Fetal stem cell transplantation

doi:10.1017/CBO9780511997778.042

Chapter 20.3 - Fetal stem cell transplantation

fetal tissue engineering

from Section 2 - Fetal disease

Published online by Cambridge University Press: 05 February 2013

Fabienne L. Gray and

Edited by

Anthony Johnson and

Mark D. Kilby: Affiliation:
Department of Fetal Medicine, University of Birmingham
Anthony Johnson: Affiliation:
Baylor College of Medicine, Texas
Dick Oepkes: Affiliation:
Department of Obstetrics, Leiden University Medical Center

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Summary

Introduction

The fetus is an ideal tissue-engineering subject, both as donor and host. The unique characteristics of fetal cells, combined with the developmental and long-term impacts of implanting tissue constructs into a fetus, add new perspectives to tissue engineering, significantly expanding its reach. Perhaps surprisingly, however, it was only a little over ten years ago that the concept widely referred to as fetal tissue engineering was first proposed and proven viable experimentally. This notion involves the procurement of fetal cells, preferably through minimally invasive techniques, followed by their processing in the engineering of tissue constructs in vitro in parallel to the remainder of gestation, so that an infant or a fetus with a prenatally diagnosed birth defect could benefit from having autologous, expanded tissue readily available for surgical implantation in the perinatal period. A variety of prenatally diagnosable birth defects may be amenable to this approach. The following is a summarized review of the current status of fetal tissue engineering, along with other pertinent information.

Historical outline

The first attempts at utilizing fetal cells in a therapeutic setting took place almost a century ago, thus long before the modern era of transplantation. The first reported transplantation of human fetal tissue took place in 1922, when a fetal adrenal graft was transplanted into a patient with Addison’s disease [1]. This, along with a few other similar efforts involving different fetal cells and tissues over the following years, was unsuccessful. It is only over the past three decades that fetal tissue transplantation has resulted in somewhat favorable outcomes, albeit essentially anecdotally.

Keywords

fetal tissue engineering maternal blood fetal cell sources fetal stem cell transplantation amniotic fluid congenital anomalies

Information

Type: Chapter
Information: Fetal Therapy
Scientific Basis and Critical Appraisal of Clinical Benefits
, pp. 407 - 416
DOI: https://doi.org/10.1017/CBO9780511997778.042 [Opens in a new window]
Publisher: Cambridge University Press
Print publication year: 2012

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References

Hurst, AF, Tanner, WE, Osman, AA. Addison’s disease with severe anemia treated by suprarenal grafting. Proc R Soc Med 1922;15:19.Google Scholar

Cacanti, JP, Morse, MA, Saltzman, WM, et al. Selective cell transplantation using bioabsorbable artificial polymer as matrices. J Pediatr Surg 1988;23(Pt 2):3–9.Google Scholar

Cusick, RA, Sano, K, Lee, H, et al. Heterotopic fetal rat hepatocyte transplantation on biodegradable polymers. Surg Forum 1995;XLVJ:658–61.Google Scholar

Fauza, DO, Fishman, SJ, Mehegan, K, Atala, A. Videofetoscopically assisted fetal tissue engineering: bladder augmentation. J Pediatr Surg 1998;33(1):7–12.Google Scholar

Fauza, DO, Fishman, SJ, Mehegan, K, Atala, A. Videofetoscopically assisted fetal tissue engineering: skin replacement. J Pediatr Surg 1998;33(2):357–61.Google Scholar

Fauza, D. Amniotic fluid and placental stem cells. Best Pract Res Clin Obstet Gynaecol 2004;18(6):877–91.Google Scholar

Hoehn, H, Salk, D. Morphological and biochemical heterogeneity of amniotic fluid cells in culture. Methods Cell Biol 1982;26:11–34.Google Scholar

Torricelli, F, Brizzi, L, Bernabei, PA, et al. Identification of hematopoietic progenitor cells in human amniotic fluid before the 12th week of gestation. Ital J Anat Embryol 1993;98(2):119–26.Google Scholar

