關於 regeneration in human liver ，我們在網路上蒐集到這些相關的討論、資訊與評價

《原來臍帶除了臍帶血還有臍帶膜？》

有不少讀者都對臍帶的醫療用途有興趣，上回跟大家分享完臍帶血後，今日跟大家講講比較少人聽過的「臍帶膜」。

上回提到過去小Baby出生後，臍帶大多被當做醫療廢物，在過去的三十年臍帶血持續發展，透過幹細胞治療血液類疾病。而近年，除了臍帶血外，科學家發現了原來臍帶外層的膜（Lining）也有潛在的醫療用途。

【何謂臍帶膜（Umbilical Cord Lining Membrane）】

在講解臍帶膜前，先講解一下臍帶的歷史背景。

17世紀英國醫學家Thomas Wharton發現臍帶組織（Stroma）含有一種啫喱狀的物質，將其命名為Wharton's jelly。這層啫喱的作用為防止臍帶血管（靜脈和動脈）交叉（clumping）和提供臍帶的彈性。1991年科學家McElreavey從Wharton's jelly中分離出類似纖維母細胞的細胞（Fibroblast-like cells）[1]，而這些Fibroblast-like cells在2004年被發現是幹細胞的一種 - 間質幹細胞（Mesenchymal Stem Cells MSCs） [2]。自此臍帶不同的組織便成為科學家的研究對象。

隨著臍帶研究的發展，近年科學家發現能夠利用CellOptimaTM 技術從臍帶外層的組織（臍帶膜）裡提取更多的幹細胞 - 除了間質幹細胞（Mesenchymal Stem Cells MSCs）外，還可提取上皮幹細胞（Epthelial Stem Cells EpSCs）［3］。

那麼，這些EpSCs和MSCs幹細胞跟臍帶血的造血幹細胞（Hematopoietic Stem Cells HSCs）有什麼分別呢？

臍帶血的造血幹細胞主要作用是生成為不同的血液細胞，如之前文章提及到的紅血球、白血球和血小板，可用作治療個別血液類疾病如血癌和個別免疫系統疾病。

MSCs幹細胞則可生成為一些組成不同器官如皮膚、軟骨組織、腦部、心臟和肌肉等等的細胞。

EpSCs幹細胞則可生成為一些組成皮膚或空心（Hollow Structure）的器官如腸臟、氣管、膀胱和子宮等等的細胞。

由於MSCs跟EpSCs幹細胞有生成作不同器官的潛能，近年不少科學家紛紛收集臍帶進行研究。

研究發現MSCs幹細胞有以下潛能並正在對這些疾病進行動物實驗和臨床試驗。[4]

1. 心血管疾病如心肌梗塞和心肌無力症
2. 腦神經系統疾病如腦退化症、多發性硬化症和脊柱神經受傷等等
3. 自體免疫系統疾病如一型糖尿病、自體免疫性肝炎、潰瘍性結腸炎、紅斑狼瘡和類風濕性關節炎等等

令人鼓舞的是，根據目前的臨床試驗公怖結果，在自體免疫系統疾病和內分泌疾病方面，移植MSCs幹細胞後，病情有顯著的改善。同時有研究亦發現MSCs幹細胞有較低的免疫原性（Immunogenicity）、相當較能避開人體免疫系統的識別，減低移植排斥反應。現時不少的臨床研究制用此特性，探討將MSCs幹細胞用作異體移植（Allogeneic Transplantation）例如近親甚至免疫不相容（HLA-Mismatch）的外人等[8]， MSCs幹細胞的移植技術的研究開始了二十多年，目前的研究成果相當正面，其低免疫原性的特質在未來能夠怎樣應用在免疫不相容的病人身上實在值得我們期待。[2][5][8]

而EpSCs幹細胞方面，研究發現或許有以下潛在臨床應用 [6][7]

1. 燒傷治療和傷口癒合
2. 一型糖尿病
3. 肝臟衰竭

不過由於有關臍帶膜的研究，並不被歸納為醫療系統常用的治療，現有的應用均為實驗性質。雖然目前研究仍處床試驗階段，但隨著移植的個案越來越多，臍帶膜的幹細胞似乎有著不少的發展潛力。

