Stem cells: therapeutic applications and experimental techniques

Stem cells are being used more frequently for research and experimental therapy, but as yet the clinical applications of stem cells are limited. Pluripotent stem cells, with embryonic stem cells as the most well know example, can differentiate into each cell type; in contrast, tissue specific stem cells can only form one or more cell types within one type of tissue. It has been possible for some time to reprogram different types of somatic cells into pluripotent stem cells. Such stem cells are termed induced pluripotent stem cells (iPS cells). iPS cells can also be created from cells of patients with genetic conditions. Research into mechanisms of pathology and new medicines can be carried out with these against a specific genetic background. Clinical application of such iPS cells is not to be expected in the short term. Facilities are being established in different Dutch academic centres to create iPS cells for scientific research. Conflict of interest: none declared.     

Circulating stem cells and tissue repair

Stem cells are defined as cells that have clonogenic, self-renewing capacities and the capability to differentiate into multiple cell lineages. Whereas embryonic stem cells are derived from mammalian embryos in the blastocyst stage and can generate terminally differentiated cells of all 3 embryonic germ layers, adult human stem cells are capable of maintaining, generating, and replacing terminally differentiated cells within their own specific tissue as a consequence of physiologic cell turnover or tissue injury. The traditional idea of organ-restricted stem-cell differentiation is now being challenged by the suggestion that adult stem cells retain developmental plasticity. Preclinical and clinical studies described in this review provide evidence that within the blood circulate not only progenitor cells that differentiate into hematopoietic cells, but also stem/progenitor cells which can participate in the homeostasis, repair and replacement of solid organ tissues. In addition to the occurrence of cell fusion, there are 4 suggested mechanisms of adult stem cell differentiation into solid organ cells. Preclinical data support these models particularly that of transdifferentiation as the most likely model, allowing stem/progenitor cells to differentiate across lineage, tissue, and germ layer boundaries. There is increasing evidence that we can manipulate in vivo circulating adult stem cells to repair or regenerate solid organ tissue, which offers potential clinical benefit in the treatment of many hereditary and acquired diseases.     

A stem cell ... is stem cell?

We are used to associate stem cells with renewable tissues such as blood, gut and skin. But some cells in the adult central nervous system have the capacity to generate new neurons and glial cells as well and as such, they are considered to be neural stem cell. Yet their ability to generate neurons and glia, and their presence in the central nervous system throughout life, suggests new, intriguing possibilities for recovery and repair after damage to the central nervous system--and unexpectedly, the regeneration of blood tissues. After transplantation into irradiated hosts, neural stem cells were found to produce a variety of blood cell types including myeloid and lymphoid cells as well as early hematopoietic cells. Therefore, the developmental potential of stem cells is not restricted to the differentiated elements of the tissue in which they reside. Multipotential stem cells can persist in an undifferentiated state, and depending on specific environmental conditions function as a stem cell for many different tissues.     

Therapeutic cloning: far from application at this stage]

Therapeutic cloning has become possible since the discovery that nuclei from somatic cells of adult animal tissue can successfully be used for cloning and the fact that human embryonic stem cell lines have been established from preimplantation embryos. When nuclei from healthy tissue of a patient are transplanted into enucleated oocytes, these oocytes can be artificially activated so that embryos develop from which embryonic stem cells of the donor can be derived. These embryonic stem cells can be cultured as permanent lines in unlimited numbers and remain pluripotent, i.e. they can be induced to differentiate into the required cell type by adding one or more specific factors. These cells can then be transplanted back into the patient suffering from either a lack or dysfunction of these cells. This approach prevents the rejection of the transplanted cells by the patient's immunological system. As this type of cloning has a very low efficiency, a large number of unfertilized donor oocytes is required. It is questionable whether enough donors are or will be available for this purpose. The cultured cells must satisfy certain conditions before they can be used for transplantation. They must be checked for chromosomal abnormalities, and a complete differentiation of the embryonic stem cells into the cells types needed by the patient is necessary as after the transplantation, undifferentiated stem cells will form teratomas. Furthermore, it is difficult to ensure that the cells end up in the right place and to ensure that they fully integrate into the existing tissue to form functional connections. Due to this array of technical problems the question remains as to whether therapeutic cloning will become feasible in the near future.     

