MAY 24 — In recent years, scientists have shown unprecedented interest in stem cells derived from menstrual blood, known as Menstrual Blood-Derived Stem Cells (MenSCs). This innovative research has sparked considerable exploration into the feasibility of menstrual blood banking, a concept that could revolutionise medical treatments across various fields.
MenSCs have emerged as a novel source of mesenchymal stem cells (MSCs), demonstrating the ability to differentiate into a wide range of cell types. This potential makes them promising candidates for regenerative therapies aimed at repairing tissues and treating previously untreatable conditions. Unlike traditional sources of stem cells, MenSCs are easily accessible through a non-invasive collection method that can be repeated during menstrual cycles.
The growing global focus on menstrual health emphasises the importance of innovative approaches to managing and utilising menstrual by-products. Menstrual blood banking aligns with these trends, providing a sustainable and ethically sound source of biological material for advanced medical therapies. As research into the capabilities and applications of MenSCs progresses, the future of menstrual blood banking looks promising, heralding a new era of personalised and regenerative medicine.
MenSCs are highly valuable for regenerative medicine due to their unique properties. They can be collected non-invasively using the menstrual cup, proliferate rapidly, and possess low immunogenicity, making them suitable for various therapeutic applications. These stem cells share similarities with bone marrow-derived MSCs and have demonstrated robust proliferation and broad differentiation capacities, making them ideal for treatments involving endothelial, cardiomyocytic, neurocytic, and osteogenic differentiation. Additionally, MenSCs exhibit immunomodulatory properties due to their exposure to cyclic menstruation and inflammatory signalling.
Recent research has highlighted the paracrine effects of MenSCs, particularly through the secretion of extracellular vesicles (EVs) like exosomes. These vesicles carry bioactive molecules, including proteins and microRNAs, which contribute to tissue repair and regeneration. Studies have shown that the reparative properties of MenSCs are primarily due to their paracrine effects rather than their ability to directly differentiate and integrate into tissues.
Despite their promise, challenges remain in standardising MenSC isolation and characterisation. Addressing these challenges is crucial to fully realising the therapeutic potential of MenSCs in regenerative medicine. Our preclinical research (at the cellular level and animal study) in collaboration with Xinxiang Medical University (XXMU), China has shown promising therapeutic potential in various disease models, including acute lung injury, type 1 diabetes, and Parkinson’s disease. For example, MenSC transplantation in type 1 diabetes mouse models improved symptoms and protected major organs, while in Parkinson’s disease models, MenSC-conditioned medium protected against neurotoxin-induced cytotoxicity.
In a clinical case study involving a Covid-19 patient with severe pulmonary injury, MenSC therapy was proposed as an alternative after traditional treatments were withdrawn due to side effects. MenSCs demonstrated the ability to regulate the inflammatory response, reduce the severe cytokine storm associated with Covid-19, and restore the normal function of immune cells and tissues, thereby improving breathing patterns. Their homing potential allows MenSCs to enhance the repair capabilities of immune and other cells, facilitating the reconstruction of damaged tissues through receptor-mediated interactions.
Furthermore, MenSC-EVs have shown efficacy in protecting against acute lung injury in a mouse model, suggesting a potential strategy for treating pulmonary inflammatory disorders. However, the trend of using stem cell secretomes in place of transplantation raises concerns about interventions without sufficient supporting data, posing risks to patients and credibility challenges in the field.
To facilitate the clinical application of MenSCs, considerations must include factors from production to evaluation, such as cell dosage, delivery route, and efficacy assessment. Ensuring MenSC quality is crucial, especially in patients with autoimmune diseases. Cryopreservation of MenSCs from younger, healthy donors may optimