Umbilical Cord Tissue Research Articles

Illicit Fentanyl in the Prenatal Period: A Significant Emerging Risk for Neonatal Opioid Withdrawal Syndrome

Objective This study aimed to evaluate the impact of in-utero illicit fentanyl exposure on neonatal outcomes, including neonatal opioid withdrawal syndrome (NOWS), length of stay (LOS), and treatment requirements. Study Design This study was conducted from March 2020 to December 2022, and focused on neonates born to mothers with opioid use or opioid use disorder (OUD). Maternal opioid use was identified through self-report or umbilical cord tissue (UCT) testing. Severe NOWS was defined as cases requiring pharmacological treatment. Statistical analyses included univariate comparisons, logistic regression, and generalized linear models to assess the associations between fentanyl exposure and neonatal outcomes. Results Forty-seven percent (75/159) of infants had in-utero fentanyl exposure. Fentanyl-positive mothers were older, 31 ± 5 years, compared to non-fentanyl mothers, 29 ± 5, p = 0.01. They were also less likely to receive prenatal care (p < 0.01) and had a higher number of polysubstance used, 5 ± 1 compared to non-fentanyl mothers, 3 ± 1, p < 0.01. Overall, infants exposed to fentanyl had a higher incidence of severe NOWS (odds ratio = 5.8, 95% confidence interval [CI]: 2.49–12.95, p < 0.01) and required earlier NOWS treatment initiation, 1 ± 1 day compared to non-exposed infants 3 ± 2 days, p < 0.01. In adjusted analysis, fentanyl exposure was associated with a nearly three-fold increased risk of NOWS (Mantel–Haenszel combined relative risk = 2.98, 95% CI: 1.94–4.57). Furthermore, fentanyl exposure led to longer LOS, with a 40% increase for preterm neonates (p < 0.01) and a 63% increase for full-term neonates (p < 0.01). Additionally, there was a significant correlation between log fentanyl concentration in umbilical cord tissue and cumulative morphine dose required for NOWS treatment, p = 0.001. Conclusion Prenatal illicit fentanyl exposure is an independent and strong risk factor for severe NOWS presentation in newborns requiring extended hospital stays. Key Points

B-259 Cannabinoid Prevalence in Umbilical Cord Tissue Toxicity Testing

Abstract Background Cannabis is rapidly becoming legalized in the United States. While its effects on the developing fetus are not fully understood, current recommendations advise against cannabis use and exposure during pregnancy due to its association with negative outcomes, such as preterm birth, fetal growth restriction, low birth weight, and developmental deficits. If drug exposure is suspected, umbilical cord tissue (UCT) testing is growing in frequency as a tissue of choice when testing infants. Neonatal testing protocols vary between hospitals, including both targeted or universal collection and targeted or universal testing of neonatal specimens. Based on the current environment of legalization, we were curious to see what the changes in cannabis use were over the previous five years, from 2019-2023. Methods We queried our laboratory information system for reported findings from screening and confirmatory umbilical cord testing, both of which were analyzed via liquid chromatography tandem-mass spectrometry (LC-MS/MS). Results were analyzed using R coding software. Results Overall, annually, 2019-2023 positivity rates for testing in general ranged from 41% - 44% positivity and maintained at 44% from 2020 onwards (n=90384 total workorders 2019-2023, n=40551 total positive workorders). Cannabinoids were starkly the most common drug found, accounting for 59-63% of all positive workorders annually from 2019-2023. There were no statistically significant differences in the cannabinoid positivity rates between 2019-2023. Of note, cannabinoid-only (delta-9-carboxy THC) workorders accounted for 28% of all positive workorders (n=25962) during that time frame. This was followed by methamphetamine-only (n=2485 workorders) and buprenorphine-only (n=1765 workorders). The combination of cannabinoids and methamphetamine, the most common drug combination found in UCT testing, had a range of positive results from 2019 - 2023 of 2.9 - 3.6% (n=1327 workorders). Cannabinoids and cocaine, the second most prevalent drug combination, ranged in positivity from 1.3 - 1.6% from 2019-2023 (n=616 workorders). Conclusions Cannabinoid exposure is prevalent in pregnant individuals undergoing UCT testing. Physicians should take care to keep informed on the impacts of cannabis exposure on the developing fetus and educating clients on the effects of cannabis exposure during pregnancy.

The Future of Regenerative Medicine: Stem Cell Research in Pakistan

The landscape of medicine is being revolutionized by the recent breakthroughs in stem cell research that offer new possibilities for treating diseases that were once deemed degenerative, incurable, or irreversible. In low and middle-income countries like Pakistan stem cell therapy holds promise for cost-effective solutions to non-communicable diseases. However, these advancements are hindered by ongoing debates, legal challenges, and public controversies. Stem cells can differentiate into various cell types and self-renew themselves, making them appealing for regenerative medicine. Unlike traditional therapies, regenerative medicine focuses on the restoration of optimal functioning of the damaged tissues and organs. Stem cells can be categorized as embryonic and adult stem cells. Adult stem cells such as mesenchymal stem cells can differentiate into various cell types. These can be obtained from bone marrow, adipose tissue, umbilical cord tissue, and amniotic fluid. Research shows that stem cells have the potential to treat cancers and advance regenerative medicine. Genetically modified stem cells can act as delivering systems for the treatment of genetic disorders and the development of therapeutic agents directly targeted to organs. Successful differentiation of stem cells into neurons, cardiomyocytes, insulin-producing cell clusters, hepatocytes, and hematopoietic precursors. These achievements are powerful tools that can help in combating human diseases. In Pakistan, while the potential of stem cell therapy has generated significant excitement, the progress is hindered by regulatory and infrastructure challenges. Addressing these concerns and fostering a supportive research environment is essential for advancing stem cell and regenerative medicine in the country. According to the WHO International Clinical Trials Registry, there are over 3000 trials on adult stem cells in progress [1]. These trials are essential in advancing the knowledge of stem cell therapies and for the establishment of realistic expectations for their outcomes. The transplantation of stem cells into non-native environments can pose risks, including tumor formation and other complications. These risks underscore the importance of rigorous evaluation and monitoring to ensure that these promising therapies are both safe and effective before they become widely available. In conclusion, stem cell research has great potential to revolutionize healthcare in Pakistan, but ethical, regulatory, and infrastructure challenges must be overcome before its benefits can be fully realized in regenerative medicine. An environment that is supportive and safe is imperative for clinical trials and research to ensure safe and effective therapies in the future.

Therapeutic potential of mesenchymal stromal cells on morphological parameters in the hippocampus of rats with brain ischemia-reperfusion modeling

Ischemic stroke is an extremely important pathology with high mortality, in which more than 50 % of patients with occlusion of the main vessels remain disabled, despite early reperfusion therapy by thrombolysis or thrombectomy. As part of the regenerative strategy, stem cell transplantation in ischemic stroke became a new impetus. Cell therapy with the use of mesenchymal stromal cells demonstrated encouraging results regarding endogenous mechanisms of neuroregeneration in response to ischemic damage to brain structures. The aim of the research is to study the influence of mesenchymal stromal cells of various genesis, lysate of mesenchymal stromal cells obtained from Wharton’s jelly umbilical cord and citicoline on the dynamics of morphological changes in the hippocampal CA1 region of rats with acute cerebral ischemia-reperfusion according to light microscopy and micromorphometry data. The experiment was carried out using 200 male Wistar rats, which were subjected to ischemia-reperfusion by reversible 20-minute bilateral occlusion of the internal carotid arteries. Animals with modeled pathology were intravenously transplanted with mesenchymal stromal cells of various genesis (from Wharton’s jelly of the human umbilical cord, human and rat adipose tissue), and rat embryonic fibroblasts, lysate of mesenchymal stromal cells and citicoline were injected. Histological analysis of rat brain sections was performed on the 7th and 14th day of the experiment. Statistical analysis was performed using “Statistica 6.0” (StatSoft® Snc, USA). The significance of differences was assessed using the Student’s t-test and the nonparametric Mann-Whitney U test. During the study, it was found that modeled ischemia-reperfusion in rats caused almost complete degeneration of the structure of the pyramidal layer of hippocampal CA1 region, gave uniformity to the structure of the radiant layer, infiltration of microglia, contributed to the disruption of the arrangement of apical dendrite bundles and narrowing of blood vessels as a result of perivascular edema. Also, the modeled pathology reduced the total number of neuronal nuclei in the hippocampal CA1 area, the overwhelming majority of which had signs of pathological changes. Transplantation of mesenchymal stromal cells of various origins, lysate of mesenchymal stromal cells and citicoline contributed to a significant increase in the number of neuronal nuclei in the hippocampal CA1 zone and nuclei that did not undergo pathological changes. The most positive effect was found in the transplantation of mesenchymal stromal cells from human Wharton’s jelly-derived cells. Thus, both in the subacute and recovery periods of ischemic stroke in rats, the transplantation of human Wharton’s jelly-derived mesenchymal stromal cells was significantly surpassed the reference drug citicoline in its ability to reduce the number of pathologically changed nuclei by 1.5 times (p<0.05). At the same time, the number of pathologically unchanged nuclei significantly exceeded the number of nuclei with signs of karyorrhexis and karyopyknosis, so it would be advisable to use mesenchymal stromal cells of various genesis, lysate or citicoline in conditions of acute cerebral ischemia-reperfusion, taking into account their ability to reduce the volume of the infarct. In the future, an injectable drug will be created from the most effective culture of mesenchymal stromal cells in terms of cerebroprotective properties for cell therapy of patients with acute ischemic stroke.

