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Dr. Sharda Jain
Dr. Ajay saxena
Dr. Rajesh Dhall
:A Hope to No Hope Disorders
Stem Cell Therapy
Life is too Precious -
don’t give up !!
Mother Teresa
STEM CELL Therapy
A HOPE TO NO HOPE DISORDERS
The fascinating new world of
STEM CELL THERAPY :
a medical revolution at the corner
Welcome
to
Future of Stem Cell Medicine
• The Indian market potential slated to be in the range of US$ 500 million.
• More than 45,000 people across the world receiving stem cell
transplant every year.
• Potential to reduce pharmaceutical R&D by 25% each year, with
savings of up to US $25 million in each drug market.
• Potential to be the next revolution in the field of medicine.
LifeCare – ReeCure Centre
of STEM CELL Therapy
“The Need”
• The physical misery
• Psychological trauma
Of “No Hope Disorder” is great!!
• No cure available for most of these diseases
Rationale of is stem cell
Therapy ??
Introduction of adult stem cells into
damaged tissue in order to treat
injuries / Disease in
“No Hope Disorders”
Stem cell potential
… beating cardiac muscle
• Is it really working?
• Why not studies are coming from premier institutes of
country ?
• Is it really possible to segregate Mesenchymal cells?
• Differentiation of cells out side body possible in India???
• If it is too good then, why not NOBEL PRIZE given ?
• ?
• ??
• ???
• Is this therapy available in India?
Questions ????
Times
of
India
9th October 2012
We are sure there are a lot of doubts plaguing
your mind about STEM CELL BANKING and
STEM CELL THERAPY.
Let us help you to ERASE these doubts.
Doubts… on SCT
1913 the great Spanish neuroscientist Santiago Ramón y Cajal
pronounced “that in adult Neurone & the nerve paths –
Everything may die, nothing may be regenerated”.
Nerve Cell
Cannot
Regenerate ?
Heart Brain
Same is our perception
for any tissue !!
Beliefs turned out to be FALSE as
several types of cells can regenerate
Major Milestones
Which Triggered Adult Stem Cell
Research ?
• Since1970’s,
BONE MARROW TRANSPLANTS
have been used for treatment of
Immunodeficient &
leukemia (with Good results).
2nd Breakthrough…
History of Human Embryonic
Stem Cell Research
In 1998, James Thomson (University of
Wisconsin-Madison) isolated cells from the inner
cell mass of the blastocyst, and developed the
first human embryonic stem cell line in culture.
Prediction was made of Making cells
and replacing all the diseased cells?
& even gametes
Stem Cell Potential
Stem Cell History
• 1970 – BM transplant for leukaemia
• 1998 - Researchers first extract stem cells from human
embryos
• 1999 - First Successful human transplant of insulin-making cells
from cadavers
• 2001 - President Bush restricts federal funding for embryonic
stem-cell research
• 2002 - Juvenile Diabetes Research Foundation International
creates $20 million fund-raising effort to support stem-
cell research
• 2003?? - California ok stem cell research
• 2004 - Harvard researchers grow stem cells from embryos
using private funding
• 2004 - Ballot measure for $3 Billion bond for stem cells
• 2006-7 – Private Banking for cord & cord blood in india.
• 2014 – Public cord banking Kolkatta – Inst. Tropical med.
What are Stem Cells
• Ability to differentiate
• Ability to regenerate
Stem Cell is a
•young,
•primitive and unspecialized cell with a
remarkable potential to renew,
•Differentiate and
Develop into any desired tissue or organ of
the body.
What is stem cells ?
Self renewal: Unlimited proliferative potential.
Differentiation: Differentiate into various cell types
Pluripotency,
Multipotency,
Unipotency)
Plasticity : Trans-differentiation
Regeneration potential: a means of Repair
Characteristic Features
A single
precursor
What is Differentiation?
Cells having infinite self renewing capacity and
potential for differentiation.
What are Stem Cells?
