aplikasi klinis stem cell by dr. indah yulianto
DESCRIPTION
A comprehensive presentation on Clinical Application of Stem CellTRANSCRIPT
INDAH YULIANTO.,RATNA JUWITA,TITI MOERTOLO,SUBANDRIO, DEWI A,YUYUN HP, KALISTA.
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 cells
Asymmetric cell division
Symmetric cell division
Morrison & Kimble 2006
Self-renewal of stem cells
Asymmetric cell division : to maintain the stem cell number
A. Intrinsic asymmetric cell division
B. 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.
Distinguish features of progenitor/precursor cells and Stem cells
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 NICHE
Niche 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.
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
Regenerative medicinal applications should meet the following criteria:
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)
Cotran et al. 1999, Majno & Joris 2004
Cotran et al. 1999, Majno & Joris 2004
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 14
A 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
Courtesy by : Yuyun, Wiwied & Yenni
80% 100%
SECRETOME FROM HUVEC (HUMAN UMBILICAL VEIN ENDOTHELIAL CELLS) from patient Alopecia
Areata for more than 10 years.
Secretome from HUVEC
Homing and Trafficking Mesenchymal Stromal cells to sites tissue injury after infusion
Neuroischemic lesion of fifth metatarsal with application : 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.
Amniotic membrane in its preserving fluid
Preparation of the amniotic membrane and the wound dressing interface before
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 Dermagraft
Healing Process with renewaldamage tissue
AMNIOTIC MEMBRANE DRESSINGPROMOTES EPITHELISATION & GRAANULATION
+ INJ EPC
1.5 MONTH AFTER
CLI – post AmputationEPC + Amnion membrane
What kind of Stem cells that we Need ?
Acne Papulo pustular + Scar Acne : before and 1 week after AAPE
(3) Scar acne pasca skin needling + product & (4) 1 week after skin needling + MCSs +_ Product
34
Acne Papulo Pustular + Scar
Courtesy by dr Titik Moertolo
1 month after Skin Needling + MShCs
Acne Scar & Box scar 1 week post Dermaroller
Acne Scar before (Box Scar)2 weeks after Skin Needling +
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
Fistula – Before
Therapy
One week after
1 Year after – no Scar
Leprosy after 30 years + 3 months burning
ulcer + Infection
3 weeks after MSCs Product Injections +
Cream
BY Indah Yulianto
Apr 12, 2023 68
Male 23 yr, Combutio more than 5 months : Injections and Topical :HUVECs (Spheroid and Hypoxia)
Luka bakar + infeksi 5 bulan y.l.
intra kutan produk MShCs
Pengolesan Krem + Produk MShCsHari ke 15 : penyembuhan 75% tanpa Cicatriks ataupun Retraksi persendian
regenerasi
Apr 12, 2023 70
Starting to heal and without scar
after 2 months
ACNE CONGLOBATA and Scar : USING‘HUVEC’
AUTISM AND PARAPLEGIA (FEMALE CHILD – 4 YEARS : USING HUVEC : 2 TIMES)
Multiple sclerosis , Asthma Bronchiale, Parkinson and Ventricle heart disease
Apr 12, 2023 74
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