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The Safety of Non-Expanded Multipotential Stromal Cell Therapies

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Safety, Ethics and Regulations

Part of the book series: Stem Cells in Clinical Applications ((SCCA))

Abstract

Tissue engineering of replacement tissues and organs manufactured with stem cells and biocompatible scaffolds has become a today’s reality. Bone marrow harbours the two types of adult stem cells—haematopoietic stem cells (HSCs) and multipotential stromal cells (MSCs). Up to date, clinical use of MSCs mostly relies on culture expansion; however, current MSC culture-expansion protocols, although clinically permittable, do not guarantee the preservation of native MSC characteristics and yield cellular products of variable quality and potency, which could be accountable for varied treatment outcomes. As a consequence, new technologies have now emerged that are based on uncultured MSCs, of various degrees of purity, in clinical settings. This chapter will provide an overview on the current state of the art in the field of uncultured MSCs as cell therapy. We will discuss highly pertinent safety issues such as purity and the role of contaminating immune and non-immune cells. Parallels will be drawn with similar treatments with cultured MSCs and uncultured HSCs. Other currently unresolved issues, such as MSC dose, route of delivery and donor-to-donor variability, for both uncultured and culture-expanded MSCs, will be discussed. Finally, we will briefly elaborate on acellular approach such as delivering MSC-derived exosomes or inducing endogenous MSC homing with the use of bioactive molecules to direct resident MSC migration to target areas in vivo. This combined knowledge should provide the platform for developing novel, safe and cost-effective MSC therapies with improved efficacy based on non-expanded MSCs and be also relevant for using other types of adult stem cells as cell therapy.

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Authors and Affiliations

  1. Department of Biomedical Research, Foundation for Research and Technology-Hellas, Institute of Molecular Biology and Biotechnology, University of Ioannina, Ioannina, Greece

    Dimitrios Kouroupis

  2. Institute of Cellular Medicine, University of Newcastle upon Tyne, Newcastle, UK

    Xiao Nong Wang

  3. Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, St James’s University Hospital, Room 5.24 Clinical Sciences Building, Leeds, LS9 7TF, UK

    Yasser El-Sherbiny, Dennis McGonagle & Elena Jones

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  1. Dimitrios Kouroupis
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  2. Xiao Nong Wang
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  3. Yasser El-Sherbiny
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  4. Dennis McGonagle
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  5. Elena Jones
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Correspondence to Elena Jones .

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  1. Stem Cell Institute, University of Science, Vietnam National University, Ho Chi Minh City, Vietnam

    Phuc Van Pham

  2. Centre for Education Studies, Faculty of Social Sciences, University of Warwick, Coventry, United Kingdom

    Achim Rosemann

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Kouroupis, D., Wang, X.N., El-Sherbiny, Y., McGonagle, D., Jones, E. (2017). The Safety of Non-Expanded Multipotential Stromal Cell Therapies. In: Pham, P., Rosemann, A. (eds) Safety, Ethics and Regulations. Stem Cells in Clinical Applications. Springer, Cham. https://doi.org/10.1007/978-3-319-59165-0_4

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