Are you preparing to become a mother?Congratulations, because the birth of a child is a real miracle. The miracle of the birth of a new life, so fragile and defenseless. And it is in your power already on the very first birthday of your baby - the day of his birth - to give him the most valuable gift that can save in the future not only the health, but also the life of your baby. We are talking about stem cells obtained from the umbilical cord blood in the first minutes after the birth of the baby. Stem cell treatment has saved more than one hundred little lives. Recently, this procedure is becoming increasingly popular among newlywed couples. However, despite this, for most future parents, such a procedure for collecting umbilical cord blood is still a novelty. Although the cost of this procedure is not that high, and there is no risk for either the child or the mother, people continue to consider the collection of umbilical cord blood nothing more than some kind of newfangled trend. Why is this happening, because the use of stem cells in modern medicine is quite widespread? In almost all cases, such erroneous judgments are caused by nothing more than the banal lack of minimal information about what the use of stem cells can be. This is what will be discussed in today's article.
What is a stem cell?
In the blood of any person, as well as in his tissuesthere is a certain number of so-called precursor cells, which have the ability to reproduce without limit and degenerate into absolutely any cells in the body. Simply put, a stem cell can produce a bone or muscle cell, as well as a blood or skin cell. There are two types of stem cells:
- Embryonic stem cells
Embryonic stem cells are thosecells that are isolated from the tissue of a blastocyte, an embryo at an early stage of development. This type of stem cells has a huge potential for rapid growth and differentiation. However, despite this, the use of embryonic stem cells gives rise to a huge number of controversies: they have a fairly high risk of degeneration into cancer cells, there is a risk of developing rejection reactions and immune conflicts. In addition, the moral and ethical side of this issue also plays an important role - after all, to obtain this type of stem cells, a healthy embryo is needed, which, accordingly, loses the right to be born. Not every person agrees to treatment that uses embryonic stem cells that are obtained as a result of an abortion - a targeted termination of pregnancy. Agree that there is something to argue about here.
- Postnatal stem cells
The same cells that are obtained from varioustissues of an already born human organism (i.e. postnatally), have a lower potential for reproduction, since they have already used part of their natural potential. However, despite this, in modern medicine at this stage of its development, this type of stem cells is widely used for cell therapy. Postnatal stem cells, in turn, are also divided into two subtypes:
- Hematopoietic stem cells.
Hematopoietic cells are blood-forming cells.which are part of the blood and ensure the transport of oxygen to tissues, blood clotting, the functioning of the immune system - protection from viruses, bacteria and other foreign agents. These cells are responsible for susceptibility or, on the contrary, immunity to most diseases.
- Mesenchymal stem cells.
Mesenchymal or, as they are also called,Stromal stem cells have the ability to recreate components of any human tissue - both bone and cartilage and skeletal muscle, as well as tissues of the heart, lungs, stomach. Stromal stem cells, unlike hematopoietic cells, must be cultivated in order for them to successfully reproduce. By the way, if you believe the latest scientific data, the same stem cells can be found in almost all tissues of the body, however, in different, sometimes very small quantities. Even in such seemingly unusual tissues as dental pulp, hair follicles, stem cells are also found. There is no need to even talk about such tissues as muscle, nerve, amniotic fluid, peripheral blood, amniotic fluid and placenta. However, despite this, stem cells obtained from far from all tissues are suitable for clinical use in order to achieve a therapeutic effect, but only from those that contain a sufficiently large number of precursor cells:
- Bone marrow - it is an indispensable source of both mesenchymal and hematopoietic stem cells.
- Cord blood - it is the best source of hematopoietic cells.
- Fatty tissue, stroma of the umbilical cord and placenta - all of these are valuable sources of mesenchymal cells.
