Rethinking importance of cord blood in regenerative medicine

General Studies Paper 2

Context

• Cord blood banking is not a ‘biological insurance’ and its role in regenerative medicine is hypothetical. It is recommended only if there is a family member (siblings or biological parents only), currently suffering from diseases approved to be benefitted by allogenic stem cell transplantation.

Cord Blood

• The blood from the newborn that is still present in the placenta and umbilical cord after birth is known as cord blood.
• Umbilical cord blood is a rich source of stem cells; i.e., Hematopoietic stem cells, which are unique cells and can be employed to cure certain disorders.
• In the body, hematopoietic stem cells can develop into many types of blood cells.
• Worldwide, cord blood banking is advised as a source of hematopoietic stem cells for transplantation for haematological malignancies and illnesses where its usage is advised (derived from bone marrow, peripheral blood, or umbilical cord blood).

Cord Blood Banking

• A System that preserves umbilical cord blood for use in the future is known as a Cord Blood Bank.
• Private and public cord blood banks have emerged in response to the prospect of using cord blood to treat immunological and blood-related illnesses.
• Public cord blood banks operate similarly to public blood banks in that they accept donations to be utilised for anybody in need. Historically, the medical establishment has been more open to the idea of public cord blood banking. Private cord blood banks only keep cord blood for the donor or the donor’s family to potentially use.
• However, the Indian Council of Medical Research (ICMR) asserts that there is no scientific support for cord blood storage for future self-use, posing moral and social concerns.
• The ICMR does not advocate using stem cells for commercial purposes and Commercial cord blood banking also.

Collection and Cryopreservation of Cord Blood

• After the umbilical cord has been severed, cord blood is collected from the foetal end of the cord.
• The placenta may be used to obtain more stem cells. The placenta is transported to the stem cell lab, where it is processed for extra stem cells after the healthcare professional takes cord blood from the placental end of the umbilical cord. In order to guarantee that there will be enough cells for a transplant, sufficient cord blood collection requires at least 75mL.
• Before the cord blood is kept for future use, it is tested for viruses, such as HIV and Hepatitis B and C, and tissue typing is done to ascertain the kind of human leukocyte antigen.
• Additionally, it will be checked for bacterial and fungal growth as well as nucleated cell count, cell viability, blood group antigen ABO & Rh blood group system, molecular cluster, and blood group antigen.
• The cord blood unit is collected, sent to the lab for processing, and then frozen.
• For the cord blood to survive the cryogenic process, a cryopreserved is added regardless of how the unit is processed. The cord blood unit can be placed in a liquid nitrogen tank to maintain freezing at 196 °C after being gradually cooled to 90 °C.

Uses of Cord Blood

• Despite primarily coming from donors, cord blood stem cells are now being used to treat a number of deadly diseases, most notably malignancies, blood disorders, and genetic diseases of the blood and immune system.
• Recent research has revealed that cord blood transplants have special benefits over conventional bone marrow transplants, especially for children.
• In rare circumstances where a suitable bone marrow donor cannot be found, cord blood transplants can even save a patient’s life.
• There is a 25% probability that siblings will match, and there is a 50% chance that grandparents and parents will match using cord blood.

Advantages of Cord Blood Banking

• Compared to bone marrow, more people can obtain stem cells from cord blood. This is due to the fact that, unlike a bone marrow transplant, cord blood does not need to closely match the recipient’s own blood.
• The probability that a person’s body will reject stem cells from cord blood is lower than that of bone marrow.
• During cancer therapies, cord blood stem cells may help the immune system. This is not a method of using bone marrow stem cells.
• Compared to collecting bone marrow, collecting cord blood is less difficult, uncomfortable, and dangerous for the donor.
• The newborn or the person giving birth is not in danger from the cord blood harvest.

Concerns Related to Cord Blood Banking

• It may not be wise or effective to use one’s own cord blood cells, particularly in situations of leukaemia and cancer in children. Because the blood also carries the same genetic abnormality, children who develop immunological disorders frequently cannot receive a transplant using their own cord blood.
• Additional problems include the potential for the cord blood unit to be contaminated with same cancer that was discovered later in life.

Conclusion

• Commercial cord blood banking involves storing a newborn’s umbilical cord blood stem cells for potential future medical use.
• The decision to bank cord blood is personal and should be based on individual circumstances and considerations such as the family history of genetic disorders and the likelihood of using the stored cells.
• It is important to carefully research and compare different cord blood banking options and consider the cost, storage options, and reputation of the facility before making a decision.