Tribute lecture at Brawijaya Women & Children Hospital

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Tribute Lecture at Brawijaya Women & Children Hospital Jakarta 2013 on the topic of the usefulness of human stem cell in dermatology including case reports

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Tribute lecture at Brawijaya Women & Children Hospital

  1. 1. Stem cells technology in Dermatology Indah Y
  2. 2. 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.
  3. 3. What are the unique properties of all stem cells ?  They are capable of dividing and renewing themself for long periods  They are unspecialized  They can give rise to specialized cell types
  4. 4. DEFINITIONS  Stem cells is a special kind of cell that has a unique to renew itself and to give rise to many specialized cell types (pluripotency)  Contrary to most cells of the body  Stem Cells is uncomitted & remains uncomitted, until it receives a signal to develop into a specialized cell
  5. 5. What are the unique properties of all stem cells Three general properties : They are capable of deviding and renewing themself of long periods They are unspecialized They can give rise to specialized cell types
  6. 6. Stem cells can remain alive in human corpses for at least 17 days after death, researchers say. Stem cells give rise to all other cells in the body, a property that ... Current Stem Cell Research & Therapy, 2013 , 8, 25-38
  7. 7. CLASSIFICATION OF STEM CELLS Bongso et al., 2005
  8. 8. STANDART MANUFACTURING SCALE OF ADULT STEM CELLS Jeffrey MG et al., 2010
  9. 9. MESENCHYMAL STEM CELLS (MSC)
  10. 10. ADULT STM CELLS IN CLINICAL APPLICATION Frank P et al., 2004
  11. 11. Mesenchymal stem cells-MSC MSC from Warthon jelly Steffano Grosy et al., 2009
  12. 12. MSC from Adipose Lypoaspirate
  13. 13. MSC from Umbilical Cord Blood (UCB-MSC) PAS + staining
  14. 14. H Emma et HEMATOPOIETIC STEM CELLS (HSC): Hierarchy concept
  15. 15. HSC from bone marrow, circulating blood, & umbilical cord blood
  16. 16. PROGENITOR CELLS Endothelial progenitor cells (EPC) from Human umbilical vein endothelial cells (HUVEC)
  17. 17. Neural progenitor cells (NPC) from Umbilical cord blood derived MSC Nestin + GFAP + NSE - Umbilical cord blood
  18. 18. EPIDERMALSTEM CELLS CELLS & SKIN EQUIVALENT
  19. 19. Cell quality asessement Stem cells sorting High pure & viable cell yieldMagnetic associated cell sorting
  20. 20. Flowcytometry Characterization for MSC MSC: Positive expression of CD73, CD105, CD29 Xu-Fang Yang et al., 2011 Stem cells characterization
  21. 21. Negative expression of hematopoietic marker: CD34, CD45, HLA DR Xu-Fang Yang et al., 2011
  22. 22. Adipogenic (Oil red staining) Osteogenic (Alizarin red staining) Xu-Fang Yang et al., 2011 MSC differentiation capacity
  23. 23. Vb stainning Xu-Fang Yang et al., 2011 Chromosomal abberation and karyotyping screening
  24. 24. FROM CELL BASED THERAPY TO “CELL FREE” BASED THERAPY Illustration of cell based therapy (Takashi et al., 2007)
  25. 25. WHAT IS “CELL FREE” BASED THERAPY? Illustration of therapeutic effect of stem cells (Tom JB et al., 2011)
  26. 26. EPC-CM and EPC transplantation improve blood perfusion in the rat ischaemic hindlimb with increased capillary density. A. doppler imaging. B. immunofluorescence
  27. 27. Angiogenic properties of EPC-CM
  28. 28. D8 Natural healing D8 With hMSC D8 with hMSC- CM
  29. 29. Stem cell based therapy Therapeutic outcome depends on cells engraftment Major limitation related to Alloimmunity reaction “Cell free” based therapy Cell free medium containing paracrine secretome may reduce risk of adverse immunological reaction
  30. 30. Xeno- free supplementation system Human Platelet Lysate (HPL) supplementation replace Fetal bovine serum (FBS) supplementation Cell culture manipulation for producing specific defined “cell free” secretome
  31. 31. Hypoxic culture condition for promoting defined secretome related Hypoxic Inducible Factor gene pathway induction
  32. 32. 3D spheroid culture system for promoting secretion of specific cytokine 3D spheroid colony (3000-5000 cells/colony)
  33. 33. Proteome profiling of cells secretome Ultrafiltration of Secretome Endotoxin & mycoplasma assay
  34. 34. Warthon jelly-MSC secretomes (NCBI, Siu KZ et al., 2007)
  35. 35. Scretome of HUVEC (NCBI-David GT et al., 2009)
  36. 36. Summary of MSC secretome (L. Da Silva et al., 2007)
  37. 37. Mesenchymal stem cell roles in each phase of the wound-healing process. Maxson S et al. Stem Cells Trans Med 2012;1:142-149 ©2012 by AlphaMed Press
  38. 38. January 31 st, , Man, 33 years old, Peri anal fistula,diameter 10 x 15 deep 10 cm after 7x surgery with general anesthesia By Indah Yulianto – 2013 Tampon Wrapped – 20 cm
  39. 39. After pulled out the TAMPON-Wrapper By Indah Yulianto – 2013
  40. 40. TOPICAL AND TRANSPLANTATION UCB-SCS BY LOCAL MULTIPLE INJECTIONS WITHOUT ANESTHESIA (31 ST JANUARY-2013) By Indah Yulianto – 2013
  41. 41. 4 DAYS – AFTER INJECTION AND TOPICAL UCB-SC (February – 4 th -2013) : Healing COMPLETELY (JUST ONE SHOT – TOPICAL and INJECTION) By Indah Yulianto – February 2013
  42. 42. Epithelization almost complete (after 2 weeks )
  43. 43. AMNIOTIC MEMBRANE DRESSING PROMOTES EPITHELISATION & GRANULATION: Topical HUVEC 1.5 MONTHs AFTER By Indah J : Nov - 2012
  44. 44. What kind of Stem cells that we Need ?
  45. 45. Leprosy after 30 years + 3 months burning ulcer + Infection 3 weeks after MSCs Product Injections + Cream BY Indah Yulianto
  46. 46. Neuroischemic lesion of fifth metatarsal with application : EPC & amnion membrane (2 months)
  47. 47. Male 23 yr, Combutio more than 5 months : Injections and Topical : HUVECs (Spheroid and Hypoxia)
  48. 48. Luka bakar + infeksi 5 bulan y.l. intra kutan produk MShCs Pengolesan Krem + Produk MShCs Hari ke 15 : penyembuhan 75% tanpa Cicatriks ataupun Retraksi persendian regenerasi
  49. 49. By dr Indah – dr Subandrio – dr Yuyun : 2012 – 2013
  50. 50. Alopecia Universalis : 1 month after MChSc and Product (AAPE)
  51. 51. After 2 Months
  52. 52. After 4 months By Indah, Dewi and Yuyun-2011
  53. 53. SECRETOME FROM HUVEC (HUMAN UMBILICAL VEIN ENDOTHELIAL CELLS) for patient Alopecia Areata with cicatrix, for more than 10 years. After 1 month By Indah - 2012
  54. 54. Secretome from HUVEC, spheroids After 3 months By Indah Y- January 2013
  55. 55. Post BASLIOMA Surgery – Using Topical HUVEC – 1 month
  56. 56. Woman, 82 years old, with BASALIOMA in uper os mandibula for 5 years, extirpation by MOHS surgery, no sutures, just only using Topical – HUVEC for getting wound closure for 6 weeks
  57. 57. Using Tumescent anesthesia
  58. 58. POST SURGERY
  59. 59. 3 days after, red arrow : epitelisation, no inflammation 2 Weeks after, red arrow : epitelisation 50 %/without scar
  60. 60. AUTOLOGOUS adipose derived adult stem cell condioned media and its topical effect on facial skin aging
  61. 61. Multi Center Clinical Study Summary PERSONAL CELL SCIENCES
  62. 62. (3) Scar acne pasca skin needling + product & (4) 1 week after skin needling + MCSs +_ Product 3 4
  63. 63. Acne Papulo Pustular + Scar Courtesy by dr Titik Moertolo
  64. 64. ACNE CONGLOBATA and Scar : USING ‘HUVEC’
  65. 65. CONCLUSION Interventions based on stem cells secretome may replace cell transplantation to enhance therapeutic tissue regeneration Cell free strategy seems to b free from the limitations and problems observed with transplantation of fresh or in vitro cultured cells
  66. 66. Terimakasih atas perhatiannya

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