Clinical Application of Stem Cells in Regeneration Medicine

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Laboratory Medicine".

Deadline for manuscript submissions: closed (20 April 2023) | Viewed by 8935

Special Issue Editor


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Guest Editor
Unidad de Gestión Clínica de Endocrinología y Nutrición - GC17, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Universitario Reina Sofía, CIBERFES, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain
Interests: mesenchymal stem cells; regenerative medicine; diabetes; wound healing; exosomes; extracellular vesicles; aging
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Special Issue Information

Dear Colleagues,

Regenerative medicine has the purpose of restoring the structure and function of damaged tissues or organs. In the body, different types of stem cells distributed in several tissues maintain homeostasis and tissue regenerative capacity. Stem cells have been isolated and expanded from different sources, including bone marrow, adipose tissue, and umbilical cord. Due to their differentiation and immunomodulatory capacity, the use of stem cells as a tool in regenerative medicine has been expanding. Stem cells are currently being used in the clinic through cell therapy techniques by means of autologous or allogeneic transplantation. In addition to cell therapy, the induction of the mobilization of circulating stem cells is another strategy to favor the regeneration of damaged tissues. Along with these possibilities, stem-cell-derived extracellular vesicles have recently been shown to have immunomodulatory and regenerative properties. This is allowing the development of cell-free therapies for regenerative purposes. In view of the increasing knowledge of the possible alternatives for the use of stem cells at the clinical level, the aim of this Special Issue is to share the latest advances on the clinical application of stem cells or their extracellular vesicles in regenerative medicine. 

Dr. Antonio Casado-Díaz
Guest Editor

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Keywords

  • stem cells
  • regenerative medicine
  • extracellular vesicles
  • cell therapy
  • stem cell preconditioning
  • stem cell mobilization

Published Papers (5 papers)

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Editorial

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4 pages, 212 KiB  
Editorial
Stem Cells in Regenerative Medicine
by Antonio Casado-Díaz
J. Clin. Med. 2022, 11(18), 5460; https://doi.org/10.3390/jcm11185460 - 16 Sep 2022
Cited by 3 | Viewed by 1716
Abstract
Stem cells constitute a set of undifferentiated cells with the capacity to differentiate into other cell types and to self-renew [...] Full article
(This article belongs to the Special Issue Clinical Application of Stem Cells in Regeneration Medicine)

Research

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18 pages, 886 KiB  
Article
Inconsistencies in Pregnant Mothers’ Attitudes and Willingness to Donate Umbilical Cord Stem Cells: A Cross-Sectional Analysis from Saudi Arabia
by Asma Ayyed AL-Shammary and Sehar un-Nisa Hassan
J. Clin. Med. 2023, 12(9), 3079; https://doi.org/10.3390/jcm12093079 - 24 Apr 2023
Cited by 4 | Viewed by 1401
Abstract
The collection and storage of umbilical cord stem cells (UCSCs) have a crucial role in improving and expanding stem cell-based therapies, which are becoming popular in Saudi Arabia and other Middle East countries. Many patients and families in Saudi Arabia depend on private [...] Read more.
The collection and storage of umbilical cord stem cells (UCSCs) have a crucial role in improving and expanding stem cell-based therapies, which are becoming popular in Saudi Arabia and other Middle East countries. Many patients and families in Saudi Arabia depend on private cord banks in foreign countries to purchase stem cells, which has financial and medical implications. The current study aims at determining the predictors of current registration status and willingness to donate cord blood stem cells among expectant mothers in Saudi Arabia. A cross-sectional study collected data from 714 expectant mothers from all thirteen regions of Saudi Arabia in December 2022. The online survey questionnaire assessed women’s awareness, direct and indirect exposure to stem-cell therapy, sources of knowledge, willingness, reluctance, and current registration status to donate cord blood. Although women demonstrated higher acceptance and lower rejection towards the donation of UCSCs, just one percent (n = 7; 1%) of expectant mothers in this sample are registered with the Saudi Stem Cell Registry. Overall, 48% indicated their willingness to register in the future. Both correlational analysis and multiple regression analysis demonstrated that awareness significantly predicted willingness to donate (p < 0.01), and rejection attitudes were negatively related to willingness to donate (p < 0.001). Although the mean scores on acceptance were high, they were not found to be significantly associated with willingness to donate. Prior direct and indirect exposure to stem cell therapy appeared to be the strongest predictor of pregnant women’s willingness to register (p < 0.001). Findings suggest that acceptance attitudes do not have a symmetrical relationship with intention. Women’s prior exposure to stem cell therapy was the most significant factor; therefore, findings demonstrate that currently women are relying on their firsthand experience to decide about cord blood donation rather than the information obtained from other sources, such as social media and the internet. Though attitudes were not identified as significant predictors in the statistical models, awareness was a relevant factor, and the findings signify increasing awareness in various target populations to enhance the probability of intention to donate cord stem cells. Full article
(This article belongs to the Special Issue Clinical Application of Stem Cells in Regeneration Medicine)
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Review