跟上回提到臍帶血一樣，從收集臍帶膜到儲存臍帶膜及臨床實驗性應用都有嚴謹的要求，例如運送的時間、過程、儲存系統以及國際認證。

近年不少提供臍帶血儲存服務的生物科技公司同時有提供儲存臍帶膜的服務[2]。跟臍帶血一樣，目前並非醫療系統會資助的常見項目，故對一般家庭來可謂一筆大開支。

正在考慮儲存臍帶血或膜的孕婦宜先充分調查不同臍帶生物科技公司的背景、財政狀況、過去的移植紀錄、使用的儲存技術等等。同時，如有任何疑問務必諮詢專家或醫生意見以作informed decision。

【Reference】
[1] Isolation, Culture and Characterisation of Fibroblast-Like Cells Derived From the Wharton's Jelly Portion of Human Umbilical Cord. Stem Cell Biochemical Society Transaction. https://portlandpress.com/biochemsoctrans/article/19/1/29S/81930/Isolation-culture-and-characterisation-of

[2] The Therapeutic Potential, Challenges and Future Clinical Directions of Stem Cells From the Wharton's Jelly of the Human Umbilical Cord. Stem Cell Reviews and Reports. https://link.springer.com/article/10.1007/s12015-012-9418-z

[3] Epithelial and Mesenchymal Stem Cells From the Umbilical Cord Lining Membrane. Cell Transplant.
https://pubmed.ncbi.nlm.nih.gov/24636188/

[4] Umbilical Cord as Prospective Source for Mesenchymal Stem Cell-Based Therapy. Stem Cells international. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5019943/

[5]Immunogenicity and Immunomodulatory Properties of Umbilical Cord Lining Mesenchymal Stem Cells. Cell Transplant. https://pubmed.ncbi.nlm.nih.gov/21054940/

[6] Short review on human umbilical cord lining epithelial cells and their potential clinical applications. Stem Cell Research & Therapy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5634865/#CR40

[7] Longitudinal In-Vivo Volumetry Study for Porcine Liver Regeneration From CT Data. 2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. https://ieeexplore.ieee.org/document/6944684

[8] The Importance of HLA Assessment in “Off-the-Shelf” Allogeneic Mesenchymal Stem Cells Based-Therapies. International Journal of Molecular Sciences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6888380/

Photo: Internet Photo

#研究分析 #科普系列 #臍帶膜 #上皮幹細胞 #間質幹細胞 #CellOptima #MesenchymalStemCells #EpthelialStemCells

Human Growth Hormone

Everything You Need to Know About HGH

Get the facts about this powerful anabolic hormone, and then decide if HGH is right for you.

Human growth hormone can turn back your body’s internal clock, helping you rapidly build muscle, slash fat, and increase libido, all while sending energy levels through the roof. but when it comes to discussions on hGh, there are often more questions than answers. to help you decide whether you need hGh, check out our straightforward Q&a, which answers some of the more commonly asked questions and learn how you can boost your own natural levels of this powerful anabolic hormone.

What is human growth hormone?
The body naturally produces growth hormone (HGH or simply GH) in the pituitary gland, and, as its name implies, it is responsible for cell growth and regeneration. Increasing muscle mass and bone density are impossible without GH, but it also plays a major role in maintaining the health of all human tissue, including that of the brain and other vital organs. When secreted, GH remains active in the bloodstream for only a few minutes, but this is enough time for the liver to convert it into growth factors, the most crucial of which is insulin-like growth factor-1, or IGF-1, which boasts a host of anabolic properties. Scientists began to harvest GH from the pituitary glands of cadavers in the 1950s, but didn’t synthesize the first HGH in laboratories until 1981, with its use as a performance-enhancing drug becoming popular shortly thereafter.

How much GH do I produce naturally?
Healthy adult men typically have just less than 5 nanograms per milliliter circulating in the blood. Healthy females can produce about twice that amount for child-bearing purposes. Levels for both sexes peak during puberty and drop sharply starting in the early 20s.

How can I learn if I have a GH deficiency?
Ask your doctor to perform a GH test. You’ll need to fast for a simple blood test that is not unlike the one administered during an annual physical.

