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The Qatar International Conference on Stem Cell Science and Policy
- Conference date: 27-01 Feb-Mar 2012
- Location: Qatar National Convention Center, Doha, Qatar
- Volume number: 2012
- Published: 01 February 2012
21 - 40 of 61 results
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Build it and they will come
By Rajan JethwaAbstractBuilding a public cord blood stem cell banking system and what it means for Qatar and the wider GCC.
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Umbilical cord blood transplantation: Saudi Arabia experience
More LessAbstractTransplantation of allogeneic bone marrow has been successfully used in the treatment of high risk or recurrent hematologic malignancies, bone marrow failure syndromes, selected hereditary immunodeficiency states and metabolic disorders. Early in the history of bone marrow transplantation, it was clear that access to a suitable donor was a major obstacle severely limiting the use of this potentially curative treatment modality. Although using an HLA sibling donor is the best choice for transplantation, not all patients could have access to such a donor, therefore transplant centers explored the possibility of using volunteer adult unrelated donors as an alternative to HLA–matched siblings. In addition, there was another alternative treatment strategy as a source of hematopoietic stem cell namely Umbilical Cord Blood. In Saudi Arabia, 60 percent of our patients who need a transplant will find an HLA-matched sibling donor, leaving 40 percent of the patients in need of alternative sources. The concept of establishing a Cord Blood Bank in Saudi Arabia under the umbrella of King Faisal Specialist Hospital & Research Centre was raised after the increase in the rate of using cord blood for transplantation due to the inability of finding fully or closely HLA-matched related donors. This Cord Blood Bank is a non-profit public cord blood bank dedicated to making high quality cord blood units available to all patients in need of related and/or unrelated transplantation in the Kingdom of Saudi Arabia and in the neighboring countries through the development and maintenance of a center of excellence for the collection, storage, search and distribution of ethnically and racially diverse cord blood units. Additionally, the mission of the Cord Blood Bank is to educate both the medical community and the public to the value of cord blood donation collection and cryopreservation, and increase the awareness of the importance of cord blood banking. To date, our inventory consists of 3,725 units of high quality cord blood with a total of 70 cord blood transplants carried out from our own inventory.
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Stem Cell Banking: Ethical and Policy Issues
By Nancy KingAbstractMuch stem cell research and many stem cell-based interventions depend on the availability of numerous viable cell lines. Multipotent and pluripotent stem cell lines may be created from embryonic stem cells, but also from stem cells found in amniotic fluid, umbilical cord blood, and other non-embryonic sources. Stem cell banks could collect, store and share enough cell lines to make good HLA matches with the vast majority of the inhabitants of a country or region, and thus might be easier and less expensive to use widely than individually matched induced pluripotent stem cell lines.
The collection, storage and sharing of stem cells in and through biobanks raises a well-known set of interesting ethical and policy issues for stakeholders: the individuals who provide their stem cells for banking, the biobanks that collect and store them, the investigators who use them for many types of research, and the patient-subjects who receive them in research studies or innovative interventions.
This presentation explores these ethical and policy issues, which include: informed consent, confidentiality and recontact, ownership and benefit-sharing, scope and control of future uses, innovation and the therapeutic misconception, and considerations of justice.
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An international perspective on the regulation of biosamples
By Sarah EllsonAbstractThis presentation will provide an additional perspective to that of the scientific and ethical issues that surround biosamples, by considering the appropriate role of regulation in this area. A regulatory regime can be used to ensure that the individuals, organisations and activities are governed in such a way as to ensure the highest ethical and scientific standards are maintained. Right touch regulation should promote innovation and should not be overly burdensome, but it is required to ensure that, in the highly sensitive area of biosampling, there is an appropriate framework in which high calibre operators can function and unsafe or unethical practise is prevented. As stem cell and biosample banking expands into new scientific and geographic areas regulation has to be sufficiently flexible to adapt to the unknown. It is also required if the bio banking communities are going to operate internationally.The presentation will consider what the international community might expect to see in regulatory terms as the Middle East expands into these opportunities. Regulation should be understood as key to ensuring confidence in the processes involved in biosampling. The presentation will look at some of the regulatory issues and challenges encountered in Europe and beyond and discuss the perspective and lessons to be learned. Central to the discussion will be consent issues and how consent may be embedded in regulation to underpin approaches to the storage, import and export and research with human tissue and cells.
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Informed consent and the Arab-Muslim research participant: tensions and challenges
More LessAbstractIt is generally accepted that the notion of informed consent first received official recognition in the Nuremberg Code of 1948. The move, which was a direct response to the inhumane and frequently fatal medical experiments on concentration camp inmates in Nazi Germany, emphasized the significance of allowing human subjects to assert their autonomy by making a decision on whether to participate in a research project only after they have been provided with sufficient information relating to the research. The concept has since assumed a prominent role in regulating the recruitment of research participants. This paper seeks to challenge its suitability for research which does not involve contact with the human body especially where it engages participants who hold values different to the Western secular worldview upon which the notion was shaped. In particular, it looks at human tissue research (e.g. stem cell research and biobank projects) involving Arab-Muslims. It seeks to draw attention to that fact that for Arab communities which have harmonised Islamic values, the decision to participate in research is made by taking into consideration firstly not individual interests, but the right of God and the interest of the society the individual belongs to. Since they also tend to define themselves and their individual worth as relative to their family, personal autonomy is therefore an alien concept and the decision to participate is taken jointly with the extended family. This has a significant practical dimension as research involving human tissues is capable of revealing information both about the participant and those related to him by blood. Further, Arab-Muslims who decide to participate in a research project would be prompted by a sense of religious duty and social responsibility. They therefore have a vested interest in knowing that the means and end-products of the research are acceptable by Islam. Yet the traditional model of informed consent only focuses on information on risks and benefits of the research. There is therefore a need to either adapt its parameters or find a suitable alternative which is sensitive to and reflective of their values.
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The Ethical Issues in Human Stem Cell Research: From Principles to Policy
More LessAbstractHuman stem cell research, because of its potential for both transformative sources of knowledge and for translation into widespread practical applications, has been a subject of ethical, religious, and policy debates since the first cells were characterized. The technology touches on some of humanities most urgent concerns and some of our most fundamental narratives. Stem cell research is characterized by a swiftly moving knowledge base, with first human embryonic (hES), then induced pluripotent cells (iPS) being seen as the best new hope in the search for cures to diseases. Each new advance in science brings new ethical and moral quandaries to the debate. This presentation will outline the history of ethical questions surrounding stem cell research, describe the variety of responses to such concerns, and define some of the international policy that has emerged to create ethical frameworks for ongoing research on stem cells. We will consider what questions, if any , can be understood as settled within a general consensus, and what questions may be raised by the future directions of stem cell research.
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Analysis of Human Endoderm Development Using Lineage-specific Reporter hESCs
By Ed StanleyAbstractHuman induced pluripotent stem cells (hiPSCs), derived by the in vitro reprogramming of somatic cells, resemble embryonic stem cells (hESCs) derived from the inner cell mass of the pre-implantation blastocyst stage embryo. In vitro, these pluripotent stem cells (PSCs) can be directed to differentiate toward specific lineages and, therefore, represent a tractable platform for the study of important events during the specification of early human cell types. A key step in differentiation is the commitment of PSCs to mesendoderm formation and the subsequent emergence of lineage-restricted progenitors. Studies from both embryology and from in vitro ESC differentiation systems have identified BMP4 and Activin A as important factors that control the direction of differentiation within nascent mesendoderm. Using a completely defined recombinant protein based differentiation medium, we have examined requirements for each of these factors in the generation of a variety of endodermal lineages, including thymus, lung and pancreas. This analysis has been aided by suite of genetically tagged hESC lines that enable precursors representing these cell types to be easily identified.
Human cells generated from differentiated PSCs represent a new tool for medical research as well as an avenue toward potential cell-based therapies of the future. In addition to the cellular products of PSC differentiation, findings from these experiments have interesting parallels with embryology and provide clues to some of the important events surrounding lineage commitment during early human development.
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Understanding the Origins and Impact of the Heterogeneous Policy Environment for Egg Donations
By Aaron LevineAbstractThe use of donated eggs is an important component of assisted reproduction and plays a prominent role in certain lines of scientific inquiry, particularly in the area of stem cell research. Yet despite these benefits, egg donation remains extremely controversial. One result of this ethical controversy has been the development of a heterogeneous policy environment where the rules for egg donation for both reproduction and research vary substantially from one country to the next or even within countries. In this presentation, I review the major policy options for egg donation that have been adopted around the world and discuss the justifications for these policies. Then, drawing on international data on assisted reproduction and published stem cell research using donated eggs, I offer a preliminary assessment of how these policy choices affect the availability of donated eggs for both reproduction and research purposes.
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Ethical Issues in Egg and Embryo Donation: Informed Consent
By Ana IltisAbstractThe use of human eggs and embryos in embryonic stem cell research raises numerous ethical issues and questions. This presentation addresses a range of ethical issues regarding the informed consent of persons who donate embryos for use in stem cell research or who donate gametes (egg or sperm) that lead to the creation of embryos that are donated for use in research. Informed consent refers to the process in which clinicians or researchers obtain permission from patients or potential research subjects prior to doing a procedure or enrolling the person in a study. The presentation will explain the main reasons for obtaining informed consent from persons during different stages of the process of donating gametes and creating or donating embryos for research. Special attention will be given to the local and international guidelines regarding informed consent, to the conditions necessary for obtaining informed consent, and to possible barriers to informed consent.
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Therapeutic and Research Potential of Human Stem Cells – The GE Healthcare Perspective
More LessAbstractThere has been significant interest in the therapeutic and scientific potential of stem cells since reconstitution of the haematopoietic system was first realized by bone marrow transplantation in the 1960s. The isolation of tissue-specific, multipotent stem cells from adult organs and the derivation of pluripotent human embryonic stem cells offer the potential for regeneration of a number of different tissues and organs susceptible to age-related degenerative conditions and traumatic injury. In the not-too-distant future, it will be possible to repair heart tissue damaged by myocardial infarction, to replace neuronal cells lost in Parkinson’s and Alzheimer’s diseases, to transplant new insulin-producing cells for diabetics and myelinating cells for individuals afflicted with multiple sclerosis, and to replace bone and cartilage lost through aging and inflammatory disease. In addition, the generation of specific populations of defined subtypes of human cells has tremendous potential to revolutionize the fields of drug discovery and investigation into the cellular bases of human disease. The newly emerging field of regenerative medicine will fundamentally alter clinical medicine and significantly influence our perceptions of aging, health and disease, with a myriad of consequences for society at large.
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NKX2-5GFP/w Human Embryonic Stem Cells Permit the Identification of Human Cardiac Progenitor Cells and Cardiomyocytes
More LessAbstractDifferentiation of human embryonic stem cells (hESCs) into cardiac progenitors is a powerful approach to dissect the molecular control of early human cardiogenesis. Cardiomyocytes can be derived from hESCs via the formation of embryoid bodies (EBs), which are cellular aggregates containing derivatives of all three germ layers that arise from differentiating hESCs. In order to identify, purify and characterize emerging cardiac progenitor cells (hESC-CPCs), we engineered a hESC line, NKX2-5GFP/w, in which GFP replaced the coding region of the conserved cardiac transcription factor NKX2-5. Using this line we have optimized a protocol for the differentiation of hESC-CPCs and cardiomyocytes (hESC-CMs) from hESCs in a 96-well plate format in serum free, chemically defined media that enables the precise and reproducible manipulation of differentiation conditions. EBs are formed by centrifugation (spin EBs). The combination of Activin A, bone morphogenetic protein 4 (BMP4), vascular endothelial growth factor (VEGF) and WNT 3a drives mesoderm formation until day three. Subsequently, the cytokine cocktail is replaced with media without growth factors and the EBs endogenous signaling networks control the specification of cardiovascular progenitors. Contractile foci are found in almost all EBs and all beating areas are GFP positive. Flow cytometric analysis for GFP demonstrates that up to 30 % of cells within the EB are NKX2-5 positive. The production of GFP+ cells is temporally restricted to day six and day nine of EB differentiation; after this time no further cardiac cells are specified. Electrophysiological studies show that the GFP+ CMs have a fetal phenotype. Expression analysis supports this finding demonstrating that NKX2-5+ hESC-CPCs and CMs constitute developmentally distinct populations with both having gene expression profiles closer to fetal heart than adult heart. Clonal analysis demonstrates that NKX2-5+ cells are capable of giving rise to the three major lineages in the heart, namely cardiomyocytes, smooth muscle and endothelium. Together, these data demonstrate that NKX2-5GFP/w hESC lines facilitate the identification, isolation and culture of human cardiovascular progenitors.
David A Elliott1*, Stefan R Braam2, Louise Lagerqvist3, Katerina Koutsis1, Rob Jenny1, Magdaline Costa1, Elizabeth Ng1, Tanya Hatzistavrou1, Rhys JP Skelton, Claire E Hirst1, Cissy Yu1, Ouda Khammy4, Xuleing Li1, Sue Mei Lim1, Richard P Davis2, Adam L Goulburn1, Robert Passier2, John M Haynes3, Colin W Pouton3, David M Kaye4, Christine L Mummery2, Andrew G Elefanty1 and Edouard G Stanley1.
