STEM CELLS AND ITS

USES TO MANKIND
2019 – 2020

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 NAVDEEP PUBLIC SCHOOL
Vettilathazam , Decent Jn., P.O ., Mukthala ,
Kollam – 691577, Kerala , India

( Managed by Navdeep Educational Trust )

( CBSE code : 930486 )

BIOLOGY PROJECT
2019 – 2020
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 NAVDEEP PUBLIC SCHOOL

DECENT JN. .P.O., VETTILATHAZHAM KOLLAM: 691577,Kerala

BIOLOGY PROJECT

Certified bonafide report of project work done by

C.B.S.E. Register No: ___________Class XII A during the
year 2019 - 2020

VALUED BY

TEACHER IN CHARGE EXTERNAL EXAMINER

DATE: PRINCIPAL

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 ACKNOWLEDGEMENT

Nothing concrete can be achieved without an optional

combination of inspiration and perspiration. No work can
be accomplished without the guidance of experts. It is
only the critics from the ingenious intellectual that help
turn a product into a quality product.

I thank and extend my whole hearted gratefulness to

my senior principal Mrs. Preetha Cletus, Principal Mrs.
Srinivasan Syama and Biology teachers Mrs. Sreelatha.R
and Mrs. Rini Arthur and all other well-wishers who
encouraged me to complete this project with the
earnest endeavour. I would also like to thank the following
doctors, Dr Manoj. V (N.S hospital ), Dr Sruthi Babu (Amrita
hospital) for helping us with our project. I would also like to
thank Dr . Nagamani .S (N.S hospital ) , Dr Ullas Mony
(Amrita hospital ) and Dr Sreeraj . V (Amrita hospital) for
your valuable time clearing our doubts .

Last but not the least, I thank God almighty without whose
blessings the project would not have been accomplished.

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 AIM
To study about the various kinds of stem cells ,
their current potential and their future scopes

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 INDEX
Sl.no : TOPIC PAGE NO:
1. Introduction 7

2. What are stem cells ? 13

3. Types of stem cells 15

4. Where are stem cells found ? 20

5. How do stem cells work and where are these used ? 23

6. Human leukocyte antigen 24

7. Sources of stem cells under exploration 25

8. Why store stem cells from umbilical cord & cord blood? 26

9. Why do we need stem cells from a donor and how can we obtain a donor? 27

10. Role of Stem cells in today’s health care 28

11. Diseases treated with Stem cells 29

12. Stem cell therapy and how does it work? 30

13. Collection Procedure ( Umbilical cord ) 31

14. Bone Marrow Transplantation 36

15. FDA Requirements for transplantation 37

16. Case study 1 38

17. Case study 2 40

18. Interview with doctor 1 42

19. Interview with doctor 2 44

20. Interview with Doctor 3 47

21. Gallery 49

22. Conclusion 55

23. Bibliography 56

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 INTRODUCTION
Terms and Definitions
Stem Cells
Stem cells are the master cells which act as basic
building block of our body. Just like a seed of a plant
that gives rise to branches, leaves and fruits, these
stem cells have the potential to develop into
specialized cells such as blood cells, muscle cells, brain
cells, etc of our body.

Umbilical Cord
The umbilical cord connects the baby to the placenta
in the mother’s womb. It helps carry oxygen to the
baby through the cord blood. Initially, it was thought
the cord only contained blood vessels. However,
scientists have shown that the tissue between the skin
and the blood vessels- known as “Wharton’s Jelly” – is
one of the human body’s richest sources of
‘Mesenchymal Stem Cells’.

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Embryonic Stem cells
Cells resulting from a blastocyst capable of giving rise to
more than 200 cell types representative of all body tissues.
These stem cells can be ‘totipotent’ or ‘pluripotent’.

Adult stem cells

Adult stem cells are undifferentiated cells, found
throughout the body after development, that
multiply by cell division to replenish dying cells and
regenerate damaged tissues. Also known as somatic
stem cells they can be found in juvenile as well as
adult animals and humans, unlike embryonic stem
cells.

