Treatment of Necrotizing Enterocolitis (NEC): The Promise of Amniotic Fluid Stem Cells. Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease that primarily affects premature neonates. Despite significant advances in research, NEC remains challenging to diagnose in its early stages, and current treatment approaches are often inadequate. The NIH conducted a study published under the title “Amniotic fluid stem cells: A novel treatment for necrotizing enterocolitis” In this review, they explore the potential of regenerative medicine, particularly the use of stem cells from amniotic fluid (AFSCs), as a promising therapeutic option for NEC. Various aspects of AFSC-based therapy that require further investigation to pave the way for its clinical application are also highlighted.
If this topic is too new or profound for you. I invite you to read our article “What Are Stem Cells?“
The Role of Amniotic Fluid in NEC
Amniotic fluid (AF) surrounds the fetus during gestation and contains essential factors such as trophic factors, cytokines, and growth factors that support intestinal development, cell proliferation, and mucosal repair. These components contribute to reducing intestinal injuries and protecting against NEC. Additionally, AF contains antimicrobial proteins and peptides that support the gut’s immune activity. Although often considered waste, AF has potential therapeutic value in preventing and treating NEC.
The Potential of Amniotic Fluid Stem Cells (AFSCs) in NEC
Treatment AFSCs are pluripotent stem cells derived from amniotic fluid. They possess the ability to differentiate into various cell types and exhibit immunomodulatory properties without the ethical concerns associated with embryonic stem cells. Studies have shown that AFSCs can effectively integrate into the injured bowel, improve gut structure and function, and promote survival in experimental NEC models. Moreover, AFSCs act in a cyclooxygenase 2 (COX-2) dependent manner, providing unique therapeutic effects.
Comparing AFSCs with Other Stem Cells in NEC
Treatment Comparative studies have shown that AFSCs outperform other stem cell types. Such as bone marrow-derived mesenchymal stem cells (BM-MSCs) and enteric neural stem cells (E-NSCs). In terms of preventing intestinal epithelial injuries and promoting regeneration. AFSCs have superior homing ability to the intestinal epithelia, making them an attractive option for clinical use against NEC.
Mechanism of Action: How AFSCs Protect against NEC
AFSCs exhibit a multifaceted mechanism of action, including the restoration of intestinal barrier function, inhibition of endoplasmic reticulum (ER) stress-induced apoptosis, regulation of immunological responses, and enhancement of intestinal stem cell (ISC) activity and proliferation. The activation of the Wnt/β-catenin signaling pathway plays a vital role in promoting ISC function and reducing inflammation, contributing to the overall restoration of the injured intestine.
AFSC Derivatives in NEC Treatment Besides using AFSCs directly, researchers have explored the therapeutic potential of AFSC-derived conditioned medium (CM) and extracellular vesicles (EVs). These cell-free derivatives contain soluble factors and bioactive components that mirror the beneficial effects of AFSCs. Studies have shown that CM and EVs improve NEC survival, reduce intestinal inflammation and apoptosis, and restore intestinal regeneration capabilities.
Challenges in Clinical Translation of AFSC-based Therapy for NEC
While AFSC-based therapy holds great promise, several challenges need to be addressed before clinical translation. These include optimizing AFSC culture conditions, determining the ideal gestational age for harvesting AFSCs. Standardizing AFSC expansion, and clarifying the impact of small molecules on AFSC functionality. Additionally, preclinical human models, like human-derived organoids, must be investigated to assess AFSC-based therapy’s potential in human neonates.
Conclusion
Amniotic fluid stem cells present a promising breakthrough in the treatment of NEC. Their pluripotent nature, immunomodulatory effects, and regenerative capabilities make them a valuable option for preventing and treating NEC. However, further research and clinical trials are needed to fully understand and harness the therapeutic potential of AFSC-based therapy. This review serves as a reference for guiding future studies and ultimately advancing AFSC-based therapy toward clinical application in the fight against NEC.
If this topic is too new or profound for you. I invite you to read our article “What Are Stem Cells?“