1000 IEC ICAs in
biocompatible capsule
IP Tx
STZ Diabetic mice
Blood glucose analysis of STZ induced
diabetic mice transplanted with hUCMSCs and
Islet like clusters (ILC)
0 10 20 30
0
100
200
300
400
500
hUCMSCs
ILCs
Normal
Diabetic control
Days after transplantation
Bloodglucoseconcentration
mg/dl
0 25 50 75 100 125 150
0
100
200
300
400
ILC
diabetic control
non diabetic control
time (mins)
Bloodglucoseconcentration
mg/dl
Glucose
Tolerance
Test
Fasting blood glucose concentration of diabetic mice after transplantation of ILCs showed
that the hyperglycemic mice reverted back to normoglycemia. Intraperitoneal glucose
tolerance test was performed on 45th day, post-transplantation. Mice transplanted with ILCs
showed similar blood glucose profile as compared to the normal non diabetic controls.
How MSCs work In vivo
Under normal circumstances MSC contribute to tissue maintenance, contributing to
immune homeostasis by avoiding unnecessary immune cell response.
With damaged tissue,
harmonious interaction between
MSC and endothelial cells are
disrupted, allowing blood
extravasations , blood clot form,
platelet release multitude of
bioactive molecule, immune
cells are attracted where they
start immune surveillance and
immune response.
MSC secrete bioactive molecules that
exert anti-apoptotic, immunomodulatory ,
angiogenic , anti-scaring , anti-fibrotic
and chemoattractant effects
Source of Adult Stem cells
• Autologus,
• Allogeneic or
• Xenogenic
Fetal tissue is the best current tissue source for
human stem cells,
However ethical issues are a major concern.
(ICMR – Autologous)
The embryos of
aborted fetuses
Umbilical cord
and cord blood of a
new born baby
Bone Marrow
Peripheral
Bloodstream
Adult Tissues Amniotic Fluid
MENSTRUAL BLOOD Dental Pulp
Sources of Stem Cells
Hair
Best Source
Amniotic fluid,
umbilical cord,
Cord blood -
Rich Source of
Stem Cells
Cord Blood Stem Cells
• Can be used only
to cure chronic
blood-related
disorders such as
sickle cell
disease,
Thalasemia, and
leukaemia.
Umbilical Cord Blood Stem Cell
Transplant
• Umbilical cord blood
stem cell transplants are
less prone to
rejection than either
bone marrow or
peripheral blood stem
cells. This is probably
because the cells have
not yet developed the
features that can be
recognized and attacked
by the recipient's
immune system
Placental Blood as a Source of Hematopoietic
Stem Cells for Transplantation into
UNRELATED RECIPIENTS
Joanne Kurtzberg, M.D.et al
PLASTICITY: The ability of one tissue to produce cells of other developmentally
unrelated tissues
Traditionally, stem cells were believed to be Lineage Restricted and
Organ Specific.
Bone marrow stem cells:
The gold standard
AUTOLOGUS – STEM CELLS
• While most blood stem
cells reside in the bone
marrow, a small number
are present in the
bloodstream. These
multipotent peripheral
blood stem cells, or
PBSCs, can be used
just like bone marrow
stem cells to treat
leukaemia, other
cancers and various
blood disorders
Adult Stem Cells - Hair
Dental Pulp
Menstrual Blood
Allogeneic – Stem Cells
• Sources of stem cells
from another donor
(allogeneic) are
primarily relatives
(familial- allogeneic) or
completely unrelated
donors (unrelated-
allogeneic). The stem
cells in this situation
are extracted from
either the donor's body
or cord blood
Xenogeny - Stem Cells
• In this stem cells from
different species are
transplanted, e.g. porcine
fetal ventral mesencephalic
(FVM) xenotransplants for
Parkinson's disease.
This has no major ethical
concerns and a large amount
of tissue is available,
however life long
immunosupression and risk
of rejection are the major
limitations
Prediction for Future
Cells from these Animal will
be used in human beings
Without risk of rejection
HOMING
• The cells reach
the target cell or
tissue
PLASTICITY
• Cells transform
into target cell or
tissue
ENGRAFTMENT
• Symbiotically
integrates with
cell or tissue for
the persons
lifetime
THE SUCCESS OF STEM CELL
THERAPY DEPENDS ON LAB.
