MXPA04007732A - Embryonic-like stem cells derived from post-partum mammalian placenta and uses and methods of treatment using said cells. - Google Patents
Embryonic-like stem cells derived from post-partum mammalian placenta and uses and methods of treatment using said cells.Info
- Publication number
- MXPA04007732A MXPA04007732A MXPA04007732A MXPA04007732A MXPA04007732A MX PA04007732 A MXPA04007732 A MX PA04007732A MX PA04007732 A MXPA04007732 A MX PA04007732A MX PA04007732 A MXPA04007732 A MX PA04007732A MX PA04007732 A MXPA04007732 A MX PA04007732A
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- Mexico
- Prior art keywords
- cells
- stem cells
- embryonic
- stem
- administration
- Prior art date
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Abstract
The present invention provides compositions and methods of using embryonic-like stem cells that originate from a post-partum placenta with conventional cord blood compositions or other stem or progenitor cells. The embryonic-like stem cells can be used alone or in a mixture with other stem cell populations. In accordance with the present invention, the embryonic-like stem cells may be mixed with other stem cell populations, including but not limited to, umbilical cord blood, fetal and neonatal hematopoietic stem cells and progenitor cells, human stem cells and progenitor cells derived from bone marrow. The embryonic-like stem cells and the mixed populations of embryonic-like stem cells and stem cells have a multitude of uses and applications, including but not limited to, therapeutic uses for transplantation and treatment and prevention of disease, and diagnostic and research uses.
Description
STEM CELLS SIMILAR TO THE EMBRYONARY, DERIVED FROM THE
PLACENTA OF MAMMALS AFTER DELIVERY AND USES AND METHODS OF TREATMENT USING SUCH CELLS
1. FIELD OF THE INVENTION The present invention relates to the use of embryonic-like stem cells that originate from a placenta after delivery with conventional cord blood or other stem or progenitor cells. Embryonic cells similar to embryonic cells can be used alone or in a mixture with other populations of stem cells. In accordance with the present invention, embryonic-like stem cells can be mixed with other populations of stem cells, including but not limited to, umbilical cord blood, fetal and neonatal hematopoietic stem cells and progenitor cells, stem cells and human progenitor cells derived from the bone marrow. Embryonic-like stem cells and mixed populations of embryonic-like stem cells and stem cells have a multitude of uses and applications, including but not limited to, therapeutic uses for transplantation, diagnostic uses and research. Stem cells similar to embryonic and mixed populations are also useful in the treatment of diseases or disorders, including vascular diseases, diseases or neurological disorders, diseases or. autoimmune disorders, diseases or disorders that involve inflammation, and cancer or the disorders associated with them. In particular, embryonic-like stem cells or mixtures that include them are administered in high doses and without HLA typology. . 2. BACKGROUND OF THE INVENTION There is considerable interest in the "identification, isolation and generation of human stem cells. Human stem cells are totipotent or pluripotent precursor cells capable of generating a variety of mature human cell lineages. This ability serves as the basis for cell differentiation and specialization necessary for the development of organs and tissues. Recent successes in the transplantation of such stem cells have provided new clinical tools for reconstituting and / or supplementing the bone marrow after myeloblation due to the disease, exposure to toxic chemicals and / or radiation. There is additional evidence that shows that stem cells can be used to repopulate many, if not all, tissues and restore physiological and anatomical functionality. The application of stem cells in tissue engineering, administration of genetic therapy and cellular therapeutics, is also advancing rapidly. Many different types of mammalian stem cells have been characterized. For example, embryonic stem cells, embryonic germ cells, adult stem cells or other stem cells or involved progenitor cells are known. Certain stem cells have not only been isolated and characterized but also have been cultured under the conditions to allow differentiation to a limited extent. A basic problem remains, however, because obtaining sufficient quantities and populations of human stem cells which are capable of differentiation in all types of cells is almost impossible. Stem cells exist in a critically scarce supply. These are important for the treatment of a wide variety of disorders including malignancies, inborn errors of metabolism, hemoglobinopathies, and immunodeficiencies. · It would be highly advantageous to have a source of more cells. embryonic mother. Obtaining sufficient numbers of stem cells has been problematic for several reasons. First, the isolation of stem cell populations that normally occur in adult tissues has been technically difficult, due in part to the very limited amount found in the blood or tissues. Secondly, the procurement of these cells from embryos of fetal tissue including abortions, has led to religious and ethical concerns. The widely held belief that human embryos and fetuses constitute independent living has prompted governmental restrictions on the use of such sources for all purposes, including medical research. Alternative sources that do not require the use of cells procured from embryonic or fetal tissue are therefore essential for further progress in the clinical use of stem cells. There are, therefore, few viable alternative sources of stem cells, particularly human stem cells, and therefore the supply is limited. Furthermore, the collection of stem cells from alternative sources, in amounts suitable for therapeutic and research purposes, is generally laborious, for example, collection of cells or tissues from a subject or patient 'donor, culture1 and / or propagation of the In vitro cells, dissection, 'etc. For example, Caplan et al., (North American Patent No.
5,486,359 entitled "Human mesenchymal stem cells," published January 23, 1996), describes compositions of mesenchymal stem cells (hMSCs) derived from bone marrow, which serve as progenitors for mesenchymal cell lineages. Caplan et al. describes that h SCs are identified by specific cell surface markers that are identified with monoclonal antibodies. The homogeneous hMSC compositions are obtained by the positive selection of adherent pessary or periosteal cells that are free of the markers associated with either the hematopoietic or cells. differentiated mesenchymal cells. These populations of isolated mesenchymal cells display epitopic features associated with mesenchymal stem cells, have the ability to regenerate in cultures without differentiation, and have the ability to differentiate into specific mesenchymal lineages when they are introduced either in vitro or in vivo. the site of the damaged tissue. The disadvantage of such methods, however, is that they require the collection of spinal or periosteal cells from a donor, from which the MSCs must subsequently be isolated. Hu et al. (WO 00/73421 entitled "Methods of isolation, cryopreservation, and therapeutic use of human amniotic epithelial cells", published on December 7, 2000) describes the human amniotic epithelial cells derived from the placenta at delivery, which are isolated, they cultivate, cryopreserved for future use, or they are induced to differentiate. According to Hu et al. , a placenta is collected immediately after delivery and the amniotic membrane is separated from the chorion, for example, by dissection. Amniotic epithelial cells are isolated from the amniotic membrane according to standard techniques for cell isolation. The cells described can be cultured in various media, expanded in the culture, cryopreserved, or induced to differentiate. Hu et al., describes that the amniotic epithelial cells are multipotential (and possibly pluripotent), and can be differentiated into epithelial tissues such as the epithelium of the corneal surface or the vaginal epithelium. The disadvantage of such methods, however, is that they require a lot of work and the performance of the stem cells at very low. For example, to obtain sufficient numbers of stem cells for typical therapeutic or research purposes, amniotic epithelial cells should be isolated first from the placenta or umbilical cord tissue, by dissection and cell separation techniques, then cultured and expanded in vitro. Umbilical cord blood ("cord blood") is a known alternative source of hematopoietic progenitor stem cells. Cord blood stem cells are routinely cryopreserved for use in hematopoietic reconstitution, a therapeutic procedure widely used in bone marrow transplants and other related transplants (see, for example, Boyse et al US 5,004,681, "Preservation. of Fetal and Neonatal Hematopoietin Stem and Progenitor Cells of the Blood ", Boyse et al., US Patent No. 5,192,553, entitled" Isolation and preservation of fetal and neonatal hematopoietic stem and progenitor cells of the blood and methods of therapeutic use ", published on March 9, 1993). Conventional techniques for cord blood collection are based on the use of a needle or cannula, which is used with the aid of gravity to drain cord blood (ie, draw blood) from the placenta (Boyse et al. al., U.S. Patent No. 5,192,553, published March 9, 1993; Boyse et al., U.S. Patent No. 5,004,681, published April 2, 1991; Anderson, U.S. Patent No. 5,372,581, entitled "Method and apparatus for placental" blood collection, published on December 13, 1994; Hessel et al., US Patent No. > 5,415,665, entitled Umbilical cord clamping, cutting, and blood collecting device and method, published May 16, 1995). The needle or cannula is usually placed in the umbilical vein and the placenta is massaged gently to aid in drainage of the cord blood from the placenta. Later, however, it has been considered that the drained placenta is no longer used and has typically been discarded. A major limitation of the procurement of cord blood stem cells has been the often inadequate volume of cord blood obtained, which results in insufficient cell numbers to effectively reconstitute the bone marrow after transplantation. Naughton et al. (US Patent No. 5,962,325 entitled "Three-dimensional stromal tissue cultures" published October 5, 1999) describes which fetal cells, including fibroblast-like and progenitor cells of chondrocytes, can be obtained from cord tissue umbilical or the placenta or umbilical cord blood. Kraus et al., (US Patent No. 6,338,942, entitled "Selective expansion of target cell populations", published January 15, 2002) describes that a predetermined target population of cells. it can be selectively expanded by introducing an initial sample of cells from cord blood or peripheral blood, into a growth medium, causing the cells of the target cell population to divide, and contacting the cells in the growth medium with a selection element comprising specific affinity binding molecules (such as a monoclonal antibody to CD34) for a predetermined population of cells (such as CD34 cells), to select cells from the predetermined target population of other cells in the Growth medium. Rodgers et al. (US Patent No. 6,335,195 entitled "Method for promoting hematopoietic and mesenchymal cell proliferation and differentiation" published January 1, 2002) describes methods for the ex vivo cultivation of hematopoietic and mesenchymal stem cells and the introduction of proliferation and differentiation of lineage-specific cells by culture in the presence of angiotensinogens, angiotensin I (AI), analogues of AI, fragments of AI and analogs thereof, angiotensin II (AII), analogs, of AII, fragments of AII or analogs thereof or agonists of the ATII type 2 AII receptor, either asylated or in combination with other growth factors and cytosines.Mother cells are derived from bone marrow, peripheral blood or umbilical cord blood.The disadvantage of such methods , however, - is that such ex vivo methods to introduce proliferation and differentiation of stem cells are slow, as cute above, and they also result in low yields of stem cells. Because of the restrictions on the collection and use of stem cells, and the inadequate numbers of cells typically collected from cord blood, the stem cells are in a critically scarce supply. Stem cells have the potential to be used in the treatment of a wide variety of disorders, including malignancies, inborn errors of metabolism, hemoglobinopathies, and immunodeficiencies. There is a critical need for an easily accessible source of large numbers of stem cells for a variety of therapeutic purposes and other medically related purposes. The present invention addresses that need and others. Additionally, a need remains here for the treatment of neurological conditions such as amilotropic lateral sclerosis (ALS). Although recent studies using irradiated mouse models for, familial ALS, a less common form of ALS, have suggested that umbilical cord blood may be useful in the treatment of this disease, the publication of the source discussed above makes this option less than ideal. See Ende et al '. , Life Sci. 67: 53059 (2000). Therefore, a need remains here for populations of stem or progenitor cells that can be used to treat diseases, particularly large amounts of these populations when diseases such as ALS are being treated.
3. BRIEF DESCRIPTION OF THE INVENTION The present invention relates to cord blood compositions or stem or progenitor cells thereof in which said compositions are supplemented with or in contact with embryonic-like stem cells originating from a placenta after childbirth. Embryonic-like stem cells which are the target of other applications, can be used here, as a composition or a. mix with other populations of stem or progenitor cells. In accordance with the present invention, embryonic-like stem cells can be contacted with other populations of stem or progenitor cells, including but not limited to umbilical cord blood, fetal and neonatal stem cells and hematopoietic progenitor cells, stem cells and progenitor cells derived from human bone marrow. Embryonic-like stem cells and mixed populations of embryonic-like stem cells and stem or progenitor cells have a multitude of uses and applications, including but not limited to, therapeutic uses for transplantation and the treatment and prevention of diseases, and uses of diagnosis and research. In accordance with the present invention, stem cell populations are mixed with embryonic-like stem cell populations to supplement, augment or ameliorate the concentrations of pluripotent or multipotent stem cells in stem cell populations, for example, in one embodiment, umbilical cord blood, or stem cells or progenitors thereof, are augmented or brought into contact with the embryonic-like stem cells of the invention, prior to administration to the patient. It is recognized what the embryonic stem cells look like. they can also be administered simultaneously or sequentially with the blood of the umbilical cord, or the cells thereof. However, it is preferred to contact the cells of each before administration. Embryonic-like stem cells of the invention can be characterized by the presence of the following cell surface markers: CD10, CD29, CD44, CD54, CD90, SH2, SH3, SH, OCT-4 and ABC-p , and the absence of the following cell surface markers: CD34, CD38, CD45, SSEA3 and SSEA4. In a preferred embodiment, such embryonic-like stem cells can be characterized by the presence of the markers of. the OCT-4 APC-p cell surface Embryonic-like stem cells that originate from the placenta have the characteristics of embryonic stem cells but are not derived from embryos. In other words, the invention encompasses mixtures of cord blood and embryonic-like stem cells isolated from placentas that are 0CT-4 + and / or ABC-p +. Such embryonic-like stem cells are as versatile (eg, pluripotent) as human embryonic stem cells. In accordance with the present invention, the populations of stem cells are mixed with the embryonic-like stem cells, which are pluripotent or mult ipotent. Such embryonic-like cells can be isolated from the placenta flooded at different times, for example, hematopoietic cells CD34 + / CD38 +, CD34 + / CD38-, and CD34- / CD38-. In one embodiment, such cells can be used to supplement populations of hematopoietic stem cells, such as those found in umbilical cord blood, in accordance with the methods of the invention. The invention also provides a composition in which a mixture of stem cells with embryonic-like stem cells is contained within a bag or container. In a preferred embodiment, the composition is a pharmaceutically acceptable unit dose composition. In another modality, the invention provides a composition in which a population of stem cells and a population of embryonic-like stem cells are contained within two separate pockets or containers. In certain embodiments, such a "two-bag" game can be mixed before, in particular immediately before, or at the time of administration to a patient in need thereof. In other embodiments, the contents of each bag can be administered separately to a patient, wherein the mixing of the two cell populations occurs in vivo. In other embodiments, the container is sealed, air tight, and sterile. The present invention relates to populations of stem cells mixed with embryonic-like stem cells. In accordance with the present invention, stem cells that can be mixed with embryonic-like stem cells include, but are not limited to, umbilical cord blood, stem cells and progenitor, hematopoietic, fetal and neonatal cells, stem cells and progenitor cells of human, derived from the bone marrow. In a preferred embodiment of the present invention, the embryonic-like stem cells are mixed with umbilical cord blood.The present invention also provides methods for treating a patient in need thereof by administering a population. of stem cells supplemented with embryonic-like stem cells In one embodiment, the supplementation of the cord blood cell population with embryonic-like stem cells occurs by mixing the stem cells and the embryonic-like cells before the administration to the patient of the combined or "pinned" population In another embodiment, the population's supplementation of stem cells with embryonic-like stem cells occurs after administration of the population supplemented to the patient, for example, by administration simultanea of cord blood cells and stem cells' sim In another embodiment, the supplementation of the stem cell population with the embryonic-like stem cells occurs after the administration of the cord blood cells to the patient, for example, by administering the. embryonic stem cells separately from, and before or after, the administration of the stem cells. According to the invention, stem cell populations, for example, umbilical cord blood, supplemented with embryonic stem cells from the placenta, have a multitude of uses, including prophylactic, therapeutic and diagnostic uses. The populations supplemented with stem cells can be used for transplantation and / or to treat or prevent diseases. In one embodiment of the invention, the supplemented populations of cells are used to renew and replenish tissues and organs, thereby replacing or repairing diseased tissues, organs or portions thereof. In another embodiment, populations supplemented with stem cells can be used as a diagnostic to select genetic disorders or a predisposition for a disease or disorder. In another embodiment, the invention provides a method for isolating other embryonic and / or multipotent or pluripotent stem cells from an extract or perfusate of a placenta from which blood has been extracted and using them to supplement cell populations. . of cord blood according to the methods of the invention. The present invention also provides pharmaceutical compositions comprising populations of stem cells, for example, umbilical cord blood cells, which have been supplemented with one or more populations of embryonic-like stem cells of the invention. The present invention provides an isolated population, homogeneous, of human placental stem cells that have the potential to differentiate into all types of cells: In another embodiment, the population of human placental stem cells has the potential to differentiate; in a type of cells. In yet another embodiment, the stem cell population of the human placenta has the potential to differentiate into several different cell types. Such cells can be used to supplement populations of stem cells, for example, umbilical cord blood, according to the methods of the invention. The invention also encompasses pharmaceutical compositions comprising populations of hematopoietic stem cells, supplemented with one or more populations of cells having high concentrations (or major populations) of hematopoietic stem cells. homogeneous including, but not limited to, CD34 + / CD38 - cells; CD34- / CD38- cells, and CD133 + cells. One or * more of these cell populations can be used with, b mixed with, hematopoietic stem cells, i.e. CD34 + / CD38 + hematopoietic cells, obtained from umbilical cord blood or other sources, for transplantation and other uses. The present invention also provides methods for mixing a population of stem, progenitor or cord blood cells, including cells. deposited in a bank or cryopreserved, with a population of stem cells similar to embryonic ones. In one modality, the two populations are physically mixed. In another aspect of this embodiment, the two populations are physically mixed and then treated with a growth factor, eg, a cytosine and / or an interleukin, to induce cell differentiation. In another aspect of this embodiment, stem cells and / or embryonic-like stem cells are treated with a growth factor, eg, a cytosine and / or an interleukin, to induce cell differentiation and then physically mixed. In one embodiment, the mixed populations are treated with a 'growth factor to induce differentiation in a variety of cell types. In another embodiment, the mixed populations are treated with a »growth factor to induce differentiation to a" particular type of cells. "In another embodiment, the mixed populations are treated with a growth factor to prevent or suppress differentiation at a particular type. In certain embodiments, the culture conditions can be controlled, for example, the mixed cell population can be treated with a specific cocktail of cytokines or interleukins, to direct or induce differentiation to a specific type of cells. In another embodiment, the invention provides a method for treating a patient in need thereof comprising the administration of a plurality of umbilical cord blood cells and a plurality of embryonic-like stem cells. another embodiment, the invention provides a method for treating myelodysplasia, which comprises, administering cell those of umbilical cord blood (or stem cells isolated from it) and embryonic-like stem cells to a patient in need of them. The invention also relates to new Uses of human placental stem cells (stem cells similar to embryonic ones). Also included here are methods for treating or preventing diseases with the compositions containing the embryonic-like stem cells and other stem or progenitor cells or sources thereof. Similarly, methods for dosing such compositions are encompassed. Finally, it should be noted that the compositions of the invention may contain populations of stem cells or progenitors of multiple donors. The invention includes the use of compositions not paired with HLA in patients as well as compositions. paired with HLA. Correspondence of the blood type with the patient is preferred but is not required when using compositions containing both embryonic-like stem cells and stem or progenitor cells.
