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History of fetal stem cell transplantation

The idea of fetal stem cell transplantation is quite clear and some would say that it is well known and that it has already been tried, etc. But simplicity and clarity can be attributed to the idea rather than the method. It has been a long way from an idea to a functional and promising method for efficient, safe, and predictable everyday application in clinical practice. For example, the idea of blood transfusion existed for millennia, with uncounted attempts to use it for saving peoples' lives, but only in the last century it has been turned into a routine method.

Application of adult cells has always been problematic secondary to such phenomenon as histocompatibility, which means almost no chance for the cells to survive and engraft. This rejection was prevented by immunosuppression, thus causing serious health problems, reducing resistance to infections, increasing probability of tumor recurrence, etc. Cord blood stem cells should also be regarded as adult stem cells, thus they can be used for autotransplantation only.

Application of animal stem cells was even more problematic. Being heterologous, they are destroyed and rejected by the immune system. Numerous methods presupposing application of animal fetal and embryonic material cannot be regarded as transplantation, secondary to their inability to restoration or substitution for damaged cells, multiplication and proper functioning in the recipient’s body. Therapeutic effects of this kind of treatment derive from biologically active substances. Duration of the effects is limited by the time of existence of these substances (a few weeks). Clinical improvements of this therapy is somewhat longer and can last several months.

History of modern fetal stem cell transplantation dates back to the 70’s of the XX century, when investigations to find an effective alternative for bone marrow transplantation for hematological diseases, condition after chemo/radiotherapy, and some types of inborn immune deficiencies were initiated.

Special collections of articles on this subject where published in 1980, 1985, and 1992.

In June 1992, The First International Congress on Cell Transplantation was held in Pittsburgh, climaxing in formation of Cell Transplant Society.

In March 1999, The Fourth International Congress on Cell Transplantation was held in Montreaux, Switzerland. Our Cell Therapy Clinic presented five papers on the unique experience of clinical application of FSCT in patients with diabetes, AIDS, cancer, autoimmune bowel diseases, and on psycho-physiological effects manifested after FSCT.

The year of 1992 was also marked by the first ever issue of a new scientific journal - Cell Transplantation.

In 1990, Network of European CNS Transplantation and Restoration (NECTAR) was founded, aimed at a joint effort of European countries to develop efficient, reliable, safe, and ethically acceptable transplantation therapy for degenerative diseases of nervous system, Parkinson's Disease and Chorea Huntington in particular. In order to support applications for human fetal or fetal neurotransplantation studies, NECTAR issued guidelines enabling European legislation start working on this issue.

In 2000, first European conference on the subject - Cellular Therapy was held at Pasteur Institute, in Paris.

During the last 20 years, doctors and researchers from more than 20 countries of the world (France, Italy, Austria, Canada, the USA, China, Russia, Czech, Ukraine, India, Columbia, Poland, Germany, United Kingdom, Japan, etc.) presented articles on cell transplantation.

"Tissue from human fetal cadavers has long been used for medical research, experimental therapies, and various other purposes. Research within the last two decades has led to substantial progress in many of these areas, particularly in the application of fetal tissue transplantation to the treatment of human disease. As a result, clinical trials have now been initiated at centers around the world to evaluate the use of human fetal tissue transplantation for the therapy of Parkinson's disease, insulin-dependent diabetes mellitus, and a number of blood, immunological and, metabolic disorders... ".

"A combination of characteristics renders fetal tissue uniquely valuable for such transplantation... Although substitutes for human fetal tissue are being actively sought, for many of these applications there are at present no satisfactory alternatives."

"Important issues remain unresolved concerning the procurement, distribution, and use of human fetal cadaver tissue as well as the effects of such use on abortion procedures and incidence. These issues can be addressed by the introduction of appropriate guidelines or legislation, and need not be an impediment to legitimate research and therapeutic use of fetal tissue."

(Fine, A. Department of Physiology and Biophysics, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. "Human fetal tissue research: practice, prospects, and policy. [Review]", Cell Transplantation. 3(2): 113-45, 1994 Mar-Apr.)