Potential for a pluripotent adult stem cell treatment for acute radiation sickness

Accidental radiation exposure and the threat of deliberate radiation exposure have been in the news and are a public health concern. Experience with acute radiation sickness has been gathered from atomic blast survivors of Hiroshima and Nagasaki and from civilian nuclear accidents as well as experience gained during the development of radiation therapy for cancer. This paper reviews the medical treatment reports relevant to acute radiation sickness among the survivors of atomic weapons at Hiroshima and Nagasaki, among the victims of Chernobyl, and the two cases described so far from the Fukushima Dai-Ichi disaster. The data supporting the use of hematopoietic stem cell transplantation and the new efforts to expand stem cell populations ex vivo for infusion to treat bone marrow failure are reviewed. Hematopoietic stem cells derived from bone marrow or blood have a broad ability to repair and replace radiation induced damaged blood and immune cell production and may promote blood vessel formation and tissue repair. Additionally, a constituent of bone marrow-derived, adult pluripotent stem cells, very small embryonic like stem cells, are highly resistant to ionizing radiation and appear capable of regenerating radiation damaged tissue including skin, gut and lung.     

Cellular therapy--the possible future of regenerative medicine

Stem cells are a unique cell population capable of self-renewal and differentiation into different cell lines. There are two main types of stem cells: embryonic stem cells (pluripotent) and somatic/adult stem cells (multipotent cells differentiated into the specific types of the tissue they originate from). Scientists are now interested in finding the sources of cells that can be used for therapeutic cloning as a method of saving human life and a new trend in regenerative medicine. Reproductive cloning, which aims at creating genetically identical human beings, is prohibited and is subject to national legislation in each country. Mesenchymal stem cells, with their capability to elude detection by the host's immune system and their relative ease of expansion in culture, are a very promising source of stem cells for regenerative medicine. This is the vast potential of cellular therapy for treating damaged and degenerating tissues.     

Comparison of neurosphere cells with cumulus cells after fusion with embryonic stem cells: reprogramming potential

Embryonic stem cells (ESCs) are the pluripotent cells that also have the capacity to induce the genomic reprogramming of differentiated somatic cells. The progressively restricted genomic potential of somatic cells observed during embryonic development can be reverted to a pluripotent state by the formation of cell hybrids with ESCs. To assess the reprogramming potential of ESCs, we investigated the reprogramming of one of two different somatic cell populations, neurosphere cells (NSCs) and cumulus cells (CCs), after fusion with ESCs. Specifically, hybrid cells were produced by cell fusion of E14 ESCs with either NSCs or CCs containing the neo/lacZ and Oct4-GFP transgenes. The first reprogramming event, observed by the presence of Oct4-GFP in the hybrid cells, could be identified on Day 2, at approximately 45 h after fusion in both ESC-NSC and ESC-CC hybrids. In addition, the two ESC-somatic cell hybrids exhibit a similar reprogramming rate and share characteristics with the E14 ESC line: (1) expression of pluripotent markers (Oct4, Rex-1 and nanog); (2) inactivation of differentiated tissue-specific gene expression; and (3) the capacity to differentiate into all three germ layers. Taken together, our results suggest that the ESC-somatic cell hybrids have fully acquired ESC characteristics and that somatic cells of different tissue origin have the same potential to be reprogrammed after fusion with ESCs.     