3. 1. DEFINITIONS As used herein, the term "birereactor" refers to an ex vivo system for propagating cells, producing or expressing biological materials and increasing or culturing cells, tissues, organoids, viruses, proteins, polynucleotides and microorganisms. As used herein, the terms "cord blood" and "umbilical cord blood" are interchangeable. As used herein, the term "embryonic stem cells" refers to cells that are derived from the internal cell mass of a blastocyst (e.g., a human embryo 4 to 5 days old) and which are pluripotent. As used herein, the term "embryonic-like stem cells" refers to cells that are not derived from the internal cell mass of a blastocyst. As used herein, "embryonic-like stem cells" may also be known as "placental stem cells," preferably human placental stem cells derived from a placenta spread after delivery. Embryonic-like stem cells are preferably pluripotent. However, stem cells which can be obtained from the placenta include, embryonic-like stem cells, multipotent cells, and involved progenitor cells. According to the methods of the invention, the embryonic stem cells derived from the placenta can be harvested from the isolated placenta once the blood has been extracted and spread for a sufficient period of time to remove the residual cells. As used herein, the term "extracted blood" or "draw blood", when used with respect to the placenta, refers to the removal and / or drainage of substantially all the blood from the placental cord. In accordance with the present invention, the removal of blood from the placenta can be achieved, for example, but not by way of limitation, by draining, gravity-induced flow, massage, constriction, pumping, etc. In a preferred embodiment, The extraction of blood from the placenta can also be achieved by flooding, rinsing or emptying the placenta with a fluid that may or may not contain agents, such as anticoagulants, to aid in the removal of blood from the placenta As used herein, the term "mix" means to combine or mix in a club or mix; put together in a mass so that the constituent parts are more or less homogeneous; create or form by combining the ingredients; form by alloy, augmentation, supplementation or mixing, or add an ingredient or element to another ingredient or element, and vice versa.
As used herein, the term "flood or perfuse" or "perfusion or flood" refers to the act of pouring or passing a fluid over or through an organ or tissue, preferably, the passage of fluid through an organ or tissue with sufficient force or pressure to remove any residual cells, for example, non-adherent cells of the organ or tissue. As used herein, the term "perfused" refers to fluid collected immediately upon passage through an organ or tissue. In a preferred embodiment, the perfusate contains one or more anticoagulants. '
As used herein, the term "exogenous cells" refers to "foreign" cells, i.e., a heterologous cell (i.e., a "non-auto" cell derived from a source other than the placental donor). ) or autologous cell (ie, an "auto" cell derived from the "placental donor") that is derived from an organ or tissue different from the placenta. As used herein, the term "organoid" refers to an aggregation of one or more types of cells assembled in surface appearance or in their current structure as any organ or gland of a mammalian body, preferably the human body. As used herein, the term "multipotent cells" refers to cells that have the ability to grow in any of a subset of the approximately 260 types of cells in the body of a mammal. Unlike the pluripotent cells, multipotent cells - do not have the capacity to form all types of cells. As used herein, the term "pluripotent cells" refers to cells that have complete differentiation versatility, i.e., the ability to grow in any of the approximately 260 types of cells in the body of a mammal. The pluripotent cells can be self-renewing, and can remain latent or inactive within a tissue. Unlike totipotent cells (eg, egg, diploid, fertilized cells), embryonic stem cells usually can not form a new blastocyst. As used herein, the term "progenitor cells" refers to cells that are committed to differentiating into a specific type of cells or forming a specific type of tissue. , * As used herein, the term "stem cells" refers to master cells that can reproduce indefinitely to form specialized cells of tissues and organs. Stem cells are pluripotent or multipotent cells from the point of view of development. The stem cells can be divided to produce two daughter stem cells, or a daughter and a progenitor ("transient") cells, which then proliferate into mature, fully formed cells of the tissue. The "stem cells" used herein include the "progenitor cells" unless otherwise indicated. As used herein, the term "totipotent cells" refers to cells that are capable of forming a complete embryo (e.g., a blastocyst). 4. DETAILED DESCRIPTION OF THE INVENTION The present invention is based in part on the unexpected discovery that embryonic-like stem cells, produced by blood-filled, flooded and / or cultured placentas, are pluripotent stem cells which can be easily differentiated, in any type of cells desired. These "embryonic-like" stem cells can be used to supplement, augment or ameliorate stem cell populations, including, but not limited to, umbilical cord blood, fetal and neonatal hematopoietic progenitor and stem cells, stem cells and cells human progenitors derived from the bone marrow According to the present invention, stem cell populations are mixed with embryonic-like stem cell populations to supplement, increase, or improve concentrations of pluripotent and multipotent stem cells in populations of Stem Cells According to the present invention, populations of stem cells mixed with populations of embryonic-like stem cells have a multitude of uses and applications, including but not limited to, therapeutic uses for transplantation and treatment and prevention. of diseases, and their diagnosis and research The invention also provides a composition in which a mixture of cells, stem and embryonic-like stem cells is obtained inside a bag or container. In another embodiment, the invention provides a composition in which a population of stem cells and a population of embryonic-like stem cells are contained within two separate pockets or containers. In certain embodiments, such a "two-bag" composition can be mixed before, in particular immediately before, or at the time of administration to a patient in need thereof. In other embodiments, the contents of each bag can be administered separately to a patient, wherein populations of two cells are used adjunct in vivo. The present invention also provides methods for mixing a population of stem or progenitor cells or cord blood, including cord blood deposited in banks or cryopreserved with a population of embryonic-like stem cells. In a modality, the two populations are physically mixed. In one aspect of this embodiment, the two populations are physically mixed-and then treated with a growth factor, eg, a cytosine and / or an interleukin, to induce cell differentiation. In another aspect of this invention, stem cells and / or embryonic-like stem cells are treated with a growth factor, for example a cytosine and / or an interleukin, to induce cell differentiation, and then physically mixed. . The present invention also provides methods for mixing a population of compromised cells, for example, a population of cells compromised to differentiate into neurons, muscle cells, hematopoietic cells, vascular cells, adipocytes, chondrocytes, osteocytes, hepatocytes, pancreatic or cardiac cells, with a population of stem cells similar to embryonic stem cells. In one modality, the two populations are physically mixed. In another aspect of this embodiment, the two populations are physically mixed and then treated with a growth factor, eg, a cytosine and / or an interleukin, to induce cellular "differentiation." In another aspect of this embodiment, the cells committed and / or embryonic-like stem cells are treated with a growth factor, eg, a cytosine and / or an interleukin, to induce cell differentiation-and then physically mixed in accordance with the methods of the invention. In the invention, embryonic-like stem cells are extracted from a drained placenta by means of a flood technique that utilizes either the umbilical artery and the umbilical vein or both.The placenta is preferably drained by blood collection and collection of the blood. residual blood (for example, residual blood from the umbilical cord) The drained placenta is then processed in such a manner to establish the bioreactor environment r, ex vivo, natural in which the embryonic-like stem cells inside are recruited into the parenchyma and the. extravascular space. The embryonic-like stem cells migrate to the drained, empty microcirculation, where, according to the methods of the invention, they are collected, preferably by washing in a collection vessel by perfusion. As discussed above, a number of different pluripotent or multipotent stem cells can be isolated from the flooded placenta. at different time points during perfusion, eg, hematopoietic cells CD34 + / CD38 + ", CD34 + / CD38-, and CD34- / CD38- In one embodiment, such cells can be used to supplement populations of stem cells, for example, cord blood cells, according to the methods of the invention The present invention also provides a homogeneous population isolated from human placental stem cells, which has the potential to differentiate into all cell types. of human placental stem cells has the potential - to differentiate into one type of cells.In yet another embodiment, the population of human placental stem cells has the potential to differentiate into several different cell types. used to supplement populations of stem cells, for example, cord blood cells, according to the methods of the invention. It also provides methods for mixing a population of stem cells with a population of embryonic-like stem cells. In one modality, the two populations are physically mixed. In another aspect of this embodiment, the two populations are physically mixed and then treated with a factor of. growth, for example, a cytosine and / or an interleukin, to induce cell differentiation. In another aspect of this embodiment, stem cells and / or embryonic-like stem cells are treated with a growth factor, for example, a cytosine and / or an interleukin, to induce cell differentiation and then physically mixed. In one embodiment, mixed populations are treated with a growth factor to induce cell differentiation in a variety of cell types. In another embodiment, the mixed populations are treated with a growth factor to induce differentiation in a particular type of cells. In another embodiment, the mixed populations are treated with a growth factor to prevent or suppress differentiation in a particular type of cells. In certain modalities, the. culture conditions can be controlled, for example, the mixed population of cells can be treated with a specific cocktail of cytokines and interleukins to direct or induce differentiation to a specific type of cells. The present invention provides pharmaceutical compositions comprising populations of stem cells, for example, cord blood cells, which have been supplemented with one or more populations of stem cells similar to the embryonic stem cells of the invention. The invention also encompasses pharmaceutical compositions comprising populations of stem cells, for example cord blood cells, supplemented with one or more populations of cells having high concentrations (or larger populations) of homogeneous hematopoietic stem cells, including, but not limited to, limited to, CD34 + / CD38- cells; and CD34- / CD38- cells. One or more of these cell populations can be used with, or mixed with, hematopoietic blood cells of the umbilical cord, i.e., CD34 + / CD38 + hematopoietic cells for transplantation and other uses. Stem cells, for example, umbilical cord blood, supplemented with embryonic stem cells similar to embryonic stem cells, have a multitude of uses, including therapeutic and diagnostic uses.Supplemented populations of stem cells can be used for transplantation or for treating or preventing diseases In one embodiment of the invention, supplemented populations of cells are used to renew and replenish tissues and organs, thereby replacing or repairing diseased tissues, organs or portions thereof In another embodiment, supplemented populations of stem cells can be used as a diagnosis for the selection of genetic disorders or a predisposition for a particular disease or disorder. The present invention provides methods for treating a patient in need thereof by administering a population of stem cells supplemented with embryonic-like stem cells. In one embodiment, the supplementation of the population of cord blood cells with similar stem cells. The embryonic stage occurs by mixing the stem cells and the embryonic-like stem cells before administration to the patient of the supplemented population. In another embodiment, the supplementation of the stem cell population with embryonic-like stem cells occurs by the administration to the patient of the supplemented population, for example, by simultaneous administration of the blood cells. of cord and stem cells similar to embryonic ones. In another embodiment, the supplementation of the stem cell population with embryonic-like stem cells occurs after administration of the cord blood cells to the patient, for example, by administering the embryonic stem cells separately from, and prior to, or then, the administration of the stem cells. '4.1. METHODS FOR ISOLATION AND CULTIVATION THE PLACENTA 4.1.1 Pretreatment of Placenta According to the methods of the invention, a human placenta recovers shortly after its expulsion after delivery and, in certain modalities, the cord blood is recovered in the placenta. In certain modalities, the placenta undergoes a conventional process of cord blood recovery. Such recovery of cord blood can be obtained commercially, for example, from LifeBank Inc., Cedar Knolls, N.J., Viacord, Cord Blood Registry and Criocell. Cord blood can be drained shortly after the expulsion of the placenta. In other embodiments, the placenta is pretreated according to the methods described in the co-pending application No '. 10 / 076,180, filed on February 13, 2002, which is hereby incorporated by reference in its entirety. 4.1.2. Removal of Placental Blood and Removal of Residual Cells As described in PCT Publication WO 02/064755, published on August 22, 2002, which is incorporated herein by reference in its entirety, the placenta after delivery contains inactive cells that can be activated if the placenta is properly processed after delivery. For example, after expulsion from the uterus, the blood is removed from the placenta as quickly as possible to prevent or minimize apoptosis. Subsequently, as soon as possible after the blood collection the placenta is flooded to remove the blood, residual cells, factors and any other material present in the organ. Waste materials can also be removed from the placenta. Perfusion is usually continued with an appropriate perfusate for at least two to more than twenty-four hours. The placenta can therefore be used easily as a rich and abundant source of embryonic-like stem cells, which cells can be used for research, including drug discovery, treatment and prevention of diseases, in particular surgeries or transplant therapies, and the generation of committed cells, tissues and organoids. Furthermore, surprisingly and unexpectedly, the human placental stem cells produced by the blood extraction, flooding and / or culture of the placenta are pluripotent stem cells which can be easily differentiated into any desired type of cells. . According to the methods of the invention, the stem cells, or progenitors, including, weight, not limited to embryonic-like stem cells, can be recovered from a placenta from which the blood has been extracted, i.e. completely drained from the cord blood remaining after delivery and / or a conventional method for recovering the cord blood According to the methods of the invention, the methods for removing blood from the placenta and removing the cells residuals can be achieved using any method known in the art, for example, the methods described in PCT publication WO 02/064755, published on August 22, 2002, which is incorporated herein by reference in its entirety. Cultivation of the Placenta After the extraction of the blood and a sufficient time of perfusion of the placenta, it is observed that the embryonic-like stem cells migrate to the placenta. acia the microcirculation of the placenta to which the blood has been extracted and flooded where, according to the "methods of the invention, they are collected, preferably by washing in a collection vessel by perfusion. 'In other embodiments, the placenta is cultured, and the propagated cells are monitored, classified and / or characterized according to the methods described in PCT publication WO 02/064755, published on August 22, 2002, which is incorporated herein. as a reference in its entirety. 