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CBC Health

From EverybodyWiki Bios & Wiki




CBC Health (Cord Blood Center Group or CBCG) is a regenerative health company that specializes in umbilical cord blood derived hematopoietic stem cell transplants for patients with ischemic stroke. The organization has active branches in Switzerland, Austria, Slovakia, Italy, Romania, Hungary, and Czech Republic. CBCG owns and operates Eurocord-Slovakia, a cord blood registry and repository.

History

CBCG was founded in 1997 as one of the first health organizations in Europe to process and prepare umbilical cord blood for regenerative transplant therapies.

CBCG was one of the first in Europe to collect, process, and store cord blood, cord tissue, and placenta tissue. It has over 160,000 clients storing cord blood and/or related tissues for use in the future.

CBCG is directly involved in regenerative clinical research to support the field of regenerative medicine. Since 2012, they have conducted and/or participated in research projects and clinical trials aimed to find therapies for diseases that have no cure, such as cerebral palsy and ischemic stroke. Several of these studies have taken place at leading medical institutions including Duke University Hospital.

In 2018, CBCG began the process of opening a new medical facility in Munich, Germany. This institution, called CBC Health Med Munich, focuses on giving cord blood treatments to patients suffering from ischemic stroke.

Eurocord-Slovakia, also founded in 1997, is a CBCG company that was among the first in Europe to establish a registry and repository for storing personal cord blood as well as donated cord blood to be used for the general population. It has granted authority from the Ministry of Health of the Slovak Republic to operate laboratories that process and store stem cells from umbilical cord blood, umbilical cord tissue, and bone marrow.

Eurocord-Slovakia is a member of the international database of Bone Marrow Donors Worldwide (BMDW), also known as the World Marrow Donor Association (WMDA). It is also a partner of the European Marrow Donor Information System (EMDIS). The BMDW has named Eurocord-Slovakia the best in the world for the highest average quantity of total nucleated cells in its cord blood grafts eight years in a row, from 2007 to 2014.

Medical Director

Nils H. Thoennissen, MD is the acting medical director of CBC Health, with over 20 years of experience in medicine and over 14 years of clinical experience in hemotherapy. Dr. Thoennissen is an international specialist in cancer, chronic degenerative diseases, and regenerative medicine.

Dr. Thoennissen has attended four accredited educational institutions: University of Münster, Germany; Cardiff University School of Medicine, Great Britain; Johannes Gutenberg University of Mainz, Germany; and Cedars-Sinai Medical Center, UCLA, U.S.A.

His doctoral thesis neurological research at the University of Münster earned summa cum laude. Since then, he has earned six awards for his innovation in medicine and has authored (or co-authored) 40 publications.

Services

CBCG performs cord blood transplants on ischemic stroke patients who qualify for this experimental treatment. The cord blood is filtered through the blood vessels of the brain to promote healing in stroke recovery.

Cord blood is used for transplantation as the only form of regenerative cells, also known as stem cells. This blood is allogenic, meaning it has been donated from members of the general population.

Cord Blood

Composition

Umbilical cord blood contains all the elements found in whole adult blood – red blood cells, white blood cells, plasma, and platelets.[1]. In addition to the basic components of blood, cord blood contains unique concentrations of certain lymphocytes and stem cells [2].

Lymphocytes

It has a higher number of natural killer cells which are critical to the innate immune system [3]. These cells provide rapid responses to virus-infected cells and tumor formation [4]. Cord blood contains a lower absolute number of T-cells and a higher proportion of immature T-cells [5]. These types of lymphocytes play a central role in controlling and shaping the immune system.

Stem Cells

Cord blood contains various types of stem cells, which is its most clinically significant component. Stem cells are described as multipotent, meaning they have the ability to differentiate into many other types of cells. They can divide in self-renewal to produce more of the same type of stem cells. Umbilical cords contain mostly hematopoietic stem cells [6].

Although some non-hematopoietic stem cell types are present, such as mesenchymal stem cells, they are present in much lower numbers than can be found in adult bone marrow [7] [8]. Therefore, the interest in umbilical cord blood is driven by its hematopoietic stem cells (HSCs) and their abilities to treat about 80 different diseases and counting [9]. HSCs have the ability to differentiate into other blood cells through a process called hematopoiesis.

