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Wikipedia

Stem cell

This article is about the cell type. For the medical therapy, see cell therapy.
"Stem cells" redirects here. For the journal, see Stem Cells (journal).
"Stem cell research" redirects here. For the journal, see Stem Cell Research (journal).

In multicellular organisms, stem cells are undifferentiated or partially differentiated cells that can differentiate into various types of cells and proliferate indefinitely to produce more of the same stem cell. They are the earliest type of cell in a cell lineage. They are found in both embryonic and adult organisms, but they have slightly different properties in each. They are usually distinguished from progenitor cells, which cannot divide indefinitely, and precursor or blast cells, which are usually committed to differentiating into one cell type.

In mammals, roughly 50–150 cells make up the inner cell mass during the blastocyst stage of embryonic development, around days 5–14. These have stem-cell capability. In vivo, they eventually differentiate into all of the body's cell types (making them pluripotent). This process starts with the differentiation into the three germ layers – the ectoderm, mesoderm and endoderm – at the gastrulation stage. However, when they are isolated and cultured in vitro, they can be kept in the stem-cell stage and are known as embryonic stem cells (ESCs).

Adult stem cells are found in a few select locations in the body, known as niches, such as those in the bone marrow or gonads. They exist to replenish rapidly lost cell types and are multipotent or unipotent, meaning they only differentiate into a few cell types or one cell type. In mammals, they include, among others, hematopoietic stem cells, which replenish blood and immune cells, basal cells, which maintain the skin epithelium, and mesenchymal stem cells, which maintain bone, cartilage, muscle and fat cells. Adult stem cells are a small minority of cells; they are vastly outnumbered by the progenitor cells and terminally differentiated cells that they differentiate into.

Research into stem cells grew out of findings by Canadian biologists Ernest McCulloch, James Till and Andrew J. Becker at the University of Toronto and the Ontario Cancer Institute in the 1960s. As of 2016[update], the only established medical therapy using stem cells is hematopoietic stem cell transplantation, first performed in 1958 by French oncologist Georges Mathé. Since 1998 however, it has been possible to culture and differentiate human embryonic stem cells (in stem-cell lines). The process of isolating these cells has been controversial, because it typically results in the destruction of the embryo. Sources for isolating ESCs have been restricted in some European countries and Canada, but others such as the UK and China have promoted the research. Somatic cell nuclear transfer is a cloning method that can be used to create a cloned embryo for the use of its embryonic stem cells in stem cell therapy. In 2006, a Japanese team led by Shinya Yamanaka discovered a method to convert mature body cells back into stem cells. These were termed induced pluripotent stem cells (iPSCs).

Contents

The term stem cell was coined by Theodor Boveri and Valentin Haecker in late 19th century. Pioneering works in theory of blood stem cell were conducted in the beginning of 20th century by Artur Pappenheim, Alexander Maximow, Franz Ernst Christian Neumann.

The key properties of a stem cell were first defined by Ernest McCulloch and James Till at the University of Toronto and the Ontario Cancer Institute in the early 1960s. They discovered the blood-forming stem cell, the hematopoietic stem cell (HSC), through their pioneering work in mice. McCulloch and Till began a series of experiments in which bone marrow cells were injected into irradiated mice. They observed lumps in the spleens of the mice that were linearly proportional to the number of bone marrow cells injected. They hypothesized that each lump (colony) was a clone arising from a single marrow cell (stem cell). In subsequent work, McCulloch and Till, joined by graduate student Andrew John Becker and senior scientist Louis Siminovitch, confirmed that each lump did in fact arise from a single cell. Their results were published in Nature in 1963. In that same year, Siminovitch was a lead investigator for studies that found colony-forming cells were capable of self-renewal, which is a key defining property of stem cells that Till and McCulloch had theorized.

The first therapy using stem cells was a bone marrow transplant performed by French oncologist Georges Mathé in 1958 on five workers at the Vinča Nuclear Institute in Yugoslavia who had been affected by a criticality accident. The workers all survived.

In 1981, embryonic stem (ES) cells were first isolated and successfully cultured using mouse blastocysts by British biologists Martin Evans and Matthew Kaufman. This allowed the formation of murine genetic models, a system in which the genes of mice are deleted or altered in order to study their function in pathology. By 1998, embryonic stem cells were first isolated by American biologist James Thomson, which made it possible to have new transplantation methods or various cell types for testing new treatments. In 2006, Shinya Yamanaka’s team in Kyoto, Japan converted fibroblasts into pluripotent stem cells by modifying the expression of only four genes. The feat represents the origin of induced pluripotent stem cells, known as iPS cells.

In 2011, a female maned wolf, run over by a truck, underwent stem cell treatment at the Zoo Brasília, this being the first recorded case of the use of stem cells to heal injuries in a wild animal.

The classical definition of a stem cell requires that it possesses two properties:

Self-renewal

Two mechanisms ensure that a stem cell population is maintained (doesn't shrink in size):

1. Asymmetric cell division: a stem cell divides into one mother cell, which is identical to the original stem cell, and another daughter cell, which is differentiated.

When a stem cell self-renews, it divides and does not disrupt the undifferentiated state. This self-renewal demands control of cell cycle as well as upkeep of multipotency or pluripotency, which all depends on the stem cell.

2. Stochastic differentiation: when one stem cell grows and divides into two differentiated daughter cells, another stem cell undergoes mitosis and produces two stem cells identical to the original.

Stem cells use telomerase, a protein that restores telomeres, to protect their DNA and extend their cell division limit (the Hayflick limit).

Potency meaning

Main article: Cell potency
Pluripotent, embryonic stem cells originate as inner cell mass (ICM) cells within a blastocyst. These stem cells can become any tissue in the body, excluding a placenta. Only cells from an earlier stage of the embryo, known as the morula, are totipotent, able to become all tissues in the body and the extraembryonic placenta.
Human embryonic stem cells
A: Stem cell colonies that are not yet differentiated.
B: Nerve cells, an example of a cell type after differentiation.

Potency specifies the differentiation potential (the potential to differentiate into different cell types) of the stem cell.

  • Totipotent (also known as omnipotent) stem cells can differentiate into embryonic and extraembryonic cell types. Such cells can construct a complete, viable organism. These cells are produced from the fusion of an egg and sperm cell. Cells produced by the first few divisions of the fertilized egg are also totipotent.
  • Pluripotent stem cells are the descendants of totipotent cells and can differentiate into nearly all cells, i.e. cells derived from any of the three germ layers.
  • Multipotent stem cells can differentiate into a number of cell types, but only those of a closely related family of cells.
  • Oligopotent stem cells can differentiate into only a few cell types, such as lymphoid or myeloid stem cells.
  • Unipotent cells can produce only one cell type, their own, but have the property of self-renewal, which distinguishes them from non-stem cells (e.g. progenitor cells, which cannot self-renew).

Identification

In practice, stem cells are identified by whether they can regenerate tissue. For example, the defining test for bone marrow or hematopoietic stem cells (HSCs) is the ability to transplant the cells and save an individual without HSCs. This demonstrates that the cells can produce new blood cells over a long term. It should also be possible to isolate stem cells from the transplanted individual, which can themselves be transplanted into another individual without HSCs, demonstrating that the stem cell was able to self-renew.

Properties of stem cells can be illustrated in vitro, using methods such as clonogenic assays, in which single cells are assessed for their ability to differentiate and self-renew. Stem cells can also be isolated by their possession of a distinctive set of cell surface markers. However, in vitro culture conditions can alter the behavior of cells, making it unclear whether the cells shall behave in a similar manner in vivo. There is considerable debate as to whether some proposed adult cell populations are truly stem cells.

Main article: Embryonic stem cell

Embryonic stem cells (ESCs) are the cells of the inner cell mass of a blastocyst, formed prior to implantation in the uterus. In human embryonic development the blastocyst stage is reached 4–5 days after fertilization, at which time it consists of 50–150 cells. ESCs are pluripotent and give rise during development to all derivatives of the three germ layers: ectoderm, endoderm and mesoderm. In other words, they can develop into each of the more than 200 cell types of the adult body when given sufficient and necessary stimulation for a specific cell type. They do not contribute to the extraembryonic membranes or to the placenta.

During embryonic development the cells of the inner cell mass continuously divide and become more specialized. For example, a portion of the ectoderm in the dorsal part of the embryo specializes as 'neurectoderm', which will become the future central nervous system. Later in development, neurulation causes the neurectoderm to form the neural tube. At the neural tube stage, the anterior portion undergoes encephalization to generate or 'pattern' the basic form of the brain. At this stage of development, the principal cell type of the CNS is considered a neural stem cell.