4.2. COLLECTION OF PLACENTA CELLS After blood extraction and perfusion of the placenta, the embryonic-like stem cells migrate towards the drained, empty microcirculation of the placenta where, according to the invention, they are collected, preferably by harvesting The perfused effluent in a. collection container. In preferred embodiments, the cells cultured in the placenta are isolated from the effluent perfusate using techniques known to those skilled in the art, such as, for example, density gradient centrifugation, magnetic cell separation, flow cytometry, or other cell separation or classification methods well known in the art and classified. In a specific embodiment, ttiadre cells similar to embryonic cells are harvested from the placenta and, in certain embodiments, are preserved, according to the methods described in PCT publication O 02/064755, published on August 22, 2002, which is incorporated here as a reference in its entirety. · 4.3. STEM CELLS SIMILAR TO EMBRYONICS Stem cells similar to embryonic stem cells obtained according to the methods of the invention can include pluripotent cells, that is, they have versatility of complete differentiation, which are self-renewing, and can remain latent or inactive inside the tissue . Stem cells which can be obtained from the placenta include embryonic-like stem cells, multipotent cells, involved progenitor cells, and fibroblast cells. The first blood collection from the placenta is known as placental blood, which contains predominantly hematopoietic progenitor cells CD34 + and CD38 +. Within the first twenty-four hours of perfusion after delivery, high concentrations of hematopoietic progenitor cells CD34 + and CD38- can be isolated from the placenta, along with high concentrations of CD34- and CD38 + hematopoietic progenitor cells. After approximately twenty-four hours of perfusion, high concentrations of CD34- and CD38- cells can be isolated from the placenta together with the aforementioned cells. The isolated, perfumed placenta of the invention provides 'a source of large amounts' of 'mother-enriched cells' for CD34 + and CD38 stem cells - and CD34- and CD38 + stem cells. The isolated placenta which has been flooded for twenty-four hours or more provides a source of large amounts of enriched stem cells for CD34- and CD38- stem cells. . In a preferred embodiment, the embryonic-like stem cells obtained by the methods of the invention are viable, inactive, pluripotent stem cells which exist within a long-term human placenta and which can be recovered immediately after delivery. , successful birth and expulsion of the placenta, resulting in the recovery of as many "as" a trillion cells that have a nucleus, which gives 50-100 million multipotent and pluripotent stem cells.The human placental stem cells provided For the placenta are surprisingly similar to embryonic, for example, the presence of the following cell surface markers has been identified for these cells: SSEA3-, SSEA4-, 0CT-4 + and ABC-p + .Preferably, the stem cells similar to the embryonic ones of the invention, they are characterized by the presence of cell surface markers 0CT-4 + and ABC-p +. the stem cells which have not been isolated or obtained in another way from an embryonic source but which can be identified by the following markers: SSAE3-, SSAE41, OCT-4 + and ABC-p +. In one embodiment, the human placental cells of the placenta do not express the MHC Class 2 antigens. The stem cells isolated from the placenta are homogeneous, and sterile. In addition, the stem cells are easily obtained in a form suitable for administration to humans, that is, they are pharmaceutical grade. Preferred embryonic-like stem cells obtained by the methods of the invention can be identified by the presence of the following cell surface markers: OCT-4 + and ABC-pt. In addition, the invention encompasses embryonic stem cells which have the following markers: CD10 +, CD38-, CD29 +, CD34-, CD44 +, CD45-, CD54 +, CD90 +, SH2 +, SH3 +, SH4 +, SSEA3-, SSEA4-, 0CT-4 + , and ABC-p +. Such cell surface markers are routinely determined according to methods well known in the art, for example, by flow cytometry, followed by washing and staining with an anti-cell surface marker antibody. For example, to determine the presence of CD-34 or CD-38, cells can be washed in PBS and then double stained with anti-CD34 phycoerythrin and anti-CD38 fluorescein isocyanate (Becton Dickinson, Mountain View, CA). In another embodiment, cells cultured in the placental bioreactor are identified and characterized by a colony formation unit analysis, which is commonly known in the art, such as Mesen Cult ™ medium (stem cell Technologies, Inc. , Vancouver British Columbia).; Embryonic-like stem cells obtained by the methods of the invention can be induced to differentiate along specific cell lineages, including adipogenic, codrogenic, osteogenic, hematopoietic, myogenic, vasogenic, neurogenic and hepatdigenic. In certain embodiments, the embryonic-like stem cells obtained according to the methods of the invention are induced to differentiate for use in transplants and ex vivo treatment protocols. In certain embodiments, the embryonic-like stem cells obtained by the methods of the invention are induced to differentiate into a particular cell type and genetically modified to provide a therapeutic gene product. In a specific embodiment, the embryonic-like stem cells obtained by the methods of the invention are incubated with an in vitro compound that induces them to differentiate, followed by the direct transplantation to a subject of the differentiated cells. Therefore, the invention encompasses methods for differentiating human stem cells from the placenta using standard culture media. In addition, the invention covers the hematopoietic cells, neuronal cells, fibroblast cells, fiber or filamentous cells and liver cells. Embryonic-like stem cells may also be further cultured after harvest from the placenta using methods well known in the art, eg, by culture in feeder cells such as irradiated fibroblasts, obtained from the same placenta as 'stem cells similar to embryonic or other human or non-human sources, or in conditioned medium obtained from cultures of such feeder cells, to obtain continuous long-term cultures of embryonic-like stem cells. Embryonic-like stem cells can also be expanded, either inside the placenta before the placenta or injector bioreactor is collected. alive- after the recovery from the placenta. In certain embodiments, embryonic-like stem cells to be expanded are exposed to, or cultured in the presence of, an agent that suppresses cell differentiation. Such agents are well known in the art and include, but are not limited to, human Delta-1 and Human Serrate-1 polypeptides (see, Sakano et al .: US Patent No. 6,337,387 entitled "Differentiation-suppressive polypeptide"). , published on January 8, 2002), the leukemia inhibitory factor (LIF) and the stem cell factor. Methods for the expression of cell populations are also known in the art (see, for example, Emerson et al., US Patent No. 6,326,198 entitled "ethods and compositions for the ex vivo replication of stem cells," for the optimization of hematopoietic progenitor cell cultures, and for increasing the metabolism, GM-CSF secretion and / or IL-6 secretion of humans stromal cells ", published December 4, 2001; raus et al., US Patent No. 6,338,942, entitled "Selective expansion of target cell populations", published on January 15, 2002. Embryonic-like stem cells can be evaluated for their viability, proliferation potential, and longevity using standard techniques known in the art, such as trypan blue exclusion analysis, fluorescein diacetate assimilation analysis, propidium iodide uptake analysis (to assess viability), and analysis isis of assimilation of thymidine, the analysis of cell proliferation by MTT (to evaluate the proliferation). Longevity can be determined by methods well known in the art, such as by determining the maximum number of doubling of the population in an extended culture. In certain modalities, the differentiation of stem cells or progenitor cells that are cultured in the placenta from which the blood has been extracted, flooded and / or cultured, is modulated using an agent or pharmaceutical compositions comprising a dose or dosages, effective after administration individual or multiple, to exert a sufficient effect to inhibit, modulate and / or regulate the differentiation of cells collected from the placenta. The agents that can induce the differentiation of stem or progenitor cells are fine. known in the art and include, but are not limited to, Ca 2+, EGF, α-FGF, β-FGF, PDGF, keratinocyte growth factor (KGF), TGF-β, βcytokines (for example IL-la, IL-? ß), IFN- ?, TFN), retinoic acid, transfer, hormones (eg, androgens, estrogens, insulin, prolactin, triiodothyronine, hydrocortisone, dexamethasone), sodium butyrate, TPA, DMSO, NMF, DMF , matrix elements (e.g., collagen, laminin, heparan sulfate, Matrigel ™), or combinations thereof. ,. Agents that suppress cell differentiation are well-known in the art and include, but are not limited to, human Delta-1 and human Serrate-1 polypeptides (see, Sakano et al., US Patent No. 6,337). , 387 entitled "Differentiation-suppressive polypeptide", published on January 8, 2002), inhibitory factor * of leukemia- (LIF), and the factor of stem cells. '<; The agent used to modulate the differentiation can be introduced into the placenta birector to induce the differentiation of the cells that are cultured in the placenta. Alternatively, the agent can be used to modulate in vitro differentiation after the cells have been harvested or removed from the placenta. The determination that stem cells have differentiated into a particular cell type can be achieved by well-known methods in the. technique, for example, by measuring changes in morphology and cell surface markers using techniques such as flow cytometry or immunocytochemistry (e.g., cells stained with tissue-specific or cell-marker-specific antibodies), by examination of cell morphology using luminous or confocal microscopy, or by measuring changes in gene expression using techniques well known in the art, such as PCR and characterization of gene expression. 4.4. SUPPLEMENT THE STEM CELL POPULATIONS WITH
STEM CELLS SIMILAR TO EMBRYONICS The present invention relates to populations of stem cells that are mixed with embryonic-like stem cells. According to the present invention, stem cells that can be mixed with embryonic-like stem cells include, but are not limited to, umbilical cord blood, fetal and neonatal stem cells and hematopoietic progenitor cells, stem cells and progenitor cells human beings derived from the bone marrow. In a preferred embodiment of the present invention, the embryonic-like stem cells of the invention are mixed with umbilical cord blood. The present invention provides an "isolated homogenous population of human placental stem cells (embryonic-like stem cells) which have the potential to differentiate into all types of cells." Such cells can be used to supplement populations of stem cells, for example, cord blood cells, according to the methods of the invention The invention also provides populations of cord blood cells that have been supplemented (ie, blended, combined or augmented) with populations of stem cells similar to embryonic originating from a placenta Supplemented populations are very versatile, because they contain populations of cells that are pluripotent or muipotent stem cells, for example, cells that display a CD34 + / CD38 +, CD34 + / CD38- or CD34- / CD38 phenotype In accordance with the present invention, the supplemented populations of stem cells of the invention They contain embryonic-like stem cells and other stem or progenitor cells at a ratio of 100,000,000: 1, 50,000,000: 1, 20,000.00.0: 1, 10,000,000: 1, 5,000,000: 1, 2,000,000: 1, 1,000,000: 1, 500,000: 1, 200,000: 1, 100,000: 1, 50,000: 1, 20,000: 1, · 10,000: 1, 5,000: 1, 2,000: 1, 1,000: 1, 500: 1, 200: 1, 100: 1, 50: 1 , 20: 1, 10: 1, 5: 1, 2: 1, 1: 1; 1: 2; 1: 5; 1:10; 1: 100; 1: 200; 1: 500; 1: 1,000; 1: 2,000; 1: 5,000; 1: 10,000; 1: 20,000; 1: 50,000; 1: 100,000; 1: 500,000;
1: 1,000,000; 1: 2,000,000; 1: 5,000,000; 1: 10,000,000;
1: 20,000,000; 1: 50,000,000; or 1: 100,000,000, comparing the numbers of cells that have a nucleus in each population. In another embodiment, the invention provides methods for supplementing, mixing, combining or augmenting the stem cells, for example, the blood of the umbilical cord, with a composition of the invention, for example, of placental stem cells similar to Pure embryos or a population of cells enriched for placental stem cells similar to embryonic stem cells. In one modality, an aliquot (or population) of similar placental stem cells. the embryonic cells are added to an aliquot of umbilical cord blood, before administration to a patient in need of them. · The present invention also provides methods for supplementing a population of cord blood cells with a population of stem cells similar to those. embryonic In one modality, the two populations are physically mixed. In another aspect of this embodiment, the populations are physically mixed and then treated with a growth factor, eg, "a cytokine and / or an interleukin, to induce cell differentiation." In another aspect of this embodiment, the cells - cord blood and / or embryonic-like stem cells - are treated with a growth factor, eg, a cytokine and / or an interleukin, to induce cell differentiation and then physically blended in. The present invention provides also methods for treating a patient in need of them by administering a population of cord blood cells with embryonic-like stem cells.In one embodiment, supplementation of the cord blood cell population with embryonic-like mother cells occur by mixing the cord blood cells and the embryonic-like stem cells before the administration to the patient of the supplemented population. In another modality, supplementation of cord blood cells with embryonic-like stem cells occurs by administration to the patient of the supplemented population, for example, by simultaneous administration of cord blood cells and stem cells similar to those of embryonic In another embodiment, supplementation of cord blood cells with embryonic-like stem cells occurs after administration to the patient of cord blood cells, for example, by administering the embryonic-like stem cells separately 'of, and - before' or after, the administration of cord blood cells.
In one embodiment, the invention provides methods for supplementing cord blood cells with embryonic-like stem cells, wherein the mixture is contained within a bag. In another embodiment, the invention provides methods for supplementing cord blood cells with embryonic-like stem cells. wherein the cord blood cells and the embryonic-like stem cells are each contained in separate bags. Such a "two-bag" composition can be mixed before or at the time of administration to the patient in need thereof. In another modality, an aliquot (or population) of placental stem cells similar to the embryonic cells are conditioned before being added to, and mixed in, an aliquot of umbilical cord blood, before administration to a patient in need. from the same. For example, in one aspect of this modality, a population of embryonic-like placental stem cells is induced to differentiate into a particular cell lineage, for example, the hematopoietic, neuronal, adipogenic, chondrogenic, osteogenic, hepatogenic, pancreatic, or myogenic, as described above in Section 4.3, by exposing, for example, to cytosines (eg, IL-la, IL-? ß, IFN- ?, TFN), retinoic acid, transferrin, hormones (eg, androgens, estrogens, insulin, prolactin, triiodothyronine, hydrocortisone, dexamethasone), sodium butyrate, TPA, DMSO, F, DMF, matrix elements (eg, collagen, laminin, heparan sulfate, Matrigel ™) , or combinations thereof, before being added to, and mixed in, an aliquot of umbilical cord blood. In another aspect of this embodiment, a population of embryonic-like placenta stem cells is conditioned by being exposed to an 'agent that suppresses differentiation, for example, Human-Delta-1 and Human Serrate-1 polypeptides, or combinations of the same, before being added to, and mixed in, an aliquot of cord blood. . , In another modality, an aliquot (or population) of placental stem cells similar to the unconditioned embryonic and an aliquot of umbilical cord blood, are mixed, and the population mixed. of cells is conditioned before being administered to a patient in need of it. In the specific modalities, the mixed population of placental stem cells similar to the. Embryonic and umbilical cord blood cells are conditioned with an agent that induces o? G? e? e cell differentiation, as discussed above. * "In a specific-modality, a population of embryonic-like stem cells of the invention is added to, or mixed in, a population of umbilical cord blood cells prior to administration to a patient in need thereof, In another specific embodiment, a population of embryonic-like stem cells of the invention is added to, or mixed in, a population of umbilical cord blood cells during, or simultaneously with, administration to a patient in need of In another specific embodiment, a population of embryonic-like stem cells of the invention and a population of umbilical cord blood cells are sequentially mixed with a patient in need thereof In one embodiment, the cell population mother similar to the embryonic is administered first and the population of cells., umbilical cord blood are administered in second place. In the modality, the umbilical cord blood cell population is administered first and the population of placental stem cells similar to the embryonic ones is administered in second place. The population of cord blood cells inserted with embryonic-like stem cells can be cultured, induced to spread, and / or induced to differentiate under a variety of conditions, including but not limited to, treating the inserted populations by introducing them into the medium of. cultivation of nutrients, hormones, vitamins, growth factors, or any combination thereof. The growth factors are usually protein and include, but are not limited to: cytosines, lymphokines, interferons, colony stimulation factors (CSF's), interferons, chemosines, and interleukins. Other growth factors that can be used include human recombinant hematopoietic growth factors including ligands, stem cell factors, thrombopoietin (po), granulocyte colony stimulating factor (G-CSF), leukemia inhibitory factor. Growth factor of the basic fibroblasts, growth factor derived from the placenta and epidermal growth factor. In one embodiment, the supplemented populations are treated with a growth factor to induce differentiation in a variety of cell types. In another embodiment, the inserted populations are treated with a growth factor to induce differentiation in a particular cell type. In another embodiment, the supplemented populations are treated with a growth factor to prevent or suppress, the differentiation into a particular type of cells. In certain embodiments of the invention, methods for supplementing a population of cord blood comprise (a) the induction of differentiation of embryonic-like stem cells, (b). mix, embryonic-like stem cells with a population of cord blood cells and (c) administration of the mixture to a patient in need thereof. In other embodiments of the invention, methods for supplementing a population of cord blood comprise (a) mixing embryonic-like stem cells with a population of cord blood cells (b) induction of differentiation of the mixture of the inserted population- of cord blood cells and embryonic-like stem cells; and (c) administration of the mixture to a patient in need thereof. In other embodiments of the invention, methods for supplementing a cord blood population comprise '(a) administering a mixture of cord blood cells supplemented with embryonic-like stem cells to a patient in need thereof and ( b) induction of the differentiation of the mixture and (c) administration to a patient in need thereof. In certain embodiments, the stem or progenitor cells are induced to differentiate into a particular cell type, by exposure to a growth factor, according to methods well known in the art. In the specific modalities, the growth factor is: GM-CSF, IL-4, Flt3L, CD40L, IFN-alpha, TNF-alpha, IFN-gamma, IL-2, IL-6, retinoic acid, basic growth factor of fibroblasts, TGF-beta-1, TGF-beta-3, hepatocyte growth factor, epidermal growth factor, cardiotropin-1, angiotensinogens, angiotensin I (AI), arigiotensin II (II), receptor agonists, AII AT2 -type 2, or analogs or fragments thereof. In one embodiment, stem or progenitor cells are induced to differentiate into neurons, according to methods well known in the art, for example, by exposure to β-mercaptoethanol or α-DMSO / butylated hydroxyanisole, according to Methods described in Section 5.4.1. In another embodiment, the stem or progenitor cells are induced to differentiate into adipocytes, according to methods well known in the art, by exposure to dexamethasone, indomethacin, insulin and IBMX, from according to the methods described in Section 5.4.2. In another embodiment, the stem or progenitor cells are induced to differentiate into chondrocytes, according to methods well known in the art., for example, by exposure to TGF-.beta-3, according to 'the methods described in Section 5.4.3. In another embodiment, the stem or progenitor cells are induced to differentiate into osteocytes, according to methods well known in the art, for example, by exposure to dexamethasone, ascorbic acid-2-phosphate and beta-glycerophosphate, according to the methods described in Section 5.4.4. In another embodiment, the stem or progenitor cells are induced to differentiate into hepatocytes, according to methods well known in the art, for example, by exposure to IL-6 +/- IL-15, according to the methods, described in Section 5.4.5. In another embodiment, the stem or progenitor cells are induced to differentiate into pancreatic cells, according to methods well known in the art, for example, by exposure to the 'basic growth factor of the fibroblast, and the transforming growth factor, beta. - 1, according to the methods described in Section 5.4.6. In another embodiment, the stem or progenitor cells are induced to differentiate into cardiac cells, according to methods well known in the art, for example, by exposure to retinoic acid, fibroblast basic growth factor, TGF-beta-1 and epidermal growth factor, by exposure to cardiotropin-1 or by exposure to human myocardium extract, according to the methods described in Section 5.4.7.
