Recently, close friends Jayesh and Simran delivered a second baby boy, Kiann. Like responsible parents, they believed in their child’s healthy future and went for private cord blood banking in spite of having preserved the umbilical cord for their firstborn a few years ago. In just 3 months’ time, their newborn was diagnosed with osteoporosis. This is possibly a condition where Kiann’s bone formation could be at risk and may lead to a fatality. The couple were optimistic because they were told that stem cell transplantation could actually save their newborn’s life.

In the rarest of cases, when Kiann’s stem cells were taken for testing, the parents found out that Kiann’s cord blood cells contained the same genetic deficiency that caused his disorder. Jayesh and Simran were distraught. But there was light at the end of the tunnel.  Precedence suggested that doctors could explore using donor cells from a close match. In order to treat a genetic disorder known as Fanconi’s anaemia, the first successful sibling-to-sibling cord-blood stem-cell transplant was performed in 1988.

There was hope yet for Kiann. Since Jayesh and Simran had opted to invest in storing their firstborn’s cord blood cells a few years ago, the doctors on testing that sample were able to get a reasonably compatible match. The doctors chose to go ahead with the stem cell transplantation and Kiann is now well on his way to recovery.

So the question that most parents spend a lot of time on is whether there is a need to store the cord blood and tissue for each individual child? In Jayesh and Simran’s case, the fact that they preserved the cord blood cells for both their children actually helped to save the life of their second born child.

According to the Parent’s Guide to Cord Blood Foundation, “Two full siblings have a 25% chance of being a perfect match, a 50% chance of being a half match, and a 25% chance of not matching at all.” However, Dr. Joanne Kurtzberg, MD, Program Director of the division of Paediatric Blood and Marrow Transplantation at Duke University Medical Center and one of the earliest to perform an unrelated cord-blood transplant in the U.S says, “One of the wonderful things about cord blood banking is that unlike bone marrow, you don’t always need a perfect match in order for it to work.”

Apart from the medical point of view of why one must consider storing the cord blood and tissue for both children, there is an additional take from a parenting perspective. By opting to bank the cord blood and tissue of a single child, most parents forget that it may lead to a regrettable situation where they may realize that they had made an unequal key medical decision.

Storing the stem cells of each child individually will allow you and your children access to a greater number of stem cells through which their future disorders and diseases can be cured. Dr. Jordan Perlow, MD, a maternal-foetal specialist in Phoenix, post attending medical conferences and having examined and analyzed findings about advances in stem-cell treatments now urges his patients to privately cord blood bank if they can meet the expense of it because he’s confident that it might save their child’s life or the life of another family member.

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In order to understand how stem cells are useful to us, we first need to understand what stem cells are. Stem Cells start in the embryo as immature biological cells, then become specialized to create bone, muscle, skin, the heart, the brain, and over 250 other types of specialized cells. This is why they are of such value to scientists doing both basic types of research in the lab and medical research in the clinic. They have the potential to regenerate tissue and cells that have been lost because of disease or injury.

Stem cell therapy has been used to cure a number of health conditions such as heart diseases, neurodegenerative ailments, and diabetes, with bone-marrow transplant being the most commonly used for stem cell therapy. There are many ways in which stem cell therapy can be conducted, however, stem cells derived from the umbilical cord blood are the safest to use for treatment. Moreover, stem cells from young individuals possess superior naivety and plasticity than stem cells from adults.

Congenital Heart Disease (CHD) is the most commonly found abnormality at birth, where the structure and function of the heart are not normal. In 2014, this congenital anomaly affected more than 1% of live born infants and accounted for more than 2.5 million affected children per year worldwide. CHD now occurs in approximately 7–8 out of 1000 live births, a slight improvement. Recent estimations reveal that up to 80% of newborns and infants with CHD are likely to reach adulthood, which can result in a high likelihood of complications later in life.

The cause of congenital heart disease is usually a combination of genetic and environmental factors. While some congenital heart diseases can be treated with medicine alone, others need to be treated with one or more heart surgeries.

