Injection Of Autologous Stem Cells Research Articles

P-785 Promising Reproductive Outcomes In Patients With Refractory Thin Endometrium After Autologous Bone Marrow Regenerative Cell Therapy (ABM-RCT) – A Case Series

Abstract Study question Does Autologous Bone Marrow Regenerative Cell Therapy (ABM-RCT) improve endometrial thickness and receptivity and restoration of fertility in refractory cases of thin endometrium? Summary answer Selective Autologous Bone Marrow Regenerative Cell Therapy from Seragen (ABM-RCT) improves endometrial thickness, pregnancy, and live birth rate in refractory cases of thin endometrium. What is known already The impaired endometrial function can limit implantation due to insufficient tissue regeneration. Clinical investigation has proved that stem cells existing in the endometrium might originate from bone marrow and provides evidence that bone marrow-derived cells have a non-hematopoietic physiologic contribution to decidual stroma and play a vital role in implantation and pregnancy maintenance and non-hematopoietic BMSCs are able to impact decidual molecular milieu and overcome implantation defects. ABM-RCT is the most commonly used cell therapy and its safety and efficacy are well-established and documented. This forms the basis for exploring and standardizing ABM-RCT in the management of refractory thin endometrium. Study design, size, duration Eleven patients (from age 29 to 43 with refractory thin endometrium resistant to conventional treatment modalities were recruited and obtained informed consent with detailed explanation that the therapy is still experimental and the risk of failure was given to the couple as part of gynec-oncology treatment. Five patients had asherman’s syndrome, two patients had genital tuberculosis, two patients had thin endometrium hypo-responsive/unresponsive to estrogens, with RIF and two patients underwent chemo and radiotherapy Participants/materials, setting, methods BM aspiration was performed under local anesthesia, from the iliac crest using a disposable BM aspiration needle (Jamshidi, 11 G) and collected in heparinized syringes. Progenitor cell enrichment was done by Seragen’s Selective Enrichment Protocol. Peripheral blood was collected to enrich growth factor concentrate. A 2.9mm Hysteroscope was used with an operating channel and egg pickup needle attached to it and cells were implanted in subendometrial zone in all four walls of the uterine cavity. Main results and the role of chance All patients presented to us with refractory thin endometrium in HRT cycle despite giving all possible medications. Hence the decision was taken for Autologous Bone Marrow Cell Concentrate Therapy.Post ABM-RCT, endometrial thickness showed increase 100% (11/11) of more than 8 mm in all cases on day of embryo transfer with average endometrial thickness improvement was 1.8 mm than previous cycles, with uniform triple layer pattern.10 out of 11 (91%) patients conceived after autologous stem cell injection. 9 Out of 10 (90%) patients conceived had delivered healthy babies and 1 patient (9%) had a miscarriage at 12th week of pregnancy. 1 patient did not conceive will be assessed for immunoprofiling and one more rejuvenation cycle. Limitations, reasons for caution Our study outcomes are consistent with several previous studies and the feasibility of treatment at an IVF setup and encouraging results. Well-planned study with more patients is warranted to evaluate safety, effectiveness, and cost of this modality before it becomes integrated in treatment of this frustrating condition during IVF procedures Wider implications of the findings Our results demonstrates selectively enriched ABM-RCT enhances endometrial thickness, tissue remodeling, uneventful gestation, improved pregnancy and live birth rate. Need for Surrogacy in Non-Responsive Thinendometrium May Be Re-Evaluated. Role of hematopoetic stem cell research and knowledge generated is representing reliable strategy in IVF that may be routinely used in clinicalpractice. Trial registration number Not applicable

Efficacy of adipose-derived stromal vascular fraction cells in the management of chronic ulcers: a randomized clinical trial.

Background: Cell therapy is a promising method for improving healing in chronic ulcers through delivery of isolated adipose-derived stromal vascular fraction. Objectives: This study investigates the autologous stem cell yield of adipose tissue and its efficacy in chronic ulcers compared with conventional methods. Methods: This study was a randomized controlled trial. After the study design and protocol were established and ethical committee approval was obtained, we enrolled 100 patients divided into study and control groups. In the study group, we performed debridement and autologous stem cell injection every 3weeks. The control group was treated with debridement and conventional dressing. Assessments included clinical and histological parameters. Results: The study group showed improved healing. Conclusion: Using autologous adipose-derived stromal vascular fraction cells is an effective treatment method for chronic ulcers. This study was registered on the Pan-African Clinical Trial Registry and the number of the registry was PACTR201709002519185.

Comprehensive Analysis of Cell Therapy on Chronic Skin Wound Healing: A Meta-Analysis.

Wound healing has been greatly challenging in different acute and chronic skin injuries. Among them, nonrevascularizable critical limb ischemic ulcers, venous leg ulcers, and diabetic lower limb or extremity ulcers are well-known refractory skin injuries that are difficult to treat. Partly differentiated, progenitor cell-based graft transplantation or direct injection of autologous stem cells might promote the wound healing process. Studies aiming to comprehensively analyze the effects of cell therapy on skin wound healing could provide clinical evidence for skin injury treatment. Different databases were searched for full-text publications on the comparison between cell therapy and regular therapy. Heterogeneity was detected by the I2 method, and a fixed effect model was applied for data pooling if heterogeneity was absent. Publication bias was analyzed using a funnel plot, and 10 studies were finally included in this study. After a long-term follow-up, fewer patients underwent major amputation in the cell therapy group, compared with the standard therapy group, and those in the cell therapy group were characterized by a smaller ulcer area. Moreover, there was a significant difference in the wound healing rate between the intervention and control groups. However, pain caused by skin wounds was hardly mitigated by cell therapy in patients with critical limb ischemia. In this study, cell therapy proved effective in decreasing the size of ulcers and improving the wound closure rate. Additionally, the major amputation rate was decreased in the cell therapy group. However, the symptoms of pain were hardly alleviated by cell therapy in patients with cutaneous ulcers caused by peripheral artery disease-related critical limb ischemia.

Stem cell therapy as a novel therapeutic intervention for resistant cases of alopecia areata and androgenetic alopecia

Background: Management of alopecia areata (AA) and androgenetic alopecia (AGA) is often challenging as patients may be resistant to currently available modalities of treatment. The use of stem cells may be a novel option for resistant cases.Objective: To evaluate the safety and efficacy of the use of autologous bone marrow derived mononuclear cells (including stem cells) as compared to follicular stems cells for the management of resistant cases of AA and AGA.Methods: This study included 40 patients (20 AA patients and 20 AGA patients), all patients were treated with a single session of intradermal injection of autologous stem cells (SCs) therapy. They were divided into four groups according to the applied modality [either autologous bone marrow derived mononuclear cells (bone marrow mononuclear cells [BMMCs] or autologous follicular stem cells [FSC]).Results: Six months after stem cell therapy (SCT) injection, there was a significant improvement, confirmed by immunostaining and digital dermoscopy. The mean improvement in all groups was “very good”. There was no significant difference between both methods in either type of alopecia. No serious adverse events were reported.Conclusion: Autologous BMMCs and FSC seem to be a safe tolerable and effective treatment for the management of both resistant AA and AGA.

Challenges in the Regulation of Autologous Stem Cell Interventions in the United States.

The direct-to-consumer marketing of stem cells for unproven therapeutic uses has grown rapidly in the United States in recent years. This development is surprising since the marketing and distribution of human cell-based medical products is stringently regulated in the US. This essay describes ambiguities, gaps, and inconsistencies in the current regulatory system that have enabled such businesses to thrive. In addition to directly challenging the authority of the Food and Drug Administration (FDA) over autologous cell-based products in the courts, stem cell marketing firms have also identified and exploited regulatory loopholes, such as the same surgical procedure exception, which exempts from FDA oversight human cell-based products that are harvested and reimplanted in a single procedure. Many businesses also advertise stem cell clinical studies on a pay-to-participate basis, which requires patients to pay large sums to enroll in clinical research. This business model not only shifts many of the cost and risks of medical experimentation from providers to patients but may also indemnify sellers from fraud litigation. Lastly, stem cell advertisers borrow heavily from the language and concepts of science-based medicine in their marketing. The inaccurate promotion of autologous stem cell injections as a form of "personalized" medicine lends a veneer of credibility and precision that may encourage patients to undergo procedures of uncertain effectiveness and to sympathize with stem cell businesses in their efforts to evade oversight.

