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Stem Cell- Review

Stem Cell- Review

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Potential Applications in Dentistry
Potential Applications in MEDICINE
Dr. Anand Pratap Singh,
Department of Oral Medicine & Radiology,
Rungta College of Dental Sciences and Research, Kohka-Kurud Road,
Bhilai-Durg (India)-490023.
Ph: +91-9425293935
E-mail: anandsingh001@gmail.com
Potential Applications in Dentistry
Potential Applications in MEDICINE
Dr. Anand Pratap Singh,
Department of Oral Medicine & Radiology,
Rungta College of Dental Sciences and Research, Kohka-Kurud Road,
Bhilai-Durg (India)-490023.
Ph: +91-9425293935
E-mail: anandsingh001@gmail.com

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Published by: Dr.Anand Pratap Singh on Jul 18, 2012
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01/03/2013

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International Journal of Oral & Maxillofacial Pathology. 2012;3(2):37-42
ISSN 2231
 –
2250
 Available online athttp://www.journalgateway.comor www.ijomp.org  ©2012 International Journal of Oral and Maxillofacial Pathology. Published by Publishing Division, Celesta Software Private Limited. All Rights Reserved
Stem Cells - Biological Solution to Biological Problems: A Review
 Anand Pratap Singh, Ankita Tandon, Sheetal Mujoo, Rajesh Mishra
Abstract
Hope is a prerequisite for any successful scientific innovation. Recent scientific discoveries in andmolecular biology have been revolutionized and this new understanding of the biologicalprocesses will have great impact and change our lives in future. Stem cells have beensuccessfully isolated from various human tissues including orofacial tissues. Research on stemcells continues to advance knowledge about how an organism develops from a single cell andhow healthy cells replace damaged cells in adult organisms. Stem cell research is one of the mostfascinating areas of contemporary biology, but, as with many expanding fields of scientific inquiry,research on stem cells raises scientific questions as rapidly as it generates new discoveries.Recent advances in stem cell biology and regenerative medicine have given opportunities for tissue engineering as well as gene based approaches in medical-dental therapies and are likely torevolutionize the entire health care delivery. Stem cells offer new potential to treat diseases, toscreen new drugs in laboratory and to develop model systems to study normal growth and identifythe causes of birth defects. Thus, by giving their unique regenerative abilities, stem cells offer newpotential for treating diseases and has brought in a lot of optimistic hope amongst researchers,doctors, and the patients who are the chief beneficiary of this innovation. The present articlereviews the various characteristics of stem cells & their applications in health care.
Key words:
Progenitor Cells;Regeneration;Adult;Embryonic Stem Cells;Totipotent; Pleuripotent;
 
Multipotent;Biological Therapy;Biomedical Stem Cell Research.
 
Anand Pratap Singh, Ankita Tandon, Sheetal Mujoo, Rajesh Mishra. Stem Cells - Biological Solution to Biological Problems: A Review. International Journal of Oral and Maxillofacial Pathology; 2012:3(2):00-00.©International Journal of Oral and Maxillofacial Pathology. Published by Publishing Division, Celesta Software Private Limited. All Rights Reserved.
Received on: 13/03/2011 Accepted on: 19/05/2012
Introduction
Cell is the basic unit of life. All human beingsdevelop from the union of an egg and asperm. The result is a fertilized egg, or zygote, a single cell that divides into other cells, which together constitute the earlyembryo.
1
The first few of the early embryoniccells are totipotent.
2
About two to elevendays after conception, a zygote divides intoabout 100 to 150 cells which form of ahollow ball called a blastocyst
1
, with a massof undifferentiated cells inside it. Theseundifferentiated cells are used to generateembryonic stem cell lines. These embryonicstem cells are pluripotent and are capable of differentiating into all the types of cells thatcomprise a human being.
3
 It has been observed that several tissues inthe body (such as blood, skin, andgastrointestinal tract) undergo rapid renewal,and have regenerative ability. Thisobservation led to hypothesize that thetissues with the regenerative potential maycontain cells that initiate their replacement.
These cells are termed as “stem cells”. The
stem cells are uncommitted entities with acapability of indefinite self-renewal to giverise to more stem cells and to differentiateinto a number of specialized daughter cellsto perform specific function.
4,5
Thus, stem
cells are „the pioneer‟ of regenerative
therapy.These cells were firstly suggested byDanchakoff and by Sabin andMaximowmay.
6
Stem cell technology is anupcoming field, but the regeneration of bodypart is not a new concept as theregeneration of lizard tail (330 BC)
7
andbone marrow transplantation (1950s)
8
hasbeen previously reported. Recentrevolutionization in cellular, molecular anddevelopmental biology along withreplacement of chemistry by biotechnology
7
 has diverted our concentration towards
“biological solutions to biological problems‟‟,
and an extraordinary ability of stem cell toself-renew and differentiating into one or more specialized cell types and function
9
,
has introduced “the stem cell therapy” as a„new optimistic hope” in medicine and
dentistry.
 
