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Dental stem cells

 Dental stem cells for cellular therapies in neurological diseases.

Dental stem cells

The purpose of this article is to review the literature on dental stem cells as a promising source for cell therapies in neurological diseases, to bring together and clarify the fundamental aspects of this topic that are the subject of many current studies and research. 

Stem cells and stem cell types 

Stem cells are specialized cells, capable of renewing themselves through cell division and differentiating into cells of multiple lineages, which could become new stem cells or specialized cells with a more specific function. No other cell in our body has this natural ability to generate new cell types
There are many types of stem cells in our body. These cells are classified into embryonic stem cells, adult stem cells, induced pluripotent stem cells, and perinatal stem cells

Embryonic stem cells come from blastocysts, which are embryos that are 3 to 5 days old. A blastocyst at this stage has approximately 150 cells. These stem cells are pluripotent, that is, they can divide into more stem cells or can become any type of cell in the body, a characteristic that is very interesting for their use in the regeneration or repair of diseased tissues or organs

Adult stem cells are found in small amounts in most adult tissues, such as bone marrow or fat. They have a more limited capacity than embryonic stem cells to generate different cells in the body. However, emerging evidence suggests that they can indeed create different cell types. Therefore, early clinical trials are currently underway to evaluate the safety and usefulness of adult stem cells in people with different diseases (neurological, cardiac...). 
Induced pluripotent stem cells are adult cells that are modified to have the properties of embryonic stem cells. This transformation process has been achieved through genetic reprogramming. By modifying the genes of adult cells, it is possible to reprogram the cells to act similarly to embryonic stem cells. The advantage of this technique is that immune system rejection of the new stem cells can be prevented. However, it is not yet clear whether the use of this type of modified adult cell would cause adverse effects in humans. 

Finally, we call perinatal stem cells the stem cells that have been discovered in amniotic fluid and umbilical cord blood. These cells also have the ability to develop into specialized cells. However, more studies on these cells are also needed to better understand their potential. 

Mesenchymal stem cells are adult stem cells that can be isolated from human and animal sources. Human mesenchymal stem cells are non-hematopoietic multipotent stem cells with the ability to differentiate into mesodermal lineages, such as osteocytes, adipocytes, and chondrocytes, as well as ectodermal (neurocytes) and endodermal (hepatocytes) lineages. They were first observed in the bone marrow and have so far been isolated from various tissues such as adipose tissue, amniotic fluid, endometrium, dental tissues, and the umbilical cord, thanks largely to increasing clinical trials. 

In addition, mesenchymal stem cells have immunomodulatory characteristics, secreting cytokines and immune receptors that regulate the microenvironment in the host tissue. These characteristics (immunomodulation and secretion of anti-inflammatory molecules) make them an effective tool in the treatment of chronic diseases

Thanks to the ability of stem cells to renew themselves and give rise to a differentiated cell, the possibility of using these properties for the repair, improvement, and replacement of damaged organs has been studied in recent decades. Stem cell transplantation has been successfully tested at the clinical level to treat various diseases, confirming the high hopes for this emerging technique

However, there are many obstacles, both scientific and ethical, that prevent rapid progress in research on the use of human stem cells

Stem cell research 

Until a few years ago, the international community was divided on the issue of stem cell research. 

Recently, several countries have enacted regulatory changes aimed at addressing some of the issues raised by research and scientific advances that have ethical and social implications

The International Society for Stem Cell Research (ISSCR), the world's largest professional organization of stem cell scientists, has also recently published updated guidelines for stem cell research and the development of new clinical therapies. These guidelines provide an internationally agreed set of principles, which have been widely adopted around the world.  

These guidelines promote appropriate and sustainable stem cell research. They do not replace local laws and regulations but can nevertheless assist in the interpretation and development of local laws, as well as provide guidance for research practices not covered by the legislation. 

Some of the guidelines that follow are standards that would apply to any basic research. Others respond to challenges that are particularly applicable to stem cell research, such as those that relate to research activities involving the use of human embryos and gametes

The new guidance comes at a time when technologies are rapidly evolving, and emerging areas of stem cell discovery and applications provide unprecedented opportunities for understanding human biology and disease, but they also raise questions that have societal and ethical implications. The guidelines are based on widely shared principles of science that call for rigor, oversight, and transparency in all areas of practice. Adherence to these principles ensures that stem cell research is conducted with scientific and ethical integrity and that new therapies are evidence-based. 

The ISSCR developed earlier sets of guidelines that are also widely followed by researchers and institutions around the world, but this new set of guidelines updates and expands on those topic areas and brings all guidance together under common principles of research integrity, patient welfare, respect for research subjects, transparency, and social justice. 

In response to advances in science, the guidelines encompass a broader and more expansive scope of research and clinical effort than before, impose rigor at all stages of research, address the cost of regenerative medicine products, and highlight the need for accurate and effective public communication

Despite the many important advances made since the discovery of stem cells, major ambiguities still exist in the field regarding the nature, identity, function, mode of isolation, and experimental management of mesenchymal stem cells; which are the focus of intensive efforts worldwide aimed at elucidating their unique nature and properties, and developing cell-based therapies for a wide range of diseases.