Progenitor Cells

Cord blood also contains progenitor cells, which are often mistakenly grouped with stem cells. They are described as oligopotent, meaning they have the ability to differentiate into a few cell types. Progenitor cells are more specific than stem cells in that they tend to differentiate into a specific type of cell [10]. The main difference between stem cells and progenitor cells is that stem cells can replicate indefinitely, whereas progenitor cells can only divide a limited number of times.

Collection

Process

Once the baby completely leaves the birth canal and the umbilical cord is cut off, there is a decent amount of leftover blood in the cord and the placenta. There are two options after birth: throw the cord away or save it for future use. There are numerous cord blood banks in the U.S. and around the world that can bank and preserve the child's cord blood. It can be banked for future use on the child, a family member, or donated to others who need it.

The process is very easy and painless for both the mother and the newborn baby. After the baby is born, the umbilical cord is cut and clamped down to hold all the fluid inside. This process is standard, whether or not the parents wish to harvest the cord blood. The doctor will then insert a thin needle into the cord to draw the blood. It takes around 10 minutes for an obstetrician or the maternity staff at the hospital to perform this blood draw.

Banking

Not all hospitals offer this service and those that do may even require a separate fee to obtain the cord blood. For questions about banking cord blood, to donate or not, parents must let their doctor know about 6 weeks before the due date. If the hospital does not offer cord blood banking, parents may have to contact the cord blood bank to organize the harvest.

Storage

Collected umbilical cord blood is cryopreserved and stored in a cord blood bank for future use. Cord blood is typically depleted of red blood cells before cryopreservation to ensure high rates of stem cell recovery [11].

Cryopreservation is a process in which biological matter is cooled to very low temperatures, typically -80 degrees Celsius using solid carbon dioxide or -196 degrees Celsius using liquid nitrogen [12]. At such low temperatures, any enzymatic or chemical activity that can cause damage and degeneration to the biological material is effectively stopped.

History

In 1983, umbilical cord blood was discovered to be a rich source of stem cells. However, it wasn't until 1988 that the first successful cord blood transplant was carried out in a child with Fanconi anemia [13]. By 2013, 30,000 cord blood procedures had been performed and about 600,000 units of cord blood were held in banks [14].

Regulation

The AABB (American Association of Blood Banks) is an international non-profit association that generates accreditation standards for cord blood banking facilities[15]. In the U.S., the FDA (Food and Drug Administration) regulates any facility that stores cord blood [16]. Cord blood intended for use in the person from whom it came from is not regulated, but cord blood for use in others is regulated as a drug and as a biologic.

The regulation of stem cell research in Europe varies based on country[17], in terms of the current legal position and ethical and regulatory oversight. In terms of cord blood, specifically, three European Union (EU) directives [18] establish the minimum requisites of quality and safety pertaining to the donation, procurement, testing, processing, preservation, storage, and distribution of cord blood cells [19].

Clinical Significance

The stem cells present in umbilical cord blood are used the same way that hematopoietic stem cell transplantation is used. This process can be used to reconstitute bone marrow after radiation treatment for various cancers. Cord blood is used to treat cancers, blood disorders, bone marrow failure syndromes, metabolic disorders, immunodeficiencies, and other conditions (Hemophagocytic lymphohistiocytosis, Osteopetrosis, and Langerhans cell histiocytosis) [20].

Mechanism of Treatment

When a brain area suffers a stroke, neurons are killed, creating an infarct. In this damaged region, beneficial neurotrophins are eliminated, cells and vascular networks are damaged, inflammation occurs, and immunity to diseases is weakened [21].

Cord blood has been effective in treating ischemic stroke by halting brain damage, improving brain function, and regenerating damaged neural pathways [22]. Infusing a patient with cord blood initiates cell replacement, provides a neurotrophic influence, promotes immune benefits, and mediates inflammation reduction [23].

Cell Replacement

The progenitor cells in cord blood migrate to the infarct and differentiate into the appropriate cells along the penumbra, replacing cells that were damaged adjacent to the infarct. This process is called neurogenesis and it is a key factor for stroke recovery [24].