These are
• Mono Nuclear cells ( MNC )
• Hematopoietic Stem Cells [HSC] family:
CD34+; CD45; CD133
• Mesenchymel count in M.N.C is just 0.001%
• Mesenchymel stem cell [MSC]: CD73; CD90;
CD106 Etc ..........
Classification Of Stem Cells
Differentiation with different cluster
coding/desire cells type ( as per disorder)
through culture.. (Mesenchymal types are -
CD 73, CD 90, CD 105 etc . .. . .
• Multiplication up label of required cells
quantity.( near to 1.5 Cr.).
• Composition of all cells like Mnc, Hsc & Msc.
Technology Behind Success
Bone Marrow Menstrual BloodHair Follicle Adipose
Tissue
STEM CELL THERAPY
Homogeneous
population and
high rate of cell
division
No risk of
rejection – USED
across HLA
barrier
No ethical
issues
Immune
privileged
Greater
potency of
cultured
expanded
product
Precise
identification
Ease of
isolation and
scale up
Genetic
stability
Advantages of
Mesenchymal
Stem Cells
No risk of
teratoma
formation
Pluripotent
Efficient large
scale expansion
Lower cost of
cell culture
process
Why MSCs ?
Indications
Indications
STEM CELL Therapy
• Diabetes
• Cerebral Palsy
• Multiple Sclerosis
• Parkinson’s Disease
•Alzheimer’s Disease
• Autism
• Anti-Ageing
Very Effective
Diabetes
STEM CELL THERAPY FOR DIABETES
Neuro-Muscular
Disorders
• Cerebral Palsy √
• Multiple Sclerosis √
• Parkinson’s Disease √
• Autism √
• Spinal Cord Injury
• Stroke
•Alzheimer’s Disease
• Muscular Dystrophy
• Spinal Muscular Atrophy
STEM CELL Therapy for
Neuro – Muscular Disorders
STEM CELL THERAPY FOR
Anti-Ageing
Effective
• Liver Cirrhosis
• Non-healing fractures
• Stroke
• Osteogenesis
Imperfecta
• Muscular Dystrophy • Myocardial Infarction
• Spinal Muscular Atrophy • Cardiomyopathy
• ALS • Chronic Heart Failure
• Osteoarthritis
• Osteogenesis
Imperfecta
• Non-healing fractures
• Osteoarthritis
• Non-healing fractures
• Osteogenesis Imperfecta
• Achondrodysplasia
Bone and Cartilage
Disorders
Cardiovascular Disorders
• Chronic Heart Failure
• Myocardial Infarction
• Cardiomyopathy
• Buerger’s Disease
STEM CELL Therapy for
Bone and Cartilage Disorders
KIDNEY LIVER
STEM CELL THERAPY FOR
KIDNEY /LIVER DISORDER
Least Effective
• Spinal Cord Injury
• Buerger’s Disease
• Eye Disorder
Not Effective/ Need More Trails
Acute Leukaemia • Inherited Platelet Abnormalities
• Chronic Leukaemia • Other Inherited Disorder
• Myelodysplastic Syndromes • Inherited Metabolic Disorders
• Marrow Failure • Histiocytic Disorders
• Thalassemia
• Inherited Erythrocyte
Abnormalities
• Myeloproliferative Disorders
• Inherited Immune System
Disorders
• Lymphoproliferative
Disorders
• Plasma Cell Disorders
• Phagocyte Disorders • Other Malignancies
Drug Testing - Quicker
• Stem cells could allow scientists to test
new drugs using human cell line which
could speed up new drug development.
• Only drugs that were safe and had
beneficial effects in cell line testing would
graduate to whole animal or human
testing.
• It would allow quicker and safer
development of new drugs.
