Lymphatic cancers are among the most challenging maladies to endure. Hodgkin’s Disease possesses the most disruptive effects on immunity. Patients suffer from an array of debilitating symptoms including persistent extreme fatigue, fever, weight loss, and night sweats. Patients’ experiences of these symptoms drives research and development of new treatments. The limitations of current treatment options and the totality of the dysfunction that current treatments leave the patient with drives researchers toward new treatments. The field of treatment of lymphatic cancers has been transformed with the introduction of umbilical cord derived mesenchymal Stem Cells (UC-MSCs). The use of this specific Stem Cell provides the option of a unique biological framework upon which expansive and potentially beneficial cellular therapies may be developed. The development of therapies using UC-MSCs may provide a positive disruption to the state of the field.
UC-MSCs Mechanisms in Hodgkin’s Disease
UC-MSCs act as a dynamic Stem Cell population active in the modification of the inflammatory response within Hodgkin’s Disease pathologies. Once in the bloodstream, the UC-MSCs direct themselves to the site of injury or to the tumor microenvironment. This is accomplished through a unique biological process that is as yet poorly understood and which is termed “homing”. The UC-MSCs interact with and modify the behavior of lymphocytes and natural killer cells in order to rebalance the inflammation. The UC-MSCs also have the ability to modify the immune response and cellular inflammation through the secretion of soluble factors. This distinctive population of Stem Cell units, specifically UC-MSCs, can also secrete small vesicles – exosomes – that contain microRNAs which impact gene regulation at their sites of delivery to counter Hodgkin’s Disease. They also remodel their extracellular matrix and thus continually create an environment that disrupts and opposes tumor progression. Because of their specialized markers, they can be used in allogeneic Stem Cell therapies where there is no complete histocompatibility matching required, and there will be minimal immune response to the graft.
Limitations of Conventional Treatments
In the past, oncologists were forced to use a combination of systemic chemotherapy and localized radiotherapy to treat all cases of Hodgkin’s Disease. The aim of these treatments is to eliminate all rapidly dividing abnormal cells. The nature of these treatments is systemic and aggressive, and thus, there is an absence of cellular specificity. Because of this, healthy surrounding cells are also destroyed and there are numerous significant adverse events that can be experienced by the patients. These events can be severe and include long-term damage of the cardiac cells and of the bone marrow, and also severe and long-lasting nausea. These old treatment methods also have a large risk of causing other cancers in the patient later in their life. There is a large group of patients that can rapidly relapse and become resistant to these toxic methods of treatment. The resistance that can be created is biological and can also be absolute. The treatments can greatly reduce the quality of life of the patient, and this can be used to justify the reason for the need for new scientific methods and Stem Cell strategies utilizing UC-MSCs to treat Hodgkin’s Disease.
Benefits of this Treatment
The use of these biological agents can respond directly to the large gaps and the limitations that can be identified in older treatment methods. Each Stem Cell used in this UC-MSCs treatment method is harvested from umbilical cords and thus, there are no ethical concerns from a bioethical standpoint, and also, these cells are more tissue and cellular proliferative than the cells that are obtained from bone marrow. These treatments also are highly relevant to the targeted treatment of Hodgkin’s Disease. The Hodgkin’s Disease pathology has a unique microenvironment characterized by an abundance of reactive immune cells and a sparsely present population of Reed-Sternberg cells. UC-MSCs manipulate this critical supportive microenvironment through precise Stem Cell interactions. Reed-Sternberg cells utilize a variety of metabolic and signaling pathways for survival, and UC-MSCs modify some of these pathways. They also change local cytokine levels, which helps prevent Reed-Sternberg cells from inhibiting anti-tumor immunity. Their low immunogenicity helps avoid many of the logistical challenges with autologous grafting. This characteristic provides a strong basis for rapid therapeutic use for patients with Hodgkin’s lymphoma, who are in critical and immediate need of clinical support.
Figure 1: Benefits of UC-MSCs stem cell therapy compared with Limitations of Conventional Treatments in Hodgkin’s Disease
Future Trajectories in Thailand
Thailand has the potential to become a major center for innovative biological therapies in Southeast Asia. It has world-class medical facilities and practices, and the ability to combine cutting-edge research with the expedited testing of new Stem Cell therapies. Thai companies and researchers are working with leading global firms to develop new therapies based on UC-MSCs. In combination with the country’s cutting-edge medical tourism industry, this has the potential to develop therapies to treat specific manifestations of Hodgkin’s Disease. Thai medical facilities are the first choice to receive advanced therapies worldwide.
Conclusion
We are seeing a vital and unprecedented evolution in the field of oncology away from the use of highly toxic therapies. The inclusion of UC-MSCs into next-generation Stem Cell treatment modalities, particularly for difficult to treat Hodgkin’s Disease lymphatic tumors, can be ground-breaking. Within this context, sophisticated biological mechanisms of Stem Cell therapy can be utilized to destroy the tumor microenvironment that sustains the progression of Hodgkin’s Disease. Most conventional treatments are burdened with gross adverse effects. However, cellular therapies can offer a dramatic improvement in both patient survival and quality of life. The significant advancements in healthcare in the form of proactive interventions in Thailand will allow these transformative cellular therapies to be more available to those in need. With commitment and time, the ongoing promise of biological cellular therapies can transform the field of immune-oncology.