Future Potential
While cell therapy describes the transplantation of stem/progenitor cells into an organism by various measures (usually intravenously), this characterization does not describe the mechanism of action by which the cells treat a disease. In cell therapy, the cells may act by secreting paracrine factors or by a receptor-ligand interaction with other cells if the immune system permits. Most work to date concentrates on this methodology.
Cell replacement therapy requires the (trans)differentiation of therapeutic stem/progenitor) cells into tissue cells of the target organ, e.g. stem cells becoming insulin-producing cells. While cell replacement therapy is the primary objective of cell therapy, it is only in clinical testing for the treatment of spinal cord injury and AMD thus far. Tissue engineering so far has only been modestly successful as the understanding of, and ability to artificially engineer, complete organ structures is still in its early days. Rather, the future potential of cell therapy may lie in the field of modulating the immune system for the treatment of autoimmune diseases like inflammatory bowel disease or rheumatoid arthritis (RA) by the mechanisms described above.
While xenotransplantation is still in its clinical infancy, without current clinical trials and exhibiting a host of ethical and technical difficulties, another very promising field is cell-based gene therapy. This would be a sequential step towards a clinically successful gene therapy and the treatment of numerous diseases like inherited disorders or cancers. It involves the genetic manipulation of patient cells, and their subsequent re-transplantation to the patient. However, any manipulation of stem or progenitor cells in vitro (cultivation, expansion or gene transfer) is a substantial matter and therefore requires a strictly regulated environment as described in guidelines by the European Medicinal Agency (EMA) or the Food and Drug Administration (FDA) to protect the potential patient from medical malpractice and to ensure the highest degree of clinical safety.
See also:Induced stem cells
Read more about this topic: Cell Therapy
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