Stem cells have become the subject of popular imagination, especially after Dr James Thompson from university of Wisconsin, USA, established the first human embryonic stem cell lines in 1998. However, it is wrong to believe that stem cells were not known before that. Actually stem cells were first discovered in the tubule by Dr Lablond and co-workers more than fifty years before. The foundation of stem cell biology were laid by Prof. Lazlo Lajtha, and co-worker at the Paterson Laboratories, Manchester, UK. His studies were in the haematopoietic systems and later extended to other tissues such as intestinal crypts, skin etc by other researchers. Bone-marrow transplantation to treat several haematopoietic diseases, such as blood cancers and anaemias is the first use of stem cells in clinics.
The first research laboratory in India to initiate investigation in stem cell biology was the Cancer Research Institute, Mumbai. The projects started in 1973 in the bone marrow stem cells of blood cancer patients. These studies helped in bringing about the first successful bone-marrow transplantation at the Tata Memorial Hospital, Mumbai. A department of stem cell biology was formed, which was awarded a project on the umbilical cord blood derived stem cell banking by the Department of Biotechnology, Govt. of India. This technology was transferred to Tata Memorial Hospital, Mumbai and the Armed Forces Medical College, Pune on the occasion of 50 years of India's independence. The National Centre for cell sciences, Pune, partnered the Cancer Research Institute in developing the technology. The Institute Rotary Cancer under the AIIMs, followed CRI closely in establishing a research group on bone marrow / fetal liver derived stem cells. Chitteranjan Cancer Centre at Kolkata was another laboratory, where studies on haematopoietic stem cells were conducted. The Centre for Cellular and Molecular Biology was one of the laboratories where muscle stem cell research was initiated. Corneal limbal cell cultures was also initiated at CCMB, which was later used clinically at the L V Prasad Eye Institute, Hyderabad. Actually this was the first instance when stem cells other than haematopoietic, were used clinically.
With James Thompson's discovery of human embryonal stem cells, there was a mad rush among research laboratories in India, to jump on to the stem cells band wagon. A hype was created that spread the mis-information that 'stem cells' means "embryonic stem cells". Embryonic stem cells research also got a massive boost since a corporate giant Reliance Life Sciences, announced their plan to initiate research into embryonic stem cell and also set up an allogeneic umbilical cord blood derived stem cell bank at Mumbai.
The major focus of stem cell research in India is in clinical application of adult stem cells in regenerative medicine. Both industry as well as government institution are involved in this research effort.
When it became clear, that embryonic stem cells were not the 'magic bullet' for treating all diseases,the focus shifted to adult stem cells mainly the bone-marrow/umbilical cord stem cells.
Stem cell banking from umbilical cord blood is one area, where there are major players. The first company to offer autologous banking of cord stem cells was the Bangalore based Cryo Stemcell Pvt. Ltd., followed by Chennai based Asia cryocell. At present there are four autologous banks and one, which is both auto as well as allogenic. Of these only Cryo Stemcells and Reliance have research programmes on stem cells. Both these companies have programmes for clinical uses of stem cells. Cryo Stemcells along with its sister company Sri Raghavendra Biotechnologies Pvt Ltd., has been a part of clinical trials involving autologous bone-marrow stem cells in Burger's diseases conducted by Dr. K.R.Suresh, Bhagwan Mahaveer Jain Hospital, Bangalore.
This trial, first of its kind in India, showed the indisputable usefulness of bone-marrow derived stem cells in treating limb ischaemia. Cryo Stemcells is now partnering CLRD, Hyderabad, in a clinical trail to investigate the use of autologous bone-marrow stem cells in treating chronic liver disease. SRB has signed an MOU, for research collaboration with NII, New Delhi for carrying out research in Mesenchymal stem cells from Wharton's Jelly present in the umbilical cord.NCRM a Japanese biotechnology company, based at Chennai, is very active in adult stem cell research and limited clinical trials using stem cells grown in a thermolabile gel called Mebiol gel.
NCRM is partnering Sankara Nethralaya in research and clinical use of limbal corneal stem cells. Frontier lifeline a Cardio-thoracic center at Chennai is carrying out very interesting research involving mesenchymal stem cells and their convertion to Cardiomyocytes precursors CMC, Vellore and Manipal Hospital, Bangalore, also have similar programmes. Embryonic stem cells research is going on at NCCS, Pune, NCBS, Bangalore and JNCAR, Bangalore. The research is purely basic with no clinical uses, in sight.
In conclusion, the major focus of stem cell research in India is in clinical application of adult stem cells in regenerative medicine. Both industry as well as government institution are involved in this research effort. Surprisingly, no major pharmaceutical company is doing stem cell research. Embryonal stem cells research is confined to basic research. Regulatory agencies need to evolve suitable rules to govern clinical application.
(The author is president, Society for Regenerative Medicine and Tissue Engineering
and chairman & MD, Cryo Stemcell (Kar) Pvt. Ltd., Sri Raghavendra Biotechnologies Pvt Ltd.)