embryonic cells are stimulated to produce bioactive molecules, such as immunoglobulins, hormones, enzymes. In another modality, the embryonic-like stem cells are stimulated to proliferate, by. example, by administration of erythropoietin, cytokines, lymphokines, interferons, colony stimulation factors (GSF's), interferons, chymosins, interleukins, recombinant human hematopoietic growth factors including ligands, stem cell factors, thrombopoietin (TPO), interleukins, and 'stimulating growth factor of the granulocyte colony (G-CSF) or other growth factors. '·. · In another embodiment, "embryonic-like stem cells are modified, genetically either before, or after harvesting from the placenta, using, for example, a viral vector - such as an adenoviral or retroviral vector , or using mechanical means such as assimilation of liposomal or chemically mediated DNA ". A vector that contains, a transgene can, be introduced into cells of interest by methods well known in the art, for example, transfection, cross-transformation, transduction, electroporation, infection, microinjection, cell fusion, DEAE dextran. · Precipitation of calcium phosphate, liposomes, LIPOFECTIN ™, lysosomal fusion,. synthetic cationic lipids, use of a genetic gun or a DNA vector transporter, so that the transgene is transmitted to the daughter cells, for example, the embryonic-like stem cells or daughter progenitor cells produced by the division of stem cells similar to the embryonic ones. For various transformation or transfection techniques of mammalian cells, see Keown et al., 1990, Methods Enzymol. 185: 527-37; Sambrook et al., 2001, Molecular Cloning, A Laboratory Manual, Third Edition, Cold Spring Harbor Laboratory Press, N.Y. Preferably, the transgene is introduced using any technique, provided that it is not destructive to the nuclear membrane of the cells or other existing cellular or genetic structures. In certain modalities, the transgene is inserted into the genetic material by microinjection. Microinjection of cells and cell structures is known and commonly practiced in the art. For stable transfection of cultured mammalian cells, such as embryonic-like stem cells, only a small fraction of cells can integrate the foreign DNA into their genome. The integration efficiency depends on the vector and the transfection technique used. To identify a selection member, a gene encoding a selectable marker (e.g., for antibiotic resistance) is generally introduced into the embryonic-like stem cells together with the sequence of the gene of interest. Preferred selectable markers include those that confer resistance to drugs, such as G418, hygromycin and methotrexate. The stability of the cells transfected with the introduced nucleic acid can be identified by drug selection (for example, the cells that have incorporated the selectable marker gene will survive, while the other cells will die). Such methods are particularly useful in methods involving homologous recombination in mammalian cells (e.g., in embryonic-like stem cells) before the introduction or transplantation of recombinant cells in a subject or patient. A number of selection systems can be used to select cells similar to the embryonic host, transformed. In particular, the vector may contain certain detectable or selectable markers. Other methods for selection include but are not limited to selecting other markers such as: the thymidine kinase of the herpes simplex virus (Wigles et al., 1977, Cell 11: 223), hypoxanthine-guanine phosphorylosiltransferase
(Szybalska and Szybalski, 1962, Proc. Nati, Acad. Sci. USA 48: 2026), and adenine phosphoribosyltransferase (Lowy et al., 1980, Cell 22: 827) the genes can be used in tk-, hgprt- or aprt-, respectively. Also, resistance to antimetabolites can be used as the "basis of selection for the following dhfr genes, which confers resistance to methotrexate (Wigler et al., 1980, Proc. Nati. Acad. Sci. USA 77: 3567; O'Hare et al., 1981, Proc. "Nati. Acad. Sci. USA 78: 1527); gpt, which confers resistance to mycophenolic acid (Mulligan 'and Berg, 1981. Proc. Natl., Acad. Sci. USA 78: 2072); neo, which confers resistance to aminoglycoside G-418 (Colberre-Gerapin et al.,? 981, J. Mol. Biol. 150: 1); and hygro, which 'confers resistance to hygromycin (Santerre et al., 1984, Gene 30: 147). The transgene can be integrated into the genome of the cells of interest, preferably by random integration. In other embodiments, the transgene can be integrated by a direct method, for example, by direct homologous recombination (i.e., "introduction or extraction" of a gene of interest in the genome of the cells of interest), Chappel, U.S. Patent No. 5,272,071; and PCT Publication No. WO 91/06667, published May 16, 1991; U.S. Patent 5,627,059, Capecchi et al., Published May 6, 1997; U.S. Patent 5,487,992, Capecchi et al., Published January 30, 1996).
Methods to generate cells that have the gene modifications. sought as target through homologous recombination are known in the art .. The construct will comprise at least a portion of a gene of interest with a desired genetic modification, and will include regions of homology for the target locus, ie the endogenous copy of the target gene in the host genome. The DNA constructs for random integration, in contrast to those used for homologous recombination, need not include regions of homology to mediate recombination. The markers can be included in the target construct or the random construct to carry out the positive and negative selection for the insertion of the transgene. , To create a homologous recombinant cell, for example, embryonic-like, recombinant homologous stem cells, endogenous cells or exogenous cells of the placenta are cultured in the placenta; a homologous recombinant vector ren-el is prepared which a gene of interest is flanked at its 5 'and 3' ends by gene sequences that are endogenous to the genome of the target cells, to allow homologous recombination to occur between the gene of interest, transported by the vector and the endogenous gene in the genome of target cells.The additional flanking nucleic acid sequences are of sufficient length for successful homologous recombination with the endogenous gene in the genome of the Target cells Typically, several, flanking DNA kilobases (both at the 5 'and 3' ends) are included in the vector The methods for constructing homologous recombination vectors and homologous recombinant animals para recombine stem cells, they are commonly known in the art (see, for example, Thomas and Capecchi, 1987, Cell 51: 503, Bradley, 1991, Curr Opin. Bio / Technol. 2: 823-29, and Publications PCT Nos. WO 90/11354, WO 91/01140 and WO 93/04169. In one embodiment, the genome of the exogenous cells cultured in the placenta according to the methods of the invention is an objective of gene targeting via homologous recombination or via random integration. In a specific embodiment, the methods of Bonadio et al., (U.S. Patent No. 5,942,496, entitled "Methods and compositions for multiple gene transfer into bone cells", published August 24, 1999; and PCT WO 95/22611, entitled "Methods and compositions for stimulating bone cell, published August 24, 1995) are used to introduce nucleic acids into cells of interest such as stem cells, progenitor cells or exogenous cells cultured in the placenta, for example, bone progenitor cells.
4. 5. USES OF THE MOTHERS SIMILAR TO THE EMBRYONARY AND THE POPULATIONS OF SUPPLEMENTED MOTHER CELLS The stem cells similar to the. embryonic can be obtained from flooded placentas according to the methods described in the co-pending US application No. 01 / 076,180, filed on February 13, 2002. Placental stem cells (embryonic-like stem cells) can be induced to differentiate _ in (a particular type of cells, well, ex vivo or in_ vivc,; "For example, stem cells similar to pluripotent embryonic stem cells can be injected into a damaged organ, and for organ neogenesis and repair · of damage in vivo.
Such damage may be due to such conditions and disorders that include, but are not limited to, myocardial infarction, epileptic disorder, multiple sclerosis, stroke, hypotension, cardiac arrest, ischemia, inflammation, loss of consciousness, cognitive function related to., aging, radiation damage, cerebral palsy, neurodegenerative disease, Alzheimer's disease,
Parkinson's disease, Leigh's disease, AIDS dementia, memory loss, amyotrophic lateral sclerosis, ischemic kidney disease, brain or bone marrow trauma, heart-lung bypass, glaucoma, ischemia. the retina, or trauma of the retina. Embryonic-like stem cells isolated from the placenta, alone or in combination with populations of stem or progenitor cells (i.e., cell compositions of the invention) can be used, in specific embodiments, in enzyme replacement therapy autologous or heterologous to treat specific diseases or conditions, including, but not limited to, lysosomal storage diseases, such as the Tay-Sachs, Niemann-Pick, Fabri, Gaucher, Hunter and Hurler syndromes, as well as other gangliosidoses , mucopolysaccharidosis, and glycogenosis. In other modalities, stem cells similar to embryonic ones, alone or in combination. With populations of stem or progenitor cells, they can be used as autologous or heterologous transgenic carriers in gene therapy to correct congenital errors of metabolism. adrenoleukodystrophy, cystic fibrosis, glycogen storage disease, hypothyroidism, sickle cell anemia, Pearson's syndrome, Pompe disease, phenylketonuria. (PKU), porphyrias, maple syrup urine disease, homocystinuria, mucopolysaccharide nosis, chronic granulomatous disease and tyrososemia and Tay-Sachs disease or to treat cancer, tumors or other pathological conditions. In other embodiments, the cell compositions can be used in the regeneration of autologous or heterologous tissues or replacement therapies or protocols, including, but not limited to, treatment of epithelial defects of the cornea, cartilage repair, facial dermabrasion, mucous membranes. , tympanic membranes, intestinal linings, neurological structures (for example, the retina, auditory neurons in the basilar membrane, olfactory neurons in the olfactory epithelium), repair of burns and wounds due to traumatic skin damage, or repair of other damaged or diseased organs or tissues. Large numbers of stem cells similar to embryonic and / or progenitor cells obtained using the methods. from; The invention should, in certain modalities, reduce the need for large donations of bone marrow. Approximately 1 x 108 to 2 x 108. Bone marrow mononuclear cells per kilogram of patient weight should be implanted for grafting in a bone marrow transplant (ie, approximately 70 mL of marrow for a 70 kg donor). To obtain 70 mL, an intensive donation and significant blood loss is required in the donation process. In a 'specific modality, the cells of a small donation of bone marrow (for example, 7-10 mL) could be expanded by propagation in a placenta birector before implantation in a patient. In addition, a small number of stem cells and progenitor cells normally circulate in the bloodstream. In another embodiment, such exogenous stem cells or exogenous progenitor cells are harvested by apheresis, a procedure in which the blood is subtracted, one or more components are removed selectively, and the rest of the blood is reinfused into the donor. The exogenous cells recovered by apheresis are expanded by propagation in a placenta birector, thus completely eliminating the need for bone marrow donation. While blood cells regenerate between chemotherapy treatments, "however, 'cancer' has time to grow and becomes possibly more resistant to chemotherapy drugs due to natural selection. prolonged chemotherapy and more, cut the duration between treatments, the greater the chances of eliminating cancer.To shorten the time between chemotherapy treatments, the embryonic-like stem cells or progenitor cells harvested according to the methods of the invention, alone or in combination with other populations of stem cells or progenitor cells, could be introduced into the patient.This treatment would reduce the time in which the patient would exhibit a low blood cell count, and thus allow the resumption prompt chemotherapy treatment.Stem cells similar to embryonic cells progenitors, foreign cells, or modified cells obtained from a placenta according to the methods of the invention, alone or in combination with other populations of stem cells or progenitor cells, can be used in the manufacture of a tissue u. organ in vivo. The methods of the invention comprise using the. cells obtained from the placenta, for example, embryonic-like stem cells, progenitor cells or foreign stem or progenitor cells, to seed a matrix and to be cultured under the appropriate conditions to allow cells to differentiate and populate the matrix. The tissues and organs obtained by the methods of the invention can be used for a variety of purposes, including research and therapeutic purposes. The cells similar to the embryonic stem cells and the supplemented populations of stem cells of the invention can also be used for a wide variety. of prophylactic or therapeutic protocols in which a tissue or organ of the body is augmented, repaired or replaced by grafting, transplantation or infusion of a desired population of cells, such as a population of stem cells or progenitor cells. Embryonic-like stem cells and supplemented stem cell populations of the invention can be used to replace or augment existing tissues, to introduce new or altered tissues, or to join other tissues or biological structures. The populations of embryonic-like stem cells and supplemented mother cells of the invention can also be replaced by embryonic stem cells in the therapeutic protocols described herein, in which embryonic stem cells would typically be used. In a preferred embodiment of the invention, populations of stem cells similar to embryonic stem cells and supplemented stem cells can be used as autologous and allogenic transplants, including compatible and incompatible hematopoietic transplants of the HLA type. According to the use of cells, mother similar to embryonic as allogeneic hematopoietic transplants, it may be necessary to treat the host to reduce immunological rejection of donor cells, such as those described in U.S. Patent No. 5,800,539, published September 1, 1998; and U.S. Patent No. 5,806,529, published September 15, 1998, both of which are incorporated herein by reference. For example, populations of stem cells similar to embryonic stem cells and supplemented stem cells of the invention, can be used for therapeutic transplantation protocols, for example, to increase or replace the stem cells or progenitor cells of the liver, pancreas, Kidney, lung, nervous system, muscle / bone system, bone marrow, thymus, basal, mucus, gonads,? hair. Embryonic stem cell populations and supplemented stem cells may * be used in place of the progenitor cell-specific classes (eg, chondrocytes, hepatocytes, * hematopoietic cells, pancreatic parenchymal cells, neuroblasts, muscle progenitor cells , etc.) in therapeutic or research protocols in which the progenitor cells would typically be used. ' Embryonic stem cell and supplemented stem cell populations of the invention can be used for the augmentation, repair or replacement of cartilage, tendons, or ligaments. For example, in certain embodiments, the prostheses (e.g., prostheses, hip) are coated with replacement cartilage tissue constructs grown from the embryonic-like stem cells of the invention. In other embodiments, the joints (for example, of the knee) are reconstructed with constructs of cartilaginous tissue grown from embryonic-like stem cells. The constructs of cartilaginous tissue can also be used in major reconstructive surgery for different types of joints (for protocols, see, for example, Resnick, D., and Niwayama, G., eds., 1988, Diagnosis of Bone and Joint Disorders, 2d ed., WB Saunders Co.). Embryonic-like stem cell populations and supplemented stem cells of the invention can be used to repair damaged tissues and organs resulting from trauma, metabolic disorders, or diseases. In such modality, embryonic-like stem cells can be administered to a patient, alone or in combination with other populations of stem or progenitor cells, to regenerate or re-establish the tissues or organs which have been damaged as a result of diseases, for example, to improve the immune system next to chemotherapy or radiation, repair cardiac tissue after myocardial infarction. Embryonic-like stem cell populations and supplemented stem cells of the invention can be used to augment or replace bone marrow cells in bone marrow transplants. Human autologous and allogenic bone marrow transplants are used as therapies for diseases such as leukemia, lymphoma and other life-threatening disorders. The disadvantage of these procedures, however, is that a large amount of bone marrow must be removed from the donor to ensure that there are enough cells for the graft. Embryonic stem cell populations and supplemented stem cells of the invention can provide stem cells and progenitor cells that would reduce the need for large donations of bone marrow. It would also be possible, according to the methods of the invention, to obtain. a small donation and then expand the number of cells. mother and progenitor cells, cultivating and expanding them in the placenta before infusion or transplant in a container. Stem cell populations similar to embryonic and supplemented stem cells of the invention can be used, in specific embodiments, in replacement therapy of autologous or heterologous enzymes to treat specific diseases or conditions, including, but not limited to lysosomal storage diseases, such as the Tay-Sachs, Niemann-Pick, Fabry, Gaucher, Hunter, Hurlér syndromes, as well as other gangliosidoses, mucopolysaccharidoses, and glycogenosis. In other embodiments, cells can be used as carriers of autologous and heterologous transgenes in gene therapy, to correct congenital errors of metabolism, such as adrenoleukodystrophy, cystic fibrosis, glycogen storage disease, hypothyroidism, sickle cell anemia , Pearson syndrome, Pompe disease, phenylketonuria (PKU), and Tay-Sachs disease, porphyrias, maple syrup urine disease, homocystinuria, mucopolipsaccharide