Autologous
Cells from one’s own body

Allogenic
Cells from a donor

Cord Blood (Placental blood)

Blood in the placenta and the umbilical cord

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Cord Blood Unit
Placental blood collected from an umbilical cord allows the
preparation of a unit of placental blood. Grafting centres
speak of cord blood units used by transplant recipients. The
use of placental blood to perform transplants was initially
limited to children. Today, it becomes possible to use two
units of cord blood to form a graft in an adult.

GVHD
It stands for “Graft Versus Host Disease”. It is a post-
transplantation complication that occurs when the
donor immune system cells recognize the patient’s
body foreign and attacks it. It is much lower incidence
is umbilical cord blood transplant than in bone marrow
transplants, which is great advantage as GVHD has high
mortality and morbidity.

Hematopoietic Stem Cells

Cells that give rise to blood cells.

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HLA
Human leukocyte antigen
Special Proteins that form HLA markers. These markets
help the immune system identify which cells belong to
you. The most successful transplant happen when the
patient’s HLA and donor HLA closely match.

HLA Compatibility
The HLA system or the ‘Major Histocompatibility
Complex’ (MHC) is the system that allows the body and
its immune system to recognize the self (e.g. tissue) of
non-specific (virus, bacteria and graft). An item that
does not have the correct tissue type HLA will be
attacked by the immune system. Each human body has
an HLA of its own, and is highly polymorphic between
individuals.

 During transplant HLA grafting is crucial to prevent

graft rejection.

Induced Pluripotent Stem Cells

Induced pluripotent stem cell, or IPS cell, is a stem cell
that has been created from an adult cell such as a skin,

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liver, stomach or other mature cell through the
introduction of genes that reprogram the cell and
transfer it into a cell that has all the characteristics of
an embryonic stem cell. The term pluripotent connotes
the ability of a cell to give rise to multiple cell types,
including all three embryonic lineages forming So far
the body’s organs, nervous system, skin, muscle and
skeleton. induced pluripotent stem cells appear to
exhibit the same key features of embryonic stem cells.

Multipotent Stem Cells

Multipotent stem cells are unspecialized cells that
have the ability to self-renew for long periods of time
and differentiate into specialized cells with specific
functions. Their specialization potential is limited and
they are committed to produce specific cell types. They
vary from stem cells such as pluripotent ones which
can give rise to almost any cell type.

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Mesenchymal Stem Cells
Mesenchymal Stem Cells (MSC) are non-hematopoietic
multipotent progenitor cells. They are capable of
differentiating into may cells types (adipose, cartilage, bone,
muscle, nerve …) and capable of reducing immune responses.
Mesenchymal stem cells were initially identified in the bone
marrow and can also be obtained from other tissues: adipose
tissue, placental blood, umbilical cord, amniotic fluid,
synovium, periosteum and perichondrium. These are
adherent cells with a fibroblastic look, not phagocytic and
their number decreases with age.

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 What are Stem cells ?

A stem cell is a cell with a unique ability to develop

into specialised cell types in the body . In the future
they may be used to replace cells and tissues that
have been damaged or lost due to disease.

 Stem cells provide new cells for the body that are
damaged or lost . They have two unique that
enable them to do this.
 They can divide over and over again to produce
new cells.
 As they divide , they can change into the other
types of cell that make up the body.

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14
 Types of Stem cells

1. Totipotent (or omnipotent ) Stem cells

These stem cells are the most powerful that most powerful
that exist. They can differentiate into embryonic , as
chorion, yolk sac amnion , and the allantois . In humans and
other placental animals , these tissues form the placenta.
The most important characteristic of a totipotent cell is that
it can generate a fully functional, living organism.
The best example of a totipotent is a fertilised egg. It is at or
around the post-fertilised stage that these cells begin to
specialize into pluripotent cells , which as described below
are flexible cell types, but cannot produce an entire
organism.

2. Pluripotent stem cells.

The next most powerful type of stem cell is the
pluripotent stem cell. The importance of this cell type is
that it can self-renew and differentiate into any of the 3
germ layers which are ectoderm, endoderm and mesoderm.
These 3 germ layers further differentiates to form all tissues
and organs within a human being.