The neural stem cells self-renew and at some point transition into radial glial progenitor cells (RGPs). Early-formed RGPs self-renew by symmetrical division to form a reservoir group of progenitor cells. These cells transition to a neurogenic state and start to divide asymmetrically to produce a large diversity of many different neuron types, each with unique gene expression, morphological, and functional characteristics. The process of generating neurons from radial glial cells is called neurogenesis. The radial glial cell, has a distinctive bipolar morphology with highly elongated processes spanning the thickness of the neural tube wall. It shares some glial characteristics, most notably the expression of glial fibrillary acidic protein (GFAP). The radial glial cell is the primary neural stem cell of the developing vertebrate CNS, and its cell body resides in the ventricular zone, adjacent to the developing ventricular system. Neural stem cells are committed to the neuronal lineages (neurons, astrocytes, and oligodendrocytes), and thus their potency is restricted.

Nearly all research to date has made use of mouse embryonic stem cells (mES) or human embryonic stem cells (hES) derived from the early inner cell mass. Both have the essential stem cell characteristics, yet they require very different environments in order to maintain an undifferentiated state. Mouse ES cells are grown on a layer of gelatin as an extracellular matrix (for support) and require the presence of leukemia inhibitory factor (LIF) in serum media. A drug cocktail containing inhibitors to GSK3B and the MAPK/ERK pathway, called 2i, has also been shown to maintain pluripotency in stem cell culture. Human ESCs are grown on a feeder layer of mouse embryonic fibroblasts and require the presence of basic fibroblast growth factor (bFGF or FGF-2). Without optimal culture conditions or genetic manipulation, embryonic stem cells will rapidly differentiate.

A human embryonic stem cell is also defined by the expression of several transcription factors and cell surface proteins. The transcription factors Oct-4, Nanog, and Sox2 form the core regulatory network that ensures the suppression of genes that lead to differentiation and the maintenance of pluripotency. The cell surface antigens most commonly used to identify hES cells are the glycolipids stage specific embryonic antigen 3 and 4, and the keratan sulfate antigens Tra-1-60 and Tra-1-81. The molecular definition of a stem cell includes many more proteins and continues to be a topic of research.

By using human embryonic stem cells to produce specialized cells like nerve cells or heart cells in the lab, scientists can gain access to adult human cells without taking tissue from patients. They can then study these specialized adult cells in detail to try to discern complications of diseases, or to study cell reactions to proposed new drugs.

Because of their combined abilities of unlimited expansion and pluripotency, embryonic stem cells remain a theoretically potential source for regenerative medicine and tissue replacement after injury or disease., however, there are currently no approved treatments using ES cells. The first human trial was approved by the US Food and Drug Administration in January 2009. However, the human trial was not initiated until October 13, 2010 in Atlanta for spinal cord injury research. On November 14, 2011 the company conducting the trial (Geron Corporation) announced that it will discontinue further development of its stem cell programs. Differentiating ES cells into usable cells while avoiding transplant rejection are just a few of the hurdles that embryonic stem cell researchers still face. Embryonic stem cells, being pluripotent, require specific signals for correct differentiation – if injected directly into another body, ES cells will differentiate into many different types of cells, causing a teratoma. Ethical considerations regarding the use of unborn human tissue are another reason for the lack of approved treatments using embryonic stem cells. Many nations currently have moratoria or limitations on either human ES cell research or the production of new human ES cell lines.

  • Mouse embryonic stem cells with fluorescent marker

  • Human embryonic stem cell colony on mouse embryonic fibroblast feeder layer

Mesenchymal stem cells

Mesenchymal stem cells (MSC) are known to be multipotent, which can be found in adult tissues, for example, in the muscle, liver, bone marrow. Mesenchymal stem cells usually function as structural support in various organs as mentioned above, and control the movement of substances. MSC can differentiate into numerous cell categories as an illustration of adipocytes, osteocytes, and chondrocytes, derived by the mesodermal layer. Where the mesoderm layer provides an increase to the body’s skeletal elements, such as relating to the cartilage or bone. The term “meso” means middle, infusion originated from the Greek, signifying that mesenchymal cells are able to range and travel in early embryonic growth among the ectodermal and endodermal layers. This mechanism helps with space-filling thus, key for repairing wounds in adult organisms that have to do with mesenchymal cells in the dermis (skin), bone, or muscle.

Mesenchymal stem cells are known to be essential for regenerative medicine. They are broadly studied in clinical trials. Since they are easily isolated and obtain high yield, high plasticity, which makes able to facilitate inflammation and encourage cell growth, cell differentiation, and restoring tissue derived from immunomodulation and immunosuppression. MSC comes from the bone marrow, which requires an aggressive procedure when it comes to isolating the quantity and quality of the isolated cell, and it varies by how old the donor. When comparing the rates of MSC in the bone marrow aspirates and bone marrow stroma, the aspirates tend to have lower rates of MSC than the stroma. MSC are known to be heterogeneous, and they express a high level of pluripotent markers when compared to other types of stem cells, such as embryonic stem cells.

Cell cycle control

Further information: Cell cycle

Embryonic stem cells (ESCs) have the ability to divide indefinitely while keeping their pluripotency, which is made possible through specialized mechanisms of cell cycle control. Compared to proliferating somatic cells, ESCs have unique cell cycle characteristics—such as rapid cell division caused by shortened G1 phase, absent G0 phase, and modifications in cell cycle checkpoints—which leaves the cells mostly in S phase at any given time. ESCs’ rapid division is demonstrated by their short doubling time, which ranges from 8 to 10 hours, whereas somatic cells have doubling time of approximately 20 hours or longer. As cells differentiate, these properties change: G1 and G2 phases lengthen, leading to longer cell division cycles. This suggests that a specific cell cycle structure may contribute to the establishment of pluripotency.

Particularly because G1 phase is the phase in which cells have increased sensitivity to differentiation, shortened G1 is one of the key characteristics of ESCs and plays an important role in maintaining undifferentiated phenotype. Although the exact molecular mechanism remains only partially understood, several studies have shown insight on how ESCs progress through G1—and potentially other phases—so rapidly.

The cell cycle is regulated by complex network of cyclins, cyclin-dependent kinases (Cdk), cyclin-dependent kinase inhibitors (Cdkn), pocket proteins of the retinoblastoma (Rb) family, and other accessory factors. Foundational insight into the distinctive regulation of ESC cell cycle was gained by studies on mouse ESCs (mESCs). mESCs showed a cell cycle with highly abbreviated G1 phase, which enabled cells to rapidly alternate between M phase and S phase. In a somatic cell cycle, oscillatory activity of Cyclin-Cdk complexes is observed in sequential action, which controls crucial regulators of the cell cycle to induce unidirectional transitions between phases: Cyclin D and Cdk4/6 are active in the G1 phase, while Cyclin E and Cdk2 are active during the late G1 phase and S phase; and Cyclin A and Cdk2 are active in the S phase and G2, while Cyclin B and Cdk1 are active in G2 and M phase. However, in mESCs, this typically ordered and oscillatory activity of Cyclin-Cdk complexes is absent. Rather, the Cyclin E/Cdk2 complex is constitutively active throughout the cycle, keeping retinoblastoma protein (pRb) hyperphosphorylated and thus inactive. This allows for direct transition from M phase to the late G1 phase, leading to absence of D-type cyclins and therefore a shortened G1 phase. Cdk2 activity is crucial for both cell cycle regulation and cell-fate decisions in mESCs; downregulation of Cdk2 activity prolongs G1 phase progression, establishes a somatic cell-like cell cycle, and induces expression of differentiation markers.

In human ESCs (hESCs), the duration of G1 is dramatically shortened. This has been attributed to high mRNA levels of G1-related Cyclin D2 and Cdk4 genes and low levels of cell cycle regulatory proteins that inhibit cell cycle progression at G1, such as p21CipP1, p27Kip1, and p57Kip2. Furthermore, regulators of Cdk4 and Cdk6 activity, such as members of the Ink family of inhibitors (p15, p16, p18, and p19), are expressed at low levels or not at all. Thus, similar to mESCs, hESCs show high Cdk activity, with Cdk2 exhibiting the highest kinase activity. Also similar to mESCs, hESCs demonstrate the importance of Cdk2 in G1 phase regulation by showing that G1 to S transition is delayed when Cdk2 activity is inhibited and G1 is arrest when Cdk2 is knocked down. However unlike mESCs, hESCs have a functional G1 phase. hESCs show that the activities of Cyclin E/Cdk2 and Cyclin A/Cdk2 complexes are cell cycle-dependent and the Rb checkpoint in G1 is functional.

ESCs are also characterized by G1 checkpoint non-functionality, even though the G1 checkpoint is crucial for maintaining genomic stability. In response to DNA damage, ESCs do not stop in G1 to repair DNA damages but instead, depend on S and G2/M checkpoints or undergo apoptosis. The absence of G1 checkpoint in ESCs allows for the removal of cells with damaged DNA, hence avoiding potential mutations from inaccurate DNA repair. Consistent with this idea, ESCs are hypersensitive to DNA damage to minimize mutations passed onto the next generation.