1 Monash Immunology and Stem Cell Laboratories, Monash University, Victoria, 3800, Australia 2 Department of Anatomy and Embryology, Leiden University Medical Centre, Leiden, The Netherlands 3 Monash Institute of Pharmaceutical Science, Monash University, Parkville, Victoria 3052, Australia 4 Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, 3004, Australia
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Dynamics of Myocardial Perfusion in Patients with Coronary Heart Disease and Post-infarction Cardiosclerosis After Stem Cell Therapy
More LessAbstractObjective: To study efficacy and safety of autologous bone marrow stem cell therapy for tissue and neoangiogenesis in ischemic parts of heart in patients with coronary heart disease (CHD) and post-infarction cardiosclerosis after macro focal myocardial infarction.
Methods: Thirty patients with a diagnosis of ischemic heart diseases and myocardial infarction were selected. Fifteen of them were treated with the standard protocol of treatment (control group). The other 15 were transplanted with their bone marrow stem cells. Stem cells CD133 were isolated from mononuclear cells using Ficoll followed by immuno-magnetic separation. Isolated cells were injected in intra-arterial into the coronary arteries under angiography in the average dose of 5ml of suspension containing 0.8-1.5 million cells. Clinical examination and current tests such as ECG, LVEF, ESV, EDV were performed. In order to evaluate the dynamics of myocardial perfusion we carried out myocardial scintigraphy using Tc99m with the ligand methoxyisobutylisonitrile (MIBI).
Results: Key indicators of hemodynamic of heart were recorded before and after six months of the introduction of autologous stem cells. As presented in the table, the ejection fraction of left ventricle and end-diastolic volume of the left ventricle had a clear tendency to normalization.
Conclusions: Our method of stem cell transplantation is safe and does not increase mortality as a consequence of heart disease. Treatment of autologous stem cells significantly improved key indicators of heart hemodynamic. We thank J Al Majid from Dubai and H Sadeghi from Cardiovascular Surgery, University of Lausanne, for their precious help.
Z Rahimov1, A Barotov1, A Dustov2, M Khidirov3, T Gulmuradov1, G Mirojov2, B Karimzade2, N Navjuvonov 1, N Olimov1, E Rizoev1, A Gaibov2, M Rahmatov1, S Muminjonov2, A Didary3, J Irgashev3, A Therwath4,O Bobokhojaev1, U Kurbonov3, S Rahmonov1, M Mirshahi3,4.
1 Deptartment of Cardiology, Cardiovascular Surgery and Hematology of Ministry of Health of the Republic of Tajikistan, 2Institute of Gastroenterology of Tajikistan Academy of Medical Science, Dushanbe, Tajikistan, 3Deptartment of Surgical Diseases and Stem Cell Laboratory, Avicenna Tajik State Medical University, 4 UMRS 872, INSERM, Paris VI Faculty of Medicine, Paris, France
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Prospective Isolation of Therapeutically Relevant Human Embryonic Stem Cell-derived Cardiovascular Progenitors
Authors: Reza Ardehali and Irving WeissmanAbstractCardiomyocytes derived from human embryonic stem cells (hESCs) are promising candidates to regenerate myocardium as a treatment for heart disease. However, this application is limited because of the inability to prospectively identify a pure population of cardiovascular progenitors (CVPs) that is devoid of residual, undifferentiated cells capable of teratoma formation. Furthermore, the potential of hESC-derived cardiovascular lineage cells to functionally couple to human myocardium remains unknown. The purpose of the current study was to test the hypotheses that (i) CVPs derived from hESCs can be isolated based on a set of distinct surface markers and (ii) they can functionally integrate into the human fetal heart. We screened a large panel of monoclonal antibodies to prospectively identify early cardiovascular precursors that emerge from differentiating hESCs based on the expression of surface markers. We discovered four surface markers that highly enrich for CVPs: receptor tyrosine kinase-like orphan receptor family, ROR2, aminopeptidase-N, CD13, kinase insert domain protein receptor, KDR, and platelet-derived growth factor-α, PDGFRα. This quadruple positive population, or QP, gave rise to cardiomyocytes, endothelial cells, and vascular smooth muscle cells in vitro. We observed rare clusters of ROR2+ cells and diffuse expression of KDR and PDGFRα in first trimester human fetal hearts. Upon delivery of the QP cells into murine hearts, they developed into mature cardiomyocytes and endothelial cells, but failed to functionally integrate. While no teratomas were observed in the animals transplanted with QP cells, one out of the seven mice transplanted with the quadruple-negative cells developed teratoma in the heart. In contrast to traditional murine heart models for cell transplantation, delivery of the QP cells into human fetal hearts, heterotopically transplanted into rat’s abdomen, resulted in structural and functional integration of hESC-derived CVPs into human hearts. Taken together, we have shown for the first time that CVPs, defined by four novel surface markers, can structurally and functionally integrate into the electrical syncytia of a human fetal heart upon transplantation.