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29 pages, 1711 KiB  
Review
Clinical Potential of Mesenchymal Stem Cell-Derived Exosomes in Bone Regeneration
by Bárbara Torrecillas-Baena, Victoria Pulido-Escribano, Gabriel Dorado, María Ángeles Gálvez-Moreno, Marta Camacho-Cardenosa and Antonio Casado-Díaz
J. Clin. Med. 2023, 12(13), 4385; https://doi.org/10.3390/jcm12134385 - 29 Jun 2023
Cited by 7 | Viewed by 2858
Abstract
Bone metabolism is regulated by osteoblasts, osteoclasts, osteocytes, and stem cells. Pathologies such as osteoporosis, osteoarthritis, osteonecrosis, and traumatic fractures require effective treatments that favor bone formation and regeneration. Among these, cell therapy based on mesenchymal stem cells (MSC) has been proposed. MSC [...] Read more.
Bone metabolism is regulated by osteoblasts, osteoclasts, osteocytes, and stem cells. Pathologies such as osteoporosis, osteoarthritis, osteonecrosis, and traumatic fractures require effective treatments that favor bone formation and regeneration. Among these, cell therapy based on mesenchymal stem cells (MSC) has been proposed. MSC are osteoprogenitors, but their regenerative activity depends in part on their paracrine properties. These are mainly mediated by extracellular vesicle (EV) secretion. EV modulates regenerative processes such as inflammation, angiogenesis, cell proliferation, migration, and differentiation. Thus, MSC-EV are currently an important tool for the development of cell-free therapies in regenerative medicine. This review describes the current knowledge of the effects of MSC-EV in the different phases of bone regeneration. MSC-EV has been used by intravenous injection, directly or in combination with different types of biomaterials, in preclinical models of bone diseases. They have shown great clinical potential in regenerative medicine applied to bone. These findings should be confirmed through standardization of protocols, a better understanding of the mechanisms of action, and appropriate clinical trials. All that will allow the translation of such cell-free therapy to human clinic applications. Full article
(This article belongs to the Special Issue Clinical Application of Stem Cells in Regeneration Medicine)
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Other