The primitive stem cells located in the organs of fetuses are referred to as fetal stem cells.

There are two types of fetal stem cells:

  1. Fetal proper stem cells come from the tissue of the fetus proper and are generally obtained after an abortion. These stem cells are not immortal but have a high level of division and are multipotent.
  2. Extraembryonic fetal stem cells come from extraembryonic membranes, and are generally not distinguished from adult stem cells. These stem cells are acquired after birth, they are not immortal but have a high level of cell division, and are pluripotent.
Main article: Adult stem cell
Stem cell division and differentiation A: stem cell; B: progenitor cell; C: differentiated cell; 1: symmetric stem cell division; 2: asymmetric stem cell division; 3: progenitor division; 4: terminal differentiation

Adult stem cells, also called somatic (from Greek σωματικóς, "of the body") stem cells, are stem cells which maintain and repair the tissue in which they are found. They can be found in children, as well as adults.

There are three known accessible sources of autologous adult stem cells in humans:

  1. Bone marrow, which requires extraction by harvesting, usually from pelvic bones via surgery.
  2. Adipose tissue (fat cells), which requires extraction by liposuction.
  3. Blood, which requires extraction through apheresis, wherein blood is drawn from the donor (similar to a blood donation), and passed through a machine that extracts the stem cells and returns other portions of the blood to the donor.[citation needed]

Stem cells can also be taken from umbilical cord blood just after birth. Of all stem cell types, autologous harvesting involves the least risk. By definition, autologous cells are obtained from one's own body, just as one may bank their own blood for elective surgical procedures.[citation needed]

Pluripotent adult stem cells are rare and generally small in number, but they can be found in umbilical cord blood and other tissues. Bone marrow is a rich source of adult stem cells, which have been used in treating several conditions including liver cirrhosis, chronic limb ischemia and endstage heart failure. The quantity of bone marrow stem cells declines with age and is greater in males than females during reproductive years. Much adult stem cell research to date has aimed to characterize their potency and self-renewal capabilities. DNA damage accumulates with age in both stem cells and the cells that comprise the stem cell environment. This accumulation is considered to be responsible, at least in part, for increasing stem cell dysfunction with aging (see DNA damage theory of aging).

Most adult stem cells are lineage-restricted (multipotent) and are generally referred to by their tissue origin (mesenchymal stem cell, adipose-derived stem cell, endothelial stem cell, dental pulp stem cell, etc.). Muse cells (multi-lineage differentiating stress enduring cells) are a recently discovered pluripotent stem cell type found in multiple adult tissues, including adipose, dermal fibroblasts, and bone marrow. While rare, muse cells are identifiable by their expression of SSEA-3, a marker for undifferentiated stem cells, and general mesenchymal stem cells markers such as CD105. When subjected to single cell suspension culture, the cells will generate clusters that are similar to embryoid bodies in morphology as well as gene expression, including canonical pluripotency markers Oct4, Sox2, and Nanog.

Adult stem cell treatments have been successfully used for many years to treat leukemia and related bone/blood cancers through bone marrow transplants. Adult stem cells are also used in veterinary medicine to treat tendon and ligament injuries in horses.

The use of adult stem cells in research and therapy is not as controversial as the use of embryonic stem cells, because the production of adult stem cells does not require the destruction of an embryo. Additionally, in instances where adult stem cells are obtained from the intended recipient (an autograft), the risk of rejection is essentially non-existent. Consequently, more US government funding is being provided for adult stem cell research.

With the increasing demand of human adult stem cells for both research and clinical purposes (typically 1–5 million cells per kg of body weight are required per treatment) it becomes of utmost importance to bridge the gap between the need to expand the cells in vitro and the capability of harnessing the factors underlying replicative senescence. Adult stem cells are known to have a limited lifespan in vitro and to enter replicative senescence almost undetectably upon starting in vitro culturing.

Also called perinatal stem cells, these multipotent stem cells are found in amniotic fluid and umbilical cord blood. These stem cells are very active, expand extensively without feeders and are not tumorigenic. Amniotic stem cells are multipotent and can differentiate in cells of adipogenic, osteogenic, myogenic, endothelial, hepatic and also neuronal lines. Amniotic stem cells are a topic of active research.

Use of stem cells from amniotic fluid overcomes the ethical objections to using human embryos as a source of cells. Roman Catholic teaching forbids the use of embryonic stem cells in experimentation; accordingly, the Vatican newspaper "Osservatore Romano" called amniotic stem cells "the future of medicine".

It is possible to collect amniotic stem cells for donors or for autologous use: the first US amniotic stem cells bank was opened in 2009 in Medford, MA, by Biocell Center Corporation and collaborates with various hospitals and universities all over the world.

Adult stem cells have limitations with their potency; unlike embryonic stem cells (ESCs), they are not able to differentiate into cells from all three germ layers. As such, they are deemed multipotent.

However, reprogramming allows for the creation of pluripotent cells, induced pluripotent stem cells (iPSCs), from adult cells. These are not adult stem cells, but somatic cells (e.g. epithelial cells) reprogrammed to give rise to cells with pluripotent capabilities. Using genetic reprogramming with protein transcription factors, pluripotent stem cells with ESC-like capabilities have been derived. The first demonstration of induced pluripotent stem cells was conducted by Shinya Yamanaka and his colleagues at Kyoto University. They used the transcription factors Oct3/4, Sox2, c-Myc, and Klf4 to reprogram mouse fibroblast cells into pluripotent cells. Subsequent work used these factors to induce pluripotency in human fibroblast cells. Junying Yu, James Thomson, and their colleagues at the University of Wisconsin–Madison used a different set of factors, Oct4, Sox2, Nanog and Lin28, and carried out their experiments using cells from human foreskin. However, they were able to replicate Yamanaka's finding that inducing pluripotency in human cells was possible.

Induced pluripotent stem cells differ from embryonic stem cells. They share many similar properties, such as pluripotency and differentiation potential, the expression of pluripotency genes, epigenetic patterns, embryoid body and teratoma formation, and viable chimera formation, but there are many differences within these properties. The chromatin of iPSCs appears to be more "closed" or methylated than that of ESCs. Similarly, the gene expression pattern between ESCs and iPSCs, or even iPSCs sourced from different origins. There are thus questions about the "completeness" of reprogramming and the somatic memory of induced pluripotent stem cells. Despite this, inducing somatic cells to be pluripotent appears to be viable.

As a result of the success of these experiments, Ian Wilmut, who helped create the first cloned animal Dolly the Sheep, has announced that he will abandon somatic cell nuclear transfer as an avenue of research.

IPSCs has helped the field of medicine significantly by finding numerous ways to cure diseases. Since human IPSCc has given the advantage to make vitro models to study toxins and pathogenesis.

Furthermore, induced pluripotent stem cells provide several therapeutic advantages. Like ESCs, they are pluripotent. They thus have great differentiation potential; theoretically, they could produce any cell within the human body (if reprogramming to pluripotency was "complete"). Moreover, unlike ESCs, they potentially could allow doctors to create a pluripotent stem cell line for each individual patient. Frozen blood samples can be used as a valuable source of induced pluripotent stem cells. Patient specific stem cells allow for the screening for side effects before drug treatment, as well as the reduced risk of transplantation rejection. Despite their current limited use therapeutically, iPSCs hold great potential for future use in medical treatment and research.

Cell cycle control

The key factors controlling the cell cycle also regulate pluripotency. Thus, manipulation of relevant genes can maintain pluripotency and reprogram somatic cells to an induced pluripotent state. However, reprogramming of somatic cells is often low in efficiency and considered stochastic.

With the idea that a more rapid cell cycle is a key component of pluripotency, reprogramming efficiency can be improved. Methods for improving pluripotency through manipulation of cell cycle regulators include: overexpression of Cyclin D/Cdk4, phosphorylation of Sox2 at S39 and S253, overexpression of Cyclin A and Cyclin E, knockdown of Rb, and knockdown of members of the Cip/Kip family or the Ink family. Furthermore, reprogramming efficiency is correlated with the number of cell divisions happened during the stochastic phase, which is suggested by the growing inefficiency of reprogramming of older or slow diving cells.

Main article: Stem cell line

Lineage is an important procedure to analyze developing embryos. Since cell lineages shows the relationship between cells at each division. This helps in analyzing stem cell lineages along the way which helps recognize stem cell effectiveness, lifespan, and other factors. With the technique of cell lineage mutant genes can be analyzed in stem cell clones that can help in genetic pathways. These pathways can regulate how the stem cell perform.