Streubel, B, Martucci-Ivessa, G, Fleck, T, Bittner, RE. [In vitro transformation of amniotic cells to muscle cells – background and outlook]. Wien Med Wochenschr 1996;146(9–10):216–17.Google Scholar

Kaviani, A, Guleserian, K, Perry, TE, et al. Fetal tissue engineering from amniotic fluid. J Am Coll Surg 2003;196(4):592–7.Google Scholar

In ‘t Anker, PS, Scherjon, SA, Kleijburg-van der Keur, C, et al. Amniotic fluid as a novel source of mesenchymal stem cells for therapeutic transplantation. Blood 2003;102(4):1548–9.Google Scholar

Noort, WA, Kruisselbrink, AB, In ‘t Anker, PS, et al. Mesenchymal stem cells promote engraftment of human umbilical cord blood-derived CD34(+) cells in NOD/SCID mice. Exp Hematol 2002;30(8):870–8.Google Scholar

Zhao, P, Ise, H, Hongo, M, et al. Human amniotic mesenchymal cells have some characteristics of cardiomyocytes. Transplantation 2005;79(5):528–35.Google Scholar

Kunisaki, SM, Jennings, RW, Fauza, DO. Fetal cartilage engineering from amniotic mesenchymal progenitor cells. Stem Cells Dev 2006;15(2):245–53.Google Scholar

Tsai, MS, Hwang, SM, Tsai, YL, et al. Clonal amniotic fluid-derived stem cells express characteristics of both mesenchymal and neural stem cells. Biol Reprod 2006;74(3):545–51.Google Scholar

De Coppi, P, Bartsch, G Jr, Siddiqui, MM, et al. Isolation of amniotic stem cell lines with potential for therapy. Nat Biotechnol 2007;25(1):100–6.Google Scholar

Kaviani, A, Perry, TE, Dzakovic, A, et al. The amniotic fluid as a source of cells for fetal tissue engineering. J Pediatr Surg 2001;36(11):1662–5.Google Scholar

Klein, JD, Fauza, DO. Amniotic and placental mesenchymal stem cell isolation and culture. Methods Mol Biol 2011;698:75–88.Google Scholar

Kunisaki, SM, Fuchs, JR, Azpurua, H, Zurakowski, D, Fauza, DO, eds. A comparison of different perinatal sources of mesenchymal progenitor cells: implications for tissue engineering. Thirty-seventh Annual Meeting of the American Pediatric Surgical Association. Hilton Head, SC, 2006.

Kunisaki, SM, Fuchs, JR, Steigman, SA, Fauza, DO. A comparative analysis of cartilage engineered from different perinatal mesenchymal progenitor cells. Tissue Eng 2007;13(11):2633–44.Google Scholar

Klein, JD, Turner, CG, Steigman, SA, et al. Amniotic mesenchymal stem cells enhance normal fetal wound healing. Stem Cells Dev 2011;20(6):969–76.Google Scholar

Fauza, DO, Marler, JJ, Koka, R, et al. Fetal tissue engineering: diaphragmatic replacement. J Pediatr Surg 2001;36(1):146–51.Google Scholar

Fuchs, JR, Terada, S, Ochoa, ER, Vacanti, JP, Fauza, DO. Fetal tissue engineering: in utero tracheal augmentation in an ovine model. J Pediatr Surg 2002;37(7):1000–6.Google Scholar

Fuchs, JR, Hannouche, D, Terada, S, Vacanti, JP, Fauza, DO. Fetal tracheal augmentation with cartilage engineered from bone marrow-derived mesenchymal progenitor cells. J Pediatr Surg 2003;38(6):984–7.Google Scholar

Fuchs, JR, Terada, S, Hannouche, D, et al. Fetal tissue engineering: chest wall reconstruction. J Pediatr Surg 2003;38(8):1188–93.Google Scholar

