In’t Anker et al (20) first showed that the AM contains a high number of MSCs with bipotential osteogenic and adipogenic differentiation. Bailo et al (38), in 2004, researched how to induce AM-hMSCs to differentiate into a variety of cell types. Chondrogenic differentiation, inferred after a 3-week immunohistochemical analysis, demonstrated the presence of human type II collagen. Osteogenic differentiation, the formation of mineralized matrix when cells become flattened and show calcium deposits, was revealed as early as the first week of induction. Adipogenic differentiation resulted in single adipocytic multivacuolar cells, together with small and large colonies, with the size increasing with the length of induction. Large-size aggregates displayed an intensive secretion of large, neutral, lipid drops. This was never observed with BM-hMSC adipogenic cells (39). Nonstimulated cells were able to give rise to capillary-like structures following the same kinetics, but with less organizational efficiency than the induced cells. Cell treatment with VEGF increased the expression levels of both VEGF receptors and was associated with a clear cytoplasmatic granular positivity for von Willebrand factor compared with untreated cells. Loh et al (40) demonstrated that AM-hMSCs expressed mRNA at greater levels than BM-hMSCs, increasing the potential for cell differentiation and the capacity of cells to be induced to form tissue structures far beyond that of BM-hMSCs. Bri-chard et al (41) demonstrated that AM-hMSCs yield more organized myogenic differentiation than those derived from adipocytes. In’t Anker et al (20) demonstrated that AM-hMSCs maintained the potential to differentiate in a multitude of cell types at a greater and more organized rate than MSCs from any other source.
As the reader can see, there is a significant body of literature and science behind the use of placental tissue allografts. Additionally there are no articles describing any adverse events using placental allografts. There are published papers demonstrating that placental tissue allografts has antimicrobial capabilities, anti tumorgenic capabilities in addition to its ability to amplify the recipient’s regenerative potential.
There still is a long way to go for us to have a deep understanding of the underlying biology of stem cells and regenerative medicine. Going from discovery to product in medicine faces a number of hurdles. Questions of source quality, scalability, cost, and regulatory standards are challenges still being solved. Stem cell therapies have also had their fair share of criticism, depending on the source of the cells. The regenerative potential present in the placental tissues is great because they’re of the highest quality. Over the years stem cells in the body accumulate defects, but placental stem cells are young, healthy, and robust, with a fresh set of instructions to reboot the system. These tissues are easily obtained, as many people dispose of the placenta after birth.
There also appears to be regulatory progress with the passage of the CURES act by congress and the RMAT program at the FDA. We are beginning to see approvals using cellular medicine to treat a variety of autoimmune diseases, degenerative diseases, and cancers
Patients and industry need to understand our present limitations, and outliers need to be corralled and controlled in order to make sure that the products are of the highest quality and the clinical application is at the highest standards.
I see a very bright future at the beginning of a new age in medicine. My vision is to extend regenerative therapeutics beyond wound care and cartilage repair to the most severe diseases such as diabetes, neurodegenerative diseases, and various organ pathologies.