Трансмиокардиальная лазерная реваскуляризация в сочетании с интрамиокардиальным введением аутологичных стволовых клеток костного мозга

Трансмиокардиальная лазерная реваскуляризация в сочетании с интрамиокардиальным введением аутологичных стволовых клеток костного мозга

Stem Cell Therapy Combined with Myocardial Revascularization: A Pilot Study using the Harvest Technique

Background: To assess the usefulness of intra-myocardial autologous stem cell injection as a hybrid procedure with coronary artery bypass grafting (CABG) compared to conventional CABG only in the patients with ischemic heart disease with non-viable or non-graftable myocardial segments. Methods: After approval of Local Ethics Committee and obtaining written informed consent, a prospective, comparative randomized study was conducted on 30 ischemic heart patients with non-viable or non-graftable segments. They were divided into two groups. Group A (15 patients): where intra myocardial injection of autologous bone marrow mononuclear cells (ABM-MNCs) was done in conjunction with CABG. Group B (15 patients): where CABG was performed only. Resting and stress echocardiography follow up was done for 6 months. Results: There was no mortality in either group. No complications were noted at a mean of 6 months after surgery. Group A showed a significant improvement (mean of 7.25% and P<0.001) in left ventricular ejection fraction (LVEF). Both end- diastolic (LVEDD) and end-systolic (LVESD) diameters showed significant decrease compared to pre- operative values. LVEDD decreased by a mean of 5.23 (P <0.001) while LVESD by a mean of4.21 (P<0.001). Conclusion: Stem cell therapy combined with CABG improves cardiac function compared with revascularization alone. In the same time, it is safe, feasible, and reproducible and doesn’t increase the risk of major adverse events or mortality.

Sphincter-sparing techniques for fistulas-in-ano

Anal fistulas require surgical treatment to cure the fistula. Fistulotomy is the treatment of choice because of its high success rate, but it also carries a risk of postoperative incontinence. Different methods have been proposed to overcome the need for dividing part or all of the sphincter, so-called "sphincter saving techniques" (SST), such as flap advancement, intrafistular injection of glue, or the insertion of a bio-prosthesis (collagen plug). However, the success rate of SSTs is lower than that of fistulotomy. Ligation of the Intersphincteric Fistula Tract (LIFT) is one of the most recent SSTs. It aims to ligate and transect the fistula by an approach through the intersphincteric space. The methodological quality of most published studies has been only average, but several studies have reported attractive success rates of 70 to 95% without postoperative incontinence. Other techniques such as endo-anal clip or injection of autologous stem cells are still anecdotal.

Therapeutic effect of adipose-derived mesenchymal stem cell injection in horses suffering from bone spavin

In this article we demonstrate the efficiency of autologous transplantations of adipose-derived mesenchymal stem cells for equine bone spavin treatment. Horses qualified to the study were divided into three groups: (i) research - treated with intra-articular injections of autologous stem cells, (ii) comparison treated with steroid drugs and (iii) control - untreated. All animals underwent comprehensive clinical examination before and after treatment. Our research confirms the long-term beneficial influence resulting from stem cell therapy in horse bone spavin treatment, in contrast to routine steroid usage.