To ensure self-renewal, stem cells undergo two types of cell division (see Stem cell division and differentiation diagram). Symmetric division gives rise to two identical daughter cells both endowed with stem cell properties. Asymmetric division, on the other hand, produces only one stem cell and a progenitor cell with limited self-renewal potential. Progenitors can go through several rounds of cell division before terminally differentiating into a mature cell. It is possible that the molecular distinction between symmetric and asymmetric divisions lies in differential segregation of cell membrane proteins (such as receptors) between the daughter cells.

An alternative theory is that stem cells remain undifferentiated due to environmental cues in their particular niche. Stem cells differentiate when they leave that niche or no longer receive those signals. Studies in Drosophila germarium have identified the signals decapentaplegic and adherens junctions that prevent germarium stem cells from differentiating.

Main article: Stem cell therapy

Stem cell therapy is the use of stem cells to treat or prevent a disease or condition. Bone marrow transplant is a form of stem cell therapy that has been used for many years because it has proven to be effective in clinical trials.

Stem cell implantation may help in strengthening the left-ventricle of the heart, as well as retaining the heart tissue to patients who have suffered from heart attacks in the past.

Advantages

Stem cell treatments may lower symptoms of the disease or condition that is being treated. The lowering of symptoms may allow patients to reduce the drug intake of the disease or condition. Stem cell treatment may also provide knowledge for society to further stem cell understanding and future treatments. The physicians' creed would be to do no injury, and stem cells make that simpler than ever before. Surgical processes by their character are harmful. Tissue has to be dropped as a way to reach a successful outcome. One may prevent the dangers of surgical interventions using stem cells. Additionally, there's a possibility of disease, and whether the procedure fails, further surgery may be required. Risks associated with anesthesia can also be eliminated with stem cells. On top of that, stem cells have been harvested from the patient's body and redeployed in which they're wanted. Since they come from the patient’s own body, this is referred to as an autologous treatment. Autologous remedies are thought to be the safest because there's likely zero probability of donor substance rejection.

Disadvantages

Stem cell treatments may require immunosuppression because of a requirement for radiation before the transplant to remove the person's previous cells, or because the patient's immune system may target the stem cells. One approach to avoid the second possibility is to use stem cells from the same patient who is being treated.

Pluripotency in certain stem cells could also make it difficult to obtain a specific cell type. It is also difficult to obtain the exact cell type needed, because not all cells in a population differentiate uniformly. Undifferentiated cells can create tissues other than desired types.

Some stem cells form tumors after transplantation; pluripotency is linked to tumor formation especially in embryonic stem cells, fetal proper stem cells, induced pluripotent stem cells. Fetal proper stem cells form tumors despite multipotency.

Ethical concerns are also raised about the practice of using or researching embryonic stem cells. Harvesting cells from the blastocyst result in the death of the blastocyst. The concern is whether or not the blastocyst should be considered as a human life. The debate on this issue is mainly a philosophical one, not a scientific one. A scientific assessment would affirm that the blastocyst is indeed alive, and that the cells are indeed human, making the blastocyst a human life.

Stem cell tourism

Stem cell tourism is the industry in which patients (and sometimes their families) travel to another jurisdiction, to obtain stem cell procedures which are not approved but which are advertised on the Internet as proven cures.

The United States, in recent years[when?], has had an explosion of "stem cell clinics"[citation needed]. Stem cell procedures are highly profitable for clinics. The advertising sounds authoritative but the efficacy and safety of the procedures is unproven. Patients sometimes experience complications, such as spinal tumors and death. The high expense can also lead to financial ruin. According to researchers, there is a need to educate the public, patients, and doctors about this issue.

According to the International Society for Stem Cell Research, the largest academic organization that advocates for stem cell research, stem cell therapies are under development and cannot yet be said to be proven. Doctors should inform patients that clinical trials continue to investigate whether these therapies are safe and effective but that unethical clinics present them as proven.

Some of the fundamental patents covering human embryonic stem cells are owned by the Wisconsin Alumni Research Foundation (WARF) – they are patents 5,843,780, 6,200,806, and 7,029,913 invented by James A. Thomson. WARF does not enforce these patents against academic scientists, but does enforce them against companies.

In 2006, a request for the US Patent and Trademark Office (USPTO) to re-examine the three patents was filed by the Public Patent Foundation on behalf of its client, the non-profit patent-watchdog group Consumer Watchdog (formerly the Foundation for Taxpayer and Consumer Rights). In the re-examination process, which involves several rounds of discussion between the USPTO and the parties, the USPTO initially agreed with Consumer Watchdog and rejected all the claims in all three patents, however in response, WARF amended the claims of all three patents to make them more narrow, and in 2008 the USPTO found the amended claims in all three patents to be patentable. The decision on one of the patents (7,029,913) was appealable, while the decisions on the other two were not. Consumer Watchdog appealed the granting of the '913 patent to the USPTO's Board of Patent Appeals and Interferences (BPAI) which granted the appeal, and in 2010 the BPAI decided that the amended claims of the '913 patent were not patentable. However, WARF was able to re-open prosecution of the case and did so, amending the claims of the '913 patent again to make them more narrow, and in January 2013 the amended claims were allowed.

In July 2013, Consumer Watchdog announced that it would appeal the decision to allow the claims of the '913 patent to the US Court of Appeals for the Federal Circuit (CAFC), the federal appeals court that hears patent cases. At a hearing in December 2013, the CAFC raised the question of whether Consumer Watchdog had legal standing to appeal; the case could not proceed until that issue was resolved.

Investigations

Diseases and conditions where stem cell treatment is being investigated.

Diseases and conditions where stem cell treatment is being investigated include:

Research is underway to develop various sources for stem cells, and to apply stem cell treatments for neurodegenerative diseases and conditions, diabetes, heart disease, and other conditions. Research is also underway in generating organoids using stem cells, which would allow for further understanding of human development, organogenesis, and modeling of human diseases.

In more recent years, with the ability of scientists to isolate and culture embryonic stem cells, and with scientists' growing ability to create stem cells using somatic cell nuclear transfer and techniques to create induced pluripotent stem cells, controversy has crept in, both related to abortion politics and to human cloning.[citation needed]

Hepatotoxicity and drug-induced liver injury account for a substantial number of failures of new drugs in development and market withdrawal, highlighting the need for screening assays such as stem cell-derived hepatocyte-like cells, that are capable of detecting toxicity early in the drug development process.

In August 2021, researchers in the Princess Margaret Cancer Centre at the University Health Network published their discovery of a dormancy mechanism in key stem cells which could help develop cancer treatments in the future.

