Tribute Lecture at Brawijaya Women & Children Hospital Jakarta 2013 on the topic of the usefulness of human stem cell in dermatology including case reports

1. Stem cells technology in Dermatology
Indah Y

2. Why Stem Cells ?
 By definition, a stem cell is
characterized by its ability to self-renew
and its ability to trans differentiate
along multiple lineage pathways.

3. What are the unique properties of
all stem cells ?
 They are capable of dividing and renewing
themself for long periods
 They are unspecialized
 They can give rise to specialized cell types

4. DEFINITIONS
 Stem cells is a special kind of cell
that has a unique to renew itself
and to give rise to many specialized
cell types (pluripotency)
 Contrary to most cells of the body
 Stem Cells is uncomitted & remains
uncomitted, until it receives a signal to
develop into a specialized cell

5. What are the unique properties of all stem
cells
Three general properties :
They are capable of deviding and renewing
themself of long periods
They are unspecialized
They can give rise to specialized cell types

7. Stem cells can remain alive in human corpses for at least 17 days
after death, researchers say. Stem cells give rise to all other cells
in the body, a property that ...
Current Stem Cell Research & Therapy, 2013 , 8, 25-38

8. CLASSIFICATION OF STEM CELLS
Bongso et al., 2005

9. STANDART
MANUFACTURING
SCALE OF
ADULT STEM CELLS
Jeffrey MG et
al., 2010

10. MESENCHYMAL STEM
CELLS (MSC)

11. ADULT STM CELLS IN CLINICAL
APPLICATION
Frank P et al., 2004

12. Mesenchymal stem cells-MSC
MSC from Warthon jelly
Steffano Grosy et al., 2009

13. MSC from Adipose Lypoaspirate

14. MSC from Umbilical Cord
Blood (UCB-MSC)
PAS + staining

15. H Emma et
HEMATOPOIETIC STEM CELLS (HSC):
Hierarchy concept

16. HSC from bone marrow, circulating
blood, & umbilical cord blood

17. PROGENITOR
CELLS
Endothelial progenitor cells (EPC)
from Human umbilical vein endothelial cells
(HUVEC)

18. Neural progenitor cells (NPC)
from Umbilical cord blood derived MSC
Nestin
+
GFAP
+
NSE -
Umbilical cord
blood

19. EPIDERMALSTEM CELLS
CELLS & SKIN EQUIVALENT

20. Cell quality asessement
Stem cells sorting
High pure & viable cell
yieldMagnetic associated cell sorting

21. Flowcytometry Characterization for MSC
MSC: Positive expression of CD73, CD105, CD29
Xu-Fang Yang et al., 2011
Stem cells
characterization

22. Negative expression of hematopoietic marker:
CD34, CD45, HLA DR
Xu-Fang Yang et al., 2011

23. Adipogenic (Oil red
staining) Osteogenic (Alizarin red
staining)
Xu-Fang Yang et al., 2011
MSC differentiation capacity

24. Vb stainning
Xu-Fang Yang et al., 2011
Chromosomal abberation and karyotyping
screening

25. FROM CELL BASED THERAPY TO “CELL FREE”
BASED THERAPY
Illustration of cell based therapy (Takashi et al., 2007)

26. WHAT IS “CELL FREE” BASED THERAPY?
Illustration of therapeutic effect of stem cells (Tom JB et al., 2011)

27. EPC-CM and EPC transplantation improve blood perfusion in the
rat ischaemic hindlimb with increased capillary density. A. doppler
imaging. B. immunofluorescence

28. Angiogenic properties of EPC-CM

29. D8 Natural healing D8 With hMSC D8 with hMSC-
CM

30. Stem cell based therapy
Therapeutic outcome depends
on cells engraftment
Major limitation related to
Alloimmunity reaction
“Cell free” based
therapy
Cell free medium containing
paracrine secretome may
reduce risk of adverse
immunological reaction

31. Xeno- free supplementation system
Human Platelet Lysate (HPL) supplementation
replace Fetal bovine serum (FBS) supplementation
Cell culture manipulation for producing specific
defined “cell free” secretome

32. Hypoxic culture condition for promoting defined
secretome related Hypoxic Inducible Factor gene
pathway induction

33. 3D spheroid culture system for promoting
secretion of specific cytokine
3D spheroid colony (3000-5000
cells/colony)

