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

Welcometo

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 Centreof 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 plaguingyour 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 20 300

100

200

300

400

500

hUCMSCsILCsNormalDiabetic control

Days after transplantationB

loo

d g

luc

os

e c

on

ce

ntr

ati

on

mg

/dl

0 25 50 75 100 125 1500

100

200

300

400ILCdiabetic controlnon diabetic control

time (mins)

Blo

od

glu

co

se c

on

cen

trati

on

mg

/dlGlucose

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 beingsWithout risk of rejection

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 Blood Hair Follicle Adipose Tissue

STEM CELL THERAPY

Homogeneous population and high rate

of cell division

Homogeneous population and high rate

of cell division

No risk of rejection –

USED across HLA barrier

No risk of rejection –

USED across HLA barrier

No ethical issues

No ethical issues

Immune privilege

d

Immune privilege

d

Greater potency of

cultured expanded

product

Greater potency of

cultured expanded

product

Precise identification

Precise identification

Ease of isolation and scale up

Ease of isolation and scale up

Genetic stabilityGenetic stability

Advantages Advantages of of

Mesenchymal Mesenchymal

Stem CellsStem Cells

No risk of teratoma formation

No risk of teratoma formation

PluripotentPluripotent

Efficient large scale expansion

Efficient large scale expansion

Lower cost of cell culture

process

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-MuscularDisorders

• Cerebral Palsy √

• Multiple Sclerosis √

• Parkinson’s Disease √• Autism √

• Spinal Cord Injury

• Stroke

•Alzheimer’s Disease

• Muscular Dystrophy

• Spinal Muscular Atrophy

• ALS

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 FORKIDNEY /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 SaxenaPh. 8467888005Website : 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