Let’s
Create a better tomorrow
for
Spread the message
Please create Public Awareness
Spinal injury
My cord blood treated
Bhai’s thalassemia major Cured of insulin dep. DM
Super man
Ajit Jogi
Only company in India with 9 type of stem cell
banking and treatment through Reecure
50 centres spread across India
Mr. Ajay Saxena
Ph. 8467888005
Website : www.reelabs.com
Email : ajay.saxena@reelabs.com
Q.& A.session Dr. Sharda Jain
Mr. Ajay Saxena
STEM CELL
Therapy
A HOPE TO NO
HOPE DISORDERS
Thank you

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Stem cell therapy : A hope to "No Hope Disorders" Diseased Dr. Sharda Jain

  • 1. Dr. Sharda Jain Dr. Ajay saxena Dr. Rajesh Dhall :A Hope to No Hope Disorders Stem Cell Therapy
  • 2. Life is too Precious - don’t give up !! Mother Teresa
  • 3. STEM CELL Therapy A HOPE TO NO HOPE DISORDERS
  • 4. The fascinating new world of STEM CELL THERAPY : a medical revolution at the corner Welcome to
  • 5. Future of Stem Cell Medicine • The Indian market potential slated to be in the range of US$ 500 million. • More than 45,000 people across the world receiving stem cell transplant every year. • Potential to reduce pharmaceutical R&D by 25% each year, with savings of up to US $25 million in each drug market. • Potential to be the next revolution in the field of medicine. LifeCare – ReeCure Centre of STEM CELL Therapy
  • 6. “The Need” • The physical misery • Psychological trauma Of “No Hope Disorder” is great!! • No cure available for most of these diseases
  • 7. Rationale of is stem cell Therapy ?? Introduction of adult stem cells into damaged tissue in order to treat injuries / Disease in “No Hope Disorders”
  • 8. Stem cell potential … beating cardiac muscle
  • 9. • Is it really working? • Why not studies are coming from premier institutes of country ? • Is it really possible to segregate Mesenchymal cells? • Differentiation of cells out side body possible in India??? • If it is too good then, why not NOBEL PRIZE given ? • ? • ?? • ??? • Is this therapy available in India? Questions ????
  • 11. We are sure there are a lot of doubts plaguing your mind about STEM CELL BANKING and STEM CELL THERAPY. Let us help you to ERASE these doubts. Doubts… on SCT
  • 12. 1913 the great Spanish neuroscientist Santiago Ramón y Cajal pronounced “that in adult Neurone & the nerve paths – Everything may die, nothing may be regenerated”. Nerve Cell Cannot Regenerate ?
  • 13. Heart Brain Same is our perception for any tissue !!
  • 14. Beliefs turned out to be FALSE as several types of cells can regenerate
  • 15. Major Milestones Which Triggered Adult Stem Cell Research ? • Since1970’s, BONE MARROW TRANSPLANTS have been used for treatment of Immunodeficient & leukemia (with Good results).
  • 16. 2nd Breakthrough… History of Human Embryonic Stem Cell Research In 1998, James Thomson (University of Wisconsin-Madison) isolated cells from the inner cell mass of the blastocyst, and developed the first human embryonic stem cell line in culture.
  • 17. Prediction was made of Making cells and replacing all the diseased cells? & even gametes
  • 19. Stem Cell History • 1970 – BM transplant for leukaemia • 1998 - Researchers first extract stem cells from human embryos • 1999 - First Successful human transplant of insulin-making cells from cadavers • 2001 - President Bush restricts federal funding for embryonic stem-cell research • 2002 - Juvenile Diabetes Research Foundation International creates $20 million fund-raising effort to support stem- cell research • 2003?? - California ok stem cell research • 2004 - Harvard researchers grow stem cells from embryos using private funding • 2004 - Ballot measure for $3 Billion bond for stem cells • 2006-7 – Private Banking for cord & cord blood in india. • 2014 – Public cord banking Kolkatta – Inst. Tropical med.
  • 20.
  • 21. What are Stem Cells • Ability to differentiate • Ability to regenerate
  • 22. Stem Cell is a •young, •primitive and unspecialized cell with a remarkable potential to renew, •Differentiate and Develop into any desired tissue or organ of the body. What is stem cells ?
  • 23. Self renewal: Unlimited proliferative potential. Differentiation: Differentiate into various cell types Pluripotency, Multipotency, Unipotency) Plasticity : Trans-differentiation Regeneration potential: a means of Repair Characteristic Features
  • 24. A single precursor What is Differentiation?