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Stem cell
Stem cell Language Watch Edit This article is about the cell type For the medical therapy see cell therapy Stem cells redirects here For the journal see Stem Cells journal Stem cell research redirects here For the journal see Stem Cell Research journal In multicellular organisms stem cells are undifferentiated or partially differentiated cells that can differentiate into various types of cells and proliferate indefinitely to produce more of the same stem cell They are the earliest type of cell in a cell lineage 1 They are found in both embryonic and adult organisms but they have slightly different properties in each They are usually distinguished from progenitor cells which cannot divide indefinitely and precursor or blast cells which are usually committed to differentiating into one cell type Stem cellTransmission electron micrograph of a mesenchymal stem cell displaying typical ultrastructural characteristicsDetailsIdentifiersLatinCellula praecursoriaMeSHD013234THH1 00 01 0 00028 H2 00 01 0 00001FMA63368Anatomical terminology edit on Wikidata In mammals roughly 50 150 cells make up the inner cell mass during the blastocyst stage of embryonic development around days 5 14 These have stem cell capability In vivo they eventually differentiate into all of the body s cell types making them pluripotent This process starts with the differentiation into the three germ layers the ectoderm mesoderm and endoderm at the gastrulation stage However when they are isolated and cultured in vitro they can be kept in the stem cell stage and are known as embryonic stem cells ESCs Adult stem cells are found in a few select locations in the body known as niches such as those in the bone marrow or gonads They exist to replenish rapidly lost cell types and are multipotent or unipotent meaning they only differentiate into a few cell types or one cell type In mammals they include among others hematopoietic stem cells which replenish blood and immune cells basal cells which maintain the skin epithelium and mesenchymal stem cells which maintain bone cartilage muscle and fat cells Adult stem cells are a small minority of cells they are vastly outnumbered by the progenitor cells and terminally differentiated cells that they differentiate into 1 Research into stem cells grew out of findings by Canadian biologists Ernest McCulloch James Till and Andrew J Becker at the University of Toronto and the Ontario Cancer Institute in the 1960s 2 3 As of 2016 update the only established medical therapy using stem cells is hematopoietic stem cell transplantation 4 first performed in 1958 by French oncologist Georges Mathe Since 1998 however it has been possible to culture and differentiate human embryonic stem cells in stem cell lines The process of isolating these cells has been controversial because it typically results in the destruction of the embryo Sources for isolating ESCs have been restricted in some European countries and Canada but others such as the UK and China have promoted the research 5 Somatic cell nuclear transfer is a cloning method that can be used to create a cloned embryo for the use of its embryonic stem cells in stem cell therapy 6 In 2006 a Japanese team led by Shinya Yamanaka discovered a method to convert mature body cells back into stem cells These were termed induced pluripotent stem cells iPSCs 7 Contents 1 History 2 Properties 2 1 Self renewal 2 2 Potency meaning 2 3 Identification 3 Embryonic 3 1 Mesenchymal stem cells 3 2 Cell cycle control 4 Fetal 5 Adult 6 Amniotic 7 Induced pluripotent 7 1 Cell cycle control 8 Lineage 9 Therapies 9 1 Advantages 9 2 Disadvantages 9 3 Stem cell tourism 10 Research 10 1 Investigations 11 Notable studies 12 See also 13 References 14 Further reading 15 External linksHistory EditThe term stem cell was coined by Theodor Boveri and Valentin Haecker in late 19th century 8 Pioneering works in theory of blood stem cell were conducted in the beginning of 20th century by Artur Pappenheim Alexander Maximow Franz Ernst Christian Neumann 8 The key properties of a stem cell were first defined by Ernest McCulloch and James Till at the University of Toronto and the Ontario Cancer Institute in the early 1960s They discovered the blood forming stem cell the hematopoietic stem cell HSC through their pioneering work in mice McCulloch and Till began a series of experiments in which bone marrow cells were injected into irradiated mice They observed lumps in the spleens of the mice that were linearly proportional to the number of bone marrow cells injected They hypothesized that each lump colony was a clone arising from a single marrow cell stem cell In subsequent work McCulloch and Till joined by graduate student Andrew John Becker and senior scientist Louis Siminovitch confirmed that each lump did in fact arise from a single cell Their results were published in Nature in 1963 In that same year Siminovitch was a lead investigator for studies that found colony forming cells were capable of self renewal which is a key defining property of stem cells that Till and McCulloch had theorized 9 The first therapy using stem cells was a bone marrow transplant performed by French oncologist Georges Mathe in 1958 on five workers at the Vinca Nuclear Institute in Yugoslavia who had been affected by a criticality accident The workers all survived 10 In 1981 embryonic stem ES cells were first isolated and successfully cultured using mouse blastocysts by British biologists Martin Evans and Matthew Kaufman This allowed the formation of murine genetic models a system in which the genes of mice are deleted or altered in order to study their function in pathology By 1998 embryonic stem cells were first isolated by American biologist James Thomson which made it possible to have new transplantation methods or various cell types for testing new treatments In 2006 Shinya Yamanaka s team in Kyoto Japan converted fibroblasts into pluripotent stem cells by modifying the expression of only four genes The feat represents the origin of induced pluripotent stem cells known as iPS cells 7 In 2011 a female maned wolf run over by a truck underwent stem cell treatment at the Zoo Brasilia this being the first recorded case of the use of stem cells to heal injuries in a wild animal 11 12 Properties EditThe classical definition of a stem cell requires that it possesses two properties Self renewal the ability to go through numerous cycles of cell growth and cell division known as cell proliferation while maintaining the undifferentiated state Potency the capacity to differentiate into specialized cell types In the strictest sense this requires stem cells to be either totipotent or pluripotent to be able to give rise to any mature cell type although multipotent or unipotent progenitor cells are sometimes referred to as stem cells Apart from this it is said that stem cell function is regulated in a feedback mechanism Self renewal Edit Two mechanisms ensure that a stem cell population is maintained doesn t shrink in size 1 Asymmetric cell division a stem cell divides into one mother cell which is identical to the original stem cell and another daughter cell which is differentiated When a stem cell self renews it divides and does not disrupt the undifferentiated state This self renewal demands control of cell cycle as well as upkeep of multipotency or pluripotency which all depends on the stem cell 13 2 Stochastic differentiation when one stem cell grows and divides into two differentiated daughter cells another stem cell undergoes mitosis and produces two stem cells identical to the original Stem cells use telomerase a protein that restores telomeres to protect their DNA and extend their cell division limit the Hayflick limit 14 Potency meaning Edit Main article Cell potency Pluripotent embryonic stem cells originate as inner cell mass ICM cells within a blastocyst These stem cells can become any tissue in the body excluding a placenta Only cells from an earlier stage of the embryo known as the morula are totipotent able to become all tissues in the body and the extraembryonic placenta Human embryonic stem cells A Stem cell colonies that are not yet differentiated B Nerve cells an example of a cell type after differentiation Potency specifies the differentiation potential the potential to differentiate into different cell types of the stem cell 15 Totipotent also known as omnipotent stem cells can differentiate into embryonic and extraembryonic cell types Such cells can construct a complete viable organism 15 These cells are produced from the fusion of an egg and sperm cell Cells produced by the first few divisions of the fertilized egg are also totipotent 16 Pluripotent stem cells are the descendants of totipotent cells and can differentiate into nearly all cells 15 i e cells derived from any of the three germ layers 17 Multipotent stem cells can differentiate into a number of cell types but only those of a closely related family of cells 15 Oligopotent stem cells can differentiate into only a few cell types such as lymphoid or myeloid stem cells 15 Unipotent cells can produce only one cell type their own 15 but have the property of self renewal which distinguishes them from non stem cells e g progenitor cells which cannot self renew Identification Edit In practice stem cells are identified by whether they can regenerate tissue For example the defining test for bone marrow or hematopoietic stem cells HSCs is the ability to transplant the cells and save an individual without HSCs This demonstrates that the cells can produce new blood cells over a long term It should also be possible to isolate stem cells from the transplanted individual which can themselves be transplanted into another individual without HSCs demonstrating that the stem cell was able to self renew Properties of stem cells can be illustrated in vitro using methods such as clonogenic assays in which single cells are assessed for their ability to differentiate and self renew 18 19 Stem cells can also be isolated by their possession of a distinctive set of cell surface markers However in vitro culture conditions can alter the behavior of cells making it unclear whether the cells shall behave in a similar manner in vivo There is considerable debate as to whether some proposed adult cell populations are truly stem cells 20 Embryonic EditMain article Embryonic stem cell Embryonic stem cells ESCs are the cells of the inner cell mass of a blastocyst formed prior to implantation in the uterus 21 In human embryonic development the blastocyst stage is reached 4 5 days after fertilization at which time it consists of 50 150 cells ESCs are pluripotent and give rise during development to all derivatives of the three germ layers ectoderm endoderm and mesoderm In other words they can develop into each of the more than 200 cell types of the adult body when given sufficient and necessary stimulation for a specific cell type They do not contribute to the extraembryonic membranes or to the placenta During embryonic development the cells of the inner cell mass continuously divide and