Autologous Immune Enhancement Therapy in Recurrent Ovarian Cancer with Metastases: A Case Report

Current therapeutic modalities for ovarian cancer such as chemotherapy, radiotherapy and surgery have been reported to yield only marginal success in improving survival rates of patients and have associated adverse effects. We report here a case of recurrent stage IV ovarian cancer, treated with cell-based autologous immune enhancement therapy (AIET) along with chemotherapy and followed up for 18 months. A 54-year-old female was diagnosed with a recurrence of ovarian carcinoma 1 year after initial surgical removal followed by chemotherapy for stage IIIC ovarian carcinoma. When diagnosed in 2010 with recurrence, she had liver and spleen metastases with a CA-125 level of 243 U/ml and a stage IV clinical status. Six infusions of AIET using autologous in vitro expanded and activated natural killer (NK) cells (CD3–CD56+) and activated T lymphocytes (CD3+CD56+) were administered in combination with 6 cycles of chemotherapy with carboplatin and doxorubicin. Following this treatment, CA-125 decreased to 4.7 U/ml along with regression of the metastatic lesions and an improved quality of life. No adverse reactions were reported after the AIET transfusions. Eighteen months of follow-up revealed a static nonprogressive disease. Combining AIET with chemotherapy and other conventional treatments has been found to be effective in our experience, as reported earlier, even in patients with advanced ovarian cancer, and we recommend this strategy be considered in treating similar cases

Successful transplantation and in vitro expansion of human retinal pigment epithelium and its characterization; a step towards cell-based therapy for age-related macular degeneration.

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Five-year trend of competitiveness and knowledge-gaining attitude of university students; Evaluation based on an event of continuing health sciences education

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The Gravity of Regenerative Medicine; Physics, Chemistry & Biology behind it

The in-vitro expansion of cells of the organs/tissues and their re-implantation into the affected region/ tissue for treating cell/organ failure have been in practice for long, but in limited specialties. The in-vitro cell culture protocols use variety of biological reagents derived from animal sources and recombinant technologies. However, the optimal quantity of such biological components such as growth factors, cytokines etc.,needed for such cells to be grown in a non-physiological environment is still unknown. The use of such biological components have started to stir a controversy of late, due to the recognition of its potential hazards such as spread of prion diseases and contamination with non-human sialic acid proteins. Therefore synthetic reproducible biomaterials are gaining popularity in cell culture and tissue engineering. The biomaterials made of several chemical components based on physical parameters are starting to change certain concepts about the niche of cell culture and that of stem cell expansion and differentiation to specific lineages. Engler et al have already proven that a simple change in the matrix elasticity alone could change the lineage of the cells. Spencer et al have reported that a change in bioelectricity could change the morphogenesis during development. NCRM has been involved in cell culture and tissue engineering using approximately 240 different materials ranging from polymer hydrogel, gel with adherent inserts, nano composite materials, nano-coating technologies, nano-sheets and nano-films. These materials are used in cell culture in different hybrid combinations such as Floating 3D cell culture without adherent components in a homogenous hydrogel. Floating 3D cell culture with anchorage inserts. Flat surface- 2D adherent cell culture. Combined flat surface 2D cell culture (for differentiating cells) and floating 3D culture (for undifferentiated cells). These combinations have started yielding several advantages in Corneal epithelial stem cells, Corneal endothelial precursors, Chondrocytes, Mouse Embryonic Stem Cells, Mouse Embryoid bodies. Expansion of undifferentiated naive and Embryonic Stem (ES) cells has been made possible employing such hybrid techniques. With similar hybrid techniques we hope to make the undifferentiated expansion of fundamental hematopoietic stem cells possible. Nijnik et al have reported that the HSCs undergo damage with aging. If such in-vitro expansion technology without biological contamination could be made available in large scale, the day is not far off, when cryopreservation of one’s own hematopoietic stem cells harvested in youth can be cryopreserved and expanded and injected after a decade or two. If this becomes a reality, it would be the first step towards a physiological rejuvenation/infusion of youth and prolongation of the lifespan. Physical parameters of such chemically constituted and reproducible hybrid scaffolds need to be studied in detail. We need to explore whether variability in these physical and chemical parameters would differentially influence the biological differentiation of cells. If this were to occur by simply manipulating either the physical or the chemical characteristics of these scaffolds, the cell of our choice can be obtained and used for treating varied human diseases affecting different cell types and organs. The effect of all physical parameters on biological differentiation can be studied on earth, with an exception of the effect of gravity. If differential physical parameters allow varied biological differentiation, the day is not too far, when people will be sending space ships carrying their cells with automated systems to the outer space of lesser or zero gravity to get the cells of their choice expanded and the same be brought back after culture in outer space to be injected as a treatment modality.Different planets with differing gravities could induce growth of different lineage of cells with different capabilities. This may herald the birth of a new scientific discipline called Astro-regenerative medicine and NCRM at that point would establish NGRM (Nichi-In Galaxy of Regenerative Medicine)

