Preface

**Section 3 Stromal Cell Therapies 141**

**VI** Contents

**Stem Cell 185**

**Orthopedic Diseases 209**

Wang, Xujin Wang and Lixin Kan

Chapter 7 **Mesenchymal Stromal Cells as a Therapeutic Intervention 143** Ivonne Hernandez Schulman and Joshua M. Hare

Daniel Ascencio González, Rogelio Hernández Pando, Miguel Ángel

Gómez Lim, Sergio Ayala Fraustro and Aaron Torres Garcia

Jiazhao Yang, Shiyuan Fang, Lei Xu, Li Li, Kai Xie, Jinsen Lu, Hao

Chapter 9 **Clinical Applications of Mesenchymal Stromal Cells (MSCs) in**

Chapter 10 **Human Placenta-Derived Mesenchymal Stromal Cells: A Review from Basic Research to Clinical Applications 227** Paz de la Torre, María Jesús Pérez-Lorenzo and Ana I. Flores

Chapter 8 **Therapeutic Strategies of Secretome of Mesenchymal**

Stromal cells are connective tissue cells of any organ, and they support the function of the parenchymal cells of that particular organ. Stromal/stromal stem cells are fundamentally a heterogeneous population of cells with contradictory differentiation potential depending upon their environmental niche. Stromal cell biology is not only intriguing, but equally stro‐ mal cell ontogeny *in vivo* remains challenging.

In recent years, there has been substantial advances in our understanding of stromal cell biology, especially stromal cell isolation, characterization, differentiation, and interactions in physiological (epithelial–stromal interactions) as well as pathophysiological (stromal–cancer interactions) contexts. In addition, stromal cells are also utilized more and more as a thera‐ peutic tool not only in the field of gene therapy but also in the translational field of tissue engineering and regenerative medicine. Therefore, the goal of this book is to consolidate the recent advances in the area of stromal/stromal stem cell biology, covering a broad range of interrelated topics in a timely fashion and to disseminate that knowledge in a lucid way to a greater scientific audience.

This book will prove highly useful for students, researchers, and clinicians in stem cell biolo‐ gy, developmental biology, cancer biology, pathology, oncology, as well as tissue engineering and regenerative medicine. This quick reference will benefit anyone desiring a thorough over‐ view of stromal cell structure, function, and its therapeutic implications in human diseases.

The book consists of nine chapters, contributed by leading experts in basic science and clini‐ cal care, and is organized into three parts. The first part introduces the structure and func‐ tion of stromal/stromal stem cells. The second part of the book deals with stromal cell interactions, such as stromal–epithelial interactions and stromal–tumor interactions. Eventu‐ ally, in contrast, the third part explores the therapeutic potential of stromal/stromal stem cells as a double-edged sword.

I would like to thank the staff of IntechOpen who have produced this book so efficiently, and in particular I am indebted to Danijela Vladika and Nina Kalinic, the publishing process managers, Romina Skomersic, the author service manager, and Anja Filipovic, the commis‐ sioning editor, for their valuable source of advice throughout the preparation of this book. Finally, I dedicate this book to my father and the memory of my mother.

> **Valarmathi M. Thiruvanamalai, MD, PhD** Department of Biomedical Engineering School of Medicine and School of Engineering UAB | The University of Alabama at Birmingham Birmingham, Alabama, USA

**Section 1**

**Stromal Cell Structure and Function**

**Stromal Cell Structure and Function**

**Chapter 1**

Provisional chapter

**Stromal Stem Cells: Nature, Biology and Potential**

DOI: 10.5772/intechopen.77346

Stromal cells are connective tissue cells of any organ. Mesenchymal stromal cells (MSCs), are multipotent progenitors, which were first described by Caplan and colleagues in 1991. MSCs hold great potential for regenerative medicine because of their ability for selfrenewal and differentiation into tissue-specific cells such as osteoblasts, chondrocytes, and adipocytes. Recent studies indicate that MSCs resemble pericytes and emerge from the peripheral stromal region surrounding blood vessels, thus clarifying their broad regenerative potential in adult tissues. The development of uniform protocols for both preparation and characterization of MSCs, including standardized functional assays for evaluation of their biological potential, are critical factors contributing to their clinical utility. Nowadays, due to the capacity of modulating immunological responses, supporting hematopoiesis and repairing tissues, MSCs have been widely used to treat immunebased disorders, such as Crohn's disease, rheumatoid arthritis, diabetes, and multiple sclerosis. Based on animal experiments and clinical studies, the most successful clinical

Stem cells have the ability of self-renewal, giving rise to a variety of cell lineages. They const-

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and eproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

Stromal Stem Cells: Nature, Biology and Potential

**Therapeutic Applications**

Therapeutic Applications

http://dx.doi.org/10.5772/intechopen.77346

Hoda Fahmy

Hoda Fahmy

Abstract

1. Introduction

Amira Hassouna, Marwa M. Abd Elgwad and

Amira Hassouna, Marwa M. Abd Elgwad and

Additional information is available at the end of the chapter

application of MSCs is in the field of hematological disease. Keywords: mesenchymal stromal cells, stromal stem cells

itute a significant paradigm of cell-based therapy for various diseases.

Additional information is available at the end of the chapter

#### **Stromal Stem Cells: Nature, Biology and Potential Therapeutic Applications** Stromal Stem Cells: Nature, Biology and Potential Therapeutic Applications

DOI: 10.5772/intechopen.77346

Amira Hassouna, Marwa M. Abd Elgwad and Hoda Fahmy Amira Hassouna, Marwa M. Abd Elgwad and Hoda Fahmy

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.77346

#### Abstract

Stromal cells are connective tissue cells of any organ. Mesenchymal stromal cells (MSCs), are multipotent progenitors, which were first described by Caplan and colleagues in 1991. MSCs hold great potential for regenerative medicine because of their ability for selfrenewal and differentiation into tissue-specific cells such as osteoblasts, chondrocytes, and adipocytes. Recent studies indicate that MSCs resemble pericytes and emerge from the peripheral stromal region surrounding blood vessels, thus clarifying their broad regenerative potential in adult tissues. The development of uniform protocols for both preparation and characterization of MSCs, including standardized functional assays for evaluation of their biological potential, are critical factors contributing to their clinical utility. Nowadays, due to the capacity of modulating immunological responses, supporting hematopoiesis and repairing tissues, MSCs have been widely used to treat immunebased disorders, such as Crohn's disease, rheumatoid arthritis, diabetes, and multiple sclerosis. Based on animal experiments and clinical studies, the most successful clinical application of MSCs is in the field of hematological disease.

Keywords: mesenchymal stromal cells, stromal stem cells