Safety and potential effects of intrathecal injection of allogeneic human umbilical cord mesenchymal stem cell-derived exosomes in complete subacute spinal cord injury: a first-in-human, single-arm, open-label, phase I clinical trial

ObjectiveNeurological and functional impairments are commonly observed in individuals with spinal cord injury (SCI) due to insufficient regeneration of damaged axons. Exosomes play a crucial role in the paracrine effects of mesenchymal stem cells (MSCs) and have emerged as a promising therapeutic approach for SCI. Thus, this study aimed to evaluate the safety and potential effects of intrathecal administration of allogeneic exosomes derived from human umbilical cord MSCs (HUC-MSCs) in patients with complete subacute SCI.MethodsThis study was a single-arm, open-label, phase I clinical trial with a 12-month follow-up period. HUC-MSCs were extracted from human umbilical cord tissue, and exosomes were isolated via ultracentrifugation. After intrathecal injection, each participant a underwent complete evaluation, including neurological assessment using the American Spinal Injury Association (ASIA) scale, functional assessment using the Spinal Cord Independence Measure (SCIM-III), neurogenic bowel dysfunction (NBD) assessment using the NBD score, modified Ashworth scale (MAS), and lower urinary tract function questionnaire.ResultsNine patients with complete subacute SCI were recruited. The intrathecal injection of allogeneic HUC-MSCs-exosomes was safe and well tolerated. No early or late adverse event (AE) attributable to the study intervention was observed. Significant improvements in ASIA pinprick (P-value = 0.039) and light touch (P-value = 0.038) scores, SCIM III total score (P-value = 0.027), and NBD score (P-value = 0.042) were also observed at 12-month after the injection compared with baseline.ConclusionsThis study demonstrated that intrathecal administration of allogeneic HUC-MSCs-exosomes is safe in patients with subacute SCI. Moreover, it seems that this therapy might be associated with potential clinical and functional improvements in these patients. In this regard, future larger phase II/III clinical trials with adequate power are highly required.Trial registrationIranian Registry of Clinical Trials, IRCT20200502047277N1. Registered 2 October 2020, https://en.irct.ir/trial/48765.