34. Proteome profiling of cells
secretome
Ultrafiltration of Secretome
Endotoxin &
mycoplasma assay

35. Warthon jelly-MSC secretomes
(NCBI, Siu KZ et al., 2007)

36. Scretome of HUVEC
(NCBI-David GT et al., 2009)

38. Summary of MSC secretome (L. Da Silva et
al., 2007)

39. Mesenchymal stem cell roles in each phase of the wound-healing process.
Maxson S et al. Stem Cells Trans Med 2012;1:142-149
©2012 by AlphaMed Press

41. January 31 st, , Man, 33 years old, Peri anal
fistula,diameter 10 x 15 deep 10 cm after 7x surgery with
general anesthesia
By Indah Yulianto – 2013
Tampon Wrapped – 20 cm

43. After pulled out the TAMPON-Wrapper
By Indah Yulianto – 2013

44. TOPICAL AND TRANSPLANTATION UCB-SCS BY
LOCAL MULTIPLE INJECTIONS WITHOUT
ANESTHESIA (31 ST JANUARY-2013)
By Indah Yulianto – 2013

45. 4 DAYS – AFTER INJECTION AND TOPICAL UCB-SC
(February – 4 th -2013) : Healing COMPLETELY
(JUST ONE SHOT – TOPICAL and INJECTION)
By Indah Yulianto – February
2013

46. Epithelization almost complete (after 2 weeks )

47. AMNIOTIC MEMBRANE DRESSING
PROMOTES EPITHELISATION &
GRANULATION: Topical HUVEC
1.5 MONTHs AFTER
By Indah J : Nov - 2012

48. What kind of Stem cells that we Need ?

50. Leprosy after 30 years + 3
months burning ulcer +
Infection
3 weeks after MSCs
Product Injections +
Cream
BY Indah Yulianto

51. Neuroischemic lesion of fifth metatarsal with
application : EPC & amnion membrane (2 months)

52. Male 23 yr, Combutio more than 5 months
: Injections and Topical :
HUVECs (Spheroid and Hypoxia)

53. Luka bakar + infeksi 5 bulan
y.l.
intra kutan produk MShCs
Pengolesan Krem + Produk MShCs
Hari ke 15 : penyembuhan 75% tanpa
Cicatriks ataupun Retraksi persendian
regenerasi

54. By dr Indah – dr Subandrio – dr Yuyun : 2012
– 2013

55. Alopecia Universalis : 1 month after MChSc and
Product (AAPE)

56. After 2 Months

57. After 4 months
By Indah, Dewi and Yuyun-2011

58. SECRETOME FROM HUVEC (HUMAN UMBILICAL
VEIN ENDOTHELIAL CELLS) for patient Alopecia Areata
with cicatrix, for more than 10 years.
After 1 month
By Indah - 2012

59. Secretome from HUVEC, spheroids
After 3 months
By Indah Y- January 2013

61. Post BASLIOMA Surgery – Using Topical
HUVEC – 1 month

62. Woman, 82 years old, with BASALIOMA in uper os
mandibula for 5 years, extirpation by MOHS surgery, no
sutures, just only using Topical – HUVEC for getting wound
closure for 6 weeks

63. Using Tumescent anesthesia

64. POST SURGERY

65. 3 days after, red arrow :
epitelisation, no inflammation
2 Weeks after, red
arrow : epitelisation 50
%/without scar

66. AUTOLOGOUS adipose derived adult
stem cell condioned media and its topical
effect on facial skin aging

67. Multi Center Clinical Study Summary
PERSONAL CELL SCIENCES

70. (3) Scar acne pasca skin needling + product &
(4) 1 week after skin needling + MCSs +_ Product
3
4

71. Acne Papulo Pustular + Scar
Courtesy by dr Titik Moertolo

72. ACNE CONGLOBATA and Scar : USING
‘HUVEC’

73. CONCLUSION
Interventions based on stem cells secretome may
replace cell transplantation to enhance therapeutic
tissue regeneration
Cell free strategy seems to b free from the limitations
and problems observed with transplantation of fresh or
in vitro cultured cells

74. Terimakasih atas perhatiannya