Transamniotic Stem Cell Therapy (TRASCET)

Abstract

Trans-Amniotic Stem Cell Therapy (TRASCET) is a novel therapeutic paradigm for the treatment of congenital anomalies. It is based on the principle of harnessing and enhancing the biological role of select population of stem cells that either naturally occur in the amniotic fluid or are present therein in the setting of disease for therapeutic benefit. It has been recently shown that amniotic fluid-derived mesenchymal stem cells (afMSCs) play a central role in the widely known enhanced ability of the fetus to repair tissue damage. This germane finding was not only the first demonstration of a biological role for any amniotic cell, it has also provided validation for the use of afMSCs in regenerative strategies, in that these cells already play a regenerative role in nature. More recently, it has also first been shown experimentally that the intra-amniotic delivery of afMSCs in large numbers can either elicit the repair, or significantly mitigate the effects associated with major congenital anomalies by boosting the activity that these cells normally have. For example, concentrated amounts of these cells injected into the amniotic cavity can induce partial or complete coverage of experimental spina bifida, the most prevalent neural tube defect compatible with life, by promoting the local formation of host-derived skin, thus protecting the spinal cord from damage. In another example, intra-amniotic administration of afMSCs in large numbers can also significantly alleviate the bowel damage associated with gastroschisis, one of the most common major abdominal wall defects. Other applications involving different congenital anomalies and/or other stem cells present in the amniotic fluid in diseased pregnancies are currently under investigation in this still very young facet of fetal stem cell therapy. Combined, these discoveries point to simple, easily accessible intra-amniotic administration of afMSCs and/or other cells as practical, minimally invasive alternatives for the management of different congenital anomalies, with significant therapeutic gain at minimal to no risk to the mother and fetus.