Neuroprotective effects of mesenchymal stromal cells in mouse models of Alzheimer’s Disease: The Mediating role of gut microbes and their metabolites via the Microbiome-Gut-Brain axis

The intricacy and multifaceted nature of Alzheimer’s disease (AD) necessitate therapies that target multiple aspects of the disease. Mesenchymal stromal cells (MSCs) emerge as potential agents to mitigate AD symptoms; however, whether their therapeutic efficacy involves modulation of gut microbiota and the microbiome-gut-brain axis (MGBA) remains unexplored. In this study, we evaluated the effects of three distinct MSCs types—derived from the umbilical cord (UCMSC), dental pulp (SHED), and adipose tissue (ADSC)—in an APP/PS1 mouse model of AD. In comparison to saline control, MSCs administration resulted in a significant reduction of behavioral disturbances, amyloid plaques, and phosphorylated tau in the hippocampus and frontal cortex, accompanied by an increase in neuronal count and Nissl body density across AD-afflicted brain regions. Through 16S rRNA gene sequencing, we identified partial restoration of gut microbial balance in AD mice post-MSCs treatment, evidenced by the elevation of neuroprotective Akkermansia and reduction of the AD-associated Sphingomonas. To examine whether gut microbiota involved in MSCs efficacy in treating AD, SHED with better anti-inflammatory and gut microbiota recovery effects among three MSCs, and another AD model 5 × FAD mice with earlier and more pathological proteins in brain than APP/PS1, were selected for further studies. Antibiotic-mediated gut microbial inactivation attenuated MSCs efficacy in 5 × FAD mice, implicating the involvement of gut microbiota in the therapeutic mechanism. Functional analysis of altered gut microbiota and targeted bile acid metabolism profiling revealed a significant enhancement in bile acid variety following MSCs therapy. A chief bile acid constituent, taurocholic acid (TCA), was orally administered to AD mice and similarly abated AD symptoms. Nonetheless, the disruption of intestinal neuronal integrity with enterotoxin abrogated the ameliorative impact of both MSCs and TCA treatments. Collectively, our findings substantiate that MSCs confer therapeutic benefits in AD within a paradigm that primarily involves regulation of gut microbiota and their metabolites through the MGBA.

The function and mechanism of Human nasal mucosa-derived mesenchymal stem cells in allergic rhinitis in mice.

To investigate the immunomodulatory effects and potential mechanisms of human nasal mucosa-derived mesenchymal stem cells(hNMSCs) on mouse allergic rhinitis, and to compare them with human umbilical cord-derived mesenchymal stem cells (hUCMSCs). hNMSCs and hUCMSCs were isolated and cultured for identification from human nasal mucosa and umbilical cord tissues. A co-culture system of LPS-stimulated RAW264.7 cells/mouse peritoneal macrophages and MSCs was employed.Changes in inflammatory factors in RAW264.7 cells and the culture medium as well as the expression of NF-κB signaling pathway in RAW264.7 cells were detected. Forty-eight BALB/c mice were randomly divided into control, OVA, hNMSCs, and hUCMSCs groups. An allergic rhinitis (AR) model was established through ovalbumin (OVA) stimulation and treated with hNMSCs and hUCMSCs. Subsequent assessments included related symptoms, biological changes, and the expression of the NF-κB signaling pathway in the nasal mucosa of mice. MSCs can be successfully isolated from human nasal mucosa. Both hNMSCs and hUCMSCs interventions significantly reverseed the inflammation induced by LPS and suppressed the upregulation of the NF-κB signaling pathway in RAW264.7 cells. Treatment with hNMSCs and hUCMSCs alleviated mouse allergic symptoms, reduced levels of total IgE, OVA-specific IgE and IgG1 in mouse serum, TH2-type cytokines and chemokines in mouse nasal mucosa, and TH2-type cytokines in mouse spleen culture medium, while also inhibiting the expression of the NF-κB signaling pathway in the nasal mucosa of mice. moreover, the hNMSCs group showed a more significant reduction in OVA-specific IgG1 in serum and IL-4 expression levels in mouse spleen culture medium compared to the hUCMSCs group. Our findings suggest that hNMSCs can ameliorate allergic rhinitis in mice, with a certain advantage in anti-inflammatory effects compared to hUCMSCs. The NF-κB pathway is likely involved in the anti-inflammatory regulation process by hNMSCs.Therefore, hNMSCs might represent a novel therapeutic approach for allergic rhinitis.