  • 25. Cells having infinite self renewing capacity and potential for differentiation. What are Stem Cells?
  • 26. 1000 IEC ICAs in biocompatible capsule IP Tx STZ Diabetic mice Blood glucose analysis of STZ induced diabetic mice transplanted with hUCMSCs and Islet like clusters (ILC) 0 10 20 30 0 100 200 300 400 500 hUCMSCs ILCs Normal Diabetic control Days after transplantation Bloodglucoseconcentration mg/dl 0 25 50 75 100 125 150 0 100 200 300 400 ILC diabetic control non diabetic control time (mins) Bloodglucoseconcentration mg/dl Glucose Tolerance Test Fasting blood glucose concentration of diabetic mice after transplantation of ILCs showed that the hyperglycemic mice reverted back to normoglycemia. Intraperitoneal glucose tolerance test was performed on 45th day, post-transplantation. Mice transplanted with ILCs showed similar blood glucose profile as compared to the normal non diabetic controls.
  • 27. How MSCs work In vivo Under normal circumstances MSC contribute to tissue maintenance, contributing to immune homeostasis by avoiding unnecessary immune cell response. With damaged tissue, harmonious interaction between MSC and endothelial cells are disrupted, allowing blood extravasations , blood clot form, platelet release multitude of bioactive molecule, immune cells are attracted where they start immune surveillance and immune response. MSC secrete bioactive molecules that exert anti-apoptotic, immunomodulatory , angiogenic , anti-scaring , anti-fibrotic and chemoattractant effects
  • 28. Source of Adult Stem cells • Autologus, • Allogeneic or • Xenogenic Fetal tissue is the best current tissue source for human stem cells, However ethical issues are a major concern. (ICMR – Autologous)
  • 29. The embryos of aborted fetuses Umbilical cord and cord blood of a new born baby Bone Marrow Peripheral Bloodstream Adult Tissues Amniotic Fluid MENSTRUAL BLOOD Dental Pulp Sources of Stem Cells Hair
  • 30. Best Source Amniotic fluid, umbilical cord, Cord blood - Rich Source of Stem Cells
  • 31. Cord Blood Stem Cells • Can be used only to cure chronic blood-related disorders such as sickle cell disease, Thalasemia, and leukaemia.
  • 32. Umbilical Cord Blood Stem Cell Transplant • Umbilical cord blood stem cell transplants are less prone to rejection than either bone marrow or peripheral blood stem cells. This is probably because the cells have not yet developed the features that can be recognized and attacked by the recipient's immune system
  • 33. Placental Blood as a Source of Hematopoietic Stem Cells for Transplantation into UNRELATED RECIPIENTS Joanne Kurtzberg, M.D.et al
  • 34. PLASTICITY: The ability of one tissue to produce cells of other developmentally unrelated tissues Traditionally, stem cells were believed to be Lineage Restricted and Organ Specific. Bone marrow stem cells: The gold standard
  • 35. AUTOLOGUS – STEM CELLS • While most blood stem cells reside in the bone marrow, a small number are present in the bloodstream. These multipotent peripheral blood stem cells, or PBSCs, can be used just like bone marrow stem cells to treat leukaemia, other cancers and various blood disorders
  • 38. Allogeneic – Stem Cells • Sources of stem cells from another donor (allogeneic) are primarily relatives (familial- allogeneic) or completely unrelated donors (unrelated- allogeneic). The stem cells in this situation are extracted from either the donor's body or cord blood
  • 39. Xenogeny - Stem Cells • In this stem cells from different species are transplanted, e.g. porcine fetal ventral mesencephalic (FVM) xenotransplants for Parkinson's disease. This has no major ethical concerns and a large amount of tissue is available, however life long immunosupression and risk of rejection are the major limitations
  • 40. Prediction for Future Cells from these Animal will be used in human beings Without risk of rejection
  • 41. HOMING • The cells reach the target cell or tissue PLASTICITY • Cells transform into target cell or tissue ENGRAFTMENT • Symbiotically integrates with cell or tissue for the persons lifetime THE SUCCESS OF STEM CELL THERAPY DEPENDS ON LAB.
