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In addition to hematopoietic cells, Mesenchymal cells derived from Wharton’s jelly are useful as feeder layers for the propagation of other stem cell types. For example, equine embryonic stem cell-like cells derived from the inner cell mass were propagated successfully for more than 350 divisions on a feeder layer derived from stem cells isolated from Wharton’s jelly of equine umbilical cords (74). The equine ES-like cells could be maintained without leukemia inhibitory factor (LIF) as long as they were on the cord matrix cells.
Stem cells are the next frontier in medicine. Stem cells are thought to have great therapeutic and biotechnological potential. This will not only to replace damaged or dysfunctional cells, but also rescue them and/or deliver therapeutic proteins after they have been engineered to do so. Currently, ethical and scientific issues surround both embryonic and fetal stem cells and hinder their widespread implementation. In contrast, stem cells recovered postnatally from the umbilical cord, including the umbilical cord blood cells, amnion/placenta, umbilical cord vein, or umbilical cord matrix cells, are a readily available and inexpensive source of cells that are capable of forming many different cell types (i.e., they are “multipotent”). This review will focus on the umbilical cord-derived stem cells and compare those cells with adult bone marrow-derived mesenchymal stem cells.
The cord blood collection process is simple, safe, and painless. The process usually takes no longer than five minutes. Cord blood collection does not interfere with delivery and is possible with both vaginal and cesarean deliveries.
Your baby isn’t the only one who may benefit from having access to preserved newborn stem cells. The cells can potentially be used by siblings and parents, too. In many cord blood treatments, stem cells from a matched family member are preferred.
Cord blood is the blood that remains in the umbilical cord and placenta following birth. This blood is usually discarded. However, cord blood banking utilizes facilities to store and preserve a baby’s cord blood. If you are considering storing your baby’s cord blood, make sure to use a cord blood bank accredited by the American Association of Blood Banks (AABB), like Viacord.
Cord Blood Registry® (CBR®) is the world’s largest newborn stem cell company. Founded in 1992, CBR is entrusted by parents with storing samples from more than 600,000 children. CBR is dedicated to advancing the clinical application of cord blood and cord tissue stem cells by partnering with institutions to establish FDA-regulated clinical trials for conditions that have no cure today.CBR has helped more than 400 families use their cord blood stem cells for established and experimental medical treatments, more than any other family cord blood bank. CBR’s goal is to expand the potential scope of newborn stem cell therapies that may be available to patients and their families.
While all three stem cell sources are used in similar procedures, they each have advantages and drawbacks. Bone marrow transplants are the traditional form of therapy, but peripheral blood cells are becoming more popular, since doctors often get more stem cells from the bloodstream.
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The baby’s cord blood will be processed and stored in a laboratory facility, often referred to as a blood bank. The cord blood should be processed and stored in a facility that is accredited by the American Association of Blood Banks (AABB) for the purpose of handling stem cells.
Collected cord blood is cryopreserved and then stored in a cord blood bank for future transplantation. Cord blood collection is typically depleted of red blood cells before cryopreservation to ensure high rates of stem cell recovery.
The therapuetic potential of cord blood continues to grow. Over the last few years cord blood use has expanded into an area known as regenerative medicine. Regenerative medicine is the science of living cells being used to potentially regenerate or facilitate the repair of cells damaged by disease, genetics, injury or simply aging. Research is underway with the hope that cord blood stem cells may prove beneficial in young patients facing life-changing medical conditions once thought untreatable – such as autism and cerebral palsy.
In 2003, we reported that UCM cells can be induced in vitro to become cells with morphological and biochemical characteristics of neurons (26). These findings have been extended by others, for example, neurons (30–32), cardiac muscle, bone, and cartilage (29,32). Using two in vitro differentiation methods, Wang et al. (32) found that umbilical cord matrix stem (UCMS) cells could be induced to exhibit cardiomyocyte morphology and synthesize cardiac muscle proteins such as N-cadherin and cardiac troponin I. The cells responded to five azacytidine or culture in cardiomyocyte-conditioned media. Fu et al. (30) used media conditioned by primary rat brain neurons to induce human UCMS cells to synthesize NeuN neurofilament. Furthermore, they could invoke an inward current in UCM cells with glutamate. In that report, exposure to neural-conditioned media also increased the proportion of cells synthesizing the astroglial protein glial fibrillary acidic protein (GFAP) from 94% initially to 5% after 9 d, although the percentage had declined to about 2% by day 12. The multilineage potential of UCMS cells was also verified by Wang and colleagues (32), who showed that they could be induced in vitro into chondrogenic, osteogenic, and adipogenic lineages.