Abstract 21: Feasibility of Harnessing Umbilical Cord Tissue for Alveolar Cleft Repair: A Collaboration between a Large Academic Institution and a Private Family Cord Blood Bank

Abstract 21: Feasibility of Harnessing Umbilical Cord Tissue for Alveolar Cleft Repair: A Collaboration between a Large Academic Institution and a Private Family Cord Blood Bank

Enumeration of mast cells in the human umbilical cord: implications for coiling patterns

The abnormal umbilical cord coiling pattern affects the well-being of the newborn in different ways. Moreover the differentiation of mast cell according to these patterns may also varies. The objective: to investigate the detection and enumeration of mast cells in different patterns in human coiling cords in order to explore their effect on the newborn baby health.Materials and methods. Umbilical cord samples were collected from 105 healthy pregnant women. The cords were collected immediately after labor and kept in formalin (10%), according to coil type. Three major categories of umbilical cord coiling (normocoiled, hypercoiled, and hypocoiled) were determined according to the Umbilical Cord Index (UCI).The histological sections of the umbilical cord were collected according to UCI. This step is followed by using different histological stains, including hematoxylin and eosin and toluidine blue stains. The expression of the CD117 mast cell population in the umbilical cord tissue was determined using the immunohistochemical method in the subamniotic, perivascular and central areas. The enumeration of mast cells was done by direct counting and using Image J software. Results. The comparison of mast cell counts using Image J showed statistically significant variations (P<0.05) between normocoiled and hypercoiled cords in mast cell populations. No significant changes (P>0.05) were found in mast cell counts between normocoiled and hypocoiled umbilical cords. Conclusions. The mast cell distribution interpretation suggested that mechanical coiling during embryonic growth affects mast cell dispersal in sectioned umbilical cords. This interpretation’s functional relevance should be applied to coiling events that do not have harmful outcomes on the fetus. Future research could be done on the distribution of mast cells in the abnormally coiled umbilical cords associated with negative perinatal outcomes.

Immunophenotyping of a population of cultured human umbilical cord cells from Wharton's jelly

BACKGROUND: Against the background of many existing methods of defect replacement in post-traumatic injuries the methods of repair of damaged tissues based on methods using products of tissue engineering and cultures of artificially cultured human cells are becoming more and more widespread in medical practice. The literature reports weak immunogenic activity of human umbilical cord tissues, which makes these cells promising components of regenerative medicine products. Due to possible errors in explant selection and cell transformation in the process of cultivation, it is necessary to reliably determine the phenotype of cells obtained as a result of tissue explantation and their further cultivation. Thus, the specificity of obtaining multipotent mesenchymal cells from human umbilical cord Warton's stool tissues requires reliable identification of the type of the obtained cells. AIM: To obtain reliable features of mesenchymal stem cells in the cell population obtained from human umbilical cord stool tissue. MATERIAL AND METHODS: Methods of cell cultivation, flow cytofluorimetry, immunocytochemistry for determination of surface and intracellular markers of mesenchymal stem cells were used in the study. RESULTS: In the course of work on the identification of cells of the population obtained by culturing explants from human umbilical cord Wharton stool, the heterogeneity of the type of cells constituting the cell population was established. Most of them are mesenchymal stem cells carrying fluorescent markers CD45, CD73, CD34, CD29, CD90, CD44, CD105, which agrees with the immunophenotype of mesenchymal stem cells defined by the International Society for Cell Therapy. The ratio of the applied markers allows us to refer the population of cells obtained by direct explantation of Varton's gelatin tissue fragments to mesenchymal stem cells. Visual control confirmed the localisation of labelled antibodies on the surface of cultured cells. And also, it was shown that there were no vascular muscle cells in the obtained culture. CONCLUSION: As a result of experiments on identification of the cells obtained during explantation of Wharton's jelly tissue fragments and their further cultivation, their belonging to mesenchymal stem cells was established by immunofluorescence cytophotometry.

Evaluation of Gelatin-Based Poly(Ester Urethane Urea) Electrospun Fibers Using Human Mesenchymal and Neural Stem Cells.

