clinical procedures collectively known as ‘cellular therapy’.In this regard, a number of features specifically related to the clinical setting require stringent evaluation, including, but not limited to: ethical appropriateness; donor and recipient informed consent; autologous versus allogeneic use; media and devices for cell collection, processing, characterization, storage and distribution; donor and recipient adverse events registration and management; risk-to-benefit and cost analysis; outcome analysis; production sites accreditation and management; regulatory oversight.This article describes recent national and international developments related to the distribution of cells and tissues for clinical use. Moreover, an example is reported of the implementation of a cellular therapy production site compliant with good manufacturing practices (GMPs) in a large European University hospital.     

Stem cell therapy for nerve injury

Peripheral nerve injury has remained a substantial clinical complication with no satisfactory treatment options.Despite the great development in the field ofmicrosurgery,some severe types of neural injuries cannot be treated without causing tension to the injured nerve.Thus current studies have focused on the new approaches for the treatment of peripheral nerve injuries.Stem cells with the ability to differentiate into a variety of cell types have brought a new perspective to this matter.In this review,we will discuss the use of three main sources of mesenchymal stem cells in the treatment of peripheral nerve injuries.     

Stem cell therapy: A novel approach for myocardial infarction

Myocardial infarction (MI) is a major cause of morbidity and mortality worldwide. Until recently, it was thought that myocardium was not able to repair itself, but studies have now shown that resident cardiac stem cells have regenerative capacity, and stem cell therapy may be a novel approach for cardiac muscle repair and regeneration. Stem cell-derived paracrine factors have been shown to regulate ventricular remodeling, inflammation, apoptosis, cardiomyocytes regeneration, and neovascularization in regions of infarcted cardiac tissue. In this review, we summarize the evidence from cellular, animal, and clinical studies supporting the potential clinical significance of stem cell therapy as a novel therapeutic approach for the treatment of MI.     

Stem cell transplantation and MBL replacement therapy

Mannose-binding lectin (or mannan-binding lectin, MBL) may have an influence on susceptibility to infection in patients given chemotherapy to induce remission or as conditioning before stem cell transplantation. The most surprising finding reported from an inconsistent literature was the observation that mbl-2 gene mutations in donors could influence the risk of serious infections in recipients of allogeneic stem cell transplants. This could be explained if leukocytes in the stem cell preparations (or their derivatives) were able to synthesize and secrete MBL, but the available evidence seems to exclude that possibility. An alternative mechanism could involve MBL binding to autologous cells and inducing immunological maturation of those cells. MBL can certainly bind to various cell types via surface glycoconjugates and the possible significance of this for MBL replacement therapy will be discussed.