The most widely used in medicine istransplantation of hematopoietic stem cells, which are obtained from umbilical cord blood cells, peripheral blood and bone marrow tissue. To date, more than 100 thousand transplants of stem cells obtained from the above sources have been performed worldwide. Stem cells extracted from umbilical cord blood account for about 30% of all these transplants. The Institute of Human Stem Cells is constantly developing and gaining momentum. The largest number of stem cell transplants were performed during the treatment of oncological diseases, including leukemia in children and adults, both acute and chronic. The peculiarity of cancer treatment is that the most powerful pharmacological drugs destroy not only cancer cells, but also quite healthy stem cells of the patient's bone marrow. In order for a sick person to recover, a transplant of stem cells is necessary - either donor cells or pre-prepared ones. And if in the recent past stem cells were used mainly to treat cancer patients, now more and more scientists say that the results of numerous studies indicate that in the very near future cell therapy will be used for fundamentally new approaches to treating a large number of widespread diseases. For example, such as heart attacks, strokes, Alzheimer's and Parkinson's diseases, diabetes. The boldest forecasts predict the possibility of curing with the help of cell therapy irreversible changes to date in almost all vital systems of the body - bone, nervous, muscular, endocrine and others. And even those tissues and organs that wear out simply from old age, scientists also promise to restore with the help of the same stem cells. And although today such promises can be classified as: "stem cells: truth and myths", all the facts indicate that very soon the whole theory can be realized in practice. And then the cultivation of stem cells will become especially relevant.
The principle of the action of stem cells
Of course, many people are interested in the principlethe body's stem cells fight the disease. However, the vast majority of stem cells, with very rare exceptions, do not treat the disease itself. They are destined to restore the bone marrow, immune system and blood of a sick person after pharmacological and other types of treatment of the main diseases. As mentioned above, chemotherapeutic drugs destroy not only cancer cells in one or another organ, but also completely healthy cells of the spinal cord, without which the body simply cannot exist. And a timely transplant literally saves the situation - newly introduced stem cells, having entered the bone marrow, begin to multiply and take on the role of previously dead cells. As a result, the full functioning of the spinal cord is restored almost in full. By the way, doctors successfully use this feature of stem cells in the fight against a number of hereditary diseases, one way or another associated with a malfunction of the circulatory, immune or metabolic systems. Doctors purposefully destroy defective spinal cord cells with potent chemotherapeutic drugs. And donor stem cells are transplanted in their place, which degenerate into healthy spinal cord cells. To prevent the patient's body from rejecting foreign donor stem cells, doctors carry out a number of preventive measures. There are also a number of certain diseases for the complete cure of which it is enough to transplant autologous (own) pre-prepared stem cells. A very important positive quality of autologous stem cells is that they are not rejected by the patient's body, as they are 100% compatible in all respects. Thus, there is no need for long-term and expensive therapy aimed at preventing the rejection reaction, which is typical for cases of donor stem cell transplantation. Today, this type of transplantation is successfully used to treat more than 70 different diseases, including the following:
- Malignant neoplasms.
- Acute myelogenous leukemia.
- Acute lymphatic leukemia.
- Neuroblastoma.
- Fanconi Anemia
- Aplastic anemia
- Various syndromes of bone marrow involvement
- Different types of immunodeficiency.
- Chronic granulomatosis.
Various studies are being conducted very activelydevelopments that will allow the successful use of stem cell transplantation to treat diseases such as diabetes, kidney disease, liver disease, cardiovascular disease, Parkinson's and Alzheimer's disease, brain and spinal cord injuries. In addition, stem cell injections are already used in cosmetology, but we will talk about this another time.
Cord blood cells
Today it is possible to get the mostthe best stem cells from the umbilical cord, in the first minutes after the birth of the child. These stem cells are the youngest and give the best result compared to all other cells of postnatal origin. In the umbilical cord blood, the overwhelming majority are hematopoietic stem cells. However, there are other types of stem cells that can be cultivated in the cells of the liver, kidneys, heart, blood vessels and other vital systems of the body. What is umbilical cord blood? As you can guess from the name, umbilical cord blood is in the vessels and lumens of the umbilical cord and placenta, the purpose of which is to ensure the exchange of substances between the body of a pregnant woman and the fetus. Today, the most accessible and suitable source of stem cells is umbilical cord blood. It is mainly used to obtain hematopoietic stem cells, which have a virtually unlimited potential for differentiation and growth. By the way, transplantation of stem cells obtained from umbilical cord blood is a wonderful alternative to bone marrow transplantation. For example, in Europe, every second transplant is a transplant of stem cells extracted from umbilical cord blood. Many parents refuse to collect umbilical cord blood, believing that their child will not be affected by such a misfortune as a serious disease. They are partly right - the risk that a child, healthy at birth, will develop acute leukemia as he or she grows is very small - no more than 1:10,000. But, nevertheless, as the child grows, including in adulthood, the probability of contracting the disease for the treatment of which stem cells may be needed, especially considering the fact that this list is constantly expanding, increases hundreds of times. Liver and kidney failure, heart attacks, strokes, diabetes, certain age-related changes - these diseases lie in wait for a huge number of people every day. Of course, if necessary, doctors will be able to perform a transplant of donor stem cells. However, it is worth remembering that donor cells, no matter how you look at it, are still foreign, so the risk of developing a rejection process is very high. In addition, the first stem cells you come across will not be suitable - sometimes finding a donor takes a huge amount of precious time, and such "pleasure" is not so cheap.
