Aplikasi Klinis Stem Cell by Dr. Indah Yulianto
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Aplikasi Klinis Stem Cell by Dr. Indah Yulianto

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A comprehensive presentation on Clinical Application of Stem Cell

A comprehensive presentation on Clinical Application of Stem Cell

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  • Abbreviations: ICAM, intercellular adhesion molecule; JAMs, junctional adhesion molecules; MSCs, mesenchymalstromal cells; PECAM, platelet-endothelial cell-adhesion molecule; PGE, prostaglandin E2; VCAM, vascular cell-adhesion molecule; VLA, very late antigen

Aplikasi Klinis Stem Cell by Dr. Indah Yulianto Aplikasi Klinis Stem Cell by Dr. Indah Yulianto Presentation Transcript

  • APLIKASI KLINIS SEL PUNCA
  • Differentiation Human Stem Cells
  • Trans-differentiation
  • Why Stem Cells ? By definition, a stem cell is characterized by its ability to self- renew and its ability to trans differentiate along multiple lineage pathways.
  • Self-renewal of stem cellsAsymmetric cell divisionSymmetric cell divisionMorrison & Kimble 2006
  • Self-renewal of stem cells Asymmetric cell division : to maintain the stem cell numberA. Intrinsic asymmetric cell divisionB. Extrinsic (Eviromental) asymetric cell devision Morrison & Kimble 2006
  • Intrinsic asymmetric cell division One stem cell divides into two daughter cells, which are different from each other. One of daughter cells is similar to the parental cell and The other daughter cell becomes progenitor cell, which will eventually differentiate into tissue committed resident cell.
  • Symmetric cell division Daughter cells
  • Stem cells NICHE The microenvironment in which stem cells are found. The microenvironment interacts with stem cells to regulate stem cell fate. Various niche factors act on stem cells to alter their gene expression, and induce their proliferation or differentiation.
  • Stem Cells NICHENiche factors include: 1. cell-cell interactions between stem cells, 2. interactions between stem cells and neighboring differentiated cells, 3. interactions between stem cells and extra- cellular matrix components, adhesion molecules,growth factors, cytokines and physiochemical nature of the microenvironment. 4. Niche has both anatomic and functional dimensions.
  • Regenerative medicinal applications should meet the following criteria: Can be found in abundant quantities (millions to billions of cells) Can be harvested by a minimally invasive procedure Can be differentiated along multiple cell lineage pathways in a regulatable and reproducible manner. Can be safely and effectively transplanted to either an autologous or allogeneic host
  • Overview of Healing response after injury
  • Goal of The Wound HealingReconstruction of : Original Architecture Function of the injured tissue. (Cotran et.al. 1999., Majno & Joris 2004)
  • Tissue Wound Healing Repair Regeneration (Majno & Joris 2004, Kumar et al. 2009)
  • Tissue Repair Replacement of injured tissue by different tissue, usually by fibrosis or scar (Kumar et al. 2009, Majno & Joris 2004)
  • Tissue Regeneration Replacement of injured tissue by the same resident cells, or by differentiation of progenitor/stem cells into tissue committed cells. (Kumar et al. 2009, Majno & Joris 2004)
  • PERANAN BERBAGAI KOMPONEN PADA “NICHE” JARINGAN KULIT (Copyright © 2012 VictorW.Wong et al.)