Can’t HGH be dangerous? What about reports of enlarged bones and vital organs?
Remember when creatine was billed by the mainstream media as potentially dangerous? Now it’s the most heavily researched supplement in the world, and studies bear out the fact that it’s one of the safest and most effective supplements you can take. Medical professionals say that the dangers surrounding HGH are similarly overblown. “Complications [with HGH use] are very minimal,” says Eric Braverman, M.D., who specializes in anti-aging at Path Medical Center in New York City. “Some people experience fluid retention, and a blood sugar rise, but even these are very rare un- less you take a lot. Only a few people ever come in with big feet or big livers—from mega-doses—and they weren’t my patients. It’s very rare.”

Age-related declines are natural. Why do I need GH if I’m not growing anymore?
Aside from GH’s crucial role in building muscle mass, not all of its benefits are necessarily evident to the naked eye. GH has been shown to slow the progression of age-related degenerative diseases, as well as increase sex drive, help maintain mental acuity, and engender a general sense of well-being. The flip side of the coin—low GH— can result in the exact opposite: muscle loss, fat gain, low sex drive and energy levels, and a poor sense of well-being.

Where can I get HGH?
HGH can be obtained only through a doctor’s prescription in the United States. Anti-aging clinics like Braverman’s specialize in identifying GH deficiencies and making the diagnosis. For those who lack GH sensitivity, a doctor may prescribe pure IGF-1. Although not uncommon, obtaining HGH through illegal means can be dangerous — you can’t be certain of what you’re actually getting—and very expensive.

How can I boost GH levels without an HGH prescription?
Two major factors that contribute to increased GH levels are ones you can control without drugs: weight training and proper sleep. The more you exercise, the more GH you release naturally. A recent study observed significant increases in circulating GH and IGF-1 after intense resistance exercise in a group of trained men but found no significant diferences in untrained men who performed the same workout. GH is also secreted while you sleep, and studies have shown a spike in GH levels at the onset of deep sleep, so getting the recommended seven to nine hours per night is essential to maintaining GH. Diet is the third major factor in keeping GH levels topped of. It’s necessary to eat a balanced diet that provides as many of the items in our “The M&F Guide to GH- Boosting Agents,” starting on page 138, as possible. Eating to stay lean is also key; fat gain leads to low levels of GH.

What supplements can I take to boost GH?
While a multivitamin may give you some of the nutrients needed to provide a small boost in GH levels, a new study reveals that arginine and glutamine can dramatically raise GH levels, but only if taken in proper ratios. You could try to mix these aminos yourself, but if you want something proven to work, you need a specialty supplement. One of our favorites is Growth Factor-9, the only supplement proven to provide a mean GH in- crease of 682% in a wide range of study subjects.

The M&F Guide to GH-Boosting Agents
The following list breaks down GH-Boosting Agents into seven categories: vitamins, minerals amino acids, hormones, vital agents, herbs and botanicals and adaptogenic herbs.
Many of the items listed here - such as vitamins A, B5, B12, chromium, and zinc, can be found in a daily multivitamin. Amino acids such as arginine, glutamine and taurine are in many of our favorite pre- and post-workout supplements. Others, such as the hormone CHEA, the botanical extract chrysin, and the adaptogenic herb panaz ginseng might not be part of the common products you already take but are sold separately.
Everything listed here is backed by years of research backing its efficacy

Vitamins
Vitamin A
Vitamin B5
Vitamin B12
Folic Acid
Inositol Hexanicotinate

Minerals
Chromium
Zinc
Magnesium
Iodine

Amino Acids
Glutamine
Glycine
Carnitine
Arginine
GABA
Taurine
Lysine
Ornithine alpha ketoglutarate

Hormones
DHEA
Pregnenolone
Melatonin
*Braverman says that real HGH is the only way to go if you truly have a deficiency, but added, “There’s no question that when you take other hormones—testosterone, DHEA, es- trogen, progesterone—lots of people get growth hormone increases.”

Vital Agents
Colostrum
Alpha GPC

Herbs, Botanicals
Tribulus terrestris
Chrysin
Coleus forskohlii
Griffonia simplicifolia
Milk thistle (silymarin)

Adaptogenic Herbs
(Herbs with multiple, nonspecific actions that generally promote overall wellness)
Panax ginseng
Eleuthero root
Ashwagandha root
Schizandra berry
Astragalus root
Dong quai
Wild yam extract
Fo-Ti root extract
Lycium berry
Red date fruit