Abstract 18356: Autologous Intracoronary Stem Cell Therapy is Safe and Feasible for Children With Dilated Cardiomyopathy: A Randomised Controlled Cross-Over Pilot Study

Meta-analysis of adult stem cell therapy studies post myocardial infarction has shown moderate &amp; sustained improvement of function. Positive results have also been seen in adult dilated cardiomyopathy (DCM) &amp; chronic ischaemic heart failure. The place of stem cells in pediatric heart failure is unknown. This randomised, blind, crossover placebo controlled trial sought to evaluate the potential use of stem cells in the management of pediatric heart failure &amp; is the first of its kind within the pediatric population. Methods &amp; results: Ten children (mean age 7.2y, range 2.2-14.1y, 6 male) with DCM were recruited from Heart Failure clinic. Patient profiles on study entry: NYHA/Ross class 3-4, ejection fraction (EF) on MRI mean 40% (range 30-48%). On enrolment patients were randomised to receive stem cell or placebo intracoronary injection &amp; MRI, with cross-over of intervention at 6 months &amp; final MRI assessment at 1 year. Bone marrow processing was performed using standard techniques. The mononuclear cells, obtained within 1.5 hours of aspiration, were divided to provide 1ml for coronary injection &amp; 1ml for phenotyping. Intracoronary injections &amp; MRI were performed under the same anaesthetic. Mononuclear cell count mean was 51.7 x 106/ml (range 11.8-115.1 x 106/ml). Nine patients completed the protocol, the tenth patient had Duchenne Muscular Dystrophy (DMD) &amp; did not undergo general anaesthesia, this data was excluded from the group analysis and is presented separately. There were no withdrawals, morbidity or mortality. Primary end point, freedom from death or transplant, was achieved in all patients. Secondary end points, indexed end diastolic volume (EDV) 6 months post cell infusion for n=9, was reduced in 7 &amp; unchanged in 2 (P=0.01 for comparison of means), end systolic volume (ESV) decreased in 6 following cell injection. (P=0.05 for comparison of means). EDV increased in 5 patients following placebo. EF did not change significantly. EDV reduced in all patients with an injected cell count &gt;34.2 x 106. Conclusion: This pilot study demonstrates that intracoronary injection of autologous stem cells is safe &amp; feasible in children. Encouraging data on EDV were generated, larger scale studies will be required to measure clinical effect.

The clinical benefit of stem cells in cartilage regeneration

The results of a recent randomized, controlled study suggest than intra-articular injection of autologous stem cells collected from peripheral blood might improve the outcome of surgical approaches to regeneration of articular cartilage after injury. However, questions remain regarding the clinical benefit and feasibility of such an approach.

Ultrasound Guided Platelet Rich Plasma and Autologous Stem Cells Injections: An Emerging Alternative Treatment for Osteochondral Defects

Osteochondral defects are a frequent cause of knee pain in the population. The majority of the diagnosed cases of osteochondral defects (OCD) are treated with surgical procedures. However, there are emerging alternative and integrative medicine options which have appeared on the horizon. These alternative treatment options are minimally invasive with a significant cost reduction and the potential for an earlier return on function due to a shorter rehabilitation period. The focus of this report will be to demonstrate the efficacy of Ultrasound (US) guided Platelet Rich Plasma (PRP) and Autologous Stem Cell Injections in the treatment of osteochondral Defects.

1005 THE FUNCTIONAL CONSEQUENCES OF ALLOGENICITY OF ADIPOSE DERIVED STEM CELLS FOR INTRACAVERNOSAL INJECTION AFTER CAVERNOUS NERVE INJURY IN RATS