Previously, a new biodegradable poly(ester urethane urea) was synthesized based on polycaprolactone-diol and fish gelatin (PU-Gel). In this work, the potential of this new material for neural tissue engineering is evaluated. Membranes with randomly oriented fibers and with aligned fibers are produced using electrospinning and characterized regarding their mechanical behavior under both dry and wet conditions. Wet samples exhibit a lower Young's modulus than dry ones and aligned membranes are stiffer and more brittle than those randomly oriented. Cyclic tensile tests are conducted and high values for recovery ratio and resilience are obtained. Both membranes exhibited a hydrophobic surface, measured by the water contact angle (WCA). Human mesenchymal stem cells from umbilical cord tissue (UC-MSCs) and human neural stem cells (NSCs) are seeded on both types of membranes, which support their adhesion and proliferation. Cells stained for the cytoskeleton and nucleus in membranes with aligned fibers display an elongated morphology following the alignment direction. As the culture time increased, higher cell viability is obtained on randomfibers for UC-MSCs while no differences are observed for NSCs. The membranes support neuronal differentiation of NSCs, as evidenced by markers for a neuronal filament protein (NF70) and for a microtubule-associated protein (MAP2).

Using umbilical cord tissue to identify prenatal ethanol exposure and co-exposure to other commonly misused substances.

Substance misuse during pregnancy can result in a variety of poor pregnancy outcomes. Objective data reporting the prevalence of neonates born with ethanol metabolites (evidence of prenatal ethanol exposure) in their fluids or tissues are limited. A secondary analysis of umbilical cord tissue specimens received for routine toxicological analysis was conducted. Prevalences of ethyl glucuronide (EtG), a long-term direct ethanol biomarker, were determined using a new laboratory tool, LDTD-MSMS. Additionally, other commonly misused substances were determined using routine procedures. Of 12,995 specimens, 238 (1.8%) specimens contained EtG. Concentrations of EtG ranged from 5 ng/g to 6679 ng/g (median 47 ng/mg; IQR: 16 ng/g, 203 ng/g). Of those 238 EtG-positive specimens, nearly 58% (N = 138) contained additional substances or metabolites. Self-report of substance use during pregnancy is under-reported. We have demonstrated co-exposure of substances with ethanol is higher than previous reports.

Immortalization of Mesenchymal Stem Cell Lines from Sheep Umbilical Cord Tissue.

Mesenchymal stem cells (MSCs) possess significant differentiation potential, making them highly promising in medicine and immunotherapy due to their regenerative capabilities and exosome secretion. However, challenges such as limited cell divisions and complex testing hinder large-scale MSC production. In this study, we successfully established an immortalized MSC line by transfecting the human telomerase reverse transcriptase (TERT) gene into MSCs isolated from pregnant sheep umbilical cords. This approach effectively inhibits cell senescence and promotes cell proliferation, enabling the generation of umbilical cord mesenchymal stem cells (UCMSCs) on a larger scale. Our findings demonstrate that these transfected TERT-UCMSCs exhibit enhanced proliferative capacity and a reduced aging rate compared to regular UCMSCs while maintaining their stemness without tumorigenicity concerns. Consequently, they hold great potential for medical applications requiring large quantities of functional MSCs.

Comparative Analysis of Decellularization Methods for the Production of Decellularized Umbilical Cord Matrix.

The importance of decellularized extracellular matrix (dECM) as a natural biomaterial in tissue engineering and regenerative medicine is rapidly growing. The core objective of the decellularization process is to eliminate cellular components while maximizing the preservation of the ECM's primary structure and components. Establishing a rapid, effective, and minimally destructive decellularization technique is essential for obtaining high-quality dECM to construct regenerative organs. This study focused on human umbilical cord tissue, designing different reagent combinations for decellularization protocols while maintaining a consistent processing time. The impact of these protocols on the decellularization efficiency of human umbilical cord tissue was evaluated. The results suggested that the composite decellularization strategy utilizing trypsin/EDTA + Triton X-100 + sodium deoxycholate was the optimal approach in this study for preparing decellularized human umbilical cord dECM. After 5 h of decellularization treatment, most cellular components were eliminated, confirmed through dsDNA quantitative detection, hematoxylin and eosin (HE) staining, and DAPI staining. Meanwhile, Masson staining, periodic acid-silver methenamine (PASM) staining, periodic acid-Schiff (PAS) staining, and immunofluorescent tissue section staining results revealed that the decellularized scaffold retained extracellular matrix components, including collagen and glycosaminoglycans (GAGs). Compared to native umbilical cord tissue, electron microscopy results demonstrated that the microstructure of the extracellular matrix was well preserved after decellularization. Furthermore, Fourier-transform infrared spectroscopy (FTIR) findings indicated that the decellularization process successfully retained the main functional group structures of extracellular matrix (ECM) components. The quantitative analysis of collagen, elastin, and GAG content validated the advantages of this decellularization process in preserving and purifying ECM components. Additionally, it was confirmed that this decellularized matrix exhibited no cytotoxicity in vitro. This study achieved short-term decellularization preparation for umbilical cord tissue through a combined decellularization strategy.

