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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.”

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Rare genetic brain disease reported, ‘Myoclonus-Dystonia’

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Bangalore: A rare genetic brain disease causing a movement disorder has been reported from Mumbai where a 21-year-old patient has been diagnosed with ‘Myoclonus-Dystonia’ with facial, neck and hand shaking and jerking due to rare genetic disorder called ADCY5-related dyskinesia.

This is a rare disease with less than 400 cases reported all over the world. The disorder is known to cause abnormal involuntary tremors in the body and is usually seen in children, but this is the first time it has been reported in an Indian adult patient.

He suffered from the condition since he was 13, but these jerks were initially mild. This progressed to moderate severity over the last few years. “We were able to manage the trembling till the time they were mild. With time, the intensity increased and so did the frequency which hampered daily activities and even any work that needed concentration”, told the parents of the 21 year old.

Dr VL Ramprasad, COO, MedGenome Labs that performed the genetic testing said, “ADCY5 mutation causes abnormal involuntary movements affecting the neck, arms and face. This mutation can also lead to episodic worsening triggered by anxiety, stress or inactivity -or characteristically periods before or after sleep. We have now published this case in MDCP (Movement Disorders Clinical Practice), which is a well-known journal.”

The doctor informed that when the patient came to them he would get these movements in spells intermittently in the early years. His whole body was shaking when he was anxious or even concentrating on an activity. After initial tests the doctors were convinced that he had a rare genetic disorder and tests confirmed ADCY5 gene mutation

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