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  Embryonic stem cells
Among the natural pluripotent stem cells, embryonic
stem cells are the best example.
 Induced pluripotent stem cells
IPS cells were first produced from mouse cells in 2006
and human cells in 2007, and are tissue specific cells
that can be reprogrammed to become functionally
similar to embryonic stem cells.
Because of their powerful ability to differentiate in a
wide diversity of tissues and their known controversial
nature, induced pluripotent stem cells are well suited
for use in cellular therapy and regenerative medicine

3. Multipotent stem cells

Multipotent stem cells are a middle-range type of stem
cell, in that they can self-renew and differentiate into a
specific range of cell types.
An excellent example of this cell type is the
mesenchymal stem cell (MSC)

MESENCHYMAL STEM CELLS

Mesenchymal stem cells can differentiate into

osteoblasts (a type of bone cell), myocytes (muscle

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 cells), adipocytes (fat cells), and chondrocytes
(cartilage cells).

These cells type are fairly diverse in their

characteristics, which is why mesenchymal stem cells
are classified as multipotent stem cells.

4. OLIGOPOTENT CELLS
The next type of stem cells, oligopotent cells, are
similar to the prior category (multipotent stem cells),
but they become further restricted in their capacity to
differentiate.
While these cells can self-renew and differentiate, they
can only do so to a limited extent. They can only do so
into closely related cell types.

An excellent example of this cell type is the

hematopoietic stem cell (HSC).

HEMATOPOIETIC STEM CELLS

 HSCs are cells derived from mesoderm that can

differentiate into blood cells. Specifically, HSCs are
oligopotent stem cells that can differentiate into both
myeloid and lymphoid cells.

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  Other Myeloid cells include basophils, dendritic cells,
eosinophils, erythrocytes, macrophages,
megakaryocytes, monocytes, neutrophils, and
platelets, while lymphoid cells include B cells, T cells,
and natural kills cells.

5. Unipotent Stem Cells

Finally we have the unipotent stem cells, which are the

least potent and most limited type of stem cell.
An example of this stem cell type would be muscle
stem cells.
Muscle Stem cells
While muscle stem cells can self-renew and
differentiate, they can only do so into a single cell type.
They are unidirectional in their differentiation capacity.

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19
 Where stem cells are found?
Stem cells are found and retrieved from various parts
of the body such as the peripheral blood, bone
marrow and the umbilical cord blood.

Peripheral blood stem cells

While most blood cells reside in the bone marrow , a
small number are present in the blood stream . These
peripheral blood stem cells , or PBCSs ,can be used
just cancers and various blood disorders.
Since they can be obtained from drawn blood , PBSCs
are easier to collect than bone marrow stem cells ,
which must be extracted from within bones . this
makes PBSCs a less invasive treatment option than
bone marrow stem cells . PBSCs are sparse in the
bloodstream , however so collecting enough to
perform a transplant can pose a challenge .

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 Umbilical Cord Blood Stem Cells

Among these sources , umbilical cord blood is

considered to be a ready source of stem cells and can
be preserved at birth, and used for treatments when
required. Stem cells extracted from cold blood are
used efficiently in the treatment of blood related
conditions such as Thalassemia, Leukaemia,
Lymphoma, Neuroblastoma and so on. Cord blood
stem cells have been used for 30 years more than 50+
transplants around the world.

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 Bone Marrow Stem Cells
Bone marrow is a part of our immune system which
protects us from infections and disease. The bone
marrow is where stem cells are made. Stem cells are
blood cells at the earliest stage of development. All
our blood cells develop from stem cells in the bone
marrow. Stem cells stay inside the bone marrow and
when they fully develop they go into the blood
stream.

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 How do Stem cells work?
When parts of our body or its functions are damaged
or affected by aging, -injury or illness , these stem
cells have the ability to both replace affected cells and
rep[air the affected parts and restore the normal
functions of our body.

Where are stem cells used?

