Regenerating life by using technology efficiently

Cellular therapy is the beginning of a new era in the world of regenerative medicine. The main goal of cellular therapy is to harness the potential of endogenous repair mechanisms to promote tissue regeneration.

Stem cells are at the forefront of cellular therapy. Stem cells are undifferentiated cells and are of two types, namely, embryonic and adult stem cells. Although embryonic stem cells are more potent, the ethical and legal considerations have raised concerns regarding their use. Adult stem cells that were earlier assumed to be present only in the bone marrow have now been identified in different organs and tissues.

Stem cells have the capacity for self-renewal and differentiation into various tissues. The role of adult stem cells in the human body is to participate in organ homoeostasis, wound healing etc. These cells secrete trophic factors which aid in cell replacement, enhancement of organ function etc. by harnessing their innate regenerative potential. Stem cells also exert a paracrine effect during active tissue inflammation; therefore therapy is most effective during early stages of a disease. By this mechanism, these cells enhance migration of cells associated with wound healing into damaged tissues/organs and induce their proliferation, thereby accelerating the healing process.

Cellular therapy also encompasses treatment using various cells of the immune system such as T cells, dendritic cells, natural killer cells etc. These effector cells are capable of modulating the immune system and thus hold promise in the management of conditions such as cancer and autoimmune conditions.

Technologies and diseases that can be treated
Autologous cellular therapy is emerging as an extremely promising approach for tissue regeneration owing to the availability, ease of harvest and transplant of cells (no surgical procedure involved). Owing to the varied properties of cells, diabetes, liver, genitourinary disorders, dermatological conditions and much more can achieve benefits from cellular therapy.

Stem cells possess the property of transdifferentiation, which is the ability of one type of cell to differentiate into another based on the environment. For example, in the context of neurological diseases, the mechanism underlying the function of stem cell transplantation in nerve repair may involve cell replacement function and neurotrophic effect. Additionally, these cells can be induced to differentiate into neuron-like cells and glial cells. These properties benefit patients with conditions such as Parkinson’s disease, motor neurone disease, Alzheimer’s disease etc. Stem cells have anti- inflammatory property, therefore has the potential to be used in inflammatory disease conditions such as arthritis and musculoskeletal disorders. These cells can induce angiogenesis/revascularization, therefore, has scope in treating conditions such as avascular necrosis, diabetic foot ulcers, chronic ischemic wounds etc.

Immunomodulatory property and contribution to hematopoiesis may aid in the correction of dysregulations in the immune system. Autoimmune diseases such as rheumatoid arthritis, diabetes mellitus type 1, ankylosing spondylitis etc. show tremendous improvement when treated with cell-based therapy.

Talking about the technology related to cellular therapy, advances have been made over the years in both diagnostic and therapeutic approaches. Molecular imaging technology (optical imaging, positron emission tomography etc.) has simplified research on disease mechanism and treatment evaluation related to cell-based therapy. Presently, fluorescence activated cell sorting (FACS) and magnetically activated cell sorting (MACS) is the common separation methods for stem cells. Several new technologies are being introduced that simplify the process of isolation and characterization of cells. One such example is the Prodigy technology which completely automates the procedure of cell manufacturing from start to finish, thus enabling standardisation and GMP compliance. In addition, detection and identification of specific cell populations are now possible through gene labelling techniques. Similarly, advances in microscopy have enabled the study of cell behaviour with respect to their surroundings.

How such technologies will bring revolution in medical world
The present century is witnessing breakthrough developments being made in the field of medicine and technology. Steady progress is noticed in the nanotechnology, genomics, regenerative medicine and cell-based therapies. These novel technologies are the need of the hour as there is the widespread occurrence of diseases, especially in younger populations. An interesting avenue of research in cellular therapy is pertaining to cancer immunotherapy wherein stem cells may behave as regulated delivery vehicles. The therapy is based on the principle of the immune system to detect transformed cells in the blood or from tumours and eradicate these via immunological processes. Mesenchymal stem cells associated with chemotherapeutic agents can function as targeting specific molecules that act against the cancerous cells. This advancement will gradually limit the need for intensive chemotherapy/radiation therapy and therefore reduce the incidence of associated side effects.

Regenerative medicine and cellular therapy also hold potential to address the issue of organ transplant and rejection, thereby providing a glimmer of hope to solve the problem of organ shortage. Resources are being invested and breakthrough scientific efforts are being made in gaining fundamental knowledge about the molecular and cellular mechanisms underlying cell-based therapy. Current research also includes the development of bioactive scaffolds that are capable of supporting activation and differentiation of host stem cells at the required site. In the future, it will be possible to use human native sites as micro-niche/micro-environment for potentiation of the human body's site-specific response. Soon there will be a day when diseases are treated with cells, not pills and the dream of organ manufacturing in a laboratory and transplantation may become a reality!

This article has been authored by Dr Pradeep Mahajan, Regenerative medicine researcher, Stemrx Bioscience Solutions Pvt Ltd