Effectiveness of acceptance and commitment therapy upon distress, emotion regulation, and self-compassion in patients with cardiovascular disease: a randomized clinical trial.

INTRODUCTION: Cardiovascular patients experience various psychological problems due to the conditions caused by their disease, which make it worse if left untreated. OBJECTIVE: The purpose of the current study was to evaluate the effects of acceptance and commitment therapy on distress, emotion regulation, and self-compassion in patients with cardiovascular disease. METHODS: This study was a randomized clinical trial with pre-test, post-test and two-month and four-month follow-up periods accompanying a control group. At four stages, patients filled out questionnaires on depression, anxiety, stress (DASS-21), emotion regulation (ERQ), and self-compassion (SCS). The experimental group underwent a treatment protocol based on acceptance and commitment therapy. Data were then analyzed using SPSS-25 with repeated measures analysis of variance. RESULTS: Act significantly reduced depression, anxiety, and stress, enhanced self-compassion, and improved emotion regulation in cardiac patients. Between-subjects (Group) partial etas for depression, anxiety, stress, reappraisal, suppression, and self-compassion were 0.61, 0.64, 0.66, 0.62, 0.66, and 0.65, respectively. Treatment efficacy was maintained during the 2- and 6-month follow-up visits. CONCLUSION: The results of this study suggest that treating cardiac patients' psychological problems in a way focused on acceptance and commitment therapy may have an impact on how well they respond to their treatment.

Effect of Replacement of Wharton Acellular Jelly With FBS on the Expression of Megakaryocyte Linear Markers in Hematopoietic Stem Cells CD34.

OBJECTIVE: Animal environments for the growth of stem cells cause the transmission of some diseases and immune problems for the recipient. Accordingly, replacing these environments with healthy environments, at least with human resources, is essential.  One of the media that can be used as an alternative to animal serums is Wharton acellular jelly (AWJ).  Therefore, in this study, we intend to replace FBS with Wharton jelly and investigate its effect on the expression of megakaryocyte-related genes and markers in stem cells. MATERIALS AND METHODS: In this study, cord blood-derived CD34 positive HSCs were cultured and expanded in the presence of cytokines including SCF, TPO, and FLT3-L. Then, the culture of expanded CD34 positive HSCs was performed in two groups: 1) IMDM culture medium containing 10% FBS and 100 ng / ml thrombopoietin cytokine 2) IMDM culture medium containing 10% AWJ, 100 ng / ml thrombopoietin cytokine.  Finally, CD41 expressing cells were analyzed with the flow cytometry method. The genes related to megakaryocyte lineage including FLI1 and GATA2 were also evaluated using the RT-PCR technique.  Results: The expression of CD41, a specific marker of megakaryocyte lineage in culture medium containing Wharton acellular jelly was increased compared to the FBS group. Additionally, the expression of GATA2 and FLI1 genes was significantly increased related to the control group. CONCLUSION: This study provided evidence of differentiation of CD34 positive hematopoietic stem cells from umbilical cord blood to megakaryocytes in a culture medium containing AWJ.
.

Regenerative potential of Wharton's jelly-derived mesenchymal stem cells: A new horizon of stem cell therapy.

Umbilical cord Wharton's jelly-derived mesenchymal stem cells (WJ-MSCs) have recently gained considerable attention in the field of regenerative medicine. Their high proliferation rate, differentiation ability into various cell lineages, easy collection procedure, immuno-privileged status, nontumorigenic properties along with minor ethical issues make them an ideal approach for tissue repair. Besides, the number of WJ-MSCs in the umbilical cord samples is high as compared to other sources. Because of these properties, WJ-MSCs have rapidly advanced into clinical trials for the treatment of a wide range of disorders. Therefore, this paper summarized the current preclinical and clinical studies performed to investigate the regenerative potential of WJ-MSCs in neural, myocardial, skin, liver, kidney, cartilage, bone, muscle, and other tissue injuries.

