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Thus tiny cell is good news for cancer survivors

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A scientist at the National Institute for Research in Reproductive Health (NIRRH) in Mumbai — an institute under the Indian Council of Medical Research (ICMR) — says a new type of stem cell identified by her team can help restore fertility in men and women who have undergone treatment for cancer.

Cancer treatment, or “oncotherapy”, that involves use of radiation and chemicals, renders patients infertile as an unwanted side effect and, while cured of cancer, they cannot beget children.

Though women are born with a lifetime reserve of “oocytes” ( immature eggs), these are wiped out by oncotherapy. In males, the testes responsible for the production of sperms, stop making them following cancer treatment.

Currently accepted approaches for fertility preservation require male patients to deposit their sperm in “cryo-banks” before beginning cancer treatment for later use. Similarly women, wanting to have children, must have their eggs or embryos “cryopreserved” for use after oncotherapy.
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“Such approaches are invasive, expensive, technically challenging and depend on assisted reproductive technologies,” reports NIRRH cell biologist Deepa Bhartiya in the latest issue of the Indian Journal of Medical Research, the flagship journal of ICMR.

According to the report, there is now a way out. Bhartiya says research by her team over the years led to identification of a novel population of “Very Small Embryonic-Like stem cells (VSELs)”, in testis (in males) and ovaries (in females).

Being “quiescent” by nature, these primitive stem cells (VSELs) survive cancer therapy and therefore can offer young cancer survivors options to have children without having to bank their sperms or embryos prior to oncotherapy, says the report.

“The VSELs have remained elusive over decades due to their small size and presence in very few numbers,” says Bhartiya.

The discovery of these unique VSELs (in testes and ovaries) that do not succumb to oncotherapy “opens up an alternative strategy to regenerate non-functional gonads and ovaries in cancer survivors”, says Bhartiya.

While VSELs survive cancer treatment, their original “habitat” (or niche) however gets destroyed by oncotherapy. To make the VSELs functional, their “niche” should be re-created by transplanting “mesenchymal cells” — another type of stem cells taken from the bone marrow — into the testes, says the report.

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A simple and direct transplantation of “mesenchymal cells in the non-functional gonads may suffice to regenerate them,” says Bhartiya. “Similarly, transplantation of “ovarian surface epithelial cells” may allow the VSELs to regenerate nonfunctional ovaries.”

“This approach to fertility restoration is safe,” says Bhartiya pointing out to earlier studies carried out in her laboratory in mice which had shown that this method restored the role of non-functional ovaries and resulted in the birth of fertile offsprings.

“Our group also successfully restored spermatogenesis (sperm production) in non-functional mouse testis by transplanting niche (mesenchymal) cells, into the testis,” Bhartiya said.

In the light of these findings, she says the field of oncofertility may undergo a sea-change and existing strategies of cryopreservation of gametes and gonadal tissue for fertility preservation in cancer patients will have to be revised. “Pilot clinical studies (in humans) need to be undertaken.”

“VSELs may be an alternative cell source for induced Pluripotent Stem (iPS) clls,” Balu Manohar, managing director of Stempeutics Research, a Bengaluru-based stem cell company told this correspondent. “But it is still far away from the clinic as isolation and large scale expansion of these cells has to be standardised.”

Corona

Dubai suspends Air India Express operations after carried COVID-19 positive passenger.

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Dubai Civil Aviation Authority has suspended Air India Express operations to the Dubai airport after the airline allegedly carried a passenger who had tested positive for COVID-19.

The suspension kicks in from September 18 and will be valid till October 2.

The suspension notice says that the airline had carried the passenger on September 4, on flight IX1135, from Jaipur to Dubai. The passenger, whose identity is not revealing, had reportedly had a positive test result, issued on September 2 at a diagnostic center in Jaipur.

Going by the notice, this was the second time that the Dubai authority had detected the airline carrying a passenger who had the infection.

“You are aware of the previous intimation made to you by our letter dated September 2, for boarding a passenger with a COVID-19 positive result, who endangered the other passengers on board and also caused a serious health risk,” the letter to the regional manager of Air India Express said.

It added that boarding a passenger with the infection, for the second time, “is contrary to and is in violation of the laid down procedure…in the Emirate of Dubai, during the corona virus SARS Cov. 2 pandemic.”

In addition to the suspension, the airline has been asked to pay for all the expenditure incurred by authorities for medical services, including quarantine, for passengers.

To resume services, the Air India subsidiary has been asked to submit a “detailed corrective action/procedure implemented to prevent such incidents…” the letter said.

Dubai is among the busiest destinations for passengers from India. As per the air travel bubble that the Indian government had arranged with a few countries, airlines from both the sides could operate scheduled flights.

This is a second such instance of Air India or its subsidiary being suspended for carrying passengers infected with the virus. On August 18, Hong Kong had banned the national airline from operating till August 31.

Separately, Malaysia had barred Indians from entering the country starting September 7, in a bid to curtail imported COVID-19 cases amid a spate of new clusters in the country.

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