Neurotrophic Influence

Cord blood contains several growth factors that aid in the proliferation, differentiation, and survival of healthy and weakened cells. Key neurotrophic factors include FGF, BDNF, NGF, VEGF, NT3, and NT4 which enhance neurogenesis and promote neuroplasticity [25].

Immune Benefits

Stem cells, especially oligodendrocyte progenitor cells, can modulate the immune response for individuals suffering from multiple sclerosis and ischemic strokes [26]. Through paracrine signaling, revived neural networks can then alert the immune system to respond to and eliminate pathogens in the brain. The pluripotent cells in cord blood can regenerate all types of cells in diseased tissue and revive natural immune response mechanisms.

One major advantage of umbilical cord blood stem cells is that they are immunologically tolerant, rendering them less reactive to human leukocyte antigen (HLA)‐mismatch than bone marrow or mobilized peripheral blood grafts. Allogeneic (donated) stem cells possess immune-privileged properties that protect tissues and regenerate neural networks adjacent to infarcts [27].

Inflammation Reduction

Neuroinflammation plays a major role in the pathophysiology of stroke. To initiate healing, inflammation must be controlled. Stem cells play an important role in modulating inflammation after an infarct so that cells can be repaired. In studies, stem cells have migrated to regions of high inflammation and have provided beneficial effects such as secreting neurotrophins to reduce brain inflammation and protect nerve cells [28].

Clinical Results

Clinical Trial

Duke University released a follow-up study to determine the effectiveness of utilizing cord blood in ischemic stroke treatment, referred to as the CoBIS (Cord Blood Infusion for Adults With Ischemic Stroke) study [29]. The clinical trial assessed the safety and feasibility of a single IV infusion of non‐human leukocyte antigen (HLA) matched, ABO matched, and unrelated allogeneic cord blood into adult stroke patients [30].

Methods & Results

Ten participants with acute middle cerebral artery ischemic stroke were enrolled. Cord blood units were matched for blood group antigens and race but not HLA and infused 3-9 days post‐stroke. The adverse event profile over a 12-month post-infusion period indicated that the treatment was well‐tolerated in these stroke patients, with no serious adverse events directly related to the study product [31].

Study participants were also assessed using neurological and functional evaluations, including the modified Rankin Score (mRS) and the National Institute of Health Stroke Scale (NIHSS). At 3 months post‐treatment, all participants had improved by at least one grade in mRS (mean 2.8 ± 0.9) and by at least 4 points in NIHSS (mean 5.9 ± 1.4), relative to baseline [32]