Fuchs, JR, Kaviani, A, Oh, JT, et al. Diaphragmatic reconstruction with autologous tendon engineered from mesenchymal amniocytes. J Pediatr Surg 2004;39(6):834–8.Google Scholar

Fuchs, JR, Hannouche, D, Terada, S, et al. Cartilage engineering from ovine umbilical cord blood mesenchymal progenitor cells. Stem Cells 2005;23(7):958–64.Google Scholar

Fuchs, JR, Nasseri, BA, Vacanti, JP, Fauza, DO. Postnatal myocardial augmentation with skeletal myoblast-based fetal tissue engineering. Surgery 2006;140(1):100–7.Google Scholar

Kaviani, A, Perry, TE, Barnes, CM, et al. The placenta as a cell source in fetal tissue engineering. J Pediatr Surg 2002;37(7):995–9.Google Scholar

Krupnick, AS, Balsara, KR, Kreisel, D, et al. Fetal liver as a source of autologous progenitor cells for perinatal tissue engineering. Tissue Eng 2004;10(5–6):723–35.Google Scholar

Kunisaki, SM, Fuchs, JR, Kaviani, A, et al. Diaphragmatic repair through fetal tissue engineering: a comparison between mesenchymal amniocyte- and myoblast-based constructs. J Pediatr Surg 2006;41(1):34–9; discussion 34–9.Google Scholar

Kunisaki, SM, Freedman, DA, Fauza, DO. Fetal tracheal reconstruction with cartilaginous grafts engineered from mesenchymal amniocytes. J Pediatr Surg 2006;41(4):675–82.Google Scholar

Steigman, SA, Ahmed, A, Shanti, RM, et al. Sternal repair with bone grafts engineered from amniotic mesenchymal stem cells. J Pediatr Surg 2009;44(6):1120–6; discussion 1126.Google Scholar

Klein, JD, Turner, CG, Ahmed, A, et al. Chest wall repair with engineered fetal bone grafts: an efficacy analysis in an autologous leporine model. J Pediatr Surg 2010;45(6):1354–60.Google Scholar

Turner, CG, Klein, JD, Steigman, SA, et al. Preclinical regulatory validation of an engineered diaphragmatic tendon made with amniotic mesenchymal stem cells. J Pediatr Surg 2011;46(1):57–61.Google Scholar

Gray, FL, Turner, CG, Ahmed, A, et al., eds. Prenatal tracheal reconstruction with a hybrid aMSC-engineered construct derived from decellularized airway. Section on Surgery of the American Academy of Pediatrics Annual Meeting. Boston, MA, 2011.

Steigman, SA, Nemes, L, Barnewolt, CE, et al. Differential risk for neonatal surgical airway intervention in prenatally diagnosed neck masses. J Pediatr Surg 2009;44(1):76–9.Google Scholar

Sartore, S, Lenzi, M, Angelini, A, et al. Amniotic mesenchymal cells autotransplanted in a porcine model of cardiac ischemia do not differentiate to cardiogenic phenotypes. Eur J Cardiothorac Surg 2005;28(5):677–84.Google Scholar

Iop, L, Chiavegato, A, Callegari, A, et al. Different cardiovascular potential of adult- and fetal-type mesenchymal stem cells in a rat model of heart cryoinjury. Cell Transplant 2008;17(6):679–94.Google Scholar

Schmidt, D, Mol, A, Breymann, C, et al. Living autologous heart valves engineered from human prenatally harvested progenitors. Circulation 2006;114(1 Suppl):I125–31.Google Scholar

Schmidt, D, Achermann, J, Odermatt, B, et al. Prenatally fabricated autologous human living heart valves based on amniotic fluid derived progenitor cells as single cell source. Circulation 2007;116(11 Suppl):I64–70.Google Scholar

