The stem cell potential in the field of Regenerative Medicine in India has been recognized in the last few decades. They have a unique feature of generating different kinds of cells, which is absent in other cells. It makes them especially useful for healing tissue damage or degeneration. Wide applications such as retinopathy, neurological disorders, ischemia, kidney damage, liver damage, etc., have urged the scientists to dive deeper. The basic understanding of the cells, genetic engineering, the formulation of stem cell-based products, and their translation into treatment in clinical settings are under investigation. The safety and efficacy studies in clinical trials have sparked hope for their clinical translation. Tremendous research has also gone into finding the optimal source, extraction protocols, dosage, and the delivery route. Despite several social and ethical concerns, India has made numerous efforts to excel in the field of stem cell research.

Bone marrow comprises hematopoietic and mesenchymal stem cells, which generate cell lineages belonging to blood and bone tissue. It is the first identified source of stem cells. Therefore, optimized protocols for the extraction from bone marrow are available. Bone marrow is commonly present in bones like the iliac crest, femur, tibia, etc. The iliac crest is the primary source in clinical settings. Clinicians aspirate the marrow by inserting a needle or syringe into the iliac crest. The aspirated marrow is then processed to isolate the stem cells. The isolated cells are then characterized by their surface markers. The quality is evaluated for the possible contamination by mycoplasma, microorganisms, and endotoxins. Many labs in India follow GMP-compliant processes and provide cells with ensured quality and quantity. It greatly boosts the potential of regenerative medicine in India.

Stem Cell Banks in India

In 1988, the first umbilical cord blood transplantation succeeded in a child suffering from Fanconi anemia. It established umbilical cord blood as a new source of stem cells. Easy, rapid, and cost-effective extraction made cord blood a preferred source. Moreover, the ability to isolate larger volumes with low rejection rates and higher differentiation potential added to its appeal. Soon a trend emerged where people began preserving cord blood stem cells after childbirth- also termed as stem cell banking. In India, various private players such as Reliance Life Science, Advancells, Life Cell, Cryo-Cell, etc., provided the required infrastructure for the banking. It is based on the hope that the preserved cells may rescue an individual from a life-threatening disease that is incurable by conventional medicine. The easy access to these cells paved the way for regenerative medicine in India.

Research Institutes in India

Several institutes have been conducting research in this field in India. NBRC, Manesar, and NIMHANS, Bangalore, have focused on neurobiological applications, while LV Prasad Eye Institute, Hyderabad, and R.P. Center, AIIMS, Delhi, are exploring their potential in ophthalmological disorders. Hospitals like CMC, Vellore; AIIMS, Delhi, etc., are already employing hematopoietic stem cells for treatment. The Institute of Stem Cell Biology and Regenerative Medicine, Bangalore, is a dedicated institute towards this research area. Reputed institutes such as NIRRH, Mumbai; NCCS, Pune; NCBS, Bangalore; and JNCASR, Bangalore, have dived into embryonic stem cell research. CDFD, Hyderabad; NIN, Hyderabad; and CCMB, Hyderabad, are exploring regenerative medicine in disorders pertaining to the liver, pancreas, and muscles, respectively. These institutes promote basic as well as clinical research in regenerative medicine in India.

Private Sector Involvement in India

Many private sector industries have also taken an interest in the area. In addition to stem cell banking, Reliance Life Sciences, Mumbai, characterized cell lines from human embryonic stem cells that were listed in the UK stem cell registry. Advancells became a pioneer in providing necessary services, infrastructure, and support to ensure the successful application of stem cells in various therapeutic areas. Stempeutics has collaborated with Manipal Hospital, Bangalore, to conduct clinical trials for disorders such as limb ischemia and myocardial infarction. Sankara Nethralaya established a research facility in his Kamalnayan Bajaj Hospital, Mumbai, and named it Kamalnayan Bajaj Institute for Research in Vision and Ophthalmology. The facility investigates the benefits of regenerative medicine in ophthalmological disorders. Private sector involvement has drastically accelerated the application of regenerative medicine in India.

Conclusion

The field of regenerative medicine has garnered attention in India. Bone marrow is already in use as a Stem Cell Source and has optimized extraction protocols. But industry-provided infrastructure has promoted the banking of umbilical cord blood stem cells for its low cost and simple extraction. Various research institutes have ventured into this area in a myriad of diseases with the aid of government funding. The private sector has also been keeping up with the research in regenerative medicine. These initiatives along with the huge amount of ongoing research in the private as well as public sectors, are rapidly changing the regenerative medicine in India.