Stem cells are currently used in modern day medicine
and can help in the treatment of many medical
conditions through replacement and repair
approaches. For over 50 years, over 30 lakhs
transplants have been done using stem cells, across
the globe, with currently over fifty thousand done
over a year.

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 Human leukocyte antigen
The HLA system is an important part of the immune system
and is controlled by genes located on chromosome C. It
encodes cell surface molecules specialized to present
antigenic peptides to the T-cell receptor on T-cells.

HLA Matching
A test similar to a blood grouping test but much more
complex.
Immediate family is the first source of donors as HLA are
marker signs inherited from parent.
4/6 HLA matching between the patient and the donor is
sufficient for cord blood stem cell transplant.

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 SOURCES OF STEM CELL UNDER
EXPLORATION

MENSTURAL BLOOD

DENTAL PULP

AMNIOTIC FLUID

INDUCED PULRIPOTENT STEM CELLS

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Why store stem cells from umbilical cord
and cord blood?
Stem cells found in cord blood are haemopoietic (blood
forming). Haemopoietic stem cells in cord blood are able to
differentiate into every blood cell type. This blood is very
rich in stem cells and can be easily collected and, processed
and stored for later use in the treatment of many diseases
and disorders. The process of collecting cord blood does not
interfere with the birth process and presents no harm to the
baby or mother.
If someone requires a haemopoietic stem cell transplant,
their doctor will want to find a donor with closest human
leukocyte antigen match possible.
It is not always possible or easy to find a sufficient HLA
match, especially because some HLA types are less common
than others. Storing of babies’ cord blood means that they
can easy access to haemopoietic stem cells that are more
likely to have a close HLA match. Most specifically siblings
who have the same parents have a one in four chance of
HLA match.

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Why do we need stem cell from a donor?
Majority of the medical conditions would require stem cells
from a healthy donor would require stem cells contain the
same genetic defect that causes the disease, hence they
cannot be used for treatment. Stem cell transplant
matching requires 4 to 6 parameters to be common
between a patient and a donor and hence the odds of
finding a match is significantly lesser than finding matching
blood unit for transfusion.

Where can you obtain a matching donor

stem cells?
Matching stem cells can be procured from a public stem cell
bank where frozen umbilical cord stem cells from unrelated
donors are available at a cost. However a public cord blood
bank have their own challenges in finding matching stem
cells when required.

 In most countries, parents are free to choose between

donating stem cells to a public bank and storing stem
cells in a family bank. It is however imperative for them
to make an informed decision. Not all healthcare
providers have this information available. This list gives
an overview of the major differences between both
options: A 2011 review states that some 1,300,000 cord
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 blood units are stored for use in both private and public
banks.

 If a stem cell transplant is needed, and no stem cells

were stored, the difficult task of finding a matching
donor begins. It can be a real challenge. Sometimes
patients cannot be treated because of the lack of such a
donor. Therefore parents opt increasingly for private
storage of stem cells of their children.
 The successful lifesaving transplantation since 1988
demonstrate that preserving the umbilical cord and
cord blood can potentially save lives. Healthcare
providers should, therefore, inform parents about the
option to store or donate stem cells and discuss the
advantages and possible disadvantages of cord blood
banking and related future cord blood usage.

What is the role of stem cells in today’s

healthcare?
Today, stem cells have the ability to treat over 80 blood
related medical conditions such as Thalassemia, Lymphoma,
Leukaemia, Multiple Myeloma, Neuroblastoma, etc.

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DISEASES TREATED WITH STEM CELLS
STANDARD THERAPIES WITH BLOOD
FORMING STEM CELLS
These are diseases for which transplants of blood
forming stem cells are a standard treatment. For
some diseases they are the only therapy, and in other
diseases they are only employed when front-line
therapy have failed or the disease is very aggressive.
The list below include all therapies that use blood-
forming stem cells, without distinction as to whether
the stem cells were extracted from bone narrow,
peripheral blood, or cord blood
Most of the diseases for which HSCT is a standard
treatment are disorders of blood cell lineage. The
proliferation by which blood cells are formed from
stem cells is illustrated in the side graphic. You can
also read about specific cell type in the immune
system in more detail. In the united states, most
health insurance providers will pay for a stem cell
transplant if it is a “Standard therapy” for the
patient’s diagnosis .