nosis, chronic granulomatous disease, and tyrosinemia, or to treat cancer , tumors or other pathological or neoplastic conditions. In other embodiments, the cells may be used in regenerative or replacement therapies or protocols of autologous or heterologous tissues, including, but not limited to, treatment of epithelial defects of the cornea, repair of cartilage, facial dermabrasion, mucous membranes, tympanic membranes, intestinal lining nales, neurological structures (for example, the retina, additive neurons in the basilar membrane, salivary neurons in the olfactory epithelium), repair of burns and wounds due to traumatic damage to the "skin, * transplantation of the scalp (hair), or for the reconstruction of other damaged or diseased organs or tissues. The large numbers of stem cells similar to the embryonic and / or progenitor cells obtained using the methods of the invention would, in certain embodiments, reduce the need for large donations of bone marrow. Approximately 1 x 108 to 2 x 108 bone marrow mononuclear cells per kilogram of patient weight should be infused for bone marrow transplantation (ie, approximately 70 mL of bone marrow) for a 70 kg donor. ). In a specific embodiment, cells from a small donation of bone marrow (e.g., 7-10 mL) could be expanded by propagation in a placenta birameter before infusion in a patient. In another embodiment, stem cell populations similar to embryonic stem cells and supplemented stem cells of the invention can be used in a supplemental treatment in addition to chemotherapy. Most of the chemotherapeutic agents used to find and destroy cancer cells act by eliminating all the proliferating cells, that is, the cells that go through cell division. Because the bone marrow is one of the most actively proliferating tissues in the body, hematopoietic stem cells are frequently damaged or destroyed. by the chemotherapeutic agents and consequently, the production of blood cells decreases or decreases. Chemotherapy must be completed at intervals that allow the system. The patient's hematopoietic resupply supplies blood cells before restarting chemotherapy. May . take a month or more for the formerly inactive stem cells to proliferate and increase the white blood cell count to acceptable levels so that the chemotherapy can be restarted (when again, the stem cells of the bone marrow are destroyed). , The white blood cells regenerate between chemotherapy treatments, however, cancer. they have time to grow and possibly become more resistant to chemotherapeutic drugs due to natural selection. Therefore, the longer the chemotherapy is and the shorter the duration between treatments, the greater the chances of successfully eliminating the cancer. To shorten the time between chemotherapeutic treatments, embryonic-like stem cells or progenitor cells harvested according to the methods of the invention could be introduced into the patient. Such treatments would reduce the time in which the patient would exhibit a low blood cell count., and would therefore allow the resumption of the chemotherapeutic treatment. In another embodiment, human placental stem cells can be used to treat or prevent genetic diseases, such as chronic granulomatous disease. 4.6. PHARMACEUTICAL COMPOSITIONS The present invention encompasses pharmaceutical compositions which comprise. the embryonic stem cell populations and supplemented stem cells of the invention. The present invention encompasses pharmaceutical compositions comprising a dose and / or several effective doses by single or multiple administration, before or after the transplantation of conditioned or non-conditioned human progenitor stem cells, which are capable of exerting a sufficient effect to inhibit, modulate and / or regulate the differentiation of: pluripotent progenitor stem cells' and multipotents of placental origin in one or more cell lineages, for example, the mesodermal, adipose, cell lineages. chondrocytic, osteocytic, myocytic, vascular, neural, endothelial, hepatic, renal, pancreatic and / or hematopoietic. According to this embodiment, the populations of stem cells similar to the embryonic stem cells and supplemented stem cells of the invention can be. formulated as an injectable (e.g., PCT WO 96/39101, incorporated herein by reference in its entirety.) In an alternative embodiment, the cells and tissues of the present invention can be formulated using polymerizable hydrogels or crosslinkers as described in US Pat. US Patents Nos. 5,709,854; 5,516,532; 5,654,381; each of which is incorporated here as a reference in its entirety. Embryonic-like stem cells can be administered as they are obtained from the placenta, or they can be inserted into umbilical cord blood and administered as a mixed cell composition, or they can be placed in any physiologically acceptable buffer or fluid for an individual . The invention also encompasses pharmaceutical compositions having high concentrations (or larger populations) of homogenous embryonic-like stem cells, wherein one or more of these cell populations can be used with, or as a mixture with, other stem cells or progenitors,. for use in transplants and other uses. Other stem or progenitor cells may include but are not limited to: adipogenic, chondrogenic, osteogenic, hematopoietic, myogenic, vasogenic, neurogenic, and hepatogenic stem cells; mesenchymal stem cells, adherent tissue cells, endothelial cells, hepatocytes, keratinocytes, and stem or progenitor cells for a particular type of cells, tissues or organs, including but not limited to neurons, myelin, muscles, blood, bone marrow, skin, heart, connective tissue, lung, kidney, liver, and pancreas (eg, pancreatic islet cells). In one embodiment, the invention provides pharmaceutical compositions having high concentrations (or major populations) of homogeneous hematopoietic stem cells including but not limited to CD34 + / CD38- cells; and CD34- / CD38- cells. One or more of these cell populations can be used with, or as a mixture with, other stem cells, for use in transplants and other uses. In a specific embodiment, the pharmaceutical composition comprises embryonic-like placenta stem cells of the invention and cord blood hematopoietic cells, i.e., CD34 + / CD38 + hematopoietic cells. One or more of these cell populations can be used with or as a mixture with hematopoietic cells of cord blood, i.e. CD34 + / CD38 + hematopoietic cells for transplants and other uses. In one embodiment, the invention provides heterogeneous populations of cells with nuclei comprising stem cells. the placenta similar to the embryonic ones. In certain embodiments, a heterogeneous population of "core" cells (rather than a pure population of placenta stem cells similar to the embryonic CD34 + cells) is preferred.
In another embodiment, the invention provides a mixed population of cells (e.g., cord blood cells and embryonic-like placental stem cells). The population of mixed cells can be frozen or not frozen. Such a mixed population can be stored and / or used in a container, for example, a bag or a syringe.
In another embodiment, the invention provides two or more separate or distinct populations of different cell types (e.g., blood cells and placental stem cells similar to embryonic cells). Each separate population can be stored and / or used in a separate container, for example, a bag (for example, the Baxter blood storage bag, Becton-Dickinson, "Medcep, National Hospital Products or Terumo) or a syringe, which contains a single type of "cells" or population ^ of; cells In certain aspects of this embodiment, the invention provides separate containers for different types of cells to be mixed before administration. Such cells may be unfrozen or frozen. In a specific modality, the cells of. Cord blood is contained in a pouch and embryonic-like placental stem cells are contained in a second pouch. In another embodiment, the invention provides placental stem cells similar to embryonic cells that are "conditioned" before freezing. In another embodiment, a population of cells including, but not limited to embryonic-like placental stem cells, can be conditioned by removal of red blood cells and / or granulocytes, according to standard methods, from so that a population of cells with a nucleus that is enriched by placental stem cells similar to embryonic ones. Such a population enriched for placental stem cells similar to embryonic ones can be used without freezing, or frozen for later use. If the cell population should be frozen, a cryopreservative (eg, DMSO, glycerol, Epilife ™ Cell Freezing Media (Cascade Biologics)) is added to the enriched cell population before freezing. In another embodiment, a population of cells including, but not limited to, embryonic-like placental stem cells can be conditioned by removing red blood cells and / or granulocytes after they have been frozen and thawed. According to the invention, agents that induce cell differentiation can be used to condition a population of embryonic-like stem cells. In certain embodiments, an agent that induces differentiation can be added to a population of cells within a container, including but not limited to, Ca2 +, EGF, OI-FGF, β-FGF, PDGF, growth factor of ceratinocytes (KGF). ), TGF-β, cytosines (eg, IL-la, IL-ββ, IFN- ?, TFN), retinoic acid, transferrin, hormones (eg, androgens, estrogens, insulin, prolactin, triiodothyronine, hydrocortisone, dexamethasone), sodium butyrate, TPA, DMSO, NMF, DMF, matrix elements (eg, collagen, laminin, heparan sulfate, Matrigel ™), or combinations thereof. In another embodiment, agents that suppress cell differentiation can be added to a population of embryonic-like stem cells. In certain embodiments, an agent that suppresses cell differentiation can be added to a population of cells within a container, including, but not limited to, human Delta-1 and Serrate-1 human polypeptides (See Sakano et al., U.S. Patent No. 6,337,387 entitled "Differentiation-suppressive polypeptide", issued January 8, 2002), leukemia inhibitory factor (LIF), stem cell factor, or combinations thereof. In certain embodiments, one or more populations of embryonic-like stem cells are administered to a patient in need thereof. In certain modalities, two or more populations of fresh (never frozen) cells are administered from a single recipient or administration system. In another embodiment, two or more populations of frozen and thawed cells are administered from an individual container or individual delivery system. In another modality, each of the populations of fresh cells (never frozen) are transferred to, and administered. from, an individual container or individual management system. In another embodiment, each of the two or more populations of frozen and thawed cells is transferred to, and administered from, an individual container or individual delivery system. In another aspect of these modalities, each population is administered from a different IV infusion bag (eg, from Baxter, Becton-Dickinson, Medcep, National, Hospital Products, or Terumo). The contents of each container (e.g., an IV infusion bag) can be administered via a separate administration system, or each container can be "piggybacked" so that its contents are combined or mixed prior to administration from a container. individual management system. For example, the two or more cell populations may be fed to and / or mixed within a common flow line (eg, tubing), or they may be fed and / or mixed into a common vessel (eg, a chamber). or bag). According to the invention, the two or more populations of cells can be combined before administration, during or during administration or delivery, simultaneously. In one embodiment, a minimum of 1.7 x 10 7 cells with core / kg are administered to a patient in need thereof. Preferably, at least 2.5 x 10 7 cells with core / kg are administered to a patient in need thereof. In one embodiment, the invention provides a method for treating or preventing a disease or disorder in a subject, comprising, administering to a subject in which such prevention treatment is desired, a therapeutically effective amount of the stem cell populations similar to those embryonic, or supplemented cells. In another embodiment, the invention provides a method for treating or preventing a disease or disorder in a subject, comprising, administering to a subject in which such treatment or prevention is desired, a therapeutically effective amount of the embryonic-like stem cells. of the invention. -, '
It is expected that the embryonic-like stem cells of the invention have an anti-inflammatory effect when administered to an individual who experiences inflammation. In a preferred embodiment, the populations of stem cells or supplementary cells of the invention can be used to treat any disease, condition or disorder that results from, or associated with, inflammation. Inflammation can be present in any organ or tissue, for example, muscles; the nervous system, including the brain, spinal cord and peripheral nervous system ^ vascular tissues, including cardiac tissue; the pancreas; the intestines or other organs of the digestive tract; lungs, liver, reproductive organs; endothelial tissue, or endodermal tissue. Stem cell populations similar to embryonic or supplemented cells of the invention can be used to treat disorders related to the autoimmune or immune system, including those associated with inflammation. Therefore, certain embodiments of the invention provide a method for treating an individual having an autoimmune disease or condition, comprising administering to such an individual, a therapeutically effective amount of the cell populations or 'supplemented cells of the invention,' in which, said disease or disorder may be, but is not limited to, diabetes, amilotropic lateral sclerosis, myasthenia gravis, diabetic neuropathy or lupus. In the related embodiments, populations of stem cells similar to embryonic or supplemented cells of the invention, can be used to treat disorders related to immunity, such as chronic or acute allergies. In certain modalities, the disease? The disorder includes, but is not limited to, any of the diseases or disorders described herein, including, but not limited to, aplastic anemia, myelodysplasia, myocardial infarction, epileptic disorder, multiple sclerosis, stroke, hypotension, cardiac arrest, ischemia, inflammation, loss of cognitive function related to aging, radiation damage, cerebral palsy, neurodegenerative disease, Alzheimer's disease, Parkinson's disease, Leigh's disease, AIDS dementia, memory loss, amilotropic lateral sclerosis (ALS) ), ischemic kidney disease, brain or spinal cord trauma, heart-lung bypass, glaucoma, retinal ischemia, retinal trauma, lysosomal storage diseases, such as Tay-Sachs syndromes, Niemann-Pick , Fabry, Gaucher, Hunter and Hurler, as well as other gangliosidoses, mucopolysaccharidosis,. glycogenosis, congenital errors of metabolism, adrenoleukodystrophy.
cystic fibrosis, glycogen storage disease, hypothyroidism, sickle cell anemia, Pearson's syndrome, Pompe's disease, phenylketonuria (PKU), porphyrias, maple syrup urine disease, homocystinuria, mucopolysaccharide nosis, chronic granulomatous disease and tyrosinemia, Tay-Sachs disease, cancer, tumors or other pathological or neoplastic conditions. In other modalities, the cells can be used in the treatment of any type of damage due to trauma, particularly trauma that involves inflammation. Examples of such trauma-related conditions include damage to the central nervous system (CNS), including damage to the brain, spinal cord, or tissue surrounding the CNS, damage to the peripheral nervous system (PNS), - or damage to any other part of the body. Such traumas can be caused by accidents, or they can be a normal or abnormal consequence of a medical procedure such as surgery or angioplasty. The trauma may be related to. a rupture or occlusion of a blood vessel, for example, in strokes or phlebitis. In specific modalities, the cells can be used in regeneration or replacement therapies or protocols of autologous or heterologous tissues, including, but not limited to, treatment of corneal epithelial defects, cartilage repair, facial dermabrasion, mucous membranes, tympanic membranes, intestinal linings, neurological structures (eg, the retina, auditory neurons in the basilar membrane, olfactory neurons in the olfactory epithelium), repair of burns or wounds due to traumatic skin damage, or for the reconstruction of other damaged or diseased organs or tissues. In a specific embodiment, the disease or disorder is aplastic anemia, myelodysplasia, leukemia, a disorder of the bone marrow or a disease or hematopoietic disorder. In another specific modality, the subject is a human. In another embodiment, the invention provides a method for treating an individual having a disease, disorder or condition associated with or resulting from inflammation. In other embodiments, the invention provides a method for treating an individual having a neurological disease, disorder or condition. In a more specific embodiment, said neurological disease is ALS. In a more specific embodiment, said neurological disease is Parkinson's disease. In another specific embodiment, said disease is a vascular or cardiovascular disease. In a more specific modality, said disease is atherosclerosis. In another specific modality, said disease is diabetes. In a specific embodiment, the pharmaceutical compositions of the invention comprise an aliquot of umbilical cord blood to which embryonic-like placental stem cells have been added, as described above in Section 4.4. A number of stem cells similar to embryonic cells, or cell populations. supplemented, administered. once, they are able to graft themselves into the host, forming "colonies" in the long term. This results in a host that is essentially chimeric. Since chimeras in other genetic contexts are generally more vigorous and elastic, it is expected that such chimerism will improve the health and well-being of the host. As such, embryonic-like stem cells can be administered not only to an individual suffering from a specific disease, disorder or condition, but can be administered to an individual to increase the overall health and well-being of the individual.
