IX Международная студенческая научная конференция Студенческий научный форум - 2017

RELEVANCE. In the last 50 years large amounts of experimental research on cell technologies have been completed, creating conditions for validation of the innovative treatments in clinical practice. Hundreds of clinical papers have been published showing positive outcomes of stem cell usage for treatment of different diseases [1,3]. The research resulted in a realization that stem cells themselves as well as their derivatives on specific histogenesis phases could be used as a basis for the development of innovative cell technologies. With that in mind, the sheer scope of medical issues that can realistically be resolved with the use of the aforementioned technologies is astonishing.

AIMS AND OBJECTIVES: To analyze the results of experimental and clinical studies of the efficacy of different diseases treatment with the use of stem cells and other cell technologies from the standpoint of evidence-based medicine.

METHODSANDMATERIALS. In this study various literature sources were investigated and analyzed, and conclusions were made regarding the efficacy and safety of cell technology application in treatment of different diseases.

THE RESULTS AND DISCUSSION. The main question that needed to be answered was was “how safe and effective is the tested form of cell therapy?” [4]. Based on literature data one can expect the following complications from using cell therapy: 1) Unwanted immune responses (graft-versus-host response, immunosuppression drugs side effects, anaphylaxis); 2) toxic effects of cryoprotectors; 3) embolism and organ micronfarctions; 4) arrhythmia; 5) fibrosis and scarring; 6) tumor formation, etc. [1].

In the issue of cell technology safety one of the key points is the prediction of immunological response to allogenic cells. When allogenic bone marrow stem cells are transplanted, either the donor needs to be histocompatible or the use of immunosuppressors is required, otherwise transplant rejection will occur. When allogenic mesenchymal stem cells are used, donor selection is not vital as there are no histocompatibility antigens presented by those cells. In some clinical trials small amounts of immunosuppressors were used during the allogenic transplantation procedure because of the safety and efficacy concerns, while in others there was no immunosuppression present. It is established that allogenic stem cells have own immune activity that prevents graft-versus-host disease (GvHD) [3].

The safety of cell technologies is ensured by adhering to the following conditions: 1) bacteriological and virological assessment of the cell source; 2) strict control over cultivation and storage procedures, 3) preclinical assessments of toxicity, mutagenicity and carcinogenicity, and 4) clinical trials on patients [5].

The efficacy and safety of cell technology are proven for treatment of such diseases as myocardial infarction, stroke consequences, neurodegenerative diseases, diabetes, vascular insufficiency, particularly that of lower limbs; diseases of the joints, toxic or other liver damages, diseases of the retina and the cornea, trophical lesions or wounds that do not heal for a long-duraion [1]. A new area of cell therapy is being developed that uses growth factors for stimulation of adaptive regeneration processes [2]. However, analysis of the literature data on clinical effects of cell therapy indicates that positive changes in patient’s health are more rapidly achieved when other methods are used in conjunction with cell therapy.

CONCLUSIONS. New cell technologies are entering clinical practices for various groups of diseases. To this date, there have accumulated numerous results of clinical trials assessing efficacy of cell therapy application in various fields of medicine. Safety and efficacy of cell therapy have been fundamentally proven, although there are no validated treatment procedures yet. The development of more successful cell therapy methods is hampered by the lack of insight into many areas of stem cell biology and genetics. The majority of clinical trials in the field of cell therapy are represented by preliminary tests of methods or descriptions of individual clinical cases. Most of the works do not have unified method protocols and they often make their conclusions based on data gathered from small groups of patiens. It should also be taken into account that there is published data that could be indicating the possibility of negative consequences from stem cells injections.

REFERENCES:

1. Bochkov, N.P. Cell therapy in light of evidence-based medicine // Klinicheskaya medicina [The Clinical Medicine]. – Moscow, 2006.- № 10. – pp. 4– 7.

2. Zatsepina E.E., Ivashov M. N., Scherbakova T. N. Adaptive-reshaping activity of Tilia fatty extract in regeneration processes in experimental pharmacology. // Sovremennye naukoyemkie technologii [Modern high-tech techologies]. – Moscow, 2012, № 12, - p. 38.

3. Lyashenko V.A. et al. Immunomodulatory effects of stem cells in transplantation of tissues and organs. Klinicheskaya tranplantaciya organov [Clinical organ transplantation] book. - Moscow; - 2005. - pp. 164-165.

4. Scherbakova T. N., Eremina A. I., Vtorova M. A., Innovative cell technologies from the standpoint of evidence-based medicine. // Pharmacy and pharmacology –Pyatigorsk, 2015. №3 (10). pp 69-71.

5. Yarygin V. N. Cellular therapy technology of the new generation: biological background and implementation issues // Russian state medical university, Moscow, 2006.

 

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