From fibroblasts and stem cells: implications for cell therapies and somatic cloning

Pluripotent embryonic stem cells (ESCs) from the inner cell mass of early murine and human embryos exhibit extensive self-renewal in culture and maintain their ability to differentiate into all cell lineages. These features make ESCs a suitable candidate for cell-replacement therapy. However, the use of early embryos has provoked considerable public debate based on ethical considerations. From this standpoint, stem cells derived from adult tissues are a more easily accepted alternative. Recent results suggest that adult stem cells have a broader range of potency than imagined initially. Although some claims have been called into question by the discovery that fusion between the stem cells and differentiated cells can occur spontaneously, in other cases somatic stem cells have been induced to commit to various lineages by the extra- or intracellular environment. Recent data from our laboratory suggest that changes in culture conditions can expand a subpopulation of cells with a pluripotent phenotype from primary fibroblast cultures. The present paper critically reviews recent data on the potency of somatic stem cells, methods to modify the potency of somatic cells and implications for cell-based therapies.     

Cell based vaccination using transplantation of iPSC-derived memory B cells

The recently developed induced pluripotent stem cell (iPSC) technique provides new direction for vaccination: somatic cells can be induced into iPSCs and expanded, then the cells are genetically or chemically promoted to a immune cell fate, followed with in vitro antigen presenting and processing processes to produce memory B cells that can secret functional antibodies to different pathogens; finally these cells are transplanted back to human.     

Spermatogonia: origin, physiology and prospects for conservation and manipulation of the male germ line

In recent years, the scientific community has become increasingly interested in spermatogonia. Methodological breakthroughs, such as germ cell transplantation and spermatogonial culture combined with novel germ line transfection strategies, have provided interesting new opportunities for studying the physiology of spermatogonial stem cells and their interaction with the stem cell niche. Furthermore, intense research into pluripotent and adult stem cells has generated new insight into the differentiation pathway of germ line stem cells and has opened new perspectives for stem cell technologies. The present review briefly introduces the physiology of spermatogonial stem cells and discusses future directions of basic research and practical approaches applicable to livestock maintenance and animal reproduction.     

间充质干细胞分泌因子调节氧化应激的作用

衰老和疾病发生发展大多伴随氧化应激水平升高，包括多囊卵巢综合征、卵巢储备减少和卵巢早衰等生殖内分泌疾病。干细胞治疗已应用于多种疾病或其临床研究，而间充质干细胞（MSC）相对于胚胎干细胞和诱导多能干细胞具有明显的优势，如应用于子宫内膜粘连、多囊卵巢综合征和卵巢早衰临床治疗的研究。MSC分泌的众多细胞因子对组织细胞内氧化应激具有调节作用。研究发现，白细胞介素6（IL-6）和脑源性神经营养因子（BDNF）能激活核因子E2相关因子2（Nrf2）通路降低氧化应激水平。综述MSC分泌因子的抗氧化应激作用，阐述其可能的细胞内作用机制，为探讨MSC临床应用提供新思路。     

Vitamin A/Retinol and Maintenance of Pluripotency of Stem Cells

Retinol, the alcohol form of vitamin A is a key dietary component that plays a critical role in vertebrate development, cell differentiation, reproduction, vision and immune system. Natural and synthetic analogs of retinol, called retinoids, have generally been associated with the cell differentiation via retinoic acid which is the most potent metabolite of retinol. However, a direct function of retinol has not been fully investigated. New evidence has now emerged that retinol supports the self-renewal of stem cells including embryonic stem cells (ESCs), germ line stem cells (GSCs) and cancer stem cells (CSCs) by activating the endogenous machinery for self-renewal by a retinoic acid independent mechanism. The studies have also revealed that stem cells do not contain enzymes that are responsible for metabolizing retinol into retinoic acid. This new function of retinol may have important implications for stem cell biology which can be exploited for quantitative production of pure population of pluripotent stem cells for regenerative medicine as well as clinical applications for cancer therapeutics.     