Banking your child’s cord blood really comes down your personal choice. Some people may seem the potential benefits, while others can’t justify the costs. No one debates cord blood cells being a lifesaver, and in recent years, more than 20,000 lives have been saved because of it; however, experts, such as The American Academy of Pediatrics, note that your odds of using this blood is about one in 200,000. Instead of buying into a company’s advertising scheme, be sure to do your own research and deem what’s best for your child’s future.
Because the team at CORD:USE is made up of many of the world’s leaders in cord blood banking, science and transplantation and because it leads the industry in cord blood protection, CORD:USE is truly unlike any other cord blood bank.
Cord blood is currently approved by the FDA for the treatment for nearly 80 diseases, and cord blood treatments have been performed more than 35,000 times around the globe to treat cancers (including lymphoma and leukemia), anemias, inherited metabolic disorders and some solid tumors and orthopedic repair. Researchers are also exploring how cord blood has the ability to cross the blood–brain barrier and differentiate into neurons and other brain cells, which may be instrumental in treating conditions that have been untreatable up to this point. The most exciting of these are autism, cerebral palsy and Alzheimer’s.
In the procurement of embryonic stem cells for research, the embryo from which the cells are harvested is destroyed. For those who believe that human life begins at conception this research is obviously unethical. In contrast, adult stem cells can be isolated from tissue from a consenting patient. While cord blood stem cells are classified as adult stem cells, they appear to have greater potency (ability to differentiate into other cell types) than other adult stem cells, making them a potentially valuable option for use in a variety of treatments and therapies. Cord blood stem cells offer some of the advantages of ESCs without any of the ethical drawbacks. Research into the use of cord blood stem cells for the treatment of disease and disability is a promising and ethical avenue of stem cell research.
Lead image of baby’s umbilical cord from Wikimedia Commons. Possible human blood stem cell image by Rajeev Gupta and George Chennell. Remaining images of blood sample bags and red blood cells from Wellcome Images.
In the public arena there has been much discussion on the benefits of for-profit private cord blood banking over public banking. Numerous for-profit companies offer new parents the option of collecting and storing cord blood for future use by the donor infant, siblings, or other family members. Parents may choose to bank cord blood if they have a family history of a particular disease or disorder, or as a means of “biological insurance” in case their child or family member develops a medical condition or becomes injured requiring a transplant.
One oft cited argument against cord blood banking is that it is not known how long these cells can remain viable in storage. While it is not known if cells taken from an individual as an infant will be beneficial to them as an adult, units stored for up to 10 years have been transplanted successfully. This indicates that there is no reason to suggest serious deterioration in the quality of cord blood units stored for longer periods of time.
Some parents-to-be are sold on the advertising that banking their child’s cord blood could potentially treat an array of diseases the child, or his siblings, could encounter in their lives. Other parents-to-be may find all the promises too good to be true.
Jump up ^ Caseiro, AR; Pereira, T; Ivanova, G; Luís, AL; Maurício, AC (2016). “Neuromuscular Regeneration: Perspective on the Application of Mesenchymal Stem Cells and Their Secretion Products”. Stem Cells International. 2016: 9756973. doi:10.1155/2016/9756973. PMC 4736584 . PMID 26880998.
Families have the additional option of storing a section of the umbilical cord, which is rich in unique and powerful stem cells that may help repair and heal the body in different ways than stem cells derived from cord blood.
^ Li, T; Xia, M; Gao, Y; Chen, Y; Xu, Y (2015). “Human umbilical cord mesenchymal stem cells: an overview of their potential in cell-based therapy”. Expert Opinion on Biological Therapy. 15 (9): 1293–306. doi:10.1517/14712598.2015.1051528. PMID 26067213.