become more specialized For example a portion of the ectoderm in the dorsal part of the embryo specializes as neurectoderm which will become the future central nervous system 22 Later in development neurulation causes the neurectoderm to form the neural tube At the neural tube stage the anterior portion undergoes encephalization to generate or pattern the basic form of the brain At this stage of development the principal cell type of the CNS is considered a neural stem cell The neural stem cells self renew and at some point transition into radial glial progenitor cells RGPs Early formed RGPs self renew by symmetrical division to form a reservoir group of progenitor cells These cells transition to a neurogenic state and start to divide asymmetrically to produce a large diversity of many different neuron types each with unique gene expression morphological and functional characteristics The process of generating neurons from radial glial cells is called neurogenesis The radial glial cell has a distinctive bipolar morphology with highly elongated processes spanning the thickness of the neural tube wall It shares some glial characteristics most notably the expression of glial fibrillary acidic protein GFAP 23 24 The radial glial cell is the primary neural stem cell of the developing vertebrate CNS and its cell body resides in the ventricular zone adjacent to the developing ventricular system Neural stem cells are committed to the neuronal lineages neurons astrocytes and oligodendrocytes and thus their potency is restricted 22 Nearly all research to date has made use of mouse embryonic stem cells mES or human embryonic stem cells hES derived from the early inner cell mass Both have the essential stem cell characteristics yet they require very different environments in order to maintain an undifferentiated state Mouse ES cells are grown on a layer of gelatin as an extracellular matrix for support and require the presence of leukemia inhibitory factor LIF in serum media A drug cocktail containing inhibitors to GSK3B and the MAPK ERK pathway called 2i has also been shown to maintain pluripotency in stem cell culture 25 Human ESCs are grown on a feeder layer of mouse embryonic fibroblasts and require the presence of basic fibroblast growth factor bFGF or FGF 2 26 Without optimal culture conditions or genetic manipulation 27 embryonic stem cells will rapidly differentiate A human embryonic stem cell is also defined by the expression of several transcription factors and cell surface proteins The transcription factors Oct 4 Nanog and Sox2 form the core regulatory network that ensures the suppression of genes that lead to differentiation and the maintenance of pluripotency 28 The cell surface antigens most commonly used to identify hES cells are the glycolipids stage specific embryonic antigen 3 and 4 and the keratan sulfate antigens Tra 1 60 and Tra 1 81 The molecular definition of a stem cell includes many more proteins and continues to be a topic of research 29 By using human embryonic stem cells to produce specialized cells like nerve cells or heart cells in the lab scientists can gain access to adult human cells without taking tissue from patients They can then study these specialized adult cells in detail to try to discern complications of diseases or to study cell reactions to proposed new drugs Because of their combined abilities of unlimited expansion and pluripotency embryonic stem cells remain a theoretically potential source for regenerative medicine and tissue replacement after injury or disease 30 however there are currently no approved treatments using ES cells The first human trial was approved by the US Food and Drug Administration in January 2009 31 However the human trial was not initiated until October 13 2010 in Atlanta for spinal cord injury research On November 14 2011 the company conducting the trial Geron Corporation announced that it will discontinue further development of its stem cell programs 32 Differentiating ES cells into usable cells while avoiding transplant rejection are just a few of the hurdles that embryonic stem cell researchers still face 33 Embryonic stem cells being pluripotent require specific signals for correct differentiation if injected directly into another body ES cells will differentiate into many different types of cells causing a teratoma Ethical considerations regarding the use of unborn human tissue are another reason for the lack of approved treatments using embryonic stem cells Many nations currently have moratoria or limitations on either human ES cell research or the production of new human ES cell lines Mouse embryonic stem cells with fluorescent marker Human embryonic stem cell colony on mouse embryonic fibroblast feeder layerMesenchymal stem cells Edit Mesenchymal stem cells MSC are known to be multipotent which can be found in adult tissues for example in the muscle liver bone marrow Mesenchymal stem cells usually function as structural support in various organs as mentioned above and control the movement of substances MSC can differentiate into numerous cell categories as an illustration of adipocytes osteocytes and chondrocytes derived by the mesodermal layer 34 Where the mesoderm layer provides an increase to the body s skeletal elements such as relating to the cartilage or bone The term meso means middle infusion originated from the Greek signifying that mesenchymal cells are able to range and travel in early embryonic growth among the ectodermal and endodermal layers This mechanism helps with space filling thus key for repairing wounds in adult organisms that have to do with mesenchymal cells in the dermis skin bone or muscle 35 Mesenchymal stem cells are known to be essential for regenerative medicine They are broadly studied in clinical trials Since they are easily isolated and obtain high yield high plasticity which makes able to facilitate inflammation and encourage cell growth cell differentiation and restoring tissue derived from immunomodulation and immunosuppression MSC comes from the bone marrow which requires an aggressive procedure when it comes to isolating the quantity and quality of the isolated cell and it varies by how old the donor When comparing the rates of MSC in the bone marrow aspirates and bone marrow stroma the aspirates tend to have lower rates of MSC than the stroma MSC are known to be heterogeneous and they express a high level of pluripotent markers when compared to other types of stem cells such as embryonic stem cells 34 Cell cycle control Edit Further information Cell cycle Embryonic stem cells ESCs have the ability to divide indefinitely while keeping their pluripotency which is made possible through specialized mechanisms of cell cycle control 36 Compared to proliferating somatic cells ESCs have unique cell cycle characteristics such as rapid cell division caused by shortened G1 phase absent G0 phase and modifications in cell cycle checkpoints which leaves the cells mostly in S phase at any given time 36 37 ESCs rapid division is demonstrated by their short doubling time which ranges from 8 to 10 hours whereas somatic cells have doubling time of approximately 20 hours or longer 38 As cells differentiate these properties change G1 and G2 phases lengthen leading to longer cell division cycles This suggests that a specific cell cycle structure may contribute to the establishment of pluripotency 36 Particularly because G1 phase is the phase in which cells have increased sensitivity to differentiation shortened G1 is one of the key characteristics of ESCs and plays an important role in maintaining undifferentiated phenotype Although the exact molecular mechanism remains only partially understood several studies have shown insight on how ESCs progress through G1 and potentially other phases so rapidly 37 The cell cycle is regulated by complex network of cyclins cyclin dependent kinases Cdk cyclin dependent kinase inhibitors Cdkn pocket proteins of the retinoblastoma Rb family and other accessory factors 38 Foundational insight into the distinctive regulation of ESC cell cycle was gained by studies on mouse ESCs mESCs 37 mESCs showed a cell cycle with highly abbreviated G1 phase which enabled cells to rapidly alternate between M phase and S phase In a somatic cell cycle oscillatory activity of Cyclin Cdk complexes is observed in sequential action which controls crucial regulators of the cell cycle to induce unidirectional transitions between phases Cyclin D and Cdk4 6 are active in the G1 phase while Cyclin E and Cdk2 are active during the late G1 phase and S phase and Cyclin A and Cdk2 are active in the S phase and G2 while Cyclin B and Cdk1 are active in G2 and M phase 38 However in mESCs this typically ordered and oscillatory activity of Cyclin Cdk complexes is absent Rather the Cyclin E Cdk2 complex is constitutively active throughout the cycle keeping retinoblastoma protein pRb hyperphosphorylated and thus inactive This allows for direct transition from M phase to the late G1 phase leading to absence of D type cyclins and therefore a shortened G1 phase 37 Cdk2 activity is crucial for both cell cycle regulation and cell fate decisions in mESCs downregulation of Cdk2 activity prolongs G1 phase progression establishes a somatic cell like cell cycle and induces expression of differentiation markers 39 In human ESCs hESCs the duration of G1 is dramatically shortened This has been attributed to high mRNA levels of G1 related Cyclin D2 and Cdk4 genes and low levels of cell cycle regulatory proteins that inhibit cell cycle progression at G1 such as p21CipP1 p27Kip1 and p57Kip2 36 40 Furthermore regulators of Cdk4 and Cdk6 activity such as members of the Ink family of inhibitors p15 p16 p18 and p19 are expressed at low levels or not at all Thus similar to mESCs hESCs show high Cdk activity with Cdk2 exhibiting the highest kinase activity Also similar to mESCs hESCs demonstrate the importance of Cdk2 in G1 phase regulation by showing that G1 to S transition is delayed when Cdk2 activity is inhibited and G1 is arrest when Cdk2 is knocked down 36 However unlike mESCs hESCs have a functional G1 phase hESCs show that the activities of Cyclin E Cdk2 and Cyclin A Cdk2 complexes are cell cycle dependent and the Rb checkpoint in G1 is functional 38 ESCs are also characterized by G1 checkpoint non functionality even though the G1 checkpoint is crucial for maintaining genomic stability In response to DNA damage ESCs do not stop in G1 to repair DNA damages but instead depend on S and G2 M checkpoints or undergo apoptosis The absence of G1 checkpoint in ESCs allows for the removal of cells with damaged DNA hence avoiding potential mutations from inaccurate DNA repair 36 Consistent with this idea ESCs are hypersensitive to DNA damage to minimize mutations passed onto the next generation 38 Fetal EditThe primitive stem cells located in the organs of fetuses are referred to as fetal stem cells 41 There are two types of fetal stem cells Fetal proper stem cells come from the tissue of the fetus proper and are generally obtained after an abortion These stem cells are not immortal but have a high