  • 42. These are • Mono Nuclear cells ( MNC ) • Hematopoietic Stem Cells [HSC] family: CD34+; CD45; CD133 • Mesenchymel count in M.N.C is just 0.001% • Mesenchymel stem cell [MSC]: CD73; CD90; CD106 Etc .......... Classification Of Stem Cells
  • 43. Differentiation with different cluster coding/desire cells type ( as per disorder) through culture.. (Mesenchymal types are - CD 73, CD 90, CD 105 etc . .. . . • Multiplication up label of required cells quantity.( near to 1.5 Cr.). • Composition of all cells like Mnc, Hsc & Msc. Technology Behind Success
  • 44. Bone Marrow Menstrual BloodHair Follicle Adipose Tissue STEM CELL THERAPY
  • 45. Homogeneous population and high rate of cell division No risk of rejection – USED across HLA barrier No ethical issues Immune privileged Greater potency of cultured expanded product Precise identification Ease of isolation and scale up Genetic stability Advantages of Mesenchymal Stem Cells No risk of teratoma formation Pluripotent Efficient large scale expansion Lower cost of cell culture process Why MSCs ?
  • 48. • Diabetes • Cerebral Palsy • Multiple Sclerosis • Parkinson’s Disease •Alzheimer’s Disease • Autism • Anti-Ageing Very Effective
  • 50. Neuro-Muscular Disorders • Cerebral Palsy √ • Multiple Sclerosis √ • Parkinson’s Disease √ • Autism √ • Spinal Cord Injury • Stroke •Alzheimer’s Disease • Muscular Dystrophy • Spinal Muscular Atrophy STEM CELL Therapy for Neuro – Muscular Disorders
  • 51. STEM CELL THERAPY FOR Anti-Ageing
  • 52. Effective • Liver Cirrhosis • Non-healing fractures • Stroke • Osteogenesis Imperfecta • Muscular Dystrophy • Myocardial Infarction • Spinal Muscular Atrophy • Cardiomyopathy • ALS • Chronic Heart Failure • Osteoarthritis • Osteogenesis Imperfecta • Non-healing fractures
  • 53. • Osteoarthritis • Non-healing fractures • Osteogenesis Imperfecta • Achondrodysplasia Bone and Cartilage Disorders Cardiovascular Disorders • Chronic Heart Failure • Myocardial Infarction • Cardiomyopathy • Buerger’s Disease STEM CELL Therapy for Bone and Cartilage Disorders
  • 54. KIDNEY LIVER STEM CELL THERAPY FOR KIDNEY /LIVER DISORDER
  • 55. Least Effective • Spinal Cord Injury • Buerger’s Disease • Eye Disorder
  • 56. Not Effective/ Need More Trails Acute Leukaemia • Inherited Platelet Abnormalities • Chronic Leukaemia • Other Inherited Disorder • Myelodysplastic Syndromes • Inherited Metabolic Disorders • Marrow Failure • Histiocytic Disorders • Thalassemia • Inherited Erythrocyte Abnormalities • Myeloproliferative Disorders • Inherited Immune System Disorders • Lymphoproliferative Disorders • Plasma Cell Disorders • Phagocyte Disorders • Other Malignancies
  • 57. Drug Testing - Quicker • Stem cells could allow scientists to test new drugs using human cell line which could speed up new drug development. • Only drugs that were safe and had beneficial effects in cell line testing would graduate to whole animal or human testing. • It would allow quicker and safer development of new drugs.
  • 58. Let’s Create a better tomorrow for Spread the message Please create Public Awareness Spinal injury My cord blood treated Bhai’s thalassemia major Cured of insulin dep. DM Super man Ajit Jogi
  • 59. Only company in India with 9 type of stem cell banking and treatment through Reecure 50 centres spread across India Mr. Ajay Saxena Ph. 8467888005 Website : www.reelabs.com Email : ajay.saxena@reelabs.com Q.& A.session Dr. Sharda Jain Mr. Ajay Saxena
  • 60. STEM CELL Therapy A HOPE TO NO HOPE DISORDERS Thank you