Stem cell populations similar to embryonic or supplemented cells of the invention can be treated before administration to an individual, with compounds that modulate TFM-ot activity. Such compounds are described in detail in copending U.S. Provisional Application No. 60 / 372,348, filed April 12, 2002, which description is incorporated herein in its entirety. Preferred compounds are known as IMiDs and SelCids, and particularly preferred compounds are available under the trade names Actimid ™ and Revimid ™. A particularly useful aspect of the embryonic-like stem cells of the invention is that, in certain embodiments, there is no need for HLA-type cells before administration. In other words, embryonic-like stem cells can be taken from a heterologous donor, or a plurality of heterologous donors, and transplanted to an individual in need of such cells, and the transplanted cells will remain within the host indefinitely. This elimination of the need for HLA typology greatly facilitates both the transplant procedure itself and the identification of donors for transplantation. However, populations of stem cells similar to embryonic or supplemented cells that contain them can be compared by HLA (donor to recipient) before administration. The inventors have discovered that the efficacy for treating an individual with embryonic-like or supplemented cell populations is improved if these cells are preconditioned. The preconditioning comprises storing the cells in a gas permeable vessel for a period of time at about -5 to 23 ° C, 0-10 IC, or preferably 4-5 ° C. The period of time can be between 18 hours and 21 days, between 48 hours and 10 days, and is preferably between 3-5 days. The cells can be cryopreserved before preconditioning or, preferably, they are preconditioned immediately before administration. Therefore, in one embodiment, the invention provides a method for treating an individual comprising, administering to said individual embryonic-like stem cells harvested from at least one donor. "Donor" as used herein means an adult, child, infant or, preferably, a placenta. In another preferred embodiment, the method comprises administering to said individual embryonic-like stem cells that are harvested from a plurality of donors and selected. In a specific embodiment, said embryonic-like stem cells are stem cells taken from a plurality of donors. When collected from multiple donors, the dosage units, where a "dosage unit" is a single-donor collection, can be selected before administration, can be administered sequentially, or can be administered alternately. In another method modality,. said embryonic-like stem cells are mixed with, or "spiked" in umbilical cord blood, and the mixture is administered to an individual. In more specific modalities of the method, the ratio of embryonic-like stem cells to cord blood can be at least 20:80, 30:70, 40:60, 50:50, 60:40, 70:30 or 80: 20, by number of cells with total nucleus. 4.7. ADMINISTRATION OF MOTHERS CELLS: DOSIFICATIONS.
A particularly useful aspect of the invention is the administration of high doses of stem cells to an individual; such numbers of cells are significantly more effective than the material (eg, bone marrow or cord blood) from which they were derived. In this context "high doses" indicates 5, 10, 15 or 25 or more times. he. number of cells' with total nucleus. Including stem cells, particularly stem cells similar to embryonic stem cells, which would be administered, for example, in a bone marrow transplant. Typically, a patient receiving an infusion of stem cells, for example, for a bone marrow transplant uses, receives a cell unit, where a unit is approximately 1 x 109 cells with core (corresponding to 1-2 x 10a stem cells) . For high-dose therapies, therefore, a patient should be administered 3 trillion, 5 trillion, 10 trillion, 15 trillion, 20 trillion, 30 trillion, 40 trillion 50 trillion or more, or alternatively 3, 5, 10, 20, 30, 40 or 50 units or more, of cells with total nuclei, either of embryonic-like stem cells alone, or of embryonic-like stem cells inserted in another population of stem or progenitor cells (e.g. embryonic cells inserted into umbilical cord blood In a preferred embodiment, for example, an individual is given 15 units of cord blood inserted, where the unit contains approximately 750 million cord cells and 500 million embryonic-like stem cells Therefore, in one embodiment, the number of stem cells with nuclei administered to an individual is at least five times the number of cells normally administered in a replacement of bone marrow In another specific embodiment of the method, the number of cells with nuclei administered to an individual is at least ten times the number of cells normally administered in a bone marrow replacement. In another specific embodiment of the method, the number of cells with core administered to an individual is at least fifteen times the number of cells normally administered in a bone marrow replacement. In another modus of the method, the total number of cells with nucleus, which includes the stem cells, administered to an individual, is between 1-100 x 108 per kilogram of body weight. In another embodiment, the number of cells with total nuclei administered is at least 5 trillion cells. In another embodiment, the total number of cells with nuclei administered is at least 15 trillion cells. In another embodiment of the method, said embryonic-like stem cells and said cord blood are mixed immediately before (i.e., in a matter of five minutes) administration to said individual. In another embodiment, said embryonic-like stem cells and said cord blood are mixed at a time point greater than five minutes before administration to said individual. In another form of the. method, the embryonic stem cells are cryopreserved and thawed before administration to said individual. In another embodiment, said embryonic-like stem cells and said blood, from the cord, are mixed to form a population of cells supplemented at a time point greater than twenty-four hours prior to administration to said individual, wherein said population of supplemented cells has been cryopreserved and thawed prior to said administration. In another embodiment, said embryonic-like stem cells and / or supplemented cell populations can be administered more than once. In another embodiment, said embryonic-like stem cells and / or said populations of supplemented cells are preconditioned by storage from 18 hours to 21 days prior to administration. In a more specific embodiment, the cells are preconditioned for 48 hours to 10 days, before administration. In a specific embodiment, said cells are preconditioned for 3-5 days before transplantation. In a preferred embodiment of any of the methods herein, said embryonic-like stem cells are not HLA-types prior to administration to an individual. In another specific embodiment of the method, said embryonic-like stem cells are mostly (ie, >50%) CD34 + cells. In a more specific mode of the method, said embryonic-like stem cells are primarily CD34 + 33 + stem cells. The therapeutic or prophylactic treatment of an individual, with populations of stem cells similar to embryonic or supplemented cells that contain them, can be considered effective if the disease, disorder or condition improves measurably in any way. Such improvement can be shown by a number of indicators. Measurable indicators include, for example, detectable changes in a physiological condition or set of physiological conditions associated with. a particular disease, disorder or condition (including, but not limited to, blood pressure, heart rate, respiratory rate, counts of various types of blood cells, levels in the blood of certain proteins, carbohydrates, lipids or cytokines or modulation in the expression of genetic markers associated with the disease, disorder or condition). The treatment of an individual with the populations of stem cells or supplemented cells of the invention, would be considered effective if any of said indicators responds to such treatment, changing to a value that is within, or closer to, the normal value. The normal value can be established by the normal ranges that are known in the art for various indicators, or by comparison with such values in a control. In the medium science, the effectiveness of a treatment is also frequently characterized in terms of the individual's impressions and the subjective feeling of the individual's state of health. The improvements, therefore, can also be characterized by subjective indicators, such as the individual's subjective feeling of improvement, increased well-being, increased health status, improved energy level, or the like, after the administration of the populations of stem cells or. of "Supplemented Cells" of the Invention Embryonic-like and supplemented cell populations of the invention can be administered to a patient in any pharmaceutically or medically acceptable manner, including by injection or transfusion. or supplemented cells can be contained, or contained in any pharmaceutically acceptable carrier (See, Section 4.8.) Embryonic-like or supplemented cell populations can be carried, stored or transported in any pharmaceutically or medically acceptable, for example, a blood bag, transfer bag, plastic tube or bottle 4.8 EQUIPMENT The invention also provides a package or equipment comprising one or more containers filled with one or more of the ingredients of the pharmaceutical compositions of the invention. Such containers may be: an apparatus for the cultivation of cells, one or more containers filled with a cell culture medium or one or more components of a cell culture medium, an apparatus for use in the administration of the compositions of the invention, for example, an apparatus for the intravenous injection of the compositions of the invention, and / or a warning in the form prescribed by a governmental agency that regulates the manufacture, use or sale of pharmaceutical products or biological, which notice reflects the approval by the agency, of manufacturing the use or sale for human administration. In a specific embodiment, the kit comprises one or more containers filled with the embryonic-like stem cells of the invention, and one or more different containers: filled with stem cell, e.g., umbilical cord blood, as discussed above. In one embodiment, the kit comprises a mixture of stem cells, for example, cord blood cells., supplemented with similar stem cells. embryonic cells contained in a bag or container. In another embodiment, the kit comprises "a population of cord blood cells and a population of embryonic-like stem cells that are contained within two separate pockets or containers." In certain embodiments, the kit comprises a "two" composition. bags "wherein the bag containing the cord blood cells and the bag containing the embryonic-like stem cells are mixed before or at the time of administration to a patient in need thereof. In other embodiments, the kit comprises a population of cord blood cells and a population of embryonic-like stem cells that are contained within two separate pockets or containers and that are administered separately (eg, simultaneously or sequentially) to a patient, wherein the mixing of the two populations of cells occurs in vivo. In another embodiment, the kit provides a population of blood cells. cord and a population of embryonic-like stem cells that are physically mixed before administration. In another aspect of this embodiment, the kit comprises a container containing a growth factor, for example, GM-CSF, IL-4, Flt3L, CD40L, IFN-alpha, TNF-alpha, IFN-gamma, IL-2, IL-6, retinoic acid, fibroblast basic growth factor, TGF-beta-1, TGF-beta-3, hepatocyte growth factor, epidermal growth factor, cardiotropin-1, angiotensinogen, angiotensin I (AI), angiotensin II (AII), AT2 receptor agonists AT2 type 2, or analog or fragments thereof. In another aspect of this embodiment, the two populations are physically mixed and then treated with the growth factor comprised in the kit, to induce cell differentiation, before administration to the patient. In another aspect of this embodiment, cord blood cells and / or embryonic-like stem cells are treated with the growth factor comprised in the kit, to induce cell differentiation and then physically mixed prior to administration to the cell. patient. The following experimental examples are offered by way of illustration and not by way of limitation. . 5. EXAMPLES 5.1 EXAMPLE 1: ANALYSIS OF TYPES OF CELLS
RECOVERED FROM THE PERFUME OF THE DRAINED PLACENTA This example describes the analysis of the types of cells recovered from the effluent perfusate of a cultured placenta according to the methods of the invention. Twenty mL of a phosphate buffered saline solution
(PBS) were added to the perfusion fluid and a 10 mL portion was collected and subjected to centrifugation for 25 minutes at 3000 rpm (revolutions per minute). The effluent was divided into four tubes and placed in a water bath. ice. 2.5 mL of a solution of fetal calf serum (FCS) at 1% was added, and the tubes were subjected to centrifugation (140 minutes x 10 g (acceleration due to gravity) .The pellet was resuspended in 5 mL of FSC at 1% and two tubes were combined.The total mononucleocytes were calculated by summing the total lymphocytes and the total monocytes, and then multiplying the result by the total volume of the cell suspension. 'The following table describes the types of cells obtained by perfusion. of a placenta cultured according to the methods described above.
WBC Volume 1000 / ml Lym% MID% GRA% Total # of Cells
CB (Blood of 10.5 43.2 8 48.8 6.3 x 108
Cord) PP (Perfected 12.0 62.9 18.2 18.9 1.8 x 10O8 Placenta, | * 'ambient temperature) PP2 (Perfused 11.7 56.0 19.2 24.8 3.5x108 placenta, 37 ° C)
PP samples were after Ficoll. The total number of cells for PP after Ficoll was 5.3 x 10a and the number of CB before processing is 6.3 x 108. Lym% indicates the percentage of lymphocytes; MID% indicates the percentage of white blood cells in the middle range; and GRA% indicates the percentage of granulocytes. 5.2. EXAMPLE 2: ANALYSIS OF THE CELLS CONTAINED BY THE
PERFUSION AND INCUBATION OF THE PLACENTA The following example describes an analysis of the cells obtained by perfusion and incubation of the placenta according to the methods of the invention. 5.2.1. MATERIALS AND METHODS Placental donors were recruited from pregnant mothers who enrolled in private umbilical cord blood bank deposition programs and provided documented consent allowing use of the placenta with blood drawn immediately after cord blood recovery. for research purposes. The data of the donor can be confidential. These donors also allowed the use of the protected data generated from the normal processing of their umbilical cord specimens for cryopreservation. This allowed comparison between the composition of the cord blood collected and the perfused effluent recovered using the experimental method described below. Following the extraction of cord blood from the umbilical cord and the placenta were stored at room temperature and delivered to the laboratory within twenty-four hours, according to the methods described here above, the placenta was placed in a sterile container, isolated, at room temperature and delivered to the laboratory within 4 hours of birth. Placentas were discarded if, on inspection, they had evidence of physical damage such as fragmentation of the organ or ablution of the umbilical vessels. Placentas were maintained at room temperature (23 + 2 ° C) or refrigerated (4 ° C) in sterile containers for 2 to 20 hours. Periodically, placentas were immersed and washed in sterile saline at 25 ± 3 ° C to remove any visible superficial blood debris. The umbilical cord was cut, transversally about 5 cm from if insertion into the placenta and the umbilical vessels were cannulated with TEFLON® or polypropylene catheters connected to a sterile fluid path, allowing bidirectional perfusion of the placenta and effluent fluid recovery . The methods described here allowed all aspects of placental conditioning, perfusion and the collection of the effluent to be carried out "under controlled atmospheric conditions., as well as real-time monitoring of intravascular pressure and flow velocities, core and perfusate temperatures, and volumes of effluent recovered.A range of conditioning protocols were evaluated during a period after the 24-hour period, and the cellular composition of the effluent fluid was analyzed by flow cytometry, light microscopy and assay of the colony formation unit 5.2.2 PLACENTA CONDITIONING The p-lacentas of the donors were processed at room temperature within a period of 12 to 24 hours after delivery Before the processing, the membranes were removed and the maternal site was washed out of the residual blood.The umbilical vessels were cannulated with catheters made of 20 gauge Butterfly needles used for the collection of blood samples. Placentas of the 1 donors were maintained under varying conditions such as maintenance to 5-37 °, 5% C02, pH 7.2 to 7.5, preferably pH 7.45, in an attempt to stimulate and sustain a physiologically compatible environment for the proliferation and recruitment of embryonic-like stem cells. The cannula was evacuated with IMDM serum free medium (GibcoBRL, NY). containing 2U / mL of heparin (Elkins-sinn, J). The perfusion of the placenta continued at a rate of 50 mL per minute until approximately 150 mL of perfusate was collected. The perfusate volume is labeled. "first fraction". Continuous perfusion of the placenta at the same rate resulted in the collection of a second fraction of approximately 150 mL and was labeled "last fraction". During the course of the procedure, the placenta was massaged gently to aid in the perfusion process and assist in the recovery of cellular material. The effluent fluid was collected from the perfusion circuit both by gravity drainage and aspiration through the arterial cannula. The placentas were perfused with heparinized Dulbeco modified Dulceco Medium Tagle (DMEM) (2U / mL) at the rate of 15 mL / minute for 10 minutes and the perfusates were collected from the maternal sites within a period of one hour and the cells with nucleus were counted. The perfusion and collection procedures were repeated once or twice until the number of recovered core cells dropped below 100 / mL. The perfusates were selected and subjected to light centrifugation to remove the platelets, debris and denuclearize the cell membranes. The nucleated cells were then isolated by Ficoll-Hypaque density gradient centrifugation and then washed, resuspended in H.DMEM. For the isolation of the adherent cells, aliquots of 10 x 106 cells were placed in each of the several T-75 flasks and cultured with commercially available Mesenchymal Stem Cell Culture Medium (MSCGM), obtained from BioWhittaker, and placed in an incubator for tissue culture (37 ° C, 5% C02). After 10 to 15 days, the non-adherent cells were removed by washing with PBS, which was then replaced by MSCGM. The bottles were examined daily for the presence of various types of adherent cells and in particular for the identification and expansion of clusters of fibroblast cells. * 5.2.3. RECOVERY AND ISOLATION OF THE. CELLS The cells recovered from the. perfused by centrifugation at 5000 x g for 15 minutes at room temperature. This procedure served to separate the cells from the polluting waste. The cell pellets were resuspended in IMDM serum-free medium, which contained 2U / mL of heparin and 2mM EDTA (GibcoBRL, NY). The total fraction of mononuclear cells was isolated using Lymphopred (Nycomed Pharma, Oslo, Norway) according to the procedure recommended by the manufacturer and the mononuclear cell fraction was resuspended. The cells were counted using a hemocytometer. Viability was assessed by trypan blue exclusion. The isolation of mesenchymal cells was achieved by "differential trypsinization" using a 0.05% trypsin solution with 0.2% EDTA (Sigma, St. Louis MO). Different trypsinization was possible because the fibroblastoid cells separated from the plastic surfaces within five minutes while the other adherent populations required more than 20-30 minutes of incubation. Separate fibroblast cells were harvested immediately after trypsinization and neutralization of trypsin, using Trypsin Neutralization Solution (TNS, BioWhittaker). The cells were washed in H.DMEM and resuspended in MSCGM. Flow cytometry was carried out using a FACSCAlibur instrument from Becton-Dickinson and the monoclonal antibodies labeled FITC and PE (mAbs), selected based on the known markers for MSCs (mesenchymal stem cells) derived from bone marrow, were purchased of BS and Caltag laboratoires (South San Francisco, CA), and hybridomas producer SH2, SH3 and SH4 antibodies were obtained from and the reactivities of the mAbs in their cultured supernatants were detected by the goat anti-mouse F (ab) '2 antibodies. labeled FITC or PE. The differentiation of the lineage was carried out using the culture medium for induction and maintenance (BioWhittaker), used according to the manufacturer's instructions. 5.2.4. ISOLATION OF MOTHER CELLS SIMILAR TO THE
PLACENTA EMBRYONISES Microscopic examination of the adherent cells in the culture flasks revealed different cell types -? morphologically different. Spindle-shaped cells, round cells with a large nucleus and numerous small perinuclear vacuoles, and cells in the form of stars with several projections (through which one of the cells in the form of stars were attached to the bottle), adhered to each other were observed. the culture flasks. Although no attempts were made to additionally characterize these adherent cells, similar cells were observed in the culture of bone marrow, cord blood and peripheral, and were therefore considered to be not cells similar to stem cells in nature. The fibroblastoid cells that appeared last as clusters were candidates for SC (mesenchymal stem cells) and were isolated by differential trypsinization and subcultured in secondary flasks. Phase microscopy of the rounded cells, after trypsinization, revealed that the cells were highly granulated; indistinguishable from MSCs derived from the bone marrow, produced in the laboratory or purchased from Bio hittaker. When subcultivaron, the embryonic stem cells derived from the placenta, in contrast to its first phase, adhered within a few hours, assumed fibroblastoid characteristics, and formed a growth pattern identical to the MSCs derived from the reference bone marrow. During the subculture and refeeding, in addition, the mononuclear cells adhered loosely were washed and the cultures remained homogeneous and devoid of any non-fibroblastoid contaminating cell. 5.2.5. RESULTS Expression of CD-34, CD-38 and other surface markers associated with stem cells in the purified mononuclear cells of the first and last fractions was evaluated by flow cytometry. The recovered, sorted cells were washed in PBS and then double stained with anti-CD34 phycoerythrin and anti-CD38 fluorescein isocyanate (Becton Dickinson, Mountain View, CA).