In 2006, research at the Boston Children’s Hospital revealed that the heart has its own source of stem cells. These heart stem cells can form two major types of heart cells: myocardial cells (the muscles that, together, contract to make the heart beat) and smooth muscle cells (the lining of the heart’s blood vessels). This finding by Stuart Orkin, MD, and Sean Wu, MD, PhD, gave researchers a better insight into how the heart forms, and also gave a fillip to the concept of treating diseased or defective heart tissue with heart stem cells.

In January 2013, a study led by Bernhard Kuhn at the Boston Children’s Hospital found for the first time that young humans (infants, children and adolescents) are capable of generating new heart muscle cells. These findings gave rise to the possibility that scientists could stimulate the production of new cells to repair injured hearts.

A team of researchers from Massachusetts General Hospital reported in PNAS Early Edition (July 2013 issue) that they were able to create blood vessels in laboratory mice using human stem cells. The authors explained that using stem cells to repair or regenerate blood vessels could eventually help treat human patients with cardiovascular and vascular diseases.

Stem cell-based strategies to cure heart failure in adults has been investigated with promising results; however, stem cell therapy strategies for the paediatric population with heart failure are in its infancy. Further clinical trial studies will be needed to understand the cell biology in order to optimise their regenerative potential.

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Over the years scientific development in neonatal medical care has been revolutionary. One of the best advances in this domain has been in the form of cord blood and umbilical cord tissue banking. Between the baby and the mother, the umbilical cord acts as the lifeline as it comprises of many blood vessels, through which the umbilical cord blood pulses. The umbilical cord tissue, on the other hand, enables the blood vessels to weather the stress and the presence of the cord protects and supports them from bending.

The umbilical cord tissue comes with a high concentration of mesenchymal stem cells or MSCs. A research article states that “MSCs derived from the umbilical cord tissue, termed UCX, were investigated for their immunomodulatory properties and compared to bone marrow-derived MSCs (BM-MSCs), the gold-standard in immunotherapy.”[1]

According to available proprietary technology, UCX is being sequestered from the umbilical cord tissue; the methodology has proven to be quite strong, reproducible and will work adequately for stem cell banking. [2] It has been seen to produce a greater number of cells along with approximately 100% success rate with limited bacterial impurities.

In the present scenario, stem cells found in the cord blood are being used in the treatment of a number of blood-related diseases. However, there is a major hindrance as the volume of blood collected from the umbilical cord is low and can pose a drawback in terms of transplants. Studies and researches are currently underway to understand possible methods to increase the efficiency of cord blood transplants. Some investigations have delved into “ex vivo expansion of the hematopoietic stem cells before transplant, intensifying the homing of hematopoietic stem cells to the patient’s bone marrow, direct injections into the patient’s femoral bone, and transplants with multiple cord blood units” as stated in Banking Stem Cells From Umbilical Cord Tissue For Future Regenerative Medicine Applications. [3] A more direct technique is to make use of another stem cell population – MSCs found in the umbilical cord tissue – for co-transplantation with a cord blood unit, could well be the solution.

With technology to extract MSCs from cord tissue, the first step is to mince the tissue. This is further supported by an enzymatic breakdown process to “melt” away the cord tissue that in turn releases the native MSCs. An alternative way to preserve MSCs is to process the tissue and extract the cells thus securing them in a “treatment ready” form.

The clinical tests conducted on these cells have revealed affinity towards treating auto-immune diseases (diabetes, Crohn’s disease, graft-vs-host-disease), neurodegenerative disorders (Parkinson’s disease, Alzheimer’s) and cardiovascular diseases (acute myocardial infractions, ischemia).[4]

Deciding to store the umbilical cord tissue will give you the opportunity to take advantage of the therapeutic potential of stem cells in regenerative medicine. Umbilical cord tissue stored in cord blood banks represents an additional source of stem cells that may have both immediate and future applications. However, the choice to store your child’s umbilical cord tissue is only available to you once, therefore, think carefully while making your decision.

Sources used:

• http://www.bloodjournal.org/content/111/1/430.short?sso-checked=true
• http://www.ncbi.nlm.nih.gov/pubmed/23755729
• http://www.ncbi.nlm.nih.gov/pubmed/23998751
• https://stemcellres.biomedcentral.com/articles/10.1186/scrt394
• http://www.assembly.wales/NAfW%20Documents/hhs74_-_anthony_nolan.pdf%20-%2024012011/hhs74_-_anthony_nolan-English.pdf
• http://www.hindawi.com/journals/sci/2015/583984/#B30
• http://www.ncbi.nlm.nih.gov/pubmed/23895058

[1] What Makes Umbilical Cord Tissue-Derived Mesenchymal Stromal Cells Superior Immunomodulators When Compared to Bone Marrow Derived Mesenchymal Stromal Cells? – R. N. Bárcia,1 J. M. Santos,1 M. Filipe,1 M. Teixeira,1 J. P. Martins,1 J. Almeida,1 A. Água-Doce,2 S. C. P. Almeida,2 A. Varela,2 S. Pohl,3 K. E. J. Dittmar,3 S. Calado,4 S. I. Simões,4 M. M. Gaspar,4 M. E. M. Cruz,4 W. Lindenmaier,3 L. Graça,2 H. Cruz,1 and P. E. Cruz1

[2] R. I. Ganchas Soares, M. C. Baptista Coelho, J. M. Silva Santos, et al., Isolation Method of Precursor Cells from Human Umbilical Cord, edited by INPI, Medinfar, ECBio, Lisbon, Portugal, 2008.

[3] Banking Stem Cells From Umbilical Cord Tissue For Future Regenerative Medicine Applications – Rouzbeh R. Taghizadeh, PhD, & Kyle J. Cetrulo

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As the science of stem cells took off in the 1970s when doctors realized that the stem cells found in the blood inside an umbilical cord could offer a much more secure substitute to bone marrow transplants that may find its way in the utilization of treating conditions such as leukaemia, lymphoma, and sickle cell anemia. This is so since cord blood is power packed with multipotent, self-renewing hematopoietic stem cells (HSCs), which are the forerunners to blood cells.

The process of extracting this cord blood immediately after birth and storing it in state-of-art laboratories in India and overseas for future use is now a convenient and affordable reality for many Indians, thanks to health companies like Cordlife India. In fact, Cordlife is the only private Cord Blood Bank in India to offer automated cord blood processing with Sepax2, a versatile patented Swiss technology. This advanced technology enables easy handling and safety of processing and aids in highly efficient and consistent cell recoveries.

Once the umbilical cord has been clamped from the newborn, the cord blood is collected from the umbilical cord vein attached to the placenta. Cord Blood extraction is not only a painless process for both mother and baby unlike bone marrow extraction, but there is a 60% higher chance of matching cord blood unit in the family vis-a-vis bone marrow. Cord Blood cells are mature, flexible and have more usage advantages than stem cells extracted from the bone marrow or umbilical blood.

After cord blood is extracted, Stem Cell Banks preserve the stem cells via Cryopreservation. Under various such methods of Cryopreservation, any damage to the stem cells caused by any enzymatic or chemical activities is prevented by cooling to very low temperatures, without further damage being triggered by the formation of ice during freezing.

Stored Cord Blood can now be available between days or weeks of processing for treatment. There is a low risk of complications when cord blood is applied for stem cell transplants and therapy since they have the ability to regenerate in the desired way.

Globally, an estimated 35,000 transplants have taken place where cord blood stem have been utilized to treat over eighty life-threatening ailments, including Alzheimer’s, Parkinson’s, bone marrow failures, genetic disorders, blood disorders and immune disorders. Several medical professionals are also researching cord blood as a potential cure for conditions that cannot be remedied presently. Umbilical Cord Blood banking is no more an option, but a necessity to secure a healthy future for the entire family.

For more details about – Why Banking Umbilical Cord Blood should be on your “To Do” List? – visit https://www.cordlifeindia.com

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