Controversies in hybrid banking: attitudes of Swiss public umbilical cord blood donors toward private and public banking.

PURPOSE: Umbilical cord blood (UCB) stored in public inventories has become an alternative stem cell source for allogeneic stem cell transplantation. The potential use of autologous UCB from private banks is a matter of debate. In the face of the limited resources of public inventories, a discussion on "hybrid" public and private UCB banking has evolved. We aimed to explore the attitudes of the donating parents toward public and private UCB banking. STUDY DESIGN AND METHODS: A standardized, anonymous questionnaire was sent to the most recent 621 public UCB donors including items regarding satisfaction with recruitment process, the need for a second consent before release of the UCB unit for stem cell transplantation, and the donors' views on public and private UCB banking. Furthermore, we asked about their views on UCB research. RESULTS: Of the questionnaires, 48% were returned, and 16% were lost due to mail contact. Of our donors, 95% would donate to the public bank again. As much as 35% of them were convinced that public banking was useful. Whereas 27% had never heard about private UCB banking, 34% discussed both options. Nearly 70% of donors opted for public banking due to altruism and the high costs of private banking. Of our public UCB donors, 81% stated that they did not need a re-consent before UCB release for stem cell transplantation. In case of sample rejection, 53.5% wanted to know details about the particular research project. A total of 9% would not consent. CONCLUSIONS: Almost all donors would choose public banking again due to altruism and the high costs of private banking. Shortly after donation, mail contact with former UCB donors was difficult. This might be a relevant issue in any sequential hybrid banking.

Cesarean section due to fetal distress increases the number of stem cells in umbilical cord blood.

BACKGROUND: Umbilical cord blood (UCB) can be used as hematopoietic stem cell source for transplantation. The success of a transplantation is highly correlated with the number of total nucleated cells (TNCs) and CD34+ cells in the UCB. Certain obstetric factors increase the yield of stem cells in the UCB. It is necessary to evaluate optimal conditions in labor to decrease the rate of sample rejection due to low cell count. No data exist regarding the difference between primary and secondary Cesarean sections in terms of efficacy of stem cell harvesting. STUDY DESIGN AND METHODS: Seventy-nine consecutive UCB units from women who had a Cesarean section between 1997 and 2003 were included. The number of TNCs, CD34+ cells, colony-forming units (CFUs), white blood cells (WBCs), nucleated red blood cells (NRBCs), and the total collection volume were compared between cases with primary and secondary Cesarean section. RESULTS: UCB obtained after a Cesarean section due to fetal distress has significantly higher numbers of TNCs, CD34+ cells, NRBCs, and WBCs compared to elective Cesarean section. Of the cases with secondary Cesarean section due to fetal distress, 67 percent resulted in UCB units with sufficient TNC numbers (> or =80 x 10(7) TNCs) compared to 42 percent of the cases with primary Cesarean section. CONCLUSION: Fetal distress increases the number of hematopoietic stem cells mobilized into UCB. Particular effort should be made to collect UCB from newborns who experienced fetal distress.

Inhibition of cell proliferation by bacterial lipopolysaccharides in TLR4-positive epithelial cells: independence of nitric oxide and cytokine release.

Phylogenetically conserved toll-like receptors (TLR) recognize "pathogen-associated molecular patterns". Upon binding of ligands, TLR initiate innate immune response in immune and most likely epithelial cells. The TLR4 isoform is considered as a lipopolysaccharide (LPS) receptor. As shown here, a rat-tongue-derived epithelial cell line RTE2 expressed TLR4 mRNA and functional protein. LPS-treated RTE2 cells responded with the transient expression of inducible nitric oxide synthase (iNOS), an effector protein of TLR4 involved in the innate immune defense of monocytes. iNOS induction occurred along a nuclear factor-kappaB (NF-kappab)-dependent pathway and correlated with the increased production of NO. Moreover, LPS and lipid A were potent inhibitors of proliferation of RTE2 cells, of mouse keratinocytes, and mouse epidermis in vivo. The inhibition depended on lipid A structure, i.e., it was related to the endotoxin activity of LPS and at least in vitro was in part mediated by NF-kappaB. C57Bl/10 ScCr mice, lacking a functional TLR4, did not respond with growth inhibition, strongly suggesting a TLR4-mediated effect. RTE2 proliferation was also inhibited by transforming growth factor beta (TGFbeta) and tumor necrosis factor alpha (TNFalpha), whereas interferon gamma (IFNgamma) was a weak inhibitor. But the growth-inhibitory effect of LPS on RTE2 cells was not mediated by TNFalpha, TGFbeta, or NO. It is concluded that besides induction of innate immune responses, LPS specifically induces growth arrest in epithelial tongue cells and keratinocytes in vitro and in mouse epidermis in a TLR4-dependent but cytokine- and NO-independent manner.