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Regenerating the human heart: proof of principle to patient-derived myocardial tissue
More LessAbstractIn the United States, nearly six million people currently suffer from heart failure. Organ transplantation remains the only definitive treatment for end-organ failure. However, the supply of donor organs is limited. Lifelong immunosuppression and chronic rejection limit widespread clinical impact of organ transplantation. The creation of an autologous bioartificial heart with preserved coronary and three-dimensional architecture could theoretically bypass these issues by providing a source of donor organs. Anterograde coronary perfusion of detergents (Sodium Dodecyl Sulfate: SDS, De-ionized water, and Triton-X) produced acellular heart scaffolds from small (rats) and human-sized (porcine and human) hearts. Perfusion-decellularized hearts were void of cellular content (DNA) and perfusing detergents (SDS) but had preserved coronary anatomy and gross structural integrity (sGAG quantification; immunohistochemistry for matrix proteins Collagen I, III, IV, X, Laminin, Fibronectin, Elastin).
Perfusion-decellularized whole heart scaffolds are biocompatible (ability to act as a substrate to support the appropriate cellular activity) when repopulated with neonatal rat cardiomyocytes1 or human induced-pluripotent stem cells (hiPSCs) as evident by cellular attachment and expansion. When seeded onto perfusion-decellularized heart scaffold slices, hiPSCs-derived cardiomyocytes form functional myocardial tissue, in vitro (visible spontaneous beating; immunofluorescence for myosin heavy chain and connexin-43).
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Professional guidelines and approaches to the ethical oversight of stem cell research
More LessAbstractThe extraordinary excitement over the scientific, medical, and financial possibilities of stem cell research has been accompanied by ethical concerns. As a consequence, professional groups have developed approaches to addressing these concerns across the continuum of stem cell research, from bench to bedside and to publication. Prominent approaches that have received considerable traction include those developed by the National Academy of Sciences, the International Society for Stem Cell Research, and the Hinxton Group. Understanding and implementing such approaches promises to mitigate some of the ethical issues related to stem cell research.
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International stem cell policies
More LessAbstractAfter the first isolation of human embryonic stem cells was reported in 1998, many countries reviewed their national policies regarding human embryo research. During this process, several countries amended current policies or created new policies to specifically address human embryonic stem cell research. These policies can be classified in three broad categories: restrictive, permissive with limits, or permissive. Over this 13 year period, there has been a global trend to transition policies from restrictive to more permissive. These shifts have occurred due to the efforts of scientists who have advocated for policy harmonization. While countries still possess a range of policies, this attempt towards harmonization has had a positive impact on the field by improving the quality and quantity of international scientific collaborations. This talk will review national stem cell policies, describe how international collaborations have been fostered under such policies, and discuss the impact of these international collaborations in the field of stem cell research.
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Conceptual and practical considerations for material and data sharing in stem cell research
By Kazuto KatoAbstractRapid development in the stem cell field, particularly in the field of pluripotent stem cells, resulted in the establishment of many cell lines, including those of ES cells and iPS cells. Some cell lines were made with the help of public funding while others with private money. The way stem cells are used also varies depending on the purpose of the types of research or medical applications. Regardless of the source of funding or the way cells are used, one important question is how to decide policies for sharing materials and data.
On one hand, to accelerate innovation and commercialization, one may need to admit that obtaining IPs and not sharing research materials and data need to be prioritized for researchers and companies. On the other hand, to facilitate overall research activities and speed up medical innovation, one can say that sharing materials and data should be encouraged by researchers and even by the business sector.