Feasibility and Safety of Peripheral Intravenous Administration of Vasopressor Agents in Resource-limited Settings

Vasopressors are conventionally administered through a central venous catheter (CVC) and not through a peripheral venous catheter (PVC) since the latter is believed to be associated with increased risk of extravasation. Placement of a CVC requires suitably trained personnel to be on hand, and in resource-limited settings, this requirement may delay placement. Because of this and in cases where suitably trained personnel are not immediately available, some clinicians may be prompted to utilise a PVC for infusing vasopressors. The objective of this study is to assess the feasibility and safety of vasopressors administered through a PVC

Stem Cell Therapy for Cardiovascular Disorders - Our Clinical Experience

Background: Autologous Bone Marrow stem Cell transplantation is a viable therapeutic option for patients with end stage heart failure due to cardiomyopathy of varied etiology as there are only limited treatment options other than cardiac transplantation. The rationale behind the application of stem cells in these patients include • Stem cells directly replace the affected cells by differentiation into the damaged cell type • Stem cells also exert Paracrine effects by secre tion of growth factors (VGEF,FGF-1)to stimu late local cell growth•In addition to the above, stem cells release signaling factors which recruit stem cells from elsewhere by modulating the immune system.Materials and Methods: In this presentation we describe our study on a series of 13 patients who received isolated and expanded CD 34 cells from the bone marrow. Seven had ischemic dysfunction, three had dilated cardiomyopathy and three had primary pulmonary hypertension. Five patients received the stem cells via intracoronary injection, three directly into the myocardium and three intrapulmonary. Results: All patients showed functional improvement of the myocardium recorded by non-invasive investigations and improvement in the quality of life. Follow up period ranged from 6 months to 2 years. Conclusion: Our experience with bone marrow derived stem cells in patients with cardiomyopathy has been encouraging. More studies are planned in the future

Autologous Immune Enhancement therapy for Advanced Carcinoma of Pancreas-A Case Report

Introduction: Autologous Immune Enhancement therapy (AIET) is one of the lesser used modality of therapy in our country for advanced cancers. AIET uses patient’s own immune cells such as NK cells and T-Lymphocytes to fight against cancer.Aim: To study the effectiveness of AIET in Advanced Carcinoma of pancreas.Case History: A 40 years old male was diagnosed with inoperable locally advanced Carcinoma of the head of pancreas when he was investigated for obstructive jaundice. Palliative bypass surgery was done, since his tumor was inoperable. Following his surgery he received 6 cycles of adjuvant chemotherapy and 3 cycles of AIET.? After completion of chemotherapy and 2 cycles of AIET therapy his tumor marker decreased significantly with decrease in tumor size.? So re-laparotomy was attempted for removal of tumor, which was unsuccessful. After a long gap he received his 3rd cycle of AIET.? He was irregular in receiving his AIET treatment. He survived for 18 months after the diagnosis. Conclusion: The median life span of patients following diagnosis of advanced Carcinoma of pancreas is usually not more than 3-6 months. Longer survival of our patient could be due to AIET, but we need further studies to prove it. There were no adverse effects encountered due to AIET

Potential Effects of Nichi Glucan as a Food Supplement for Diabetes Mellitus and Hyperlipidemia: Preliminary Findings from the Study on Three Patients from India