Shin’oka, T, Imai, Y, Ikada, Y. Transplantation of a tissue-engineered pulmonary artery. N Engl J Med 2001;344(7):532–3.Google Scholar

Hibino, N, McGillicuddy, E, Matsumura, G, et al. Late-term results of tissue-engineered vascular grafts in humans. J Thorac Cardiovasc Surg 2010;139(2):431–6, 6.e1–2.Google Scholar

Horwitz, EM, Prockop, DJ, Fitzpatrick, LA, et al. Transplantability and therapeutic effects of bone marrow-derived mesenchymal cells in children with osteogenesis imperfecta. Nat Med 1999;5(3):309–13.Google Scholar

Guillot, PV, Abass, O, Bassett, JH, et al. Intrauterine transplantation of human fetal mesenchymal stem cells from first-trimester blood repairs bone and reduces fractures in osteogenesis imperfecta mice. Blood 2008;111(3):1717–25.Google Scholar

Turner, CG, Klein, JD, Gray, FL, et al., eds. Craniofacial repair with fetal bone grafts engineered from amniotic mesenchymal stem cells. 42nd Annual Meeting of the American Pediatric Surgical Association. Palm Desert, CA, 2011.

Adzick, NS, Thom, EA, Spong, CY, et al. A randomized trial of prenatal versus postnatal repair of myelomeningocele. N Engl J Med 364(11):993–1004.

Fauza, DO, Jennings, RW, Teng, YD, Snyder, EY. Neural stem cell delivery to the spinal cord in an ovine model of fetal surgery for spina bifida. Surgery 2008;144(3):367–73.Google Scholar

Turner, CG, Klein, JD, Wang, J, et al., eds. A practical prenatal source of autologous neural progenitor cells for the treatment of spina bifida. 42nd Annual Meeting of the American Pediatric Surgical Association. Palm Desert, CA, 2011.

Sumi, S, Gu, Y, Hiura, A, Inoue, K. Stem cells and regenerative medicine for diabetes mellitus. Pancreas 2004;29(3):e85–9.Google Scholar

Furth, ME, Atala, A. Stem cell sources to treat diabetes. J Cell Biochem 2009;106(4):507–11.Google Scholar

Kadam, SS, Sudhakar, M, Nair, PD, Bhonde, RR. Reversal of experimental diabetes in mice by transplantation of neo-islets generated from human amnion-derived mesenchymal stromal cells using immuno-isolatory macrocapsules. Cytotherapy 2010;12(8):982–91.Google Scholar

Li, B, Wang, S, Liu, H, et al. Neuronal restrictive silencing factor silencing induces human amniotic fluid-derived stem cells differentiation into insulin-producing cells. Stem Cells Dev 2011;20(7):1223–31.Google Scholar

Biffl, WL, Spain, DA, Reitsma, AM, et al. Responsible development and application of surgical innovations: a position statement of the Society of University Surgeons. J Am Coll Surg 2008;206(3):1204–9.Google Scholar

International Society for Stem Cell Research. Guidelines for the Clinical Translation of Stem Cells. 2008. Available at (accessed September 2012).

Bouchie, A. Tissue engineering firms go under. Nat Biotechnol 2002;20(12):1178–9.Google Scholar

Fauza, DO. Tissue engineering: current state of clinical application. Curr Opin Pediatr 2003;15:267–71.Google Scholar

Vacanti, JP. Tissue engineering: from bench to bedside via commercialization. Surgery 2008;143(2):181–3.Google Scholar

Kunisaki, SM, Armant, M, Kao, GS, et al. Tissue engineering from human mesenchymal amniocytes: a prelude to clinical trials. J Pediatr Surg 2007;42(6):974–9; discussion 979–80.Google Scholar

Steigman, SA, Armant, M, Bayer-Zwirello, L, et al. Preclinical regulatory validation of a 3-stage amniotic mesenchymal stem cell manufacturing protocol. J Pediatr Surg 2008;43(6):1164–9.Google Scholar

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