Isolation of the cells was achieved using magnetic separation of cells, such as, for example, Auto Macs (Miltenyi). Preferably, the isolation of the CD 34+ cells is carried out first. 5.3. EXAMPLE 3: MEANS OF PERFUSION The following example provides a solution formula for the preferred perfusate for the culture of isolated placenta.
Chemical Source Concentration Concentration 500 mL Final Base DMEM-LG GibcoBRL 1 1885- 300 mL 084 MCDB201 Sigma M-6770 dissolved in ph at 7.2 200 ml H20 filter FCS Hyclone 100% 2% 10 mL ITS Sigma 1-3146 or lOOx lx 5 mL GibcoBRL41400-045 Pend & Strep GibcoBRL15140- lOOx lx 5 mL 122 LA + BSA Sigma + GibcoBRL 100x (l μg / mL 10 ng / mL of 5 mL BSA of LA LA Dexamethasone Sigma D-2915 0.25mM in 0.05 μ? ??? μ? H20 L-Sigma A-8960 lOOOx (lOOmM) lx (0.1 mM) 500 μ? Ascorbic PDGF (50 R & D 220BD 10 μg / mL in 4 10 ng / mL 500 μ? mM HC1 + EGF (200 μg ) Sigma E-9644 10 μg / mL in 10 ng / mL 500 μ? HAc + 10 mM The composition above is a perfusate that can be used at a variety of temperatures to flood the placenta. such as antibiotics, anticoagulants and other growth factors, can be used in perfumes or culture media 5.4 EXAMPLE 4: INDUCTION OF DIFFERENTIATION IN TYPES
OF PARTICULAR CELLS Cord blood cells and / or cells. Similar to embryonic stem cells are induced to differentiate into a particular cell nucleus by exposure to a growth factor. Growth factors that are used to induce induction include, but are not limited to GM-CSF, IL-4, Flt3L, CD40L, IFN-alpha, TNF-alpha, IFN-gamma, IL-2, IL-6, retinoic acid, fibroblast growth factor, TGF-beta-1, TGF-beta-3, hepatocyte growth factor, epidermal growth factor, cardiotropin-1, angiotensinogens, angiotensin I (AI), angiotensin II (AII), AT2 receptor agonists AT2 type 2, or analogs or fragments thereof. 5.4.1 Induction of Differentiation in Neurons This example describes the induction of cord blood cells and / or embryonic-like stem cells to differentiate neurons. The following protocol is used to induce neuronal differentiation: 1. The placental stem cells are cultured for 24 h in a preinduction medium consisting of DMEM / 20% FBS and 1-mM beta-mercaptoethanol. 2. The pre-induction medium is removed and the cells are washed with PBS. 3. Neuronal induction medium consisting of DMD and 1-10 mM betamercaptoethanol is added. Alternatively, induction media consisting of DMDM / 2% DMSO / 200 μ ?, butylated hydroxyanisole can be used to improve the efficiency of neuronal differentiation. 4. In certain embodiments, morphological and molecular changes may occur as early as 60 minutes after exposure to serum free medium and betamercaptoethanol (O'odbury et al., Neurosoi, Res., 61: 364-370). RT / PCR can be used to evaluate the expression of, for example, the nerve growth factor receptor and the heavy chain genes of the neurofilaments. 5.4.2. Induction of Adipocyte Differentiation This example describes the induction of cord blood cells and / or embryonic-like stem cells to differentiate into adipocytes. The following protocol will be. • Used to induce adipogenic differentiation: 1. Placental stem cells are cultured in MSCGM (Bio hittaker) or DMEM supplemented with 15% cord blood serum. 2. Three induction cycles are used. Each cycle consists of feeding the placenta stem cells with Adipogenesis Induction Medium (Bio Whittaker) and culturing the cells for 3 days (at 37 ° C, 5% C02), followed by 1-3 days of culture in medium. of Maintenance of Adipogenesis (Bio Whittaker). An induction medium containing dexamethasone 1 μ ?, indomethacin 0.2-mM, 0.01 mg / mL insulin, 0.5 mM IBM, DMEM-high glucose, FBS, and antibiotics are used. . 3. After 3 complete induction / maintenance cycles, the cells are cultured for an additional 7 days in the maintenance medium of adipogenesis, replacing the medium every 2-3 days !. 4. Adipogenesis can be evaluated by the development of multiple intracytoplasmic lipid vesicles that can be easily observed using the red O lipophilic dyeing oil. RT / PCR assays are used to examine the expression of lipase and protein genes. of binding of the fatty acid. 5.4.3. Induction of Chondrocyte Differentiation This example describes the induction of cord blood cells or embryonic-like stem cells to differentiate into chondrocytes. The following protocol is used to induce chondrogenic differentiation: 1. Placental stem cells are maintained in MSCGM (Bio Whittaker) or DMEM supplemented with 15% cord blood serum. 2. Placental stem cells are taken as aliquots in a sterile polypropylene tube. The cells are subjected to centrifugation (150 x g for 5 minutes) and washed twice in half of incomplete chondrogenesis (Bio Whittaker). 3. After the last wash, the cells are resuspended in Incomplete Condrogenesis Medium (Bio Whittaker) containing 0.01 and g / mL of TGF-beta-3 at a concentration of 5 x 10 (5) cells / mL. 4. 0.5 mL of the. Cells are taken as aliquots in a 15 mL polypropylene culture tube. The cells are pelletized at 150 x g for 5 minutes. The pellet is left intact in the middle. 5. Loosely capped tubes are incubated at 37 ° C, 5% C02 for 24 hours. 6. The cell pellets are fed every 2-3 days with freshly prepared complete chondrogenesis medium. 7. The pellets are suspended in the medium by daily agitation using a low speed vortex. 8. Chondrogenic cell pellets are harvested after 14-28 days in culture. 9. Chondrogenesis can be characterized, for example, by observing. the production of the substance esophnophilic. milled, evaluating the morphology of. cells and / or RT / PCR to examine the expression of the collagen 2 gene and t collagen 9.,. 5.4.4 Induction of Differentiation in Osteocytes This example describes the induction of cord blood cells and stem cells similar to embryonic stem cells to differentiate into osteocytes. The following protocol is used to induce osteogenic differentiation: 1. Adherent cultures of placental stem cells are grown in MSCGM (Bio Whittaker) or DMEM supplemented with 15% cord blood serum. 2. The cultures are allowed to stand for 24 hours in tissue culture bottles. 3. Osteogenic differentiation is induced by replacing the MSCGM with osteogenic induction medium (Bio Whittaker) containing 0.1 μm dexamethasone, 0.05 mM ascorbic acid 2-phosphate, and 10 mM beta-glycerophosphate. 4. Cells are fed every 3-4 days for 2-3 weeks with Osteogenesis Induction Medium. 5. Differentiation is analyzed using a specific calcium dye and RT / PCR for alkaline phosphatase and the expression of the osteopontin gene. 5.4.5. Induction of Differentiation in Hepatocytes This example describes the induction of blood cells, cord or stem cells similar to embryonic, to differentiate into hepatocytes. The following protocol is used to induce hepatogenic differentiation: 1. Placental stem cells are cultured in DMEM / 20% CBS supplemented with hepatocyte growth factor, 20. ng / mL; and the epidermal growth factor, 100 mg / mL. The Agnesecan Serum Replacement can be used instead of CBS. 2. 50 ng / ml of IL-6 was added to the induction bottles. 5.4.6. Induction of Differentiation in Pancreatic Cells This example describes the induction of cord blood cells and / or embryonic-like stem cells to differentiate into pancreatic cells. The following protocol is used to induce pancreatic differentiation: 1. Placental stem cells are cultured in DMEM / 20% CBS supplemented with basic fibroblast growth factor, 10 ng / mL; and the transforming growth factor beta-1, 2 ng / mL. The Agnesecan Serum Replacement can be used instead of CBS. 2. The conditioned medium of the nestin-positive neuronal cell cultures is added to the medium at a concentration of 50/50. 3. Cells are cultured for 14-28 days, feeding every 3 -4 days. 4. The differentiation is characterized by analyzing the insulin protein or the expression of the insulin gene by RT / PCR. 5.4.7 Induction of Differentiation in Cardiac Cells This example describes the induction of cord blood cells or embryonic-like stem cells to differentiate into cells, cardiac cells. The following protocol is used to induce myogenic differentiation. | -. 1. The placental stem cells are grown in
DMEM / 20% CBS, supplemented with retinoic acid, 1 μ ?, fibroblast growth factor, 10 ng / mL; and the transforming growth factor beta-1, 2 ng / mL; and the epidermal growth factor, 100 ng / mL. Agneseic Serum Replacement may be used instead of CBS. 2. Alternatively, the placental stem cells are cultured in DMEM / 20% GBS supplemented with 50 ng / mL Cardiotropin-1 for 24 hours. , 3. Alternatively, the placenta stem cells are kept in protein-free medium for 5-7 days, then stimulated, with human myocardium extract (analysis of increasing doses). The extract of. Myocardium is produced by homogenizing 1 gm of human myocardium in 1% HEPES buffer supplemented with 1% cord blood serum. The suspension is incubated for 60 minutes, after which it is subjected to centrifugation and the supernatant is collected. 4. Cells are grown for 10-14 days, feeding them every 3-days. 5. Differentiation is evaluated using analysis of cardiac actin gene expression by RT / PCR. 5.4.8. Characterization of Cord Blood Cells and / or Embryonic-like Stem Cells Before and / or After Differentiation Embryonic-like stem cells, cord blood cells and / or blood cell populations of the cord inserted with embryonic-like stem cells are characterized before and / or after differentiation, measuring changes in morphology and cell surface markers, using techniques such as flow cytometry and immunocytochemistry, and measuring Changes in gene expression using techniques such as PCR. Cells that have been exposed to growth factors and / or that have differentiated are characterized by the presence or absence of the following cell surface markers; CD10 +, CD29 +, CD34-, CD38-, CD44 +, CD45-, CD54 +, CD90 +, SH2 +, SH3 +, SH4 +, SSEA3-, SSEA4-, 0CT-4 +, and ABC-p +. Preferably, the embryonic-like stem cells are characterized prior to differentiation, by the presence of the cell surface markers OCT-4 +, APC-p +, CD34- and GD38-. Stem cells carrying these markers are as versatile (eg, pluripotent) as human embryonic stem cells. The cord blood cells are characterized, before differentiation, by the presence of cell surface markers CD34 + and CD38 +. Differentiated cells derived from embryonic-like stem cells, cord blood cells and / or populations of cord blood cells inserted with embryonic-like stem cells preferably do not express these markers. 5.5 EXAMPLE 5: TREATMENT OF INDIVIDUALS WHO HAVE AMILOTROPIC SIDE SCLEROSIS, WITH AS MOTHER CELLS SIMILAR TO THE EMBRYONIALS Amyotrophic Lateral Sclerosis (ALS, also called Lou Gehrig's disease) is a fatal neurodegenerative disease affecting the motor neurons of the cortex, brainstem and spinal cord ALS affects as many as 20,000 Americans with 5,000 new cases occurring in the US each year.Most cases of ALS are sporadic (S-ALS) while -5-10% are inherited (Familial F-ALS) ALS occurs when specific nerve cells in the brain and spinal cord, which control voluntary movement, degenerate gradually.The cardinal feature of ALS is the loss of spinal motor neurons, which causes the Muscles under your control are weakened and discarded leading to paralysis.The ALS manifests itself in different ways, depending on which muscles are weakened. The ALS impacts on mature age with men who are one and a half times more likely to have the disease than women. ALS is usually fatal within five years after diagnosis. ALS has both the familial and sporadic form, and family forms have not been currently linked to several different genetic loci. Only about 5-10% of ALS cases are familial. Of these, 15-20% are due to mutations in the. gene encoding Cu / Zn superoxide dismutase 1 (SOD1). These appear to be "gain-of-function" mutations that confer toxic properties to the enzyme. The discovery of SOD mutations as a cause for ALS has paved the way for some progress in understanding the disease; animal models for the disease are now available and hypotheses are being developed and tested with respect to the molecular events that lead to cell death. The one presented below is an exemplary method for treating an individual who has ALS with the embryonic-like stem cells derived from the placenta. The intravenous infusion method involúcrala. through a peripheral, temporal angiocatheter. An individual who has ALS is evaluated first by performing the standard laboratory analyzes. Such analyzes may include a metabolic profile; CDC with differential; lipid profile, fibrinogen level; typing ABO rh of the blood; tests of liver function; and determination of BU / creatine levels. Individuals are instructed the day before the transplant to take the following medications: diphenhydramine (Benadryl ™), 25 mg t.i.d, and perdnisone, 10 mg. Embryonic-like stem cells, either isolated or inserted into cord blood, are taken from cryopreserved, thawed, and maintained for approximately two days before transplantation at a temperature of approximately 5 ° C. The individual is transplanted into a clinical center of external attention which has all the necessary facilities for intravenous infusion, monitors, physiological and physical observation. Approximately one hour before transplantation, the individual receives diphenhydramine (Benadryl ™), 25 mg x 1 P.O., and prednisone, 10 mg x 1 P.O. This is precautionary, and means reducing the likelihood of an acute allergic reaction. At the time of transfusion, a resident peripheral venous line 18 G is placed in one of the extremities of the individual and is kept open by the infusion of normal saline D5 ½ + 20 mEq of KCl at a rate of TKO. The individual is examined before transplantation, specifically to note the 'heart rate, respiratory rate, and temperature. Other monitoring can be carried out, such as an electrocardiogram and a blood pressure measurement. The embryonic-like stem cells are then infused at a rate of 1 unit per hour in a total administered volume of 60 mL, where one unit is approximately 1-2 x 109 cells with total nuclei. Alternatively, the unit of cells, embryonic-like stem, is administered in cord blood that has a total fluid volume of 60 mL. In this case, the ratio of the number of embryonic stem cells to stem cells in the cord blood is at least 2: 1. The administered unit may also consist of cord blood alone. Based on the data from the preclinical studies, a total of 2.0-2.5 x 108 cells per kilogram of body weight would be administered. The individual should be monitored for the signs of the allergic response "or hypersensitivity, which are signs of the immediate arrest of the infusion. After . of the infusion, the individual should be monitored in a recumbent position for at least 60 minutes, after which, he or she may resume normal activities. 5.6. EXAMPLE 6: TREATMENT OF INDIVIDUALS WHO HAVE
ATEROESCLEROSIS, USING STEM CELLS SIMILAR TO EMBRYONICS The infusion protocol delineated in Example 5 can be used to administer embryonic-like stem cells, either singly or inserted into umbilical cord blood, to a patient having atherosclerosis. Embryonic-like stem cells or supplemented e-cell populations can be administered to asymptomatic individuals, individuals who are candidates for
Claims (108)