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Basic Research II1 Apr 20121005 THE FUNCTIONAL CONSEQUENCES OF ALLOGENICITY OF ADIPOSE DERIVED STEM CELLS FOR INTRACAVERNOSAL INJECTION AFTER CAVERNOUS NERVE INJURY IN RATS Naside Mangir, Cem Akbal, Ferruh Simsek, Tufan Tarcan, and Levent Turkeri Naside MangirNaside Mangir Istanbul, Turkey More articles by this author , Cem AkbalCem Akbal Istanbul, Turkey More articles by this author , Ferruh SimsekFerruh Simsek Istanbul, Turkey More articles by this author , Tufan TarcanTufan Tarcan Istanbul, Turkey More articles by this author , and Levent TurkeriLevent Turkeri Istanbul, Turkey More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1107AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Intracavernous injection of adipose derived stem cell(ADSC)s can ameliorate erectile functions after cavernous nerve injury in rats. The use of pre- prepared allogenic stem cells are desired but no comparative studies exist. The aim of this study is to evaluate functional consequences of either allogenic or autologous use of adipose derived stem cells. METHODS All rats underwent bilateral paratesticular fat tissue excision at the beginning of the study. ADSCs are isolated from the excised adipose tissue in Marmara University School of Medicine Urologic Research Laboratory. After 15 days of fat excision bilateral cavernous nerve injury is performed which is followed by intracavernosal injection of stem cells or stem cell lysates accordingly to each group. One month after injection Intracavernosal Pressure/ Mean Arterial Pressure(ICP/ MAP) values are calculated after intracavernosal pressure measurement. All rats are sacrificed at the end and penile tissues are taken for immunohistochemical and molecular investigation. RESULTS A total of 36 Sprague Dawley rats were used. ADSCs isolated from the excised paratesticular fat tissue were characterized with flowcytometry and these cells were demonstrated to be CD90 and CD 44 positive; CD11b, CD 34 and CD45 negative. These stem cells were also differentiated into 2 different tissues to prove their multilineage differentiation capacity. One month after injection ICP/ MAB values in the sham group (Group 1) were significantly higher compared to PBS injection (Group 2) group, 73,1 (±10,3) ve 47,1 (±14,2) (Mann Whitney U test p: 0,009), respectively. Both autologous stem cell injection group (Group 5) and allogenic stem cell injection group (Group 3) showed statistically insignificant but still better results when compared to PBS injection (Group 2), 62,1 (±12,3), 61,0 (±10,6) and 47,1 (±14,2) respectively. Autologous or allogenic stem cell lysate injections(Group 4 and 6) were not better than PBS injection. The nNOS staining in corpus cavernosum of rats treated with autologous or allogenic stem cells were stronger. Also nNOS expression was quantitatively better in stem cell injection groups. CONCLUSIONS ADSC injection can be an effective treatment to regain erectile functions after cavernous nerve injury. The use of either autologous or allogenic stem cells does not change the functional results. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e409 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Naside Mangir Istanbul, Turkey More articles by this author Cem Akbal Istanbul, Turkey More articles by this author Ferruh Simsek Istanbul, Turkey More articles by this author Tufan Tarcan Istanbul, Turkey More articles by this author Levent Turkeri Istanbul, Turkey More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Intracoronary bone marrow cell application for terminal heart failure in children

In spite of tremendous progress in the medical and surgical treatment of children with congenital heart disease and dilated cardiomyopathy achieved during the past few decades, for some children a heart transplant remains the only option. Clinically relevant benefits of intracoronary injection of autologous stem cells on cardiac function and remodelling have been demonstrated in adult patients with acute myocardial infarction. Experience with autologous stem cell therapy in children with severe congenital or acquired pump failure is limited to a small number of case reports. Between 2006 and 2010, nine severely ill children were treated with intracoronary infusion of autologous bone marrow-derived mononuclear cells as part of a compassionate therapy in our centre. No procedure-related unexpected adverse events occurred. There was one patient on extracorporeal membrane oxygenation who died of haemorrhage unrelated to the procedure; three patients proceeded to heart transplantation once a donor heart became available. The other five patients showed an improvement with respect to New York Heart Association classification (greater than or equal to 1), brain natriuretic peptide serum levels, and ejection fraction. Similar to adults, intracoronary injection of autologous bone marrow cell is technically feasible and safe for children. On the basis of our data, we propose to perform a pilot study for children with congestive heart failure, to formally assess the efficacy of intracoronary autologous bone marrow cell therapy.