高效诱导iPS的方法模型

Kazutoshi Takahashi和Shinya Yamanaka首次发现,来自“正常”体细胞的诱导多能干细胞（induced pluripotent stem cell,iPS细胞）利用所定义的一些因子可以再生,但所转染的细胞,仅百分之几变成多能细胞,而且整个过程非常慢。     

Blutstammzelltransplantation Ein Beispiel praktizierter Stammzelltherapie

Hematopoietic stem cells (HSC) generate all blood cell lineages during ontogeny, and their continuous function is required for the maintenance of blood cells and immune tissues throughout life. HSC are characterized by certain key properties (multipotency, clonogenicity, self-renewal). These stem cell criteria also apply to non-hematopoietic stem cells. The capacity of HSC to self-renew is the basis for experimental and clinical bone marrow transplantation in which host HSC can engraft in donor bone marrow at long term (engraftment). HSC can also be used as cellular vectors for gene transfers in vivo. Most recently, several reports have suggested the exciting possibility that HSC can, in addition to blood cells, also generate non-blood cell types such as heart muscle or neuronal tissues. Is this potential for transdifferentiation a physiological HSC function? Are transdifferentiating HSC recruited to sites of tissue damage in vivo, and, if so, can this HSC property be used to “repair” adult tissues from bone marrow stem cells? The answers are, at present, highly speculative. In the present review we will thus focus primarily on the basic biology of HSC, and on some aspects of the clinical use of HSC in bone marrow transplantation.     

诱导多潜能性干细胞的研究现状与临床应用前景

胚胎干细胞可作为细胞替代治疗中很好的供体细胞来源。但由于伦理学的原因,限制了胚胎干细胞在细胞替代治疗中的应用前景,而诱导多潜能性干细胞(induced pluripotent stem cell,iPS细胞)的出现则提供了一种替代胚胎干细胞的多潜能性细胞。因为iPS细胞的建立不需要卵细胞,也不破坏发育中的胚胎,所以iPS细胞不涉及伦理学问题。而且iPS细胞的建立相对简单,重复性好。因此,iPS细胞在细胞替代治疗和再生医学中有着广泛的应用前景。本文将回顾iPS细胞技术发展的历史,介绍现有的建立iPS细胞的不同方法和评估iPS细胞质量的手段,展望iPS细胞在细胞替代治疗上有待解决的问题和应用前景。     

Developmental complexity of early mammalian pluripotent cell populations in vivo and in vitro

Early mammalian embryogenesis is characterised by the coordinated proliferation, differentiation, migration and apoptosis of a pluripotent cell pool that is able to give rise to extraembryonic lineages and all the cell types of the embryo proper. These cells retain pluripotent differentiation capability, defined in this paper as the ability to form all cell types of the embryo and adult, until differentiation into the three embryonic germ layers at gastrulation. Our understanding of pluripotent cell biology and molecular regulation has been hampered by the difficulties associated with experimental manipulation of these cells in vivo. However, a more detailed understanding of pluripotent cell behaviour is emerging from the application of molecular technologies to early mouse embryogenesis. The construction of mouse mutants by gene targeting, mapping of gene expression in vivo, and modelling of cell decisions in vitro are providing insight into the cellular origin, identity and action of key developmental regulators, and the nature of pluripotent cells themselves. In this review we discuss the properties of early embryonic pluripotent cells in vitro and in vivo, focusing on progression from inner cell mass (ICM) cells in the blastocyst to the onset of gastrulation.     

Embryonale Stammzellen der Maus Eigenschaften, Potenzial und Verwendung

During the last few years research on embryonic stem cells has received much public attention due to the fact that these cells are able to differentiate in vitro into many specialized cells and thus may serve as a source for a variety of tissues. The following article focuses on mouse embryonic stem cells (murine ES cells), because research on these cells has given insight into the potential of embryonic stem cells. Murine ES cells are permanent cell lines established from the inner cell mass (ICM) of early embryos (blastocysts). ES cells are undifferentiated pluripotent cells that are able to undergo an unlimited number of cell divisions without loosing the undifferentiated phenotype. The same is true for mouse primordial germ cell lines (murine EG cell lines), that where established from the fetal progenitor cells of primordial germ cells. Mouse embryonic stem cells are used for different purposes. In basic research they are used to study the consequences of mutations within genes that control embryonic development and/or the development of diseases. Because of their ability to differentiate into a variety of specialized cell types, murine ES cells also serve as model systems to establish specific differentiation protocols. In the last few years protocols were established for the in vitro development of undifferentiated embryonic stem cells into differentiated cardiac, skeletal muscle, neural, adipogenic, haematopoietic, endothelial, chondrogenic or vascular smooth muscle cells. Last but not least, studies on mouse ES cells have demonstrated that embryonic cells and their differentiated derivatives can be used to analyse the effects of toxic substances or of pharmaceutical drugs.     

Stem cell therapy in cardiovascular diseases

Myocardial infarction is the leading cause of congestive heart failure in the industrialized world. Current treatments fail to address the underlying scarring and cell loss, which are the causes of ischaemic heart failure. Recent interest has focused on stem cells, which are undifferentiated and pluripotent cells that can proliferate, potentially self-renew, and differentiate into cardiomyocytes and endothelial cells. Myocardial regeneration is the most widely studied and debated example of stem cell plasticity. Early reports from animal and clinical investigations disagree on the extent of myocardial renewal in adults, but evidence indicates that cardiomyocytes were generated in what was previously considered a postmitotic organ. So far, candidates for cardiac stem cell therapy have been limited to patients with acute myocardial infarction and chronic ischaemic heart failure. Currently, bone marrow stem cells seem to be the most attractive cell type for these patients. The cells may be delivered by means of direct surgical injection, intracoronary infusion, retrograde venous infusion, and transendocardial infusion. Stem cells may directly increase cardiac contractility or passively limit infarct expansion and remodeling. Early phase I clinical studies indicate that stem cell transplantation is feasible and may have beneficial effects on ventricular remodeling after myocardial infarction. Future randomized clinical trials will establish the magnitude of benefit and the effect on mortality after stem cell therapy.     

Stem cells and lineage development in the mammalian blastocyst

The mammalian blastocyst is the source of the most pluripotent stem cells known: embryonic stem (ES) cells. However, ES cells are not totipotent; in mouse chimeras, they do not contribute to extra-embryonic cell types of the trophectoderm (TE) and primitive endoderm (PrE) lineages. Understanding the genetic pathways that control pluripotency v. extra-embryonic lineage restriction is key to understanding not only normal embryonic development, but also how to reprogramme adult cells to pluripotency. The trophectoderm and primitive endoderm lineages also provide the first signals that drive patterned differentiation of the pluripotent epiblast cells of the embryo. My laboratory has produced permanent mouse cell lines from both the TE and the PrE, termed trophoblast stem (TS) and eXtra-embryonic ENdoderm (XEN) cells. We have used these cells to explore the genetic and molecular hierarchy of lineage restriction and identify the key factors that distinguish the ES cell v. the TS or XEN cell fate. The major molecular pathways of lineage commitment defined in mouse embryos and stem cells are probably conserved across mammalian species, but more comparative studies of lineage development in embryos of non-rodent mammals will likely yield interesting differences in terms of timing and details.     

干细胞向雌性生殖细胞分化的研究进展

干细胞是一类具有自我更新和多向分化潜能的细胞。根据其来源不同,干细胞可分为胚胎干细胞、成体干细胞以及诱导性多能干细胞。生殖细胞系负责跨代传递遗传和表观遗传信息,以确保新的正常个体产生。人类辅助生殖技术(ART)虽可解决部分难治性不孕不育患者的生育问题,但尚不能解决由于卵巢早衰生殖细胞缺乏导致的不孕,如果在体外可以将干细胞定向诱导分化为生殖细胞,则可能通过ART帮助卵巢早衰患者获得健康后代。雌性配子发育经历了多个严格、复杂的过程,包括原始生殖细胞(PGC)特化、增殖、迁移到生殖嵴并最终分化为成熟的卵母细胞。然而具体过程尚不明确。近年来学者已建立了干细胞向雌性生殖细胞分化的体外模型,并取得了长足进步。