References

  1. ↑ https://www.karger.com/Article/Abstract/46537
  2. ↑ Newcomb, J. D.; Sanberg, P. R.; Klasko, S. K.; Willing, A. E. (2007). "Umbilical Cord Blood Research: Current and Future Perspectives". Cell Transplantation. 16 (2): 151–158. doi:10.3727/000000007783464623. PMC 2720821. PMID 17474296.
  3. ↑ Vivier, E.; Raulet, D. H.; Moretta, A.; Caligiuri, M. A.; Zitvogel, L.; Lanier, L. L.; Yokoyama, W. M.; Ugolini, S. (2011). "Innate or Adaptive Immunity? The Example of Natural Killer Cells". Science. 331 (6013): 44–49. Bibcode:2011Sci...331...44V. doi:10.1126/science.1198687. PMC 3089969. PMID 21212348.
  4. ↑ Vivier, E.; Raulet, D. H.; Moretta, A.; Caligiuri, M. A.; Zitvogel, L.; Lanier, L. L.; Yokoyama, W. M.; Ugolini, S. (2011). "Innate or Adaptive Immunity? The Example of Natural Killer Cells". Science. 331 (6013): 44–49. Bibcode:2011Sci...331...44V. doi:10.1126/science.1198687. PMC 3089969. PMID 21212348.
  5. ↑ Beck, R.; Lam-Po-Tang, P. R. (1994). "Comparison of cord blood and adult blood lymphocyte normal ranges: A possible explanation for decreased severity of graft versus host disease after cord blood transplantation". Immunology and Cell Biology. 72 (5): 440–4. doi:10.1038/icb.1994.65. PMID 7835989.
  6. ↑ Galieva, L. R.; Mukhamedshina, Y. O.; Arkhipova, S. S.; Rizvanov, A. A. (2017). "Human Umbilical Cord Blood Cell Transplantation in Neuroregenerative Strategies". Frontiers in Pharmacology. 8: 628. doi:10.3389/fphar.2017.00628. PMC 5599779. PMID 28951720.
  7. ↑ Newcomb, J. D.; Sanberg, P. R.; Klasko, S. K.; Willing, A. E. (2007). "Umbilical Cord Blood Research: Current and Future Perspectives". Cell Transplantation. 16 (2): 151–158. doi:10.3727/000000007783464623. PMC 2720821. PMID 17474296.
  8. ↑ Beck, R.; Lam-Po-Tang, P. R. (1994). "Comparison of cord blood and adult blood lymphocyte normal ranges: A possible explanation for decreased severity of graft versus host disease after cord blood transplantation". Immunology and Cell Biology. 72 (5): 440–4. doi:10.1038/icb.1994.65. PMID 7835989.
  9. ↑ https://www.viacord.com/treatments-and-research/treatable-diseases-today/list-of-diseases/
  10. ↑ Roura, S.; Pujal, J. M.; Gálvez-Montón, C.; Bayes-Genis, A. (2015). "The role and potential of umbilical cord blood in an era of new therapies: A review". Stem Cell Research & Therapy. 6 (1): 123. doi:10.1186/s13287-015-0113-2. PMC 4489204. PMID 26133757.
  11. ↑ Pegg, David E. (2007). "Principles of Cryopreservation". Cryopreservation and Freeze-Drying Protocols. Methods in Molecular Biology. 368. pp. 39–57. doi:10.1007/978-1-59745-362-2_3. ISBN 978-1-58829-377-0. Search this book on
  12. ↑ Pegg, David E. (2007). "Principles of Cryopreservation". Cryopreservation and Freeze-Drying Protocols. Methods in Molecular Biology. 368. pp. 39–57. doi:10.1007/978-1-59745-362-2_3. ISBN 978-1-58829-377-0. Search this book on
  13. ↑ https://www.nature.com/articles/bmt2009280
  14. ↑ "Archived Copy". Archived from the original on 2021-01-14. Retrieved 2019-09-25.CS1 maint: Archived copy as title (link)
  15. ↑ Armitage, S. (2016). "Cord Blood Banking Standards: Autologous Versus Altruistic". Frontiers in Medicine. 2: 94. doi:10.3389/fmed.2015.00094. PMC 4705863. PMID 26779485.
  16. ↑ https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/cord-blood-banking-information-consumers
  17. ↑ https://www.eurostemcell.org/regulation-stem-cell-research-europe
  18. ↑ "European Union".
  19. ↑ Petrini, Carlo (2012). "European regulations on cord blood banking: An overview". Transfusion. 52 (3): 668–679. doi:10.1111/j.1537-2995.2011.03257.x. PMID 21790628.
  20. ↑ https://www.viacord.com/treatments-and-research/treatable-diseases-today/list-of-diseases/