Regarding the latter view, we can learn some lessons from genome research areas, where notions of equity, justice and benefit sharing have been emphasized throughout the history of the field. One well-known example is Bermuda principle formulated in 1996. The principle declared that genome sequence data in the Human Genome Project (HGP) should be released into the public domain as soon as data is produced. One reason behind the principle was to emphasize that human genome data should not be privately owned by a few, but needs to be utilized by all of the researchers around the world. Another reason is a kind of moral consideration – human genome research should give benefit to the people of the society where advanced biomedical science cannot be conducted. The concept has been inherited in many subsequent research activities and has become a basic norm for genome research areas. I would like to argue that stem cell research community needs to learn the same notion of sharing and to pay attention to the concept of global equity and benefit sharing. Moreover, to actually facilitate sharing of materials and data, various points need to be considered. For example, informed consent that enables sharing of cells and data should be obtained. I will talk about conceptual reasoning as well as practical points to facilitate material and data sharing in the stem cell field.
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Policy Paradoxes: The Commercialization of Stem Cell Research
More LessAbstractOver the past several years the funding of stem cell research has often been justified on the grounds that it could serve as an engine of regional economic growth. To some degree, this is part of a larger trend, one that has placed biomedical research as a central component of many jurisdictions’ economic strategies. This has led to increasing pressure on researchers to build links with industry, to rapidly move their work to the clinic and to develop commercializable products. While there are undeniable benefits with this approach, it has also created some interesting policy challenges. In this presentation I will both review the nature and extent of the commercialization pressure and explore the related legal, ethical and social issues, including the possible adverse impact commercialization pressure may have on the research environment and the promotion of inappropriate 'hype'.
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CNS Remyelination – Can We Wrap It Up? – Regulators of Neural Stem/Precursor Cells in the Process of Myelin Regeneration
By Mark KotterAbstractEnhancing the regeneration of myelin sheaths in the central nervous system has been identified as an important therapeutic strategy to ameliorate the devastating consequences of demyelination that occur in diseases such as multiple sclerosis (MS). For remyelination to occur successfully oligodendrocyte precursor cells (OPCs) need to be recruited into areas of demyelination, engage with axons, and differentiate into myelin forming oligodendrocytes. However, in the context of demyelinating disease the differentiation of OPCs into oligodendrocytes often fails, resulting in chronic demyelination despite the presence of OPCs.
Important insight has been gained from studies investigating the interaction of stem/precursor cells with the distinct environment of demyelinating lesions. These suggest that successful regeneration depends on a signaling environment conducive to remyelination, which is provided in the context of acute inflammation. On the other hand it has been proposed that the specific environment of MS lesions contains factors that exert inhibitory effects on OPC differentiation. The pattern by which remyelination inducers and inhibitors are expressed in multiple sclerosis lesions may determine a window of opportunity during which oligodendrocyte precursor cells can successfully differentiate. This presentation will discuss evidence of inhibitory mechanisms associated with early stages of MS lesion development. Based on these findings it will outline novel approaches for enhancing remyelination in the central nervous system.
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Secreted Noncoding RNAs and Therapeutic Neural Stem Cell Plasticity
More LessAbstractCompelling evidence exists that somatic stem cell-based therapies protect the central nervous system (CNS) from chronic inflammation-driven degeneration, such as that occurring in experimental autoimmune encephalomyelitis (EAE), multiple sclerosis (MS) and cerebral ischemic/hemorrhagic stroke. However, while it was first assumed that stem cells may act through direct replacement of lost/damaged cells, it has now become clear that they are able to protect the damaged nervous system through a number of ‘bystander’ mechanisms other than cell replacement. In immune-mediated experimental demyelination and stroke – both in rodents and non-human primates – others and we have shown that transplanted neural stem/precursor cells (NPCs) possess a constitutive and inducible ability to mediate efficient ‘bystander’ myelin repair and axonal rescue. Yet a comprehensive understanding of the multiple mechanisms by which NPCs exert their therapeutic impact is lacking. We envisage that the remarkable therapeutic plasticity of NPCs results from their capacity to engage highly sophisticated programmes of horizontal cell-to-cell communication at the level of the (micro) environment and we attribute a key role to the transfer of secreted membrane vesicles (MVs) from (donor) NPCs to (recipient) neighbouring cells. We are starting to define whether this form of communication is biologically relevant for NPCs, and look forward to establishing whether it is associated to cell-to-cell trafficking of non-coding RNAs (ncRNAs), and indeed on elucidating its molecular signature and therapeutic significance for MS. We believe that the true innovation of this approach relies in its unique peculiarity to look into an innate cellular mechanism with the visionary focus of translating the knowledge of basal stem cell functions into innovative high-impact clinical therapeutics for MS.
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