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 What is stem cell therapy (regenerative
medicine) and how does it work?
Stem cell therapy, also known as regenerative medicine,
promotes the repair response of diseased, dysfunctional or
injured tissue using stem cells or their derivatives. It is the
next chapter in organ transplantation and uses cells instead
of donor organs, which are limited in supply.
Researchers grow stem cells in a lab. These stem cells are
manipulated to specialize into specific types of cells, such as
heart muscle cells, blood cells or nerve cells.
The specialized cells can then be implanted into a person.
For example, if the person has heart disease, the cells could
be injected into the heart muscle. The healthy transplanted
heart muscle cells could then contribute to repairing
defective heart muscle.
Researchers have already shown that adult bone marrow
cells guided to become heart-like cells can repair heart
tissue in people, and more research is ongoing.

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 COLLECTION PROCEDURE
UMBILICAL CORD STEM CELLS
A) Read the instructions and check the expiry date.
B) The procedure for cord blood collection begins
immediately after the newborn has been disconnected
from its mother and preferably before removal of the
placenta.
C) Since stem cells have the tendency to migrate
quickly towards the direction of the newborn, the area
of collection should be close to where the newborn
was detached.

D) Locally sterilize the area of the umbilical cord

which will be injected. Inject with the needle the area

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which has been previously sterilized. It does not
matter if either a vein or artery is injected.
E) If the area which you have initially injected does not
provide enough blood, you can repeat the procedure
several times as required, always moving towards the
direction of the placenta. Note that you must always
carefully sterilize locally before injecting, so as to avoid
infecting the blood.

F) It is important to collect as much blood as is possible

in the blood bag. The more blood that is collected, the
larger the quantity of stem cells which are likely to be
found. The minimum quantity of blood that must be
collected is 80 ml, exclusive of the anticoagulant in the

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bag. (The blood in the blood bag should acquire a dark
red color).
G) As soon as collection is completed, squeeze the tube
so that any remaining blood can pass into the blood
bag.
H) Leave as much tube as possible on the bag.
I) Finally, cut the needle which is attached and discard
it.
J) Place and secure the clip so as to avoid any possible
leakage, and for additional safety, make at least two
knots on the tube. Do not use staples or stitches.

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K) Lightly shake the bag so that the blood is mixed with
the anticoagulant.
L) Place the blood bag in absorbent pouch and seal it
inside the biohazard bag.
M) Place the sealed blood bag in the SS Vacuum
Insulated Container along with the foam brick.

FIGURE: CORD BLOOD COLLECTION PROCEDURE.

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CORD BLOOD PROCESSING

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BONE MARROW TRANSPLANTATION

PROCEDURE

There are three main steps in the transplantation

process.
 The first step is the collection of the bone marrow
or stem cells (the harvest) from the donor. We
now know that the umbilical cord blood is also a
rich source of stem cells.
 The second step is to completely destroy the
existing bone marrow and thereby help the
patient receive the new stem cells.
 The third step is to infuse the bone marrow or the
stem cells through the intravenous route, like a
blood transfusion. There may be no signs of a
new bone marrow growing for two to three
weeks, and occasionally it may be a few months
before the new bone marrow produces all the
components of the adequately

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 FDA Requirements for Transplant
Results of
Product
Sample Product
Characteristics Testing
(Type and Timing) Testing

All tests -ve except

non-treponemal
test for
Maternal peripheral syphilis
blood obtained within 7 when confirmatory
Infectious diseases – Testing required days of cord blood test is –ve
(21 CFR 1271.45 through 1271.90) collection –Type and (CMV results
timing required are recorded)
(21 CFR 1271.80(a), (b))

CMV – Report

Safety

Sterility: Bacterial and fungal -Testing required No growth

HPC-C (pre-cryopreservation)
(21 CFR 211.165(b), and 21 CFR 610.12)

