For any disease condition, there are two possible approaches to treatment. Treatment
approaches that alleviate or suppress the disease condition are the most widespread
available options for majority of diseases. This type of treatment is often applied
in the form of drugs (chemical or biological) with or without surgical intervention.
The second type of treatment approach reverts the pathogenic situation to normal or
original state. This second option is rare, applicable to few of the diseases where
drugs cannot mend the situation and are not able to restore or regenerate the normal
function of the damaged tissue or organ. Regenerative remedies are commonly applied
through stem cell therapy and to some extent by organ transplantation. Stem cells,
the architect of all the structural and functional units of our body, are the utmost
hope for many incurable diseases like diabetes, cardiac disease, Parkinson's, Alzheimer's,
and other neurodegenerative diseases and injury related trauma. These cells depending
upon their nature of origin can differentiate into many or specific kind of mature
cell type to rebuild the tissue. Stem cells are present at various stages of life
(embryonic, fetal, and adult). Adult stem cells have the most potential and are the
safest for therapeutic utilization. Stem cell therapy is extensively used in clinic
for curing hematological malignancies. However, for many other dreadful life threatening
diseases, stem cell therapy is still in experimental phase and requires major effort
to bring them into clinical practice.
For the last few months, we have been busy reviewing various articles sent by renowned
scientists across the world for our special issue on “Application of Adult Stem Cells
in Medicine.” After stringent reviews, ten articles have been selected that cover
many critical aspects of stem cell therapy. They include reviews focusing on success
of stem cell therapy in various diseases and original research and articles related
to improvement in various aspects of stem cell therapy.
Cartilage defects and/or degeneration resulting from injury, aging, and osteoarthritis
are a major cause of joint pain and disability that seriously affect quality of life.
Unfortunately current surgical or pharmacological treatments can only help in temporary
relief and delay in disease progression. In recent years, new strategies have been
devised to repair the damaged cartilage using adult stem cells. This pressing issue
of regenerating cartilage using stem cells has been elaborated by two papers in this
issue. F. Perdisa et al. have discussed all recent in vivo studies on adipose derived
mesenchymal stem cells for the treatment of articular cartilage defect. However, C.
Bauge and K. Boumediene have reviewed the current status and future developments of
adult stem cell therapy towards cartilage tissue engineering. Both of these papers
have elucidated the promises and limitations of stem cell transplantation for cartilage
defect. Readers will be aware of the major development and the specific future focus
happening in this field.
Intracerebral hemorrhage (ICH) caused by sudden increase in blood pressure is not
as common as ischemic stroke but is more serious and quickly causes brain and nerve
damage. Depending on the location of hemorrhage and amount of injury long term treatments
including physical, speech, and occupational therapy are applied but majority survive
with some kind of permanent disability. In recent years, stem cell transplantation
as well as cell engineering has shown promising results for various neurological diseases
and regeneration of injured nerves. Application of such therapies is rare in patients
suffering from ICH. J. Zhu et al., in this issue, discussed their findings on autologous
bone marrow stromal cell transplantation for treating 206 patients suffering from
ICH. This clinical study assessed the safety profile, feasibility, and effectiveness
of surgery combined with autologous BMSC transplantation for treating ICH. Though
they were unable to assess the differentiation ability of BMSC into neuronal cells
and could not pursue long term followup, their study indisputably showed encouraging
clinical outcome. In another review by V. Sabapathy et al., the potential of various
cell therapy strategies for treating spinal cord injury has been discussed in detail
with an emphasis on source of cells and appropriate preclinical models. This review
highlights the insufficient data and research involved in spinal cord injury and calls
for more complete and multicentric clinical trials.
Probably the most demanding area for stem cell application is the incurable neurodegenerative
disorders such as Alzheimer's disease, Parkinson disease, and Huntington disease.
Though etiology and symptoms of these diseases are well characterized, the underlying
mechanism is yet to be understood. Therefore current treatments majorly aim towards
delaying progression of the disease. Lack of appropriate animal models simulating
the human pathogenesis also demands development of human disease-specific models to
identify new drugs. Induced pluripotent stem cells or iPSCs have revolutionized the
field of regenerative medicine and are now being utilized as models for neurodegenerative
disorders to understand the biology of pathogenesis and screen novel therapeutics.
Recent advancements in this newly emerging area are described in detail by W. Wan
et al. in this special issue. Their manuscript presents a comprehensive review on
application of iPSC in various neurodegenerative diseases narrating the promises and
concerned issues.
A major thrust in stem cell research is to experiment new approaches for efficient
and lineage specific differentiation of stem cells. In this special issue, three independent
investigations highlight the importance of such trials for various diseases. Oliviera
et al. demonstrated that priming of MSCs with endothelial growth medium improves therapeutic
efficacy in the treatment of systemic arterial hypertension in a rat model. Enhanced
differentiation of neuronal stem cells by Oleanolic Acid (OA) was evaluated by Y.
Ning et al., who found that Nkx-2.5 transcription factor partially regulates this
differentiation process. Similarly, V. Nardone et al. showed that in vitro Strontium
treatment of hADSCs enhances cell proliferation and osteogenic differentiation through
expression of early and late osteoblastic biomarkers such as ALP and HA, respectively.
Their findings clearly support the use of Strontium in in vitro induction of bone
regeneration.
The placenta, amniotic fluid, and umbilical cord are known to be rich source for neonatal
MSCs. Cryopreservation of umbilical cord immediately after birth has already been
commercial practice to tackle future life threatening diseases. However, such practice
must be dealt with care and properly designed expreiments as discussed by O. Maslova
et al. in their review.
Last but not the least, S. Kumar et al. investigated an important aspect required
for final acceptance of stem cells in clinic by repetitive and noninvasive tracking
of ICG labeled human placental derived MSC transplanted in live mouse.
Altogether, this special issue compiles a wide range of information on experimental
and translational application of adult stem cell in regenerative medicine. We hope
that contributions will generate new thoughts to readers of this journal.