The pro-Inflammatory cytokines effects on mobilization, self-renewal and differentiation of hematopoietic stem cells.

Different mature immune cells are being produced during infection by hematopoietic stem cells in order to compensate the required cells battling against pathogens. A wide variety of pro-inflammatory cytokines like G-CSF, TNFα, IFNα, IL-1, IL-6, etc. affect HSCs and provoke different responses including maintenance, survival, activation, proliferation, differentiation, and immune responses. The exact mechanisms of translating pathogen sensing into cytokine signals for regulating HSCs are not fully understood yet. Moreover, the interaction between these cytokines modulating different responses have to be well established in order to understand HSC responses during inflammatory complications, since several different effects have been attributed to cytokines in various conditions. IFNγ demonstrates pleiotropic influences on various cell types such as HSCs and HSPCs. It can induce HSC proliferation, quiescence, reconstitution, mobilization and differentiation. Similar to other inflammatory cytokines including IL-6, IL-3, IL-2, and GM-CSF, G-CSF is a significant mobilizing factor. It contributes to increase phenotypic HSCs in bone marrow (BM), induction of HSC cycling and quiescence, and declined long-term repopulating activity of HSCs. Growth inhibition and apoptosis induction have been understood to be elicited by TNFα, similar to IFNγ. IL-1 is a significant component for inflammatory responses, which can synergize with TNFα enhancing neutrophil production in bone marrow. It has been demonstrated that HSPC-derived cytokines, especially IL-6, is important in the functional context for promoting myelopoiesis in vitro and in vivo. Therefore, understanding their effects on HSCs in normal and stressed situation can be helpful in managing different inflammatory complications.

Human umbilical cord mesenchymal stem cell-derived extracellular vesicles: A novel therapeutic paradigm.

Mesenchymal stem cells (MSCs) have been revealed to hold great potential for the development of new treatment approaches for various diseases. However, the clinical use of these cells is limited due to their tumorigenic effects. The therapeutic benefits of MSCs are largely dependent on paracrine factors including extracellular vesicles (EVs). EVs are nano-sized bilayer membrane structures containing lipids, microRNAs and proteins which play key roles in cell-to-cell communications. Because of their lower immunogenicity, tumorigenicity, and easier management, EVs have emerged as a new promising alternative to whole-cell therapy. Therefore, this paper reviews current preclinical studies on the use of EVs derived from human umbilical cord MSCs (hucMSCs) as a therapeutic approach in treatment of several diseases including neurological, cardiovascular, liver, kidney, and bone diseases as well as the cutaneous wound, inflammatory bowel disease, cancers, infertility, and other disorders.

Strategies for elevating hematopoietic stem cells expansion and engraftment capacity.

Hematopoietic stem cells (HSCs) are a rare cell population in adult bone marrow, mobilized peripheral blood, and umbilical cord blood possessing self-renewal and differentiation capability into a full spectrum of blood cells. Bone marrow HSC transplantation has been considered as an ideal option for certain disorders treatment including hematologic diseases, leukemia, immunodeficiency, bone marrow failure syndrome, genetic defects such as thalassemia, sickle cell anemia, autoimmune disease, and certain solid cancers. Ex vivo proliferation of these cells prior to transplantation has been proposed as a potential solution against limited number of stem cells. In such culture process, MSCs have also been shown to exhibit high capacity for secretion of soluble mediators contributing to the principle biological and therapeutic activities of HSCs. In addition, endothelial cells have been introduced to bridge the blood and sub tissues in the bone marrow, as well as, HSCs regeneration induction and survival. Cell culture in the laboratory environment requires cell growth strict control to protect against contamination, symmetrical cell division and optimal conditions for maximum yield. In this regard, microfluidic systems provide culture and analysis capabilities in micro volume scales. Moreover, two-dimensional cultures cannot fully demonstrate extracellular matrix found in different tissues and organs as an abstract representation of three dimensional cell structure. Microfluidic systems can also strongly describe the effects of physical factors such as temperature and pressure on cell behavior.