  • Stem Cells Transplantation Autologous Allogeneic : from individuals belonging to the same species but genetically dissimilar (and hence immunologiccally incmpatible) Syngeneic : between geneticcally identical individual (tween) Xenogeneic : From individuals of different species (hence of disparate cell type)
  • Adult (Somatic) Stem Cells Hematopoietic stem cells (HSC) Mesenchymal stem cells (MSC) Endothelial progenitor cells (EPC) Neural stem cells Hepatic stem cells etc. Adipocyte Stem Cells
  • Why Adipocyte Tissue ?
  • Bone marrow harvest (2)
  • Flow Chart Elucidating possible commitment,lineage progression and maturation ADMSCs from Aldeman D., Alexander ,R.W.,PPM : Oct 2011
  • Hasil lemak dari liposuction
  • pellet
  • Adipocyte after 24 hours Adipocyte after 24 hours ADSC pasage 1 : hari ke 3
  • A. ADSCs hari ke 7 dan B. ADSC hari ke 14A B by dr Indah Yulianto – dr. Yuyun Rindiastuti
  • Alopecia Universalis : 1 month after MChSc and Product (AAPE)
  • Alopecia Universalis :1 month after MCSc + Product MSCc By Indah Yulianto
  • After 2 Months
  • After :2 Months By Indah Yulianto
  • After 4 months
  • EPC : Primer Culture 80% 100% Courtesy by : Yuyun, Wiwied & Yenni
  • SECRETOME FROM HUVEC (HUMAN UMBILICALVEIN ENDOTHELIAL CELLS) from patient Alopecia Areata for more than 10 years.
  • Secretome from HUVEC
  • Homing and Trafficking MesenchymalStromal cells to sites tissue injury after infusion
  • Neuroischemic lesion of fifth metatarsal withapplication : EPC & amnion membrane (2 months) Courtesy : By Indah Yulianto, &Yuyun Rindiastuti
  • Female patient (64 years old) with Basaloma in her left cheek
  • Preparing Secretome from Wharton Jelly
  • BASALIOMA(Surgery + Secretome fetal Endothelial progenitor Cells / EPC)
  • Peeling the amniotic membrane from the placenta(Once again using Hypoxia methode) Figure 1: Processing of amniotic membrane.
  • Preparation of the amniotic membraneAmniotic membrane in its and the wound dressing interface before preserving fluid placement of a wound dressing.
  • No healing ulcer (1 month) post op-Squamous Cell Carcinoma Surgery in Head (Male, 84 yr) Placing AMNION
  • Wound Regeneration after 2 Surgeried : SCC and UNSECCESSFUL DermagraftHealing Process with renewal damage tissue
  • AMNIOTIC MEMBRANE DRESSING PROMOTES EPITHELISATION & GRAANULATION + INJ EPC 1.5 MONTH AFTER
  • CLI – post AmputationEPC + Amnion membrane
  • What kind of Stem cells that we Need ?
  • (3) Scar acne pasca skin needling + product & (4) 1 week after skin needling + MCSs +_ Product3 4
  • Acne Papulo Pustular + Scar Courtesy by dr Titik Moertolo
  • Acne Scar & Box scar 1 week post Dermaroller
  • 2 weeks after Skin Needling +Acne Scar before (Box Scar) MShCs Courtesy by dr Titik Moertolo
  • Infant 2 weeks, with fistula supra ani
  • Tissue regeneration after 1 week using MshCs Product - Cream BY Indah Yulianto
  • One week afterFistula – Before Therapy 1 Year after – no Scar
  • Leprosy after 30 years + 3 3 weeks after MSCs months burning ulcer + Infection Product Injections + Cream BY Indah Yulianto
  • Male 23 yr, Combutio more than 5 months : Injections and Topical : HUVECs (Spheroid and Hypoxia)25-Jan-13 68
  • Luka bakar + infeksi 5 bulan intra kutan produk MShCs y.l. regenerasi Hari ke 15 : penyembuhan 75% tanpaPengolesan Krem + Produk MShCs Cicatriks ataupun Retraksi persendian
  • Starting to heal and without scar after 2 months25-Jan-13 70
  • ACNE CONGLOBATA and Scar : USING ‘HUVEC’
  • AUTISM AND PARAPLEGIA (FEMALECHILD – 4 YEARS : USING HUVEC : 2 TIMES)
  • Multiple sclerosis , Asthma Bronchiale, Parkinson and Ventricle heart disease
  • Terimakasih atas perhatiannya25-Jan-13 74