Abstract
Stem cells are proving to be a promising therapy for a wide range of pediatric disorders, from neonatal hypoxic-ischemic encephalopathy to pediatric leukemia. Owing to their low immunogenicity and ease of availability, umbilical cord blood (UCB) progenitor cells are increasingly replacing fetal- and adult-derived cells in therapeutic settings. Multiple environmental and demographic factors affect the number and type of stem cells extracted from UCB, and these differences have been associated with disparities in outcomes after transplantation. To avoid variations in efficacy, as well as the potential adverse effects of stem cell transplantation, evaluation of the stem cell secretome is critical to identify key paracrine signals released by the stem cells that could be used to provide similar neuroprotective effects to stem cell transplantation. This article describes the cell types found in UCB and reviews the available literature surrounding the effects of collection timing and volume, maternal risk factors, delivery characteristics, and neonatal demographics on the cellular composition of UCB. In addition, the current findings regarding the stem cell secretome are discussed to identify factors that could be used to supplement or replace stem cell transplantation in pediatric neuroprotection.
Highlights
Stem cells are proving to be a promising therapy for a wide range of pediatric disorders, from neonatal hypoxic–ischemic encephalopathy to pediatric leukemia
The number of nucleated cells recovered from umbilical cord blood (UCB) is significantly lower than that from bone marrow (BM), there is a higher frequency of primitive cells in UCB
Umbilical vein endothelial cells being examined for their potential therapeutic effect in pediatric brain injury, and we may discover that UCB mesenchymal stromal/stem cells (MSCs) are less effective than one or more of the other umbilical cord (UC)–derived populations
Summary
Being examined for their potential therapeutic effect in pediatric brain injury, and we may discover that UCB MSCs are less effective than one or more of the other UC–derived populations. Other UCB MSCs have been induced in vitro to express neural-specific antigens and take on the morphology of neural cells after being exposed to neural culture [13]. Has DCC been associated with decreases in intraventricular hemorrhage and respiratory distress syndrome, but a number of authors have argued that DCC may be the most effective way to noninvasively administer autologous stem cells [24,25,26] Cord milking is another procedure that has been used to improve passage of placental blood to the neonate immediately after birth, especially in situations where DCC may be inappropriate due to the need for resuscitation [27]. Transplantation of hypoxia-preconditioned stem cells into a mouse model of an ischemic limb resulted in decreased muscle atrophy, bone loss, and apoptosis, and increased
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