level of division and are multipotent Extraembryonic fetal stem cells come from extraembryonic membranes and are generally not distinguished from adult stem cells These stem cells are acquired after birth they are not immortal but have a high level of cell division and are pluripotent 42 Adult EditMain article Adult stem cell Stem cell division and differentiation A stem cell B progenitor cell C differentiated cell 1 symmetric stem cell division 2 asymmetric stem cell division 3 progenitor division 4 terminal differentiation Adult stem cells also called somatic from Greek swmatikos of the body stem cells are stem cells which maintain and repair the tissue in which they are found 43 They can be found in children as well as adults 44 There are three known accessible sources of autologous adult stem cells in humans Bone marrow which requires extraction by harvesting usually from pelvic bones via surgery 45 Adipose tissue fat cells which requires extraction by liposuction 46 Blood which requires extraction through apheresis wherein blood is drawn from the donor similar to a blood donation and passed through a machine that extracts the stem cells and returns other portions of the blood to the donor citation needed Stem cells can also be taken from umbilical cord blood just after birth Of all stem cell types autologous harvesting involves the least risk By definition autologous cells are obtained from one s own body just as one may bank their own blood for elective surgical procedures citation needed Pluripotent adult stem cells are rare and generally small in number but they can be found in umbilical cord blood and other tissues 47 Bone marrow is a rich source of adult stem cells 48 which have been used in treating several conditions including liver cirrhosis 49 chronic limb ischemia 50 and endstage heart failure 51 The quantity of bone marrow stem cells declines with age and is greater in males than females during reproductive years 52 Much adult stem cell research to date has aimed to characterize their potency and self renewal capabilities 53 DNA damage accumulates with age in both stem cells and the cells that comprise the stem cell environment This accumulation is considered to be responsible at least in part for increasing stem cell dysfunction with aging see DNA damage theory of aging 54 Most adult stem cells are lineage restricted multipotent and are generally referred to by their tissue origin mesenchymal stem cell adipose derived stem cell endothelial stem cell dental pulp stem cell etc 55 56 Muse cells multi lineage differentiating stress enduring cells are a recently discovered pluripotent stem cell type found in multiple adult tissues including adipose dermal fibroblasts and bone marrow While rare muse cells are identifiable by their expression of SSEA 3 a marker for undifferentiated stem cells and general mesenchymal stem cells markers such as CD105 When subjected to single cell suspension culture the cells will generate clusters that are similar to embryoid bodies in morphology as well as gene expression including canonical pluripotency markers Oct4 Sox2 and Nanog 57 Adult stem cell treatments have been successfully used for many years to treat leukemia and related bone blood cancers through bone marrow transplants 58 Adult stem cells are also used in veterinary medicine to treat tendon and ligament injuries in horses 59 The use of adult stem cells in research and therapy is not as controversial as the use of embryonic stem cells because the production of adult stem cells does not require the destruction of an embryo Additionally in instances where adult stem cells are obtained from the intended recipient an autograft the risk of rejection is essentially non existent Consequently more US government funding is being provided for adult stem cell research 60 With the increasing demand of human adult stem cells for both research and clinical purposes typically 1 5 million cells per kg of body weight are required per treatment it becomes of utmost importance to bridge the gap between the need to expand the cells in vitro and the capability of harnessing the factors underlying replicative senescence Adult stem cells are known to have a limited lifespan in vitro and to enter replicative senescence almost undetectably upon starting in vitro culturing 61 Amniotic EditAlso called perinatal stem cells these multipotent stem cells are found in amniotic fluid and umbilical cord blood These stem cells are very active expand extensively without feeders and are not tumorigenic Amniotic stem cells are multipotent and can differentiate in cells of adipogenic osteogenic myogenic endothelial hepatic and also neuronal lines 62 Amniotic stem cells are a topic of active research Use of stem cells from amniotic fluid overcomes the ethical objections to using human embryos as a source of cells Roman Catholic teaching forbids the use of embryonic stem cells in experimentation accordingly the Vatican newspaper Osservatore Romano called amniotic stem cells the future of medicine 63 It is possible to collect amniotic stem cells for donors or for autologous use the first US amniotic stem cells bank 64 65 was opened in 2009 in Medford MA by Biocell Center Corporation 66 67 68 and collaborates with various hospitals and universities all over the world 69 Induced pluripotent EditMain article Induced pluripotent stem cell Adult stem cells have limitations with their potency unlike embryonic stem cells ESCs they are not able to differentiate into cells from all three germ layers As such they are deemed multipotent However reprogramming allows for the creation of pluripotent cells induced pluripotent stem cells iPSCs from adult cells These are not adult stem cells but somatic cells e g epithelial cells reprogrammed to give rise to cells with pluripotent capabilities Using genetic reprogramming with protein transcription factors pluripotent stem cells with ESC like capabilities have been derived 70 71 72 The first demonstration of induced pluripotent stem cells was conducted by Shinya Yamanaka and his colleagues at Kyoto University 73 They used the transcription factors Oct3 4 Sox2 c Myc and Klf4 to reprogram mouse fibroblast cells into pluripotent cells 70 74 Subsequent work used these factors to induce pluripotency in human fibroblast cells 75 Junying Yu James Thomson and their colleagues at the University of Wisconsin Madison used a different set of factors Oct4 Sox2 Nanog and Lin28 and carried out their experiments using cells from human foreskin 70 76 However they were able to replicate Yamanaka s finding that inducing pluripotency in human cells was possible Induced pluripotent stem cells differ from embryonic stem cells They share many similar properties such as pluripotency and differentiation potential the expression of pluripotency genes epigenetic patterns embryoid body and teratoma formation and viable chimera formation 73 74 but there are many differences within these properties The chromatin of iPSCs appears to be more closed or methylated than that of ESCs 73 74 Similarly the gene expression pattern between ESCs and iPSCs or even iPSCs sourced from different origins 73 There are thus questions about the completeness of reprogramming and the somatic memory of induced pluripotent stem cells Despite this inducing somatic cells to be pluripotent appears to be viable As a result of the success of these experiments Ian Wilmut who helped create the first cloned animal Dolly the Sheep has announced that he will abandon somatic cell nuclear transfer as an avenue of research 77 IPSCs has helped the field of medicine significantly by finding numerous ways to cure diseases Since human IPSCc has given the advantage to make vitro models to study toxins and pathogenesis 78 Furthermore induced pluripotent stem cells provide several therapeutic advantages Like ESCs they are pluripotent They thus have great differentiation potential theoretically they could produce any cell within the human body if reprogramming to pluripotency was complete 73 Moreover unlike ESCs they potentially could allow doctors to create a pluripotent stem cell line for each individual patient 79 Frozen blood samples can be used as a valuable source of induced pluripotent stem cells 80 Patient specific stem cells allow for the screening for side effects before drug treatment as well as the reduced risk of transplantation rejection 79 Despite their current limited use therapeutically iPSCs hold great potential for future use in medical treatment and research Cell cycle control Edit The key factors controlling the cell cycle also regulate pluripotency Thus manipulation of relevant genes can maintain pluripotency and reprogram somatic cells to an induced pluripotent state 38 However reprogramming of somatic cells is often low in efficiency and considered stochastic 81 With the idea that a more rapid cell cycle is a key component of pluripotency reprogramming efficiency can be improved Methods for improving pluripotency through manipulation of cell cycle regulators include overexpression of Cyclin D Cdk4 phosphorylation of Sox2 at S39 and S253 overexpression of Cyclin A and Cyclin E knockdown of Rb and knockdown of members of the Cip Kip family or the Ink family 38 Furthermore reprogramming efficiency is correlated with the number of cell divisions happened during the stochastic phase which is suggested by the growing inefficiency of reprogramming of older or slow diving cells 82 Lineage EditMain article Stem cell line Lineage is an important procedure to analyze developing embryos Since cell lineages shows the relationship between cells at each division This helps in analyzing stem cell lineages along the way which helps recognize stem cell effectiveness lifespan and other factors With the technique of cell lineage mutant genes can be analyzed in stem cell clones that can help in genetic pathways These pathways can regulate how the stem cell perform 83 To ensure self renewal stem cells undergo two types of cell division see Stem cell division and differentiation diagram Symmetric division gives rise to two identical daughter cells both endowed with stem cell properties Asymmetric division on the other hand produces only one stem cell and a progenitor cell with limited self renewal potential Progenitors can go through several rounds of cell division before terminally differentiating into a mature cell It is possible that the molecular distinction between symmetric and asymmetric divisions lies in differential segregation of cell membrane proteins such as receptors between the daughter cells 84 An alternative theory is that stem cells remain undifferentiated due to environmental cues in their particular niche Stem cells differentiate when they leave that niche or no longer receive those signals Studies in Drosophila germarium have identified the signals decapentaplegic and adherens junctions that prevent germarium stem cells from differentiating 85 86 Therapies EditMain article Stem cell therapy Stem cell therapy is the use of stem cells to treat or prevent a disease or condition Bone marrow transplant is a form