Review Article
 
38
Anand Pratap Singh et al.,
ISSN 2231 - 2250
 
Properties
Stem cells are unspecialized cells. Self-renewal and differentiation potential are twodefining properties of stem cells.
10
Self-regeneration is the ability of stem cells todivide and produce more stem cells.
11
 During early development, the cell division issymmetrical and daughter cells have thesame potential. Later in development, thecell divides asymmetrically and gives rise toone daughter stem cell and one progenitor cell.
12
The progenitor cell (derived from germlayer stem cells) is responsible to producespecialized cell with special function bydifferentiation
13
and is also called as Transit-amplifying cells, Precursor cells, Lineagestem cells, and Tissue-determined stemcells. Progenitor cell undergoesasymmetrical, while a stem cell undergoessymmetrical cell division.
14
 After the differentiation, most of theembryonic stem cells lose their ability todifferentiate further and act as morespecialized cells (process calleddetermination). Only a small number of cellsretain some ability to differentiate and calledas the adult stem cells.
15,16
Thesemultipotent cells replenish and repair manycells of the body.
17
Hierarchy sequence of stem cells during differentiation occurs as:zygote (totipotent), embryonal stem cells(pleuripotent), germ layer stem cell(multipotent), lineage stem cell or transit-amplifying cells (oligopotent), tissue-determined stem cell (tri or bi-potent) andterminal cell (nullipotent).
18
 
Classification and Sources
19-21
 
Stem Cells can be classified according totheir origin, potential for differentiation(characteristics), different models of cellular differentiation and capacity for tissue re-population
in vivo 
in short, medium or longtime regeneration.I.
Based on Origin,
they
 
can be classifiedinto four broad types:
a) Stem Cells From Embryo
Blastocyst (5 - 7 days) embryonicstem cells.
Gonadal ridge (6 week) embryonicgerm cells.
b) Stem Cells From Fetus
Abortus (Fetal tissues) fetal stemcells.
c) Stem Cells From Infant
Umbilical cord blood stem cells.
 
Wharton‟s
Jelly Umbilical cordmatrix stem cells.d)
Stem Cells From the Adult
 
Germline Spermatogonia andOogonia.
Somatic Hemopoietic (Bone marrowand Peripheral Blood),Mesenchymal (Bone marrowStroma), Liver, Epidermal (skin,hair), Neuronal, Eye, Gut, Pancreas.II.
Based on Differentiation Potential
 which ranges from totipotent tonullipotent cells:a)
Totipotent
: Generate all types of cellsincluding germ cells.b)
Pluripotent
: Generate all types of cellsexcept cells of the embryonicmembrane.c)
Oligopotent
: Differentiate into five typesof blood cells (monocytes,macrophages, eosinophils, neutrophilsand erythrocytes).d)
Multipotent
: Differentiate into more thanone mature cell (skeletal muscle, cardiacmuscle, liver cells, all blood cells).e)
Quadripotent
: Differentiate into four types of cells (cartilage cells, fat cells,stromal cells and bone-forming cells).f)
Tripotent
: Differentiate into three typesof cells (2 types of astrocytes andoligodendrocytes).g)
Bipotent
: Differentiate into two types of cells (b cells and macrophages).h)
Unipotent
: Differentiate into single typeof cell (mast cells).i)
Nullipotent
: No cell division and areterminally differentiated like red bloodcells. j)
Self-renewal
: Divide withoutdifferentiation and create everlastingsupply.k)
Plasticity
: Mature cells have plasticityand can undergo differentiation. Thetrigger for plasticity is stress or tissueinjury which up regulates the stem cellsand releases chemo-attractants andgrowth factors.
III. Based on Different Models of CellularDifferentiation
a.
Direct-Differentiating
: A specific type of cell developed in a multistepunidirectional pathway.b.
Trans-Differentiating
: Directconversion of one cell type to another different cell type.c.
De-Differentiating
: A unipotent stemcell becoming a multipotent.d.
Cell Fusion
: A stem cell fusing with asomatic cell resulting in another lineage.
 
ISSN 2231
 –
2250
Stem Cells - Biological Solution to Biological Problems....
.
39
Potential Applications in Medicine
Stem cells are being explored for a variety of chronic debilitating diseases that have so far escaped remedial measures from traditionalallopathic approaches with a hope that celltherapy would repair, repopulate, replace,and rewire tissues and organs regeneratinghope and kindling confidence in suchtherapies. In the medical science, stem cellresearch is directed towards: braindamage
8,22
, cancer 
23,24
, spinal cord injury
24
,heart damage
25,26
, haematopoiesis
27
,baldness
24
, deafness
8
, blindness and visionimpairment
12
, p
arkinson‟s disease
24,28,29
,
alzheimer‟s disease
24
, amyotrophic lateralsclerosis, multiple sclerosis, muscledamage, diabetes
30
, diabetic foot ulcer 
30
,diabetic neuropathy
29
, diseases such assevere combined immunodeficiencydisease
30
, wiskott-aldrich syndrome, bonediseases
31,32,33
the autoimmune diseaselupus, as well as AIDS and a number of other impairments and conditions.
34
Potential Applications in Dentistry
The regenerative potential of adult stemcells obtained from various sourcesincluding dental tissues has been of interestfor clinicians over the past years. Theproperty of stem cells to reach the site of injury or disease makes them suitable in cellbased therapy. The two common methods of cell delivery are intravenous injection andcell encapsulation systems.
36
In the field of dentistry, stem cell research is directedtowards achieving the following:Regeneration of damaged coronal dentineand pulp,
36
regeneration of resorbed root
37
,cervical or apical dentin and perforations
36,37
,periodontal regeneration
38
, craniofacialdefects by osteogenesis
39
, whole toothregeneration
40,41
(Figure 1) and treatment of oral mucosal lesions
37
(oral submucousfibrosis, oral lichen planus, dyskeratosiscongenita, premalignant lesions likeleukoplakia, recurrent oral ulcers, graftversus host disease and oral cancers). Advances in the isolation and understandingof dental stem cells have opened areas of 
research into the possibility to „regrow‟ lost
dental tissues. This may not only preventtooth loss but also fundamentally change theconcept and definition of a dental caregiver.The impact of this source of stem cells iseven more far-reaching for the medical field.Current research is exploring the capabilityof the dental stem cells to differentiate intonon-dental tissues such as cardiac muscle.Previously untreatable patients may now beimproved by using stem cells harvested fromtheir own teeth.
42
Figure 1: Development of bioengineeredtooth.Mesenchymal-originated dental stem cellspossess a high self-renewal capacity andthe potential to differentiate into mesodermallineages thus forming cartilage, bone,adipose tissue, skeletal muscle, and thestroma of connective tissues. Mesenchymalprogenitors have been assessed for toothengineering purposes, such as progenitorsderived from teeth and bone marrow.
43
Stemcells from human exfoliated deciduousteeth
44
, Dental pulp stem cells
45
, Stem cellsfrom the apical part of the papilla
46
, Dentalfollicle stem cells
47
, Periodontal ligamentstem cells
48
, Bone marrow-derivedmesenchymal stem cells
49
are examples of mesenchymal-originated dental stem cells.The major problem with epithelium-originated dental stem cells is that dentalepithelial cells such as ameloblast and itsprecursors are eliminated soon after tootheruption. Therefore, epithelial cells thatcould be stimulated in vivo to form enamelare not present in the human adult teeth.
43
Stem Cell Banking
Cord stem cell preservation consists of collecting the 'leftover' umbilical cord bloodfrom the placenta and umbilical cord after the baby is delivered and the cord is cut.
50
 This blood is sent to a bank where it isprocessed and preserved by freezing themin liquid nitrogen at temperature of -195
o
C.Many clinical studies showed that unrelatedcord blood transplantation is safe and is anacceptable alternative to bone marrowtransplantation for many patients. However,the studies also found that, as with bonemarrow transplants, patients who receive

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