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 Stem Cells from Cord Blood

Stem cells (immature cells capable of unlimited self-replication and far-going specialisation) may be the key to curing many diseases and repairing damaged tissues.
The blood-forming stem cells of umbilical cord blood are already used as an alternative to bone marrow transplants, and numerous other applications are on the horizon.
A network of clinical centres (FP5, Quality of Life) is evaluating the safety and efficacy of such an approach, which should lead to new protocols for gene therapy and stem cell therapy
using cord blood-derived cells.
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Prospects of stem cells
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The discovery of the immortal stem cells, more than 20 years ago, created a biological and medical sensation. Since then, biologists better understand how various kinds of body tissues develop, grow and repair themselves, while medical researchers see prospects for promising new therapeutic approaches. Each type of tissue (muscles, skin, organs, blood, neurons) has its own stem cells, called adult stem cells. In undifferentiated embryos, however, stem cells are able to form any part of the ‘later’ body: they are pluripotent. Hence, they are called embryonic stem cells, or ESCs for short. Even though adult stem cells were thought always to be specialised, researchers have revealed the possibility of engineering them back into the stage of pluripotency. Blood-derived stem cells, for instance, could be triggered into building cartilage, neuronal, or epithelial tissue. In animal models, stem cells have already been shown to cure leukaemia, diabetes, neurodegenerative diseases (such as Parkinson’s disease), or able to repair stroke-induced damage to nervous tissue. The validity of these results has, of course, to be verified in humans.

An ethical whirlwind
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For obvious reasons, it would be most appropriate to use ESCs for all kinds of therapeutic purposes. However, unlike adult stem cells which can be taken from any person, ESCs can only be obtained from embryos in the first stages of their development (i.e. blastocyte stage). And the process will inevitably destroy the embryos. Although only supernumerary embryos would be considered, the prospect of creating embryos for research purposes has given rise to an ethical outcry and initiated a sophisticated ethical discussion on the definition of the beginning of life and the human dignity of embryos.

Looking for alternatives
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The obvious ethical problems caused researchers to look for alternative sources, such as adult stem cells. One promising source was found in umbilical cord blood which can be obtained in large quantities at birth and used without risking ethical objections. Back in 1963, such blood-forming (haematopoietic) stem cells were discovered in mice. Their use first and foremost will be to replace bone marrow transplants wherever feasible. Although these stem cells are specialised in producing blood cells, it may be possible to demonstrate that they are pluripotent by transforming them into neural stem cells.

A European network approach
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The EU is financing (€1.4 million) a network of clinical centres to organise the transfer of expertise on the technologies concerned in order to improve, evaluate, standardise and, finally, apply them (QLK3-1999-0380). The project will permit a pan-European evaluation of the impact of this type of stem cell transplants on the survival of patients. The results will also contribute to the improvement of donor searches and will lead to the creation of new protocols for gene therapy and umbilical cord blood stem cell therapy.

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CO-ORDINATOR
Prof. Eliane Gluckman
Association pour la Recherche sur les Transplantations Médullaires Hôpital Saint-Louis
1 avenue Claude Vellefaux
FR-75475 Paris
Tel: +33 1 42 49 96 44
E-mail: eliane.gluckman@sls.ap-hop-paris.fr

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