Cord blood or donor sample

Nohomozygous hemoglobinopathy
Hemoglobin obtained at time of cord blood
recovery

≥ 5.0 x 108
Total nucleated cells (TNC) HPC-C (pre-cryopres) TNC/unit HPC-C

≥ 85%
Purity viable
Viable nucleated cells HPC-C (pre-cryopres)
and nucleated cells
Potency

≥ 1.25 x 106 viable

CD34+
Viable CD34+ cells (flow) HPC-C (pre-cryopres)
cells/unit HPC-C

Report
HLA Typing Cord blood

Identity Confirms initial

Confirmatory HLA typing Attached segment

Report
ABO and Rh Type Cord blood

Latest Requirements By FDA

 Infant Health History
 APGAR Score: Appearance, Pulse, Grimace, Activity, Respiration
Evaluation of Hemodilution of maternal blood samples
 Obstetrician declaration

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 Case study-1
Stem Cell Therapy in Crohn’s Disease

PATIENTS:-Male, 21
FINAL DIAGNOSIS:- Crohn’s disease

SYMPTOMS:- Intolerance to specific foods, abdominal

pain and diarrhoea
MEDICATION:- Human embryonic stem cell therapy
CLINICAL PROCEDURE:- Human embryonic stem cell
transplantation
SPECIALITY:- Gastroenterology
OBJECTIVE:-Unusual or unexpected effect of
treatment
BACKGROUND:- Crohn’s disease is a chronic
inflammatory disease of the intestines, mainly the
colon and ileum, related with ulcers and fistulae. It is
estimated to affect 565000 people in the U.S.
Currently available therapies, such as antibiotics
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thiopurines and anti-tumour necrosis factor alpha
agents, are only observed to reduce the
complications associated with Crohn’s diseases and to
improve quality of life , but cannot cure the disease.
Stem cell therapy appears to have certain advantages
over conventional therapies.
DATE OF TREATMENT: 11 JULY 2011

CASE REPORT: A 21- year old male with chief

complaints of intolerance to specific foods, abdominal
and diarrhoea underwent human embryonic stem
cells therapy for 2 months. After going human
embryonic stem cell therapy, the patient showed
symptomatic relief. He had no complaints of back
pain, abdominal pain, or diarrhoea and had improved
digestion. The patient had no signs and symptoms of
skin infection, and had improved limb stamina ,
strength and endurance . The condition of patient was
stable after the therapy .

CONCLUSION: Human embryonic stem cell therapy

might serve as a new optimistic treatment approach
for Crohn’s disease.
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 CASE STUDY 2
Stem Cell therapy in Broncho Pulmonary
Dysplasia
PATIENT: Male, 8 months
FINAL DIAGNOSIS: severe Broncho Pulmonary
Dysplasia
SYMPTOMS: Respiratory distress, infections, anaemia
and low platelet counts.
MEDICATION: Human embryonic stem cell therapy
CLINICAL PROCEDURE: Human embryonic stem cell
transplantation
SPECIALITY: Neonatal and Pulmonology
BACKGROUND: Bronchopulmonary dysplasia (bpd) is
a form of chronic lung disease that affects new-borns
(mostly premature) and infants. it results from
damage to the lungs caused by mechanical ventilation
(respirator) and long-term use of oxygen.
DATE OF TREATMENT: JULY 24, 2018
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CASE REPORT: A one month old premature baby boy
was suffering from respiratory distress, infections,
anaemia and low platelet counts. he was kept on the
ventilator support. premature babies have very tiny
air sacks which makes the breathing difficult. the
baby was injected with 40 million stem cells and
gradually the lungs began to repair. after the
treatment he was weaned off the ventilator,
continuous positive airway pressure (cpap) machine,
and oxygen support step by step.
CONCLUSION: Human embryonic stem cell therapy
serve as a cure for bronchopulmonary dysplasia.