of stem cell therapy that has been used for many years because it has proven to be effective in clinical trials 87 88 Stem cell implantation may help in strengthening the left ventricle of the heart as well as retaining the heart tissue to patients who have suffered from heart attacks in the past 89 Advantages Edit Stem cell treatments may lower symptoms of the disease or condition that is being treated The lowering of symptoms may allow patients to reduce the drug intake of the disease or condition Stem cell treatment may also provide knowledge for society to further stem cell understanding and future treatments 90 91 The physicians creed would be to do no injury and stem cells make that simpler than ever before Surgical processes by their character are harmful Tissue has to be dropped as a way to reach a successful outcome One may prevent the dangers of surgical interventions using stem cells Additionally there s a possibility of disease and whether the procedure fails further surgery may be required Risks associated with anesthesia can also be eliminated with stem cells 92 On top of that stem cells have been harvested from the patient s body and redeployed in which they re wanted Since they come from the patient s own body this is referred to as an autologous treatment Autologous remedies are thought to be the safest because there s likely zero probability of donor substance rejection Disadvantages Edit Stem cell treatments may require immunosuppression because of a requirement for radiation before the transplant to remove the person s previous cells or because the patient s immune system may target the stem cells One approach to avoid the second possibility is to use stem cells from the same patient who is being treated Pluripotency in certain stem cells could also make it difficult to obtain a specific cell type It is also difficult to obtain the exact cell type needed because not all cells in a population differentiate uniformly Undifferentiated cells can create tissues other than desired types 93 Some stem cells form tumors after transplantation 94 pluripotency is linked to tumor formation especially in embryonic stem cells fetal proper stem cells induced pluripotent stem cells Fetal proper stem cells form tumors despite multipotency 95 Ethical concerns are also raised about the practice of using or researching embryonic stem cells Harvesting cells from the blastocyst result in the death of the blastocyst The concern is whether or not the blastocyst should be considered as a human life 96 The debate on this issue is mainly a philosophical one not a scientific one A scientific assessment would affirm that the blastocyst is indeed alive and that the cells are indeed human making the blastocyst a human life Stem cell tourism Edit Stem cell tourism is the industry in which patients and sometimes their families travel to another jurisdiction to obtain stem cell procedures which are not approved but which are advertised on the Internet as proven cures 97 The United States in recent years when has had an explosion of stem cell clinics citation needed Stem cell procedures are highly profitable for clinics The advertising sounds authoritative but the efficacy and safety of the procedures is unproven Patients sometimes experience complications such as spinal tumors 98 and death The high expense can also lead to financial ruin 98 According to researchers there is a need to educate the public patients and doctors about this issue 99 According to the International Society for Stem Cell Research the largest academic organization that advocates for stem cell research stem cell therapies are under development and cannot yet be said to be proven 100 101 Doctors should inform patients that clinical trials continue to investigate whether these therapies are safe and effective but that unethical clinics present them as proven 102 Research EditFurther information Consumer Watchdog vs Wisconsin Alumni Research Foundation Some of the fundamental patents covering human embryonic stem cells are owned by the Wisconsin Alumni Research Foundation WARF they are patents 5 843 780 6 200 806 and 7 029 913 invented by James A Thomson WARF does not enforce these patents against academic scientists but does enforce them against companies 103 In 2006 a request for the US Patent and Trademark Office USPTO to re examine the three patents was filed by the Public Patent Foundation on behalf of its client the non profit patent watchdog group Consumer Watchdog formerly the Foundation for Taxpayer and Consumer Rights 103 In the re examination process which involves several rounds of discussion between the USPTO and the parties the USPTO initially agreed with Consumer Watchdog and rejected all the claims in all three patents 104 however in response WARF amended the claims of all three patents to make them more narrow and in 2008 the USPTO found the amended claims in all three patents to be patentable The decision on one of the patents 7 029 913 was appealable while the decisions on the other two were not 105 106 Consumer Watchdog appealed the granting of the 913 patent to the USPTO s Board of Patent Appeals and Interferences BPAI which granted the appeal and in 2010 the BPAI decided that the amended claims of the 913 patent were not patentable 107 However WARF was able to re open prosecution of the case and did so amending the claims of the 913 patent again to make them more narrow and in January 2013 the amended claims were allowed 108 In July 2013 Consumer Watchdog announced that it would appeal the decision to allow the claims of the 913 patent to the US Court of Appeals for the Federal Circuit CAFC the federal appeals court that hears patent cases 109 At a hearing in December 2013 the CAFC raised the question of whether Consumer Watchdog had legal standing to appeal the case could not proceed until that issue was resolved 110 Investigations Edit Diseases and conditions where stem cell treatment is being investigated Diseases and conditions where stem cell treatment is being investigated include Diabetes 111 Androgenic Alopecia and hair loss 112 113 Rheumatoid arthritis 111 Parkinson s disease 111 Alzheimer s disease 111 Osteoarthritis 111 Stroke and traumatic brain injury repair 114 Learning disability due to congenital disorder 115 Spinal cord injury repair 116 Heart infarction 117 Anti cancer treatments 114 Baldness reversal 118 Replace missing teeth 119 Repair hearing 120 Restore vision 121 and repair damage to the cornea 122 Amyotrophic lateral sclerosis 123 Crohn s disease 124 Wound healing 125 Male infertility due to absence of spermatogonial stem cells 126 In recent studies scientist have found a way to solve this problem by reprogramming a cell and turning it into a spermatozoon Other studies have proven the restoration of spermatogenesis by introducing human iPSC cells in mice testicles This could mean the end of azoospermia 127 Female infertility oocytes made from embryonic stem cells Scientists have found the ovarian stem cells a rare type of cells 0 014 found in the ovary They could be used as a treatment not only for infertility but also for premature ovarian insufficiency 128 Research is underway to develop various sources for stem cells and to apply stem cell treatments for neurodegenerative diseases and conditions diabetes heart disease and other conditions 129 Research is also underway in generating organoids using stem cells which would allow for further understanding of human development organogenesis and modeling of human diseases 130 In more recent years with the ability of scientists to isolate and culture embryonic stem cells and with scientists growing ability to create stem cells using somatic cell nuclear transfer and techniques to create induced pluripotent stem cells controversy has crept in both related to abortion politics and to human cloning citation needed Hepatotoxicity and drug induced liver injury account for a substantial number of failures of new drugs in development and market withdrawal highlighting the need for screening assays such as stem cell derived hepatocyte like cells that are capable of detecting toxicity early in the drug development process 131 Notable studies EditIn August 2021 researchers in the Princess Margaret Cancer Centre at the University Health Network published their discovery of a dormancy mechanism in key stem cells which could help develop cancer treatments in the future 132 See also 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082405 095329 PMID 17076602 Hanna V Gassei K Orwig KE 2015 Stem Cell Therapies for Male Infertility Where Are We Now and Where Are We Going In Carrell D Schlegel P Racowsky C Gianaroli L eds Biennial Review of Infertility pp 17 39 doi 10 1007 978 3 319 17849 3 3 ISBN 978 3 319 17849 3 Bone marrow transplantation is as of 2009 the only established use of stem cells Valli H Phillips BT Shetty G Byrne JA Clark AT Meistrich ML Orwig KE January 2014 Germline stem cells toward the regeneration of spermatogenesis Fertility and Sterility 101 1 3 13 doi 10 1016 j fertnstert 2013 10 052 PMC 3880407 PMID 24314923 White YA Woods DC Takai Y Ishihara O Seki H Tilly JL February 2012 Oocyte formation by mitotically active germ cells purified from ovaries of reproductive age women Nature Medicine 18 3 413 21 doi 10 1038 nm 2669 PMC 3296965 PMID 22366948 Bubela T Li MD Hafez M Bieber M Atkins H November 2012 Is belief larger than fact expectations optimism and reality for translational stem cell research BMC Medicine 10 133 doi 10 1186 1741 7015 10 133 PMC 3520764 PMID 23131007 Ader M Tanaka EM December 2014 Modeling human development in 3D culture Current Opinion in Cell Biology 31 23 8 doi 10 1016 j ceb 2014 06 013 PMID 25033469 Greenhough Sebastian Hay David C April 2012 Stem Cell Based Toxicity Screening Recent Advances in Hepatocyte Generation Pharmaceutical Medicine 26 2 85 89 doi 10 1007 BF03256896 S2CID 15893493 Garcia Prat Laura Kaufmann Kerstin B Schneiter Florin Voisin Veronique Murison Alex Chen Jocelyn Chan Seng Yue Michelle Gan Olga I McLeod Jessica L Smith Sabrina A Shoong Michelle C Parris Darrien Pan Kristele Zeng Andy G X Krivdova Gabriela Gupta Kinam Takayanagi Shin Ichiro Wagenblast Elvin Wang Weijia Lupien Mathieu Schroeder Timm Xie Stephanie Z Dick John E August 2021 TFEB mediated endolysosomal activity controls human hematopoietic stem cell fate Cell Stem Cell 28 10 1838 1850 e10 doi 10 1016 j stem 2021 07 003 PMID 34343492 S2CID 236915618 Further reading EditManzo Carlo Torreno Pina Juan A Massignan Pietro Lapeyre Gerald J Lewenstein Maciej Garcia Parajo Maria F 25 February 2015 Weak Ergodicity Breaking of Receptor Motion in Living Cells Stemming from Random Diffusivity Physical Review X 5 1 011021 arXiv 1407 2552 Bibcode 2015PhRvX 5a1021M doi 10 1103 PhysRevX 5 011021 S2CID 73582473 External links EditWikimedia Commons has media related to Stem cells National Institutes of Health Stem Cell Information Nature com Stem Cells Retrieved from https en wikipedia org w index php title Stem cell amp oldid 1055036963, wikipedia, wiki, book,

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