Reversibly immortalized human umbilical cord-derived mesenchymal stem cells (UC-MSCs) are responsive to BMP9-induced osteogenic and adipogenic differentiation.

Human mesenchymal stem cells (MSCs) are a heterogeneous subset of nonhematopoietic multipotent stromal stem cells and can differentiate into mesodermal lineage, such as adipocytes, osteocytes, and chondrocytes, as well as ectodermal and endodermal lineages. Human umbilical cord (UC) is one of the most promising sources of MSCs. However, the molecular and cellular characteristics of UC-derived MSCs (UC-MSCs) require extensive investigations, which are hampered by the limited lifespan and the diminished potency over passages. Here, we used the piggyBac transposon-based simian virus 40 T antigen (SV40T) immortalization system and effectively immortalized UC-MSCs, yielding the iUC-MSCs. A vast majority of the immortalized lines are positive for MSC markers but not for hematopoietic markers. The immortalization phenotype of the iUC-MSCs can be effectively reversed by flippase recombinase-induced the removal of SV40T antigen. While possessing long-term proliferation capability, the iUC-MSCs are not tumorigenic in vivo. Upon bone morphogenetic protein 9 (BMP9) stimulation, the iUC-MSC cells effectively differentiate into osteogenic, chondrogenic, and adipogenic lineages both in vitro and in vivo, which is indistinguishable from that of primary UC-MSCs, indicating that the immortalized UC-MSCs possess the characteristics similar to that of their primary counterparts and retain trilineage differentiation potential upon BMP9 stimulation. Therefore, the engineered iUC-MSCs should be a valuable alternative cell source for studying UC-MSC biology and their potential utilities in immunotherapies and regenerative medicine.

Cervical tuberculosis treated with closed system abscess evacuation, and percutaneous laser disc decompression combined with secretome derived from umbilical cord mesenchymal stem cells: A case report.

INTRODUCTION AND IMPORTANCE: Minimal invasive surgery is preferred as it offers the same benefit with less tissue damage, especially in the cervical area where a lot of critical structure resides. Mesenchymal stem cells (MSCs) and its secretome provide a promising regenerative intervention to damaged tissue. We report a cervical spinal tuberculosis case with hemiparesis treated with minimally invasive surgery combined with a regenerative approach. CASE PRESENTATION: A 13-year-old boy presented with weakness in his left arm and left leg, accompanied by hemiparesthesia. The patient was unable to get up from bed, run, and jumpRadiology examination showed compression fracture, intervertebral disc retropulsion, spinal cord compression, and paravertebral cold abscess. The patient was treated with a single minimal invasive surgery consisting of closed system abscess evacuation, and percutaneous laser disc decompression combined with umbilical cord-derived mesenchymal stem cells. CLINICAL DISCUSSION: The pain, weakness, and numbness were gone two days after surgery. The patient could carry out normal activities, even doing sports such as mini soccer and badminton. This clinical improvement was obtained as he carried out some procedures. The cold abscess aspiration removed infection focus which prevents further vertebra destruction, PLDD which decompresses the retropulsed discs, and implantation of MSCs and secretomes which regenerate and strengthen the destructed bone and surrounding tissue. CONCLUSION: Closed system abscess evacuation, and percutaneous laser disc degeneration combined with secretome derived from UC-MSC are minimally-invasive strategies with promising results. Further studies are required to investigate its efficacy.

Comprehensive approach to degenerative spine with fragility spine fracture to improve quality of life: A case report study.

INTRODUCTION AND IMPORTANCE: Degeneration process occurs in humans after reaching their maximum potential. The degeneration process in the spine includes osteoporosis and degenerative disc disease, however, the conventional treatment causes many post-operative complications. Minimally invasive procedures have recently been carried out considering the same expected outcome and minimally injuring other tissues. Biological approaches using mesenchymal stem cells (MSCs) and secretomes are more promising for bone-related issues. We report a degenerative spine case managed with minimally invasive procedures combined with a biological approach. CASE PRESENTATION: An 83-year-old woman with a chief complaint of back pain after a fall, the physical examination found a painful area in the lower back accompanied by motor weakness in both legs, causing daily use of a wheelchair. Radiology examinations showed compression fracture, bulging disc, and osteoporosis. The patient underwent multiple minimally invasive procedures, namely vertebroplasty, MSCs implantation, PLDD, and secretome implantation. CLINICAL DISCUSSION: From 6 months of follow-up, it was found that the patient's posture getting better, the pain was reduced, and the results of the BMD examination were improved. The patient was able to carry out normal activities. This is due to vertebroplasty which strengthens the structure, PLDD which decompresses the disc, and implantation of MSCs and secretomes which improves the quality of the bone and surrounding tissue. CONCLUSION: The multi-minimally invasive procedure is potential for complex degenerative spine cases, particularly when combined with biological approaches using stem cells and secretomes in elderly, considering that complications from conventional treatment are quite common in elderly.