Neue Verwendungsmöglichkeiten von Nachgeburtsgewebe für die Regenerative Medizin

Zusammenfassung

Einleitung:

Nachgeburtsgewebe, also Nabelschnur, Plazenta, Eihaut und Nabelschnurblut, werden in der Regel nach der Geburt verworfen. Fortschritte in der Regenerativen Medizin lassen es jedoch geboten erscheinen, diese Materialien auf ihre Eignung für therapeutische Zwecke zu überprüfen.

Methodik:

Zunächst werden die einzigartigen Eigenschaften der Materialien und ein Überblick über die Verwendungsmöglichkeiten von Nachgeburtsgewebe in der Regenerativen Medizin dargestellt. Nachfolgend werden die Erfahrungen einer Kooperation von mehreren Instituten zur Sammlung und Verwertung von Nachgeburtsgewebe vorgestellt und diskutiert.

Ergebnisse:

Neben der allogenen Transplantation von hämatopoietischen Stammzellen aus Nabelschnurblut wurde Nachgeburtsgewebe auch für die Isolierung von Stammzellen, Progenitorzellen und ausdifferenzierten Zellen zur Herstellung von künstlichen Gewebeersatz sowie für die Entwicklung von künstlichem Gefäßersatz aus den Umbilikalgefäßen verwendet. Die Versorgung mit Nabelschnüren bei dem Projekt unserer Arbeitsgruppe konnte durch die 2 Geburtskliniken und den Blutspendedienst des Bayerischen Roten Kreuzes organisiert werden. Die Sammelquote war von mitarbeitermotivierenden Maßnahmen abhängig. Es wurden über 4 300 Nabelschnüre für Versuche zur Entwicklung von künstlichem Gefäßersatz gesammelt bei einer sehr geringen Kontaminationsrate. Der Geburtsmodus hatte einen signifikanten Einfluss auf die Funktion der Umbilikalvene, während Ischämiezeiten bis 40 h unkritisch waren. Umbilikalvenen können unter teilweisem Erhalt ihrer Funktion kryokonserviert werden. Um die Gefäße mit einem autologen Endothel zu versehen, wurden Verfahren zur Endothel-Denudierung und zur Besiedelung mit Endothelzellen aus Patienten mit Koronarer Herzkrankheit entwickelt.

Schlussfolgerung:

Nachgeburtsgewebe hat einzigartige Eigenschaften, die es zu einem idealen Ausgangsmaterial für die Regenerative Medizin macht. Die Versorgung mit Nachgeburtsgewebe kann auch ohne direkte räumliche Nähe zu den Geburtskliniken erfolgreich und mit hoher Ausbeute organisiert werden.

Abstract

Introduction:

Afterbirth tissues, which include the umbilical cord, placenta, amnion, and cord blood, are usually discarded. Recent progress in regenerative medicine suggests that we re-evaluate these tissues and assess their therapeutic potential.

Methods:

Firstly the unique properties of afterbirth tissues and their current use in regenerative medicine are summarised. Then we introduce the cooperation of our institutions and our experiences regarding the collection and utilisation of afterbirth tissues.

Results:

A literature survey suggests that besides the well-known transplantation of hematopoietic stem cells from cord blood, afterbirth tissues were also used as a source of stem cells, progenitor cells, differentiated cells, and blood vessels for tissue engineering purposes. According to our own experience, the two participating OB/GYN departments and the blood donation service were able to organise a sufficient supply of umbilical cords for research purposes. The yield correlated with incentives for the midwives. A total of more than 4 300 cords was collected for experiments designed to create small caliber vessel grafts. The contamination rate was low. Birth mode significantly affected umbilical vein function, whereas ischaemia for up to 40 h did not have any deleterious effects. Umbilical veins were cryopreserved with a moderate loss of function. Fresh umbilical veins were endothelium-denuded and reseeded with endothelial cells harvested from coronary artery disease patients to generate an autologous surface.

Conclusions:

Afterbirth tissues have unique properties which make them ideally suited for regenerative medicine. These tissues can be procured and utilised in research facilities even in the absence of an in-house birthing centre.

Schlüsselwörter

regenerative Medizin - Nachgeburtsgewebe - Umbilikalgefäße

Key words

regenerative medicine - afterbirth tissues - umbilical vessels

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