Arguments in favor of cord blood sampling
In case of use for transplantationThe cells of the umbilical cord blood of the sick person himself have a huge advantage over the transplantation of donor cells - complete genetic identity with the tissues of the body. Thanks to this, a number of questions and problems are removed. Thus, by preserving the umbilical cord blood of their newborn baby, parents provide the child with a kind of biological medical insurance for the rest of his life. This position is also fully confirmed by a number of the following factors:
- Duration of storage.
Stem cells extracted from umbilical cord blood can be stored frozen for much longer than one or two decades.
- Readiness for various diseases.
Of course, most likely neither you nor yoursthe child, and perhaps your grandchildren, will never need stem cells in their lives. In any case, I really want to hope so. However, alas, too often doctors encounter cases when the mother of a child suffering from cancer is forced to urgently give birth to a second child. But no doctor, and not even nature itself, can give such desperate women a guarantee that the older and younger children will be genetically compatible. In the same case, if the parents took care of collecting their child's umbilical cord blood in a timely manner, they will never have to take such an extreme measure.
- Quick access to stem cells.
In the event that your child stilla stem cell transplant is needed, the doctor will only need to extract them from a special container and defrost them, without wasting time searching for a compatible donor, which, alas, is often completely useless.
- The price of the issue.
Many parents are confused by the need to paystorage facilities a certain amount of money to store their child's stem cells. However, it is worth remembering that this cost is hundreds of times higher than finding and purchasing donor stem cells, which may not be suitable for your child.
- Potential of stem cells.
Cord Blood Derived Stem Cellschildren are the youngest, so they not only reproduce better than all others, but also restore damaged tissues of the human body.
- Sterility and safety of stem cells.
Chances of cord blood becoming infectedduring intrauterine development of the fetus – are minimal. As statistics show, cytomegalovirus or herpes virus is found in umbilical cord blood in no more than one percent of all cases. In the blood of an adult, the same viruses are found in about 30% of all cases. It is almost impossible for even the ubiquitous herpes viruses to penetrate the placental barrier – they are almost never found in the blood of those newborns whose mothers were infected.
- The possibility of transplanting the child's stem cells to blood relatives.
Unfortunately, there are diseases that can be treated withstem cell transplantation is necessary, can befall any person. And it can be a close blood relative of the child - father, mother, brother or sister. Stem cells obtained from umbilical cord blood, when transplanted to close relatives, give a much lower percentage of rejections than, for example, a bone marrow transplant or a transplant of completely foreign stem cells. Thus, by preserving the stem cells of the baby, parents protect the health of not only the baby, but also their entire family.
Rules for selecting a donor
On the question of stem cell transplantation,obtained from the umbilical cord blood of the child, not to him himself, but to his blood relatives, it is worth focusing on. Parents often wonder if this is possible in principle. Transplant doctors answer absolutely clearly: yes, it is. The chances of a successful completion of the transplant and achieving success in similar, related, cases are much higher than in others. The success of the transplant is entirely determined by how accurately the donor-recipient pair is selected. This compatibility is determined by special proteins - antigens. Let's consider this in more detail using the example of a "brother - sister" pair. If you are lucky and there is an ideal option, that is, a complete genetic match, this means that both the boy and the girl received half of the genes from the mother and half from the father. And the same half. The more such discrepancies, the higher the risk of developing the rejection process. As a rule, almost always 100% genetic compatibility can be observed in twins, and about 7% compatibility - children of the same parents. Therefore, storing stem cells makes sense. It should also be noted that in some cases, transfusion of umbilical cord blood itself or cells isolated from it can be carried out without taking into account genetic compatibility, taking into account only the Rh compatibility factor.