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 INTERVIEW WITH THE DOCTOR
Interview with Dr. Nagamani
(Department of gynaecology)
TOPIC: STEM CELLS
Stem cells are special human cells that have the
ability to develop into many different cell types, from
muscle cells to brain cells. In some cases, they also
have the ability to repair damaged tissues.
(The following is a brief extract of our conversation with the
following doctor in charge)

1.Madam, is the collection procedure of umbilical cord stem

cells exceedingly complicated? [Is this procedure very
complicated]
Ans: No. The collection of umbilical cord blood stem cell
(Hametopotic) is not a complicated one. Just need to collect
through a blood bag once the baby is out. Regarding the
cord tissue Stem cell, presently there is a ban from ICMR on
collection and banking of them (Mesenchymal) for
commercial purpose.
2.How long can stem cells be stored?
Ans: Technically, Stem cells can be stored for any number of
years; provided the storage conditions are right. The oldest
Stem cell stored is now 33 years old in USA.

42
3.How can Stem cells treat disease?
Ans: Stem cells create additional, new cell/tissue growth at
the damaged site, once its injected. Over a period of time,
the older cells would have got destroyed and fresh new
cells from these Stem cells would have formed.
4. Can stem cell therapies increase the chances of a
tumour?
Ans: No. As of now there are no studies which shows such a
detrimental possibility
5. Is there any risk of immune rejection from stem cells?
Ans : Stem cell therapies are done after much tests and
everything in a patient. There is always an incubation
period of close to 21 days, where the patient will be
isolated and closely monitored in the ICU after the therapy.
As of now Life cell has supported for 52 successful
transplants.

43
 INTERVIEW WITH DOCTOR
INTERVIEWSECTION WITH DR. ULLAS MONY PhD
(haematology)
Topic: Stem cells and their future in medicine

“Stem cells is the cells which have the capacity to self-

renew and differentiate into specific lineage.”
- Dr. Ullas Mony

1. Why is it not possible to transplant pluripotent stem

cells ?
Ans: Not really , IPSC is the area where we reprogram normal
adult cells into human embryonic stem cells.
2. But is it clinically possible ?
Ans: There are already things happening in Japan . One of my
students is working on IPSC , differentiate them into different
lineage. She differentiated normal adult blood cells into
human embryonic stem cell stage from which she already
differentiated them into heart cells and adipose cells.

44
3. How can it be done?
Ans: We take any normal adult cells and put 4 transcription
factors , that is 4 genes into that system and then you can
reprogram the normal adult cell into an pluripotent stem
cell or what you can call a embryonic stem cell.
4. Sir , please enlighten us with the research behind the
procedure?
Ans: When you look at the history behind it, a pool of 22
genes was identified and from which it was narrowed
down into 4 genes which is Oct4, Sox2 , cMyc and Klf4 . And
if u put those genes into an adult cell , the cell will
reprogram into a pluripotent stage . Once we reach that
stage a proper cue can be given for it to develop into any
one of the 3 germ layers and the cells which are developed
from it.
5. Are these technique used in treatment of disease?
Ans: It is still in the developmental stage . Currently these
are used in various disease modelling systems and toxicity
screening platforms . It is now done in animals and slowly
moving into human.

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6. How long can stem cells be stored ?
Ans: Depends on what cryopreservation technique you are
following and at what temperature it is stored , −196°C
in liquid nitrogen temperature , it can go many years . I
have been working on with cells even leukemic cells
which have been stored for 15 –16 years .
7. What are the criteria for a cell to be classified as a stem
cell ?
Ans: For a cell to be classified as a stem cell it should
have the following properties :
A) It should have the ability to self renew .
B) It should have the self differentiation capacity .
C) It should repopulate in on an immuno-compromised
mice multiple times by serial transplantation technique.
8. What are the events that lead to the popularity of stem
cells?
Ans : There are 3 events that changed the face of stem
cells . And those are :
A) Cloning of Dolly the sheep ( major breakthrough ) .
From an adult cell a mammal is grown . Done by Sir Ian
Wilmut and Keith Campbell and his co-workers at the
Roslin institute a part of University of Edinburg .
B) Development and derivation of embryonic stem cell
lineage.
C) Invention of IPSC BY Shinya Yamanaka

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 INTERVIEW WITH DOCTOR
INTERVIEW SECTION WITH Dr. Sreeraj V
(MD) (DM) (Haematology)
Topic: Stem cell therapy ( leukaemia) and
collection methods.
Stem cells can be used to cure leukaemia ( blood
cancer ) with stem cell transplant .