Fortunately, those odds should improve soon. In 2005, Congress passed the Stem Cell Therapeutic and Research Act, which provides $79 million in federal funding to create a centralized cord-blood registry much like the one that exists for bone marrow. The goal is to expand the existing inventory of 45,000 donated cord-blood units to 150,000.
With public cord blood banks, there’s a greater chance that your cord blood will be put to use because it could be given to any child or adult in need, says William T. Shearer, M.D., Ph.D., professor of Pediatrics and Immunology at Baylor College of Medicine in Houston. Cord blood is donated and is put on a national registry, to be made available for any transplant patient. So if your child should need the cord blood later in life, there’s no guarantee you would be able to get it back.
It’s the First Annual #WorldCordBloodDay. Take the time today to spread awareness and learn about current cord blood applications and ground-breaking research: bit.ly/wordlcordblood… twitter.com/CordBloodDay/s…
When an immediate family member has a disease that requires a stem cell transplant, cord blood from a newborn baby in the family may be the best option. There is a 25% chance, for example, that cord blood will be a perfect match for a sibling, because each child shares one of its two HLA genes with each parent. Occasionally cord blood will be a good match for a parent if, by chance, both parents share some of the six HLA antigens. The baby’s cord blood is less likely to be a good match for more distant relatives. The inventories of unrelated cord blood units in public cord blood banks are more likely to provide appropriate matches for parents and distant relatives, as well as for siblings that do not match.
Cord blood, which is harvested from the umbilical cord right after a baby is born, is marketed as a treatment for diseases such as leukemia and sickle cell disease, and as a potential source of cells for regenerative medicine – a cutting-edge field of medicine studying how to repair tissues damaged by everything from heart disease to cerebral palsy.
Your adult cells have one disadvantage to cord blood cells – they cannot change their cell type. When stem cells from cord blood and tissue are transplanted, they adjust to fit the individual patient and replace damaged cells. Adult stem cells are also older, which means they have been exposed to disease, and may damage patients after the transplant. Compared to cord blood cells, adult cells have a higher chance for graft-versus-host disease.
Complicating matters further, each public bank has its own registry, so transplant centers must search many different databases to find a match for a patient. Currently, a Caucasian patient has an 88 percent chance of finding a cord-blood match through a public-bank registry, and minorities have a 58 percent chance. (Collection hospitals tend to be in areas with higher rates of Caucasian births, and parents from certain ethnic groups are wary of donating for religious or cultural reasons.)
While cord-blood companies herald the possible future treatments of many adult diseases with stem cells, they rarely mention a key issue. Researchers have greater hopes for the potential of embryonic stem cells, which are thought to have the ability to develop into many different types of cells. It is not known whether the stem cells in cord blood have that ability; until recently, it was thought that they (like those in bone marrow) could only regenerate blood and immune cells.
There are some hospitals that have dedicated collections staff who can process mothers at the last minute when they arrive to deliver the baby. However, in the United States that is the exception to the rule.
Stem cell transplants from a related family member are less likely to be rejected, therefore having your baby’s stem cells available makes it less likely you would have to search for an unrelated donor who is a match
There is no significant opposition in the medical community to the public banking of cord blood. The donation of cord blood to public banks has generally been encouraged by the medical profession. The American Academy of Pediatrics encourages the public donation of cord blood with appropriate genetic and infectious disease testing, although they caution that parents should be notified that they will receive the results of this testing. They also recommend that parents be informed that publicly banked cord blood may not be available for future private use.
A bone marrow or cord blood transplant replaces diseased blood-forming cells with healthy cells. Cells for a transplant can come from the marrow of a donor or from the blood of the umbilical cord collected after a baby is born. Sometimes special qualities of umbilical cord blood make it a better choice of blood-forming cells for transplant.
FAQ172: Designed as an aid to patients, this document sets forth current information and opinions related to women’s health. The information does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations, taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice, may be appropriate.
The procedure for peripheral blood harvesting is easier on the patient than a bone marrow transplant, and stem cell transplants are faster. However, the chances for graft-versus-host disease, where donated cells attack the patient’s body, are much higher after a peripheral blood transplant.