  21. ↑ Xu, W.; Zheng, J.; Gao, L.; Li, T.; Zhang, J.; Shao, A. (2017). "Neuroprotective Effects of Stem Cells in Ischemic Stroke". Stem Cells International. 2017: 4653936. doi:10.1155/2017/4653936. PMC 5512103. PMID 28757878.
  22. ↑ Zhao, Li-Ru; Willing, Alison (2018). "Enhancing endogenous capacity to repair a stroke-damaged brain: An evolving field for stroke research". Progress in Neurobiology. 163-164: 5–26. doi:10.1016/j.pneurobio.2018.01.004. PMC 6075953. PMID 29476785.
  23. ↑ Zhao, Li-Ru; Willing, Alison (2018). "Enhancing endogenous capacity to repair a stroke-damaged brain: An evolving field for stroke research". Progress in Neurobiology. 163-164: 5–26. doi:10.1016/j.pneurobio.2018.01.004. PMC 6075953. PMID 29476785.
  24. ↑ Abu-Rub, M.; Miller, R. H. (2018). "Emerging Cellular and Molecular Strategies for Enhancing Central Nervous System (CNS) Remyelination". Brain Sciences. 8 (6): 111. doi:10.3390/brainsci8060111. PMC 6024921. PMID 29914096.
  25. ↑ Zhao, Li-Ru; Willing, Alison (2018). "Enhancing endogenous capacity to repair a stroke-damaged brain: An evolving field for stroke research". Progress in Neurobiology. 163-164: 5–26. doi:10.1016/j.pneurobio.2018.01.004. PMC 6075953. PMID 29476785.
  26. ↑ Abu-Rub, M.; Miller, R. H. (2018). "Emerging Cellular and Molecular Strategies for Enhancing Central Nervous System (CNS) Remyelination". Brain Sciences. 8 (6): 111. doi:10.3390/brainsci8060111. PMC 6024921. PMID 29914096.
  27. ↑ Li, L.; Baroja, M. L.; Majumdar, A.; Chadwick, K.; Rouleau, A.; Gallacher, L.; Ferber, I.; Lebkowski, J.; Martin, T.; Madrenas, J.; Bhatia, M. (2004). "Human Embryonic Stem Cells Possess Immune-Privileged Properties". Stem Cells. 22 (4): 448–456. doi:10.1634/stemcells.22-4-448. PMID 15277692.
  28. ↑ Ul Hassan, A.; Hassan, G.; Rasool, Z. (2009). "Role of Stem Cells in Treatment of Neurological Disorder". International Journal of Health Sciences. 3 (2): 227–233. PMC 3068820. PMID 21475541.
  29. ↑ Laskowitz, Daniel T.; Bennett, Ellen R.; Durham, Rebecca J.; Volpi, John J.; Wiese, Jonathan R.; Frankel, Michael; Shpall, Elizabeth; Wilson, Jeffry M.; Troy, Jesse; Kurtzberg, Joanne (2018). "Allogeneic Umbilical Cord Blood Infusion for Adults with Ischemic Stroke: Clinical Outcomes from a Phase I Safety Study". Stem Cells Translational Medicine. 7 (7): 521–529. doi:10.1002/sctm.18-0008. PMID 29752869.
  30. ↑ Laskowitz, Daniel T.; Bennett, Ellen R.; Durham, Rebecca J.; Volpi, John J.; Wiese, Jonathan R.; Frankel, Michael; Shpall, Elizabeth; Wilson, Jeffry M.; Troy, Jesse; Kurtzberg, Joanne (2018). "Allogeneic Umbilical Cord Blood Infusion for Adults with Ischemic Stroke: Clinical Outcomes from a Phase I Safety Study". Stem Cells Translational Medicine. 7 (7): 521–529. doi:10.1002/sctm.18-0008. PMID 29752869.
  31. ↑ Laskowitz, Daniel T.; Bennett, Ellen R.; Durham, Rebecca J.; Volpi, John J.; Wiese, Jonathan R.; Frankel, Michael; Shpall, Elizabeth; Wilson, Jeffry M.; Troy, Jesse; Kurtzberg, Joanne (2018). "Allogeneic Umbilical Cord Blood Infusion for Adults with Ischemic Stroke: Clinical Outcomes from a Phase I Safety Study". Stem Cells Translational Medicine. 7 (7): 521–529. doi:10.1002/sctm.18-0008. PMID 29752869.
  32. ↑ Laskowitz, Daniel T.; Bennett, Ellen R.; Durham, Rebecca J.; Volpi, John J.; Wiese, Jonathan R.; Frankel, Michael; Shpall, Elizabeth; Wilson, Jeffry M.; Troy, Jesse; Kurtzberg, Joanne (2018). "Allogeneic Umbilical Cord Blood Infusion for Adults with Ischemic Stroke: Clinical Outcomes from a Phase I Safety Study". Stem Cells Translational Medicine. 7 (7): 521–529. doi:10.1002/sctm.18-0008. PMID 29752869.


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