Retrospective Evaluation of Cryopreserved Human Umbilical Cord Tissue Allografts in the Supplementation of Cartilage Defects Associated with Hip Osteoarthritis.

Background: Osteoarthritis is a chronic disorder that affects the synovial joints by the progressive loss of articular cartilage. In the hip, the largest weight-bearing joint, the deterioration of articular cartilage and acetabular labrum can cause pain, diminishing the quality of life for patients. This study presents changes in reported pain scales from patients who received Wharton's jelly applications to cartilage deterioration in the hip from the observational retrospective repository at Regenative Labs. Methods: Sixty-nine patients were selected based on inclusion criteria with patient-reported pain scales, including the Numeric Pain Rating Scale and the Western Ontario and McMaster University Osteoarthritis Index, collected at the initial application, 30, and 90-day follow-up visits. Thirteen patients received a second allograft application and had additional follow-up visits at 120 and 180 days. Results: Five of the six scales used showed a statistically significant improvement in average scores across the cohort. The greatest improvements were observed in the NPRS with a 31.36% improvement after 90 days and a 44.64% improvement for patients with two applications after 180 days. The minimal clinically important difference (MCID) was also calculated to determine the perceived value of care for each patient with 44.9% of patients exceeding the MCID and 78.3% reporting at least one level of improvement. Conclusions: The positive outcomes for the patients in this cohort suggest WJ to be a promising alternative care option for patients with structural tissue degeneration in the hip refractory to the current standard of care.

Evolving trends in stem cell therapy: an emerging and promising approach against various diseases

Stem cell therapy is growing in popularity as a form of regenerative medicine with the capacity to treat a wide range of ailments. Stem cells exhibit the ability to differentiate into a diverse array of cell types within the organism due to their undifferentiated state. These cell sources include bone marrow, induced pluripotent stem cells, and umbilical cord tissue 1. Significant advancements in clinical applications and fundamental research of stem cells in regenerative medicine and other domains have occurred in recent years, motivating individuals to delve deeper into the study of stem cells. Stem cells, owing to their virtually limitless capacity for self-renewal, offer vast potential for advancements in the treatment of various diseases and human organ damage. Stem cell-related technologies for induction and isolation are relatively developed in the field of stem cell research, and numerous stable stem cell lines have been constructed with outstanding results 2. This editorial will delve into the latest advancements in stem cell therapy, shedding light on key developments, their clinical applications, and the promising future prospects.

Stem Cell Therapies for Spinal Cord Injury - A Review

The escalating incidence of Spinal Cord Injury (SCI), with approximately 0.9 million cases globally, underscores its growing public health concern. Traumatic SCI, often prevalent in developing nations due to factors like motor vehicle accidents and falls, leads to secondary damage involving inflammation, neuronal death, and ionic dysregulation. Despite the absence of an effective treatment for SCI, Stem Cell Therapy (SCT) emerges as a promising avenue, harnessing stem cells' unique capabilities for regeneration and replacement. The review explores various stem cell types, such as Neural Stem/Progenitor Cells (NS/PCs), Embryonic Stem Cells (ESCs), Induced Pluripotent Stem Cells (iPSCs), and Mesenchymal Stem Cells (MSCs), detailing their potential in preclinical and clinical contexts. Specifically, NSCs exhibit therapeutic promise by modulating astrocyte contribution, enhancing differentiation, and promoting growth factors. ESCs, despite their pluripotency, face ethical concerns and potential teratocarcinoma formation. IPSCs, reprogrammed from somatic cells, showcase potential in treating SCI without ethical issues. MSCs, with diverse sources like bone marrow, umbilical cord, and adipose tissue, offer versatility in differentiation and therapeutic benefits. Clinical trials with MSCs, especially BM-MSCs, UC-MSCs, and AD-MSCs, demonstrate improvements in motor and sensory functions, highlighting their regenerative potential. Despite promising results, challenges such as potential tumorigenesis and high costs persist, warranting further exploration and clinical translation of these stem cell therapies for SCI.

Identification of Mucopolysaccharide Types in Diabetic Placenta and Umbilical Cord Tissues

Identification of Mucopolysaccharide Types in Diabetic Placenta and Umbilical Cord Tissues

The I-Guana Shot Protocol, An Intracavernosal Application of Wharton's Jelly Stem Cells for the Treatment of Erectile Dysfunction, Phase II Study

Umbilical cord has become an increasingly used source of mesenchymal stromal cells for preclinical and, more recently, clinical studies. Different clinical uses on multiple anatomical structures have demonstrated the safe use of the umbilical cord tissue and derivates with multiple potentially different options to treat difficult diseases or clinical conditions. Immunophenotypic analysis and characterization of stem cells isolated from Wharton’s jelly via various methods is currently underway in clinical research. Stem cells are the body’s basic cells from which all other cells with specialized functions are generated. Under the right conditions in the body or perinatal environment, stem cells divide to form more new cells. These new cells become stem cells (self-renewal type of cells), and can also become specialized cells (differentiated) with more specific functions, such as blood cells, brain cells, heart muscle, urinary and genital tract, bone, etc. No other cell in the body has the natural ability to generate new cell types as stem cells do. As with any emerging scientific/medical field having such incredible potential, numerous research trials and data gathering efforts are currently being conducted world-wide. New data is being reported daily that present compelling cases for therapies using certain pathologies on selected patients. Scientists have been working for decades to harness the regenerative “power” of stem cells for the possible repair and rejuvenation of certain organs to activate tissue regeneration. The ultimate objectives of all these studies are the same: deliver transformative therapies. The capacity for these cells to transform into whatever cells or tissues that the body may need to regenerate itself could, within the next 3 generations, potentially provide the means to successfully treat blindness, spinal cord injuries, diabetes, cystic fibrosis, muscular dystrophy, or even erectile dysfunction in affected patients. Such future outcomes may be possible for candidate patients who are fortunate enough to have access to those scientific and evidence- based medical protocols that use such potent biological sources. It is vital that, in the light of the dazzling potential, mesenchymal stem cells research and medical applications continue, especially for compassionate medical use (e.g. for No Option patients).

Establishing a mesenchymal stem cell bank from umbilical cord tissue for cell therapy and initial application in the treatment of knee osteoarthritis at Tam Anh general hospital

Osteoarthritis (OA) is a natural aging process of joints that often occurs as age increases. In knee osteoarthritis, the cartilage that cushions the ends of the thigh bone and shinbone within the knee joint deteriorates, leading to a loss of cushioning and flexibility. This can result in pain, swelling, and stiffness when moving the knee joint. In the treatment of knee osteoarthritis, methods often include symptom management with pain-relieving and anti-inflammatory medications, lifestyle modifications to reduce stress on the knee joint; in some cases, surgery may be considered if nonsurgical interventions are ineffective. Stem cell therapy has emerged as a promising approach for treating knee osteoarthritis. This method has been demonstrated to be safe and effective. Still, one of the most important considerations when using stem cell therapy is quality regulation and safety standards regarding cell culture. This has led to the emergence of stem cell banks, where they are manufactured, preserved and stored. In this study, we utilized stem cells derived from allogeneic umbilical cord tissue. The stem cells were expanded and administered to patients via two injections spaced one month apart, with follow-up lasting an additional six months. The initial treatment results using stem cells for patients with knee osteoarthritis have been very promising. Through assessments of mobility, pain levels (measured by the VAS), and improvement in quality of life (measured by the Lequesne index) over 6 months, the research team has demonstrated the effectiveness of using mesenchymal stem cells (MSCs) from umbilical cord tissue for treating knee osteoarthritis.