Cord tissue use is still in early research stages, and there is no guarantee that treatments using cord tissue will be available in the future. Cord tissue is stored whole. Additional processing prior to use will be required to extract and prepare any of the multiple cell types from cryopreserved cord tissue. Cbr Systems, Inc.’s activities for New York State residents are limited to collection of umbilical cord tissue and long-term storage of umbilical cord–derived stem cells. Cbr Systems, Inc.’s possession of a New York State license for such collection and long-term storage does not indicate approval or endorsement of possible future uses or future suitability of these cells.
There are no health risks related to cord blood collection. Cord blood is retrieved from the umbilical cord after it has been cut, thus preventing any pain, discomfort, or harm. This process is completely safe.
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The longest study to date, published in 2011 by Broxmeyer at al found that stem cells cyro-preserved for 22.5 years engrafted as expected. There was no significant loss of stem cell recovery or proliferation.
A major limitation of cord blood transplantation is that the blood obtained from a single umbilical cord does not contain as many haematopoeitic stem cells as a bone marrow donation. Scientists believe this is the main reason that treating adult patients with cord blood is so difficult: adults are larger and need more HSCs than children. A transplant containing too few HSCs may fail or could lead to slow formation of new blood in the body in the early days after transplantation. This serious complication has been partially overcome by transplanting blood from two umbilical cords into larger children and adults. Results of clinical trials into double cord blood transplants (in place of bone marrow transplants) have shown the technique to be very successful. Some researchers have also tried to increase the total number of HSCs obtained from each umbilical cord by collecting additional blood from the placenta.
The use of cord blood is determined by the treating physician and is influenced by many factors, including the patient’s medical condition, the characteristics of the sample, and whether the cord blood should come from the patient or an appropriately matched donor. Cord blood has established uses in transplant medicine; however, its use in regenerative medicine is still being researched. There is no guarantee that treatments being studied in the laboratory, clinical trials, or other experimental treatments will be available in the future.
In Europe and other parts of the world, cord blood banking is more often referred to as stem cell banking. As banking cord blood is designed more to collect the blood-forming stem cells and not the actual blood cells themselves, this term may be more appropriate.
Dr. C. L. Cetrulo is thanked for critically reviewing the manuscript. Thanks to Dr. M. S. Rao and the members of the stem cell laboratory at NIA for their hospitality during my sabbatical leave and their continued assistance with this work. Thanks to my wife, Betti, and my children, Rita, Jonathan, Ellen, and James, for their patience and understanding. Dr. S. Bennet is thanked for assisting with umbilical cord collection. The anonymous donors are thanked for donating their umbilical cords. The Midwest Institute for Comparative Stem Cell Biology members who contributed to this work: M. Pyle, J. Hix, R. Rakasheklar, D. Davis, R. Carlin, D. Davis, S. Medicety, K. Seshareddy, C. Anderson, and M. Burton are thanked for their assistance. Thanks to our collaborators at ViaCell, Inc. (E. Abraham and A. Krivtsov, M. Kraus, S. Wnendt, and J. Visser) and at Athersys, Inc. (R. Deans and A. Ting) for their assistance and support. Drs. H. Klingemann (Tufts) and F. Marini (MD Anderson) are thanked for sharing the results of their ongoing work. This work was supported by National Institutes of Health (NIH) (salary support during sabbatical leave), Department of Anatomy and Physiology, College of Veterinary Medicine Dean’s office, Terry C. Johnson center for Basic Cancer Research and NIH NS034160. MLW is a paid consultant for RMI (Las Vegas, NV).
Genes: Segments of DNA that contain instructions for the development of a person’s physical traits and control of the processes in the body. They are the basic units of heredity and can be passed down from parent to offspring.
If everyone donated cord blood to public registries for the ‘common good’ this would increase the chances of someone benefiting from a double cord blood transplant. This far outweights the actual probability of the person who donated the sample being able to usefully use it for themself.
Cord blood donation doesn’t cost anything for parents. Public cord blood banks pay for everything which includes the collection, testing, and storing of umbilical cord blood. This means that cord blood donation is not possible in every hospital.