Autologous stem cells for the treatment of post-mastectomy lymphedema: a pilot study

BACKGROUND AIMS. Lymphedema is a common complication with breast cancer treatment that does not have a definite cure. Our objective was to determine the efficacy of autologous stem cells (ASC) in the treatment of lymphedema secondary to mastectomy and axillary lymphadenectomy in comparison with traditional decongestive treatment with compression sleeves. METHODS. A prospective study including 20 women with lymphedema secondary to breast cancer surgery with axillary lymphadenectomy was conducted. Women were assigned at random to one of two groups. One group of 10 women was injected with ASC in the affected arm, whereas the other 10 women comprised the control group and received traditional compression sleeve therapy (CST). The follow-up for both groups was 12 weeks. Pain, sensitivity and mobility were assessed before and after therapy. RESULTS. There was improvement in the volume of lymphedema in both groups, with no significant difference. In the ASC group there was an overall volume reduction during the follow-up, whereas in the CST group lymphedema recurred after the compression sleeve was removed. CONCLUSIONS. Our findings suggest that ASC injection for patients with lymphedema can be an effective treatment. It reduces arm volume and associated co-morbidities of pain and decreased sensitivity. Traditional CST was also effective for lymphedema reduction, but it was dependent on continuous use of the treatment.

Baseball Player Steals Home with Left Knee Platelet Rich Plasma and Autologous Stem Cell Injections

Baseball Player Steals Home with Left Knee Platelet Rich Plasma and Autologous Stem Cell Injections

Anestesia inhalatoria con preservación de la ventilación espontánea en un paciente trasplantado de laringe y tráquea sometido a desbridamiento intraluminal

Graft stenosis from fibrous granulation tissue is not an uncommon problem in recipients of a transplanted trachea and larynx. We describe the case of a man with a transplanted trachea who was seen for respiratory difficulty and stridor secondary to stenosis. Examination through a rigid bronchoscope and surgical debridement were both performed under anesthesia with sevoflurane alone while the man breathed spontaneously. The outcome of treatment with sequential debridements of fibrotic tissue and autologous stem cell injection was satisfactory and the patient was discharged.

Angiomyeloproliferative Lesions Following Autologous Stem Cell Therapy

Some reports suggest that autologous hematopoietic stem cell transplantation holds potential for treatment of renal diseases such as lupus nephritis, but the safety of delivering various stem cell types (hematopoietic, mesenchymal, and endothelial precursors) is not well established. Here, we report a case of lupus nephritis treated by direct renal injection of autologous stem cells recovered from peripheral blood. The patient developed masses at the sites of injection and hematuria. We suspected transitional cell carcinoma but nephrectomy revealed that the masses were angiomyeloproliferative lesions. We believe that this previously undescribed pathologic entity is stem cell-derived or -induced. The biologic potential, including the neoplastic potential, of this lesion is unknown. This case illustrates that the development of angiomyeloproliferative lesions is a possible complication of stem cell therapy.

Adult Stem Cell Therapy of Female Stress Urinary Incontinence

ObjectivesTo investigate the efficacy of transurethral ultrasound (TUUS)-guided injections of autologous myoblasts and fibroblasts in women with incontinence. MethodsBetween January and June 2005, 20 female patients suffering from stress urinary incontinence (SUI) were included. Skeletal muscle biopsies were taken from the left arm to obtain cultures from autologous fibroblasts and myoblasts. By TUUS guidance the fibroblasts were injected into the urethral submucosa and the myoblasts were injected into the rhabdosphincter. A defined incontinence score, quality-of-life score and urodynamic, electromyographic, and laboratory parameters, as well as morphology and function of urethra and rhabdosphincter were evaluated before and up to 2 yr after therapy. ResultsEigtheen of 20 patients were cured 1 yr after injection of autologous stem cells and in 2 patients SUI was improved. Two years after therapy 16 of the 18 patients presented as cured, 2 others were improved, and 2 were lost to follow-up. Incontinence and quality-of-life scores were significantly improved postoperatively. The thickness of urethra and rhabdosphincter as well as activity and contractility of the rhabdosphincter were also statistically significantly increased after therapy. ConclusionsClinical results demonstrate that SUI can be treated effectively with autologous stem cells. The present data support the conclusion that this therapeutic concept represents an elegant and minimally invasive treatment modality to treat SUI.