SHED: Stem cells in

human exfoliated

deciduous teethHope or Hype!!!!!

DR. UPAMA SISHAN

IMPORTANCE OF STEM CELL RESEARCH

WHAT IS A

STEM

CELL???????

“If the potential of stem cell research is realized, it would mean

an end to the suffering of millions of people. If stem cell research

succeeds, there isn’t a person in the country who wont benefit, or

know somebody who will”- MICHAEL J FOX

COMMON SOURCES OF STEM CELLS

• Bone marrow: invasive & painful procedure for the donor,

requires a greater immunocompatibility.

• Umbilical cord blood: was the only storage option to guard

against future illness or disease.

SHED are immature, unspecialized cells in the human deciduous teeth

that are able to grow into specialized cell types by a process known as

“differentiation”.

Dr. Songtao Shi discovered SHED in

2003.

SHED

(STEM CELLS IN HUMAN EXFOLIATED DECIDUOUS TEETH)

HISTORY

In 2003

Miura & co workers discovered a multipotent

stem cell population in human exfoliated deciduous

teeth.

(2)Wang’s study on the therapeutic efficacy of SHED in

Parkinsons disease in rat model concluded that SHED may

be an optimal source of post natal stem cells for parkinsons

disease treatment.

In 2009

(1) Sayaka & co workers - SHED have highest proliferative

ability than the dental pulp stem cell of permanent teeth &

human bone marrow stem cells.

(2)Takayoshi Yamaza - SHED have same

immunomodulatory properties as that of human bone marrow

stem cells .

In 2012

Vakhrushev & co workers pulp of the deciduous teeth is a promising

source of cell material for scaffold population in tissue bone

engineering.

In 2010

(1) Yudai Nishino - SHED have similar effects of wound healing

properties as human fibroblasts.

SALIENT FEATURES OF SHED

• a multipotent stem-cell population.

• can be isolated and expanded ex vivo.

• have higher proliferation rate

• increased cell-population doublings

• sphere-like cell-cluster formation

• osteoinductive capacity in vivo

Types of stem cells in human exfoliated

deciduous teeth

1. Adipocytes:

2. Chondrocytes and Osteoblasts:

• used to grow bone & cartilage suitable for transplant.

3. Mesenchymal :

• repair spinal cord injury

• to restore feeling & movement in paralyzed human patients.

• neuronal degenerative disorders

ADVANTAGES OF BANKING SHED

• It Provides a guaranteed matching donor (autologous

transplant) for life.

• Saves cells before natural damage occurs.

• Simple and painless for both child and parent.

• Less than one third of the cost of cord blood storage.

• SHED are adult stem cells and are not the subject of the

same ethical concerns as embryonic stem cells.

• SHED are able to regenerate solid tissue types that cord blood

cannot -repairing connective tissues, dental tissues, neuronal

tissue and bone.

• SHED may also be useful for close relatives of the donor such as

grandparents, parents, uncles, and siblings.

Tooth Eligibility Criteria for SHED Banking

INCLUSION CRITERIA:

• Primary incisors & canines with no pathology and at least one third

of root left.

• Early removal of deciduous molars for orthodontic considerations

(e.g. early intervention for space maintenance).

• Tooth exfoliated should have pulp red in colour(indicating cell

viability).

EXCLUSION CRITERIA:

• Primary teeth distal to the canine.

• Primary molars.

• The pulp which is grey in colour (compromised blood

supply- necrotic pulp).

• Teeth that become very mobile, either through trauma

or disease (e.g. Class III or IV mobility).

Collection, Isolation and preservation of SHED

1.Tooth collection

Inform parent

Put tooth in sterile saline solution

Give a call to tooth bank

Confirm presence of healthy pulpal tissue

Tranfer tooth to a vial (hypotonic phosphate buffered

saline solution) & sealed. Vial placed into a thermette.

2. Stem cell isolation

3. Stem cell storage:

CRYOPRESERVATION

MAGNETIC FREEZING

SUMMARY

• Recent studies - SHED can develop into more types of body tissue

than other types of stem cells.

• There is much research left to be conducted.

• The immense scope & magnitude of stem cell therapies will only be

fully realized in the future.

• Dental Professionals have realized that the critical time to act is now.

• So its better that the dentist bank their patients dental stem cells while

patients are young and healthy –simple & convenient

-Primary teeth are better source of stem cells.

References:

1. SHED: stem cells from human exfoliated deciduous teeth.

Miura M, Gronthos S, Zhao M, Lu B, Fisher L W, Robey PG, Shi S.

2. Stem cells from human exfoliated deciduous teeth (SHED)

enhance wound healing and the possibility of novel cell therapy.

Nishino Y , Yamada Y , Ebisawa K, Nakamura S .

3. Immunomodulatory properties of stem cells from human

exfoliated deciduous teeth .Yamaza T, Kentaro A, Chen C, Liu Y,

Shi Y, Gronthos S, Wang S, Shi S.

4. Banking Stem Cells from Human Exfoliated Deciduous Teeth

(SHED): Saving for the Future . Vipin Arora , Pooja Arora& AK

Munshi.

6. Stem Cells from Human-Exfoliated Deciduous Teeth Can

Differentiate into Dopaminergic Neuron-Like Cells.

Wang J, Wang X , Sun Z ,Wang Z , Yang H, Shi S & Wang S.

5. Stem cells from human exfoliated deciduous teeth (SHED)

enhance wound healing and the possibility of novel cell therapy.

Yudai Nishino , Yoichi Yamada , Katsumi Ebisawa , Sayaka

Nakamura ,Kazuto Okabe , Eri Umemura , Hara k & Ueda M.