Definition and Overview
Stem cells are cells with self-renewal ability and multi-differentiation potential. There are various types, from embryonic stem cells at the developmental stage to adult stem cells that exist in various tissues of the adult. Stem cell therapy is a core field of regenerative medicine that uses these cells to treat diseases.
The most widely studied and applied clinically are mesenchymal stem cells (mesenchymal stem cell/stromal cell, MSC). MSCs can be collected from various tissues such as bone marrow, adipose tissue, umbilical cord (cord blood), dental pulp, and placenta, and have the ability to differentiate into osteocytes, chondrocytes, and adipocytes and have strong immune-regulating and anti-inflammatory functions.
Therapeutic mechanism of mesenchymal stem cells
It is understood that mesenchymal stem cells exert therapeutic effects through various factors they secrete rather than directly replenishing cells from damaged tissues.
Neurotrophic factor secretion: Secretes BDNF (brain-derived neurotrophic factor), NGF (nerve growth factor), and NT-3 (neurotrophin-3) to promote nerve survival, growth, and functional recovery.
Anti-inflammatory effect: Secretes prostaglandin E2, IL-10, and TGF-β to suppress inflammatory responses and induce regulatory T cells.
Promotes angiogenesis: Helps blood vessel regeneration by secreting VEGF (vascular endothelial growth factor) and FGF.
Secretome and exosome: Exosomes secreted from MSCs contain growth factors, miRNAs, and proteins and induce tissue regeneration through intercellular communication.
Nervous System Applications
Clinical applications of MSCs are being studied in spinal cord injury, ALS, Parkinson's disease, post-stroke rehabilitation, and autonomic dysfunction. Small-scale clinical studies have reported the effect of MSC administration in restoring some neurological function or slowing progression, but evidence from large-scale randomized controlled trials is still limited.
In autonomic dysfunction, MSCs can help restore function by distributing around damaged autonomic ganglia and peripheral autonomic nerve fibers, supplying neurotrophic factors and suppressing inflammation.
Fat-derived regenerative cells
Adipose tissue is a rich source of MSCs and other regenerative cells. A stromal vascular fraction (SVF) is obtained when fat tissue obtained through liposuction or small collection is treated with enzymes and then centrifuged. SVF includes mesenchymal stem cells, pericytes, endothelial progenitor cells, macrophages, and T lymphocytes.
Autologous SVF has the advantage of being able to be performed on the same day without immune rejection. Clinical applications of SVF in arthritis, neuropathy, and autonomic dysfunction are ongoing.
safety
In a meta-analysis, treatment using MSCs was confirmed to have a good overall safety profile and a low incidence of major side effects. Short-term side effects include pain at the injection site, mild fever, and headache. Although there have been concerns about the risk of tumor development, to date, a causal relationship between MSC administration and tumor development has not been established in clinical studies.
Because long-term safety data are not yet sufficient, it is important that it is performed according to clinical protocols in certified medical institutions.