Papaccio, Gianpaolo

Tirino, Virginia

English

PubMed

TIRINO, Virginia

PAPACCIO, Gianpaolo

Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli"

A New, Most Likely Unusual Approach is Crucial and Upcoming for the Use of Stem Cells in Regenerative Medicine.

Gianpaolo ePapaccio

Virginia eTirino

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Frontiers in Physiology

A new, most likely unusual approach is crucial and upcoming for the use of stem cells in Regenerative Medicine.

Virginia Tirino

Gianpaolo Papaccio

Frontiers - Publisher Connector

OpiniOn Article
published: 05 January 2012
doi: 10.3389/fphys.2011.00119
A new, most likely unusual approach is crucial and upcoming 
for the use of stem cells in regenerative medicine
Virginia Tirino and Gianpaolo Papaccio*
Tissue Engineering and Regenerative Medicine Laboratory, Department of Experimental Medicine, Second University of Naples, Naples, Italy
*Correspondence: gianpaolo.papaccio@unina2.it
(f) It would be more easy and effective 
to activate inflammation or other 
mechanisms for endogenous stem 
cell recruitment and proliferation. 
In other terms, should we stimulate 
the physiological role of endogenous 
stem cells instead of their grafting?
(g) The research of “ideal” stem cells, with 
a full and standardized characteriza-
tion/selection is difficult to be followed 
and requires high costs that cannot be 
supported, using the actual techno-
logy. Can we overcome this step?
In our opinion researchers must change 
their traditional approaches if the goal of a 
large-scale use of stem cells is compulsory.
This does not imply that basic studies 
on biology of stem cells must not be done: 
they should continue, independently from 
the practical use of stem cells, which, on the 
other hand, cannot wait for more.
Moreover, the studies on non-human 
stem cells (i.e. rat, mice, and other ani-
mals) must be reduced to the minimum, 
this because those cells show many differ-
ences with human stem cells and we need 
to study more human stem cells.
We are sure that our goal are patients, 
while several animal stem cells features or 
proteins or other features cannot be found 
in human stem cells.
In summary, a great effort must be tried 
in order to avoid that we will acquire a lot 
of knowledge but no translation of studies 
in patients will be performed.
The latter would really be a great failure 
or “default.”
RefeRences
d’Aquino, R., De Rosa, A., Lanza, V., Tirino, V., Laino, L., 
Graziano, A., Desiderio, V., Laino, G., and Papaccio, 
G. (2009). Human mandible bone defect repair by 
the grafting of dental pulp stem/progenitor cells and 
collagen sponge biocomplexes. Eur. Cell. Mater. 18, 
75–83.
Tirino, V., Paino, F., d’Aquino, R., Desiderio, V., De 
Rosa, A., and Papaccio, G. (2011). Methods for the 
been prepared and performed. This 
can be a serious problem depending 
on the response of stem cells to cancer 
because opposite opinions and effects 
exist at present on this topic;
(5) Cell selection, as well as GMP proce-
dures, must be deeply discussed. The 
search of a high purity and selection 
decreases the quantity of stem cells 
and their effectiveness; GMP pro-
cedures are difficult to be followed, 
their costs are too high and cannot be 
supported by a large patient number 
(d’Aquino et al., 2009). Bureaucracy 
procedures, not only in Europe, are 
long, difficult, often require to “de 
novo” design the graft design and are 
required for each protocol and often 
the trials cannot be done.
Therefore, is it possible to have a new, 
different, and provocative approach? Can 
we answer to the following questions?
(a) How is possible to perfectly measure 
and standardize quality and quan-
tity of stem cells? Are we sure that we 
are in search of such a purity (Tirino 
et al., 2011)?
(b) A “full” characterization and selection 
of stem cell populations decreases 
their quantity and/or potentials: is 
this necessary or needed all the time?
(c) How is possible to overcome the high 
costs of GMP procedures and reach 
the goal of a large-scale use of stem 
cells?
(d) Do stem cells can be still studied and 
used as components of a whole tissue/
organ (house to build) or as a vehicle 
of molecules and as a terrific recruit-
ment for other cells?
(e) It would be possible and more “natu-
ral” to follow and recapitulate the 
embryonic development and physio-
logical tissue repair processes (mainly 
niches for bone);
To date many articles and reviews have been 
devoted to the use of stem cells in regen-
erative medicine. Of the previous, some 
articles, about 20%, are interesting and 
constitute an advance in knowledge, the 
majority (50%) are of marginal interest, 
and some (30%) are completely not useful, 
although they can be found in literature.
The emerging major problems affecting 
the impact of this field in patient’s cure can 
be mainly found in the high costs of proce-
dures and in other problems that need to be 
fully addressed by the scientific community, 
that we evidence below.
The following major questions must be 
still addressed for a true enhancement of the 
practical use of stem cells in patient’s cure:
(1) New methods for GMP stem cell cul-
tures, dedicated to grafts, must be 
used, including, for instance, micro-
gravity, omega3 fatty acids, new 
oxygen bioreactors; this is a major 
point, of interest and that can be 
addressed by both biologists, physi-
cians, and engineers;
(2) Ascertain genetic stability of stem 
cells before and after grafting is ano-
ther key step. A schedule should be 
delivered and published on this issue 
by researchers, often after having 
obtained data of graft trials;
(3) The problem of quality and quantity 
of cells must be unambiguous and a 
general rule established. Many rese-
archers try to demonstrate the purity 
of stem cell populations and try to 
obtain a translation of their findings. 
This point presents several ambigui-
ties, mainly residing in the purity 
judgment itself;
(4) Interactions with already existing 
cancer stem cells in patients to be 
grafted is another great problem to 
be discussed and rules needed. Niches 
of cancer cells may already reside in 
the patient where a stem cell graft has 
www.frontiersin.org January 2012 | Volume 2 | Article 119 | 1
Copyright © 2012 Tirino and Papaccio. This is an open-
access article distributed under the terms of the Creative 
Commons Attribution Non Commercial License, which 
permits non-commercial use, distribution, and reproduc-
tion in other forums, provided the original authors and 
source are credited.
Citation: Tirino V and Papaccio G (2012) A new, most 
likely unusual approach is crucial and upcoming for the 
use of stem cells in regenerative medicine. Front. Physio. 
2:119. doi: 10.3389/fphys.2011.00119
This article was submitted to Frontiers in Craniofacial 
Biology, a specialty of Frontiers in Physiology.
 identification, characterization and banking of 
human DPSCs: current strategies and perspectives. 
Stem Cell. Rev. 7, 608–615.
Received: 03 November 2011; accepted: 16 December 2011; 
published online: 05 January 2012.
Tirino and Papaccio New approaches for stem cell use
Frontiers in Physiology | Craniofacial Biology  January 2012 | Volume 2 | Article 119 | 2


A New, Most Likely Unusual Approach is Crucial and Upcoming for the Use of Stem Cells in Regenerative Medicine

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A New, Most Likely Unusual Approach is Crucial and Upcoming for the Use of Stem Cells in Regenerative Medicine

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Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli"

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