Families at high risk
From all of the above, a simple conclusion follows.– cord blood collection ensures the protection of your child’s health throughout its life. However, there are families that are part of the so-called risk group. For them, collecting the umbilical cord blood of a newborn baby is more relevant than ever. So:
- Cases of cancer in the family. In the event that cases of cancer have already been encountered in the child's family or close relatives, cord blood collection is highly desirable, since stem cell cancer treatment is very effective.
- Problems with health in older children. Also, umbilical blood simply needs to be collected if the baby has an older brother or sisters who suffer from a disease in which stem cell transplantation is indicated.
- The father and mother of the child are representatives ofdifferent nations. In this situation, in the event that suddenly a child in the future will need a stem cell transplant, picking them up will be extremely problematic and incredibly long. The precious time necessary to save the child's health, and possibly his life, will be irretrievably lost.
- There are three or more children in your family.
- Pregnancy was the result of extra corporal fertilization.
- The presence of any other fears that stem cells can ever be needed by your child.
How is cord blood collected?
As a rule, in all large maternity hospitalsmedical personnel have the skills to collect umbilical cord blood. Immediately after the baby is born, the umbilical cord is cut, and the umbilical cord blood is collected in a specially designed sterile sealed container. The entire procedure for collecting umbilical cord blood takes no more than a few minutes during the period preceding the expulsion of the placenta from the uterine cavity. Many mothers worry about whether collecting umbilical cord blood is safe for the baby and whether it causes discomfort. As is clear from the above, the process of collecting umbilical cord blood is carried out after the umbilical cord is cut, the baby does not take part in it at all, and, accordingly, it does not have any effect on the child. Another very widespread misconception is the opinion that collecting umbilical cord blood is possible only if the birth occurs naturally, without any complications. However, in fact, this opinion is a pure misconception that arises due to an insufficiently high level of information. Stem cell collection is carried out without any problems or difficulties both during natural childbirth and cesarean section, or during multiple pregnancy. When deciding to collect umbilical cord blood, be sure to consider the following factor. Cord blood should be processed in a specialized laboratory no more than 48 hours after collection, provided that storage conditions were strictly observed during transportation. With each subsequent hour, the viability of stem cells significantly decreases. That is why make sure that the stem cell clinic is within reach.
Cord Blood Tests
After the container containingumbilical cord blood will be sent to the laboratory, and a number of specific tests and manipulations will be carried out in accordance with the requirements of Russian and international standards:
- The Rh factor and blood group of the child will be determined.
- The number of stem cells stored in the umbilical cord blood will be counted, both before their release and after it.
- Using a special measurement, both the relative and absolute content of stem cells will be determined.
- Before the freezing process, the level of viability of all stem cells will be determined.
- Bacteriological sowing will be carried out in order to identify possible infection.
All samples go through quarantine, and beforethe end of its term are stored separately. And only if all indicators correspond to the norm, the stem cells will be obtained. The stem cells will be placed in the main storage of the bank, where the preservation of the umbilical cord blood will continue for as long as necessary. The umbilical cord blood stem cells are stored in cryocontainers specially designed for this purpose. These cryocontainers are either test tubes or bags made of very thick and durable plastic. The fact that exactly what your child's umbilical cord cells will be stored in depends on the volume of the cells.
Cord blood storage banks
It would seem that the practice of collecting and storingcord blood appeared in Russia relatively recently. However, today there are quite a large number of stem cell banks. All of them are divided into two types:
- Banks-«registers»
In such banks all stored samplesnameless, so it is often impossible to establish who exactly is the stem cell donor. These organizations are state institutions that operate solely on the basis of gratuitous assistance and voluntary donation.
- Nominal cord blood bank.
Personalized stem cell banks, or as they are also calledFamily banks of personal storage, they store stem cells under strict control and accounting. If necessary, your child's stem cells will be issued immediately, at the first request of parents or doctors. Such banks currently operate exclusively on a commercial basis. However, regardless of whether we are talking about a state bank of stem cell storage or a commercial one, it is necessary to remember that we are talking about the provision of highly specialized medical services. And this means that the activities of any bank of umbilical cord blood storage must be exclusively licensed. To summarize today's conversation, we can say the following: when bringing up the question of "umbilical cord blood - pros and cons" to a family council, remember that the old proverb says "measure seven times - cut once." Your child will never have such an opportunity to receive personal medical insurance from nature itself again in his life. Of course, we sincerely wish you never to experience the need to use stem cells. Be healthy! We advise you to read:
