Biomedical Engineering Reference
In-Depth Information
GVHD following hematopoietic stem cell transplantation. Two pediatric patients
with severe steroid-resistant GVHD were infused with CT MSCs. The GVHD
improved dramatically in both patients following infusion of CT MSCs, although
one patient received multiple infusions of MSCs over the course of treatment was
complete [
82
]. CT MSCs have also been evaluated for potential therapeutic
benefits in autoimmune diseases. Liang et al. reported that CT MSCs stabilized the
disease course of a patient with progressive multiple sclerosis that was not
responsive to conventional treatment [
83
]. A subsequent study from the same
group reported dramatic improvements in a patient with systemic lupus erythe-
matosus following intravenous infusion of CT MSCs [
84
]. Importantly none of the
case reports indicated adverse effects associated with infusion of CT MSCs.
14.7 Conclusions
Although many individuals have elected to collect and bank cord blood for its
potential use in the treatment of hematopoietic cancers and genetic blood, more
and more, individuals are now banking both cord blood and cord tissue for uses
that are only now being realized or have yet to be discovered. Primarily, these stem
cell applications are in tissue engineering and regenerative medicine. Regenerative
medicine has the ability to treat many of the above discussed conditions by
replacing or repairing malfunctioning tissues. Because regenerative medicine
focuses on functional restoration of damaged tissues, not just the abatement or
moderation of symptoms, this field has the potential to cut healthcare costs sig-
nificantly. In the United States cardiovascular disease is the leading cause of death,
and the costs associated with major cardiovascular diseases are estimated to be
almost $291 billion annually [
85
]. In the U.S. 1.7 million people sustain a trau-
matic brain injury annually, and the total costs, both direct medical and indirect
costs, associated with traumatic brain injury in 2000 were estimated to be
$60 billion [
86
]. The CDC estimates that 3.3 in 1,000 children in the U.S have
cerebral palsy and that the lifetime cost of caring for an individual with cerebral
palsy is close to $1 million [
87
]. However, in order for the promise of regenerative
medicine to be realized, it is necessary to identify optimal stem cell sources for
particular disease states, and make efforts to inform the lay and medical com-
munities as to their options.
Already the therapeutic potential of cord blood stem cells to treat children born
with neurological defects and cerebral palsy, post-natal strokes and type 1 diabetes
is being evaluated in clinical trials,. Other trials will surely rapidly follow,
including therapies for the eye, joints, wound healing, and spinal cord injuries. In
the next decade there will likely be additional uses that are not yet anticipated. The
key to these advances lies in the pluripotency of CB and CT stem cells and their
ability to be used in many cases under the practice of medicine, since it appears in
many instances that it is possible to merely infuse the stem cells directly without
timely and costly in vitro culture and differentiation. In my opinion cord blood and