13 pages, 1181 KiB  
Systematic Review
Mesenchymal Stromal Cell Healing Outcomes in Clinical and Pre-Clinical Models to Treat Pressure Ulcers: A Systematic Review
by Ricardo A. Torres-Guzman, Francisco R. Avila, Karla Maita, John P. Garcia, Gioacchino D. De Sario, Sahar Borna, Abdullah S. Eldaly, Alfredo Quinones-Hinojosa, Abba C. Zubair, Olivia A. Ho and Antonio J. Forte
J. Clin. Med. 2023, 12(24), 7545; https://doi.org/10.3390/jcm12247545 - 7 Dec 2023
Viewed by 963
Abstract
Background: Despite numerous measures used to prevent pressure ulcers, their growing prevalence in recent years is expected to continue as the population ages. This review aims to report the outcomes of the regenerative potential of MSCs in treating pressure ulcers, assessing the effectiveness [...] Read more.
Background: Despite numerous measures used to prevent pressure ulcers, their growing prevalence in recent years is expected to continue as the population ages. This review aims to report the outcomes of the regenerative potential of MSCs in treating pressure ulcers, assessing the effectiveness of MSCs in treating pressure ulcers. Methods: A computerized search for articles on animal models that use MSCs as primary therapy to treat pressure ulcers, published from conception to present, was conducted using PubMed, MEDLINE, Embase, and CINAHL. Our search yielded 52 articles, narrowed to 44 after excluding duplicates. Results: Out of 52 articles collected from four databases, 11 met the inclusion criteria. A total of 11 articles published between 2008 and 2020 met the inclusion criteria. Eight studies were observational descriptive papers in animal models, and three were prospective. Six studies used autologous MSCs, while five used allogenic MSCs. Three studies were conducted in humans, and the remaining eight were conducted in animals. The most common method of cell delivery was an intradermal injection in the margins of the ulcer. All studies reported positive results, including improved wound healing, reduced inflammation, and improved tissue regeneration. Conclusions: MSCs have shown promising results in treating pressure ulcers in animal and clinical trials. The combination of MSCs and scaffold materials has also been studied and found to be effective in wound healing. A standardized human wound model has been proposed further to investigate the efficacy of cell-based therapies for chronic wounds. However, more research is needed to determine the best quantity of cells to apply for pressure ulcers and to ensure the safety and efficacy of these treatments in clinical settings. Full article
(This article belongs to the Special Issue Clinical Application of Stem Cells in Regeneration Medicine)
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16 pages, 1309 KiB  
Systematic Review
Bone Morphogenic Protein and Mesenchymal Stem Cells to Regenerate Bone in Calvarial Defects: A Systematic Review
by Ricardo A. Torres-Guzman, Francisco R. Avila, Karla C. Maita, John P. Garcia, Gioacchino D. De Sario, Sahar Borna, Abdullah S. Eldaly, Alfredo Quinones-Hinojosa, Abba C. Zubair, Olivia A. Ho and Antonio J. Forte
J. Clin. Med. 2023, 12(12), 4064; https://doi.org/10.3390/jcm12124064 - 15 Jun 2023
Cited by 3 | Viewed by 1383
Abstract
Background: The use of bone morphogenic protein and mesenchymal stem cells has shown promise in promoting bone regeneration in calvarial defects. However, a systematic review of the available literature is needed to evaluate the efficacy of this approach. Methods: We comprehensively searched electronic [...] Read more.
Background: The use of bone morphogenic protein and mesenchymal stem cells has shown promise in promoting bone regeneration in calvarial defects. However, a systematic review of the available literature is needed to evaluate the efficacy of this approach. Methods: We comprehensively searched electronic databases using MeSH terms related to skull defects, bone marrow mesenchymal stem cells, and bone morphogenic proteins. Eligible studies included animal studies that used BMP therapy and mesenchymal stem cells to promote bone regeneration in calvarial defects. Reviews, conference articles, book chapters, and non-English language studies were excluded. Two independent investigators conducted the search and data extraction. Results: Twenty-three studies published between 2010 and 2022 met our inclusion criteria after a full-text review of the forty-five records found in the search. Eight of the 23 studies used mice as models, while 15 used rats. The most common mesenchymal stem cell was bone marrow-derived, followed by adipose-derived. BMP-2 was the most popular. Stem cells were embedded in Scaffold (13), Transduction (7), and Transfection (3), and they were delivered BMP to cells. Each treatment used 2 × 104–1 × 107 mesenchymal stem cells, averaging 2.26 × 106. Most BMP-transduced MSC studies used lentivirus. Conclusions: This systematic review examined BMP and MSC synergy in biomaterial scaffolds or alone. BMP therapy and mesenchymal stem cells in calvarial defects, alone, or with a scaffold regenerated bone. This method treats skull defects in clinical trials. The best scaffold material, therapeutic dosage, administration method, and long-term side effects need further study. Full article
(This article belongs to the Special Issue Clinical Application of Stem Cells in Regeneration Medicine)
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