Beta Glucan food supplements have been reported to be of benefit in diabetes and hyperlipidemia. We report a pilot study of the effects of Nichi Glucan, 1, 3-1, 6 Beta Glucan food supplement, in lowering the blood glucose and lipid levels in three patients with noninsulin-dependent diabetes mellitus (NIDDM) from India. These patients had increased blood glucose and lipid levels inspite of routine antidiabetic and lipid level lowering medications. Each of the participants took 1.5 g of Nichi Glucan per day with food for two months along with their routine medications. The relevant parameters to assess glycemic status and lipid levels were calculated at the baseline and at the end of two months. After two months of continuous consumption, in one patient, the HbA1c decreased from 9.1% to 7.8%, and the glycemic target of HbA1c <6.5% laid down by the International Diabetes Federation was reached in two patients. Lipid levels also decreased significantly. Based on our findings, Nichi Glucan food supplement can be considered along with routine medications in patients with Type II diabetes with hyperlipidemia. Further studies are needed to validate the results

Metaniche session 2016: Tailor-made sensors for rapid Therapeutic Drug Monitoring –Interactions between Biomaterial Physicists, Chemical Engineers and Clinicians for successful translation of technologies in Healthcare

The Metaniche session is an academic session conducted as a part of Nichi-In Centre for Regenerative Medicine (NCRM)’s novel Initiatives' Conclave in Healthcare Every year (NICHE), the ‘NCRM NICHE’ organized every year in the month of October by Nichi-In Centre for Regenerative Medicine (NCRM), an Indo-Japan academic Institute based at Chennai, India. The Metaniche session aims to bring together the realms of Physics, Chemistry and Biology by portraying inventions or discoveries in physical and chemical sciences which are in the pipeline with high application potential in biology and healthcare. The Metaniche session-2016, held on 22nd October, 2016 in Chennai, India was on the application of biomaterial-based sensors for application in rapid therapeutic drug monitoring (TDM) systems. The session focussed on the role of biomaterials in medicine giving an overview and history of the evolution of biomaterials to suit the growing needs in medicine, followed by emphasizing the need for rapid TDM systems. The final part portrayed the development of tailor-made sensors for rapid TDM using molecularly imprinted polymers as given below. Biomaterials and Medicine It has been always medical practitioners coming first to identify the need to lead themselves and others towards the best therapy. When patient services emerged, the clinicians themselves were everybody. Dr Gibbon, when he did his first open heart case in 1950’s, he was the perfusionist and perhaps anaesthetist too. To get into its (bio) materials, through a case study, let us take a review of a simple clinical procedure. Wound closure through suturing. Its tribology matrix highlighted below (Figure 1), sketches its journey, clinical demands, scientific solutions and biomaterials thereof. The bottom line, best is still (re)searched

Autologous Immune Enhancement Therapy for cancer using NK cells and CTLs without feeder layers; our six year experience in India

Background: Autologous Natural Killer (NK) cells and Cytotoxic T Lymphocytes (CTLs) based immune-cell therapy, otherwise called as Autologous Immune enhancement therapy (AIET), though has been in clinical practice in several developed nations since early 90s, in India it is in infancy due to lack of technological knowhow. Our institute has been providing the AIET cell expansion services since 2005 and we here in report our experience in 30 such patients of both solid tumours and hematological malignancies.Materials and Methods: The number of AIET transfusions in each patient ranged from one to six. All the patients included had Stage III to IV malignancy. AIET was either given along with the chemotherapy or after the completion of a minimum of six cycles of chemotherapy in all the patients. 70 ml of Peripheral Blood was collected each time. The protocol followed was as per Terunuma et al (Breast Cancer 2010) which uses only the patients’ autologous plasma for expansion of the Natural Killer Cells and Cytotoxic T lymphocytes from the peripheral blood. The cells were cultured for a period of 10 to 16 days and then transfused to the patients intravenously. The cells were subjected to Flow cytometry before and after the in vitro expansion. Feeder layers were not used in the procedure of in vitro expansion at any stage.Results: The percentage of NK cells and CTLs after expansion by flow cytometry ranged from 60 to 82 %. There were no adverse reactions in any of the patients following transfusion. The mean prolonged survival time was 15 months and 27% of the patients had Static non-progressive disease after the therapy. Two patients reported significant decrease in Cancer marker levels after AIET and among the terminally ill, two had more than two years survival. All the patients reported improvement in quality of life and resumption of appetite following AIET. Conclusion: Optimal in vitro expansion of NK cells and CTLs of patients with stage III-IV cancer either concurrently or after chemotherapy could be accomplished using autologous serum without use of feeder layers. The In vitro expanded NK cells and CTLs when given intravenously decrease the tumor size and prolong the survival without any adverse effect in our experience