- Angioplasty, or to patients who have recently suffered (within a week) of cardiac surgery. The present invention should not be limited in its scope to the specific embodiments described herein. Certainly, various modifications of the invention in addition to those described herein will become apparent to those skilled in the art from the foregoing description. Such modifications are intended to fall within the scope of the appended claims. All references cited herein are hereby incorporated by reference in their entirety and for all purposes to the same extent as if each patent publication or individual patent application was specifically and individually indicated to be incorporated as a reference in its entirety for all purposes. The citation of any publication is for description before the filing date and should not be considered as an admission that the present invention is not entitled to precede such publication by virtue of the prior invention. CLAIMS 1. A composition, characterized in that it comprises stem or progenitor cells and stem cells similar to embryonic ones. 2. A composition, characterized in that it comprises umbilical cord blood cells and embryonic-like stem cells. 3. The composition of claim 1, characterized in that it comprises a population of stem or progenitor cells and a population of embryonic-like stem cells. 4. The composition of claim 1 or 2, characterized in that it is contained in a container. The composition of claim 4, characterized in that the container is sealed, is air tight, and is sterile. 6. The composition of claim 1 or 2, characterized in that the stem or progenitor cells and the cm. they are in contact with each other before or at the time of administration to a patient in need thereof. The composition of claim 1 or 2 characterized in that the stem or progenitor cells of the embryonic-like stem cells are suitable for administration separately to a patient. 8. The composition of claim 1 or 2, 42 characterized because it is suitable for bone marrow transplantation. The composition of claim 1 or 2, characterized in that it is suitable for administration in r 5 humans. The composition of claim 1 or 2, characterized in that the stem or progenitor cells are blood cells of the umbilical cord or blood of the placenta, fetal or neonatal hematopoietic stem cells, 10 human stem cells, adult cells or stem cells or progenitors of the bone marrow. The composition of claim 10, characterized in that the stem or progenitor cells are fetal or neonatal hematopoietic stem or progenitor cells. 12. The composition of claim 11, characterized in that a plurality of hematopoietic stem or progenitor cells express cell surface markers CD34 + and CD38-. The composition of claim 10, characterized in that the stem or progenitor cells are blood stem cells of the umbilical cord. The composition of claim 13, characterized in that a plurality of umbilical cord blood stem cells express cell surface markers CD34 + and CD38-. 15. The composition of claim 13, characterized in that one. Plurality of umbilical cord blood stem cells express cell surface markers CD34 + and CD38 +. The composition of claim 1 or 2, characterized in that the embryonic-like stem cells exhibit at least one of the following cell surface markers: CD10, CD29, CD44, CD54, CD90, SH2, SH3, SH4, OCT-4 or ABC-p, or lack at least one of the following cell surface markers: CD34, CD45, SSEA3, SSEA4. . . 17. The composition of claim 16, characterized in that the embryonic-like stem cells are OCT-4 + and ABC-p +. 18. The composition of claim 16, characterized in that the embryonic-like stem cells are SSEA3- and SSEA4-. 19. A package comprising a composition of claim 1 or 2, characterized in that said stem or progenitor cells are in a first container and said embryonic-like stem cells are in a second container. 20. A method for preparing a composition comprising a plurality of stem or progenitor cells and a plurality of embryonic-like stem cells, which is characterized in that it comprises isolating and contacting the plurality of stem cells with the plurality of cells mother similar to the embryonic. 21. The method of claim 20, characterized in that the plurality of stem or progenitor cells and the plurality of embryonic-like stem cells are each contained in a separate container, prior to mixing. 20, characterized in that the composition is suitable for administration in humans 23. The method of claim 20, characterized in that the stem or progenitor cells are blood cells from the umbilical cord or blood of the placenta, fetal hematopoietic stem cells, stem or progenitor cells. or neonatal, adult cells or bone marrow progenitor or stem cells 24. The method of claim 20, characterized in that the stem or progenitor cells are fetal or neonatal hematopoietic stem or progenitor cells 25. The method of the claim 20, characterized in that a plurality of hematopoietic stem or progenitor cells express the arcs of the cell surface CD34 + and CD38-. 26. The method of claim 20, characterized in that the plurality of stem or progenitor cells and the plurality of embryonic-like stem cells are physically mixed. 27. A method for treating a patient in need thereof, characterized in that it comprises the administration of a plurality of stem cells or progenitors and a plurality of embryonic-like stem cells. 28. The method of claim 27, characterized in that the plurality of stem or progenitor cells and the plurality of embryonic-like stem cells are each contained in. a container, separate before mixing. 29. The method of claim 27, characterized in that the plurality of stem or progenitor cells and the plurality of embryonic-like stem cells are in contact with each other before or at the time of administration to a patient in need. from the same. 30. The method of claim 27, characterized in that the progenitor- and stem cells similar to embryonic stem cells are suitable for bone marrow transplantation. 31. The method of claim 27, characterized in that the stem or progenitor cells and embryonic-like stem cells are suitable for administration to a human. The method of claim 27, characterized in that the stem or progenitor cells are blood cells from the umbilical cord or blood from the placenta, fetal or neonatal hematopoietic stem or progenitor cells, human stem cells, adult cells, or cells mother or progenitors of the bone marrow. 33. The method of claim 32, characterized in that the stem or progenitor cells are fetal hematopoietic stem or progenitor cells. or neonatal 34. The method of claim 33, characterized in that a plurality of hematopoietic stem or progenitor cells express cell surface markers CD34 + and CD38-. 35. The method of the. Claim 32, characterized in that, stem or progenitor cells with blood stem cells. of the umbilical cord. . 36. The method of claim 35, characterized in that a plurality of umbilical cord blood stem cells express cell surface markers CD34 + and CD38-. 37. The method of claim 35, characterized in that ,, a plurality of umbilical cord blood stem cells express cell surface markers CD34 + and CD38 +. 38. The method of claim 27, characterized in that the embryonic-like stem cells exhibit at least one of the following cell surface markers: CD10 +, CD29 +, CD34-, CD44 +, CD45-, CD54 +, CD90 +, SH2 +, SH3 +, SH4 +, SSEA3-, SSEA4-, 0CT-4 + and ABC-p +. 39. The method of claim 38, characterized in that the embryonic-like stem cells are OCT-4 + and ABC-p +. 40. · The method of claim 38, characterized in that the embryonic-like stem cells are SSEA3- and SSEA4-. 41. The method of claim 27, characterized in that the plurality of stem or progenitor cells and the plurality of embryonic-like stem cells are mixed before or at the time of administration to a patient in need thereof. 42. The method of claim 27, characterized in that, the plurality of stem cell or. progenitors and the plurality of embryonic-like stem cells are physically mixed. 43.? The method of claim 27, characterized in that the plurality of stem or progenitor cells and / or the plurality of embryonic-like stem cells are treated with a growth factor to induce cell differentiation in a particular type of cells. 44. The method of claim 27, characterized in that the plurality of stem or progenitor cells and / or the plurality of embryonic-like stem cells are treated with a growth factor to prevent or suppress differentiation in a particular cell type. . 45. A method for treating a patient in need thereof, characterized in that it comprises the administration of a plurality of umbilical cord blood cells and a plurality of embryonic-like stem cells. 46. The method of claim 45, characterized in that the plurality of umbilical cord blood cells and the plurality of embryonic-like stem cells are each contained in a separate vessel prior to mixing. 47. The method of claim 45, characterized in that the plurality of umbilical cord blood cells and the plurality of embryonic-like stem cells are in contact with each other before or at the time of administration to a patient in need of treatment. the same. 48. The method of claim 45, characterized in that the plurality of umbilical cord blood cells and the plurality of embryonic-like stem cells are suitable for administration separately to a patient. 49. The method of claim 45, characterized in that the umbilical cord blood cells are fetal or neonatal hematopoietic progenitor or stem cells. 50. The method of claim 49, characterized in that a plurality of the hematopoietic stem or progenitor cells express the cell surface markers CD34 + and CD38 -.- 51. The method of claim 45, characterized in that a plurality of the stem cells of umbilical cord blood express cell surface markers CD34 + and CD38-. 52. The method of claim 45, characterized in that a plurality of umbilical cord blood stem cells express cell surface markers CD34 + and CD38 +. 53. The method of claim 45, characterized in that the embryonic-like stem cells exhibit at least one of the following cell surface markers: CD10 +, CD29 +, CD34-, CD44 +, CD45-, CD54 +, CD90 +, SH2 +, SH3 + , SH4 +, SSEA3-, SSEA4-, OCT-4 + and ABC-p +. 54. The method of claim 53, characterized in that the embryonic-like stem cells are OCT-4 + and ABC-pt. 55. The method of claim 53, characterized in that the embryonic-like stem cells are SSEA3- and SSEA4-. 56. The method of claim 45, characterized in that the plurality of stem or progenitor cells and the plurality of embryonic-like stem cells are mixed before or at the time of administration to a patient in need thereof. The method of claim 45, characterized in that the plurality of stem cells or progenitors and the plurality of embryonic-like stem cells are physically mixed. 58. The method of claim 45, characterized in that the plurality of umbilical cord blood stem cells and / or la. plurality of embryonic-like stem cells are treated with a growth factor. 59. The method of claim 58, characterized in that the plurality of umbilical cord blood stem cells and / or the plurality of embryonic-like stem cells are treated with a growth factor to induce differentiation in a particular type of cells 60. The method of claim 58, characterized in that the plurality of umbilical cord blood stem cells and / or the plurality of embryonic-like stem cells are treated with the growth factor to prevent or suppress differentiation in a particular type of cells . 61. The method of claim 45, characterized in that said patient has a disease, disorder or condition that includes an inflammation component. 62. The method of claim 45, characterized in that said patient has a disease, disorder or vascular condition. 63. The method of claim 62, characterized in that said disease, disorder or condition is atherosclerosis. 64. The method of claim 45, characterized in that said patient has a disease, disorder or neurological condition. 65. The method of claim 64, characterized in that said disease, disorder or condition is selected from the group consisting of amilotrophic lateral sclerosis and multiple sclerosis. 66. The method of claim 45, characterized in that said patient has an autoimmune disorder. 67. The method of claim 66, characterized in that said disorder is selected from the group consisting of diabetes and amilotropic lateral sclerosis. 68. The method of claim 45, characterized in that said patient has a condition that is caused by or associated with trauma or injury. 69. The method of claim 68, characterized in that said trauma or injury is a trauma or damage to the central nervous system. 10 70. - The method of claim 68, characterized in that said trauma or injuries is traumatic or injuries to the peripheral nervous system. 71. A method for treating myelodysplasia, which is characterized in that it comprises, administering blood cells 15 of the umbilical cord or stem cells isolated from it, and embryonic-like stem cells, to a patient in need of them. 72. The method of claim 71, characterized in that the administration of cord blood cells 20. umbilical (or stem cells isolated from it) and the administration of 'embryonic-like stem cells is concurrent. 73. The method of claim 71, characterized in that umbilical cord blood cells (or stem cells isolated therefrom) and embryonic-like stem cells are combined prior to administration. 74. A method for transplanting hematopoietic progenitor cells for the treatment or prevention of diseases, which method is characterized in that it comprises administering umbilical cord blood cells (or stem cells isolated therefrom) and embryonic-like stem cells, a patient in need of them. 75. The method of claim 74, characterized in that the administration of umbilical cord blood cells, or stem cells isolated therefrom, and the administration of embryonic-like stem cells, is concurrent. 76. The method of claim 74, characterized in that the umbilical cord blood cells, • the stem cells isolated therefrom, and the embryonic-like stem cells, are combined before administration. 77. A composition, which is characterized in that it comprises stem cells or umbilical cord blood progenitors supplemented with a plurality of embryonic-like stem cells. 78. A method for treating a patient in need thereof, characterized in that it comprises the administration of at least 5 x 109 cells with nucleus to said patient, said at least 5 x 108 cells with nucleus comprising stem cells similar to those embryonic 79. The method of claim 78, characterized in that said embryonic-like stem cells are contained in a. container. 80. The method of claim 78, characterized in that said embryonic-like stem cells are suitable for administration to a patient. 81. The method of claim 78, characterized in that said embryonic-like stem cells are suitable for bone marrow transplantation. 82. The method of claim 78, characterized in that said embryonic-like stem cells are suitable for administration in humans. 83. The method of claim 78, characterized in that the embryonic-like stem cells exhibit at least one of the following cell surface markers: CD10 + CD29 +, CD34-, CD44 +, GD45-, CD54 +, CD90 +, SH2 +, SH3 +, SH4 +, SSEA3-, SSEA4-, OCT-4 + and ABC-p +. 84. The method of claim 83, characterized in that the embryonic-like stem cells are OCT-4+ and ABC-p +. " 85. The method of claim 83, characterized in that the embryonic-like stem cells are SSEA3- and SSEA4-. . 86. The method of claim 78, characterized in that the embryonic-like stem cells are treated with a growth factor. 87. The method of claim 8.6, characterized in that the growth factor is a cytokine, lymphokine, interferon, colony stimulating factor (CSF), interferon, chemokine, interleukin, human hematopoietic growth factor, hematopoietic growth factor ligand , stem cell factor, thrombopoietin (Tpo), granulocyte colony stimulating factor (G-CSF), leukemia inhibitory factor, fibroblast basic growth factor, placental-derived growth factor or epidermal growth factor . 88. The method of claim 87, characterized in that the embryonic-like stem cells are treated with the growth factor to induce differentiation in a plurality of cell types. 89. The method of claim 87, characterized in that the plurality of embryonic-like stem cells is treated with the growth factor to prevent or suppress differentiation in a particular type of cells. 90. The method of claim 78, characterized in that said treatment comprises administering at least 10 x 108 cells with total nucleus. 91. The method of claim 78, characterized in that said treatment comprises administering at least 20 x 109 cells with total nucleus. 92. The method of claim 27, characterized in that the 30% hands of said cells in said composition are embryonic-like stem cells. 93. The method of claim 27, characterized in that at least 60% of said cells in said composition are embryonic-like stem cells. 94. The method of claim 78, characterized in that said patient has a disease, disorder or condition that includes an inflammation component. 95. The method of claim 78, characterized in that said patient has a disease, disorder or vascular conditions. 96. The method of claim 95, characterized in that said disease, disorder or condition is atherosclerosis. 97. The method of claim 78, characterized in that said patient has a disease, disorder or neurological condition. 98. The method of claim 97, characterized in that said disease, disorder or condition is selected from the group consisting of amilotropic lateral sclerosis and multiple sclerosis. 99. The method of claim 78, characterized in that said patient has a disorder related to immunity. 100. The method of claim 99, characterized in that said autoimmune disorder is selected from the group consisting of allergies, diabetes and amilotropic lateral sclerosis. 101. The method of claim 78, characterized in that said patient has a condition that is caused by or associated with trauma or injury. 102. The method of claim 101, characterized in that said trauma or injury is trauma or damage to the central nervous system. 103. The method of claim 101, characterized in that said trauma or injury is trauma or injury to the peripheral nervous system. 104. The method of claim 78, characterized in that said at least 5 x 109 cells with core comprise a selection of cells derived from a plurality of donors. 105. The method of claim 78, characterized in that none of said cells in said at least 5 x 109 cells with nucleus is typed as HLA before said administration. 106. The method of claim 78, characterized in that said at least 5 x 109 nucleated cells are preconditioned between 18 hours and 21 days prior to said administration. 107. The method of claim 78, characterized in that said at least 5 x 109 nucleated cells are preconditioned between 48 hours and 10 days prior to said administration. 108. The method of claim 78, characterized in that said at least 5 x 109 nucleated cells are preconditioned between 3-5 days prior to said administration.
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US10/076,180 US20030032179A1 (en) | 2000-12-06 | 2002-02-13 | Post-partum mammalian placenta, its use and placental stem cells therefrom |
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PCT/US2003/004539 WO2003068937A2 (en) | 2002-02-13 | 2003-02-13 | Embryonic-like stem cells derived from post-partum mammalian placenta and uses and methods of treatment using said cells |
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MX (1) | MXPA04007732A (en) |
NZ (1) | NZ534643A (en) |
WO (1) | WO2003068937A2 (en) |
ZA (1) | ZA200406356B (en) |
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AU2008249204B2 (en) | 2011-03-10 |
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AU2003216286A1 (en) | 2003-09-04 |
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AU2003216286B2 (en) | 2008-08-28 |
IL163439A (en) | 2011-03-31 |
KR20040094426A (en) | 2004-11-09 |
NZ534643A (en) | 2010-06-25 |
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