1 . Sir, if all cells of our body was originated from a single

cell , then isn’t it possible to create a stem cell from a
normal somatic cell?
Ans : Yes it is possible to create stem cells . That is called
Induced Pluripotent Stem cells . There is research going
on for that . Any cell can be turned into a stem cell.

2 .How does one get a stem cell from a donor ?

Ans:We ask for you to donate your HLA typing . Once a
patient undergoing stem cell treatment comes we contact
the websites or collection centres for the matching HLA
typing . Once we get the perfect match , we contact the
respective person asking them if they are willing to donate.

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3. Is stem cells stored ?
Ans: It is not necessary to store stem cells. If you are
storing , then it should be stored in a nitrogen chamber
with temperature of -180 to -200 °C .Still there is a
possibility of stem cells losing its viability , ability to
regenerate .

4. In pregnancy parents collect stem cells , Is it useful ?

Ans: Stem cell collected is umbilical cord stem cells which
is very small in quantity . For a treatment in an adult we
need more quantity of stem cells that means with one cord
blood unit we cannot successfully treat an adult patient .
For an adult we need four or more stem cells donor , that
means we need multiple cord blood donors .

5 . How is stem cell transplant cure leukaemia ?

Ans : Why we got the disease , there is something in my

immunity which allowed it to happen. In a bone marrow
transplant, the patient's bone marrow stem cells are
replaced with those from a healthy, matching donor. To do
this, all of the patient's existing bone marrow and
abnormal leukocytes are first killed using a combination of
chemotherapy and radiation. Next, a sample of donor bone
marrow containing healthy stem cells is introduced into
the patient's bloodstream. If the transplant is successful,
the stem cells will migrate into the patient's bone marrow
and begin producing new, healthy leukocytes to replace
the abnormal cells.

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6 . How long does a stem cell transplant procedure take ?
Ans: First we have to find a donor which takes almost 5
days. Then a 15 days for stem cell to grow and regenerate.
So a time period of one month.

7 . Are stem cell injections safe ?

Ans : It is very safe , as long as the donor’s HLA match
with the patient .

8 . What is the survival rate of a stem cell transplant?

Ans : The survival rate depends on the disease and the
type of treatment provided. And to find the best donor .

9 . Sir, is there any side effects for stem cell therapy ?

Ans : Side effects include Graft versus host disease, Graft
failure, Infection , Bleeding and Transfusion.

10 . Can leukaemia return after stem cell transplant ?

Ans: The possibility is very less .

11 . What if stem cell transplant fails ?

Ans : One more transplant can be done and still it fails ,
then there is no method of curing so it results in death .

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.

GALLERY

With Dr.Nagamani.S

50
With Dr. Ullas Mony

With Dr. Sreeraj . C

51
Infront of research lab
Inside the Lab

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53
Lab equipment

54
Outside the hospital

55
Placenta

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 CONCLUSION

After several decades of experiments, stem

cell therapy is becoming a magnificent
game changer for medicine. With each
experiment, the capabilities of stem cells
are growing, although there are still many
obstacles to overcome. Regardless, the
influence of stem cells in regenerative
medicine and transplantology is immense.
Currently, untreatable neurodegenerative
diseases have the possibility of becoming
treatable with stem cell therapy. Induced
pluripotency enables the use of a patient’s
own cells. Tissue banks are becoming
increasingly popular, as they gather cells
that are the source of regenerative
medicine in a struggle against present and
future diseases. With stem cell therapy and
all its regenerative benefits, we are better
able to prolong human life than at any time
in history.

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 BIBLIOGRAPHY

www.yourgenome.org
www.bioinformant.com
www.wikipedia.com
www.mayoclinic.com
www.closerlookatstemcell.org
 Life cell umbilical cord blood collection bank
 American journal of case studies
 Amrita hospital , Ernakulam
 N.S hospital , Kollam

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