STEM CELL THERABY FOR

SOME PARASITIC DISEASES

BY
ENAS FAKHRY
EMAN MAGDY

WHAT IS STEM CELL?

Stem cells are undifferentiated biological cells
that can differentiate into specialized cells and can
divide (through mitosis) to produce more stem cells.
They are found in multicellular organisms.

TYPES OF STEM CELLS

In mammals, there are two broad types of stem
cells: embryonic stem cells which are isolated
from the inner cell mass of blastocysts, and adult
stem cells, which are found in various tissues.

SOURCES OF AUTOLOGOUS ADULT STEM

CELLS IN HUMANS

Bone marrow, which requires extraction by harvesting.

Adipose tissue (lipid cells), which requires extraction by
liposuction.

Blood, which requires extraction through apheresis.

PROPERTIES OF STEM
CELLS
Self-renewal: the ability to go through
numerous cycles of cell division while maintaining
the undifferentiated state.

Potency: the capacity to differentiate into

specialized cell types .

The patients with parasitic infections, who usually

belong to the lower socioeconomic strata of our society,
have limited therapeutic options. Chemotherapy is virtually
the first choice for the treatment of many parasitic
infections. However, there is a worry about drug resistance
following long-term, repeated implementation of mass
drug administration. Stem cell therapy may help these
patients.

STEM CELL THERAPY

is an interventional treatment that introduces new cells into

damaged tissues, which help in treating many diseases and injuries.
is effective for the treatment of cancers, diabetes mellitus,
Parkinson's disease, Huntington's disease, cardiovascular diseases,
neurological disorders, and many other diseases.
Recently, stem cell therapy has been introduced to treat parasitic
infections.

THERAPUTIC ROLE OF
STEM CELLS IN PARASITIC
INFECTION

IN SCHISTOSOMIASIS

 Mesenchymal stem cells ameliorate S.japonicum induced

liver injury in mice through:

a. Reducing granuloma egg diameter,
b. Decreasing serum concentration of TGF-B1 and

hyaloronic acid;
c. Inhibiting collagen deposition and expression of collagen
type 3in infected mice liver tissues.

SO; prolong the survival time of the infected mice and this
effect is inhanced by combination with praziquantel.

 CD(133) human umbilical cord blood stem cells enhance hepatic

angiogenesis and neovascularization in expermintal animals ,SO,
enable prolifiration and survival of the damaged cells rather than
by direct differantiation to hepatocytes.

By immunohistichemical analysis the newly formed blood vessels

show +ve expression of human specific angiogenic markers
CD31,CD34 and von willebrand factors.

Transplantation of bone marrow-derived stem

cells hold a great potential in treating human
hepatic cirrhosis as they can:
a. Differentiate into hepatocytes;

b. Stimulate regeneration of endogenous

parenchymal cells;
c. Enhance fibrous matrix degradation.

IN MALARIA

Based on the finding that hemoglobin

variants protect from malaria, it is

hypothesized that stem cell engineering may

yield erythrocytes with new modified

hemoglobin that may protect against severe

malaria.

Scientists from the National Institute for Medical

Research, UK have identified an atypical progenitor

cells from malaria-infected mice which can give rise

to a lineage of cells capable of fighting this disease,
and transplantation of these cells into mice with
severe malaria helps mice recover from the disease.

MSCs play an important role in host protective

immune responses against malaria as they
increase IL- 12 production
suppress IL-10 production in recipient animals

and dramatic reductions of regulatory T cells in

animals undergoing infusion with these MSCs. .

 Glycophorin C (CD236R)receptors mediates vivax malaria

parasite rosetting to normocytes.
Rosetting assays using CD236R knockdown normocytes
derived from hematopoietic stem cells further supports the role
of glycophorin C as a receptor in P vivax rosette formation.
Blocking of spesific regions of CD236R significantly inhibit
rosette formation in P.vivax and P.falciparum.

IN CHAGAS DISEASE

Typical cardiac manifestations of Chagas disease

include dilated cardiomyopathy, congestive heart

failure, arrhythmias, cardio embolism, and stroke .

In mouse models of Chagas disease, bone marrow

mono- nuclear cell was found to be effective in:

a.

reducing inflammation and fibrosis induced by

T. cruzi,

b. prevented and reversed the right ventricular

dilatation caused by this protozoon.

 It has been shown that repeated injections of granulocyte

colony-stimulating factor (G-CSF), which mobilizes stem
cells from the bone marrow, decreases inflammation and
fibrosis in the hearts of chagasic mice.
While chagasic mice had 1,702 cardiac genes with
expression altered by infection, after bone marrow
mononuclear cell therapy, 96 % of these genes were
restored to normal levels

Small animal positron emission tomography

(microPET) is used to investigate the migration of
transplanted MSCs in a murine model of Chagas

disease, and correlate MSC bio-distribution with

glucose metabolism and morphology of heart in
chagasic mice .

 Cotransplant of stem cells and skeletal myoblasts is

functionally effective in the Chagas disease ventricular
dysfunction through:
improving ejection fraction (EF);

reducing left ventricular end- diastolic volume (LVEDV)

and left ventricular end-systolic volume (LVESV).

In 28 patients with heart failure due to Chagas

disease; intracoronary injection of bone marrow
mono- nuclear cells caused significant
improvements in the New York Heart
Association (NYHA) class, quality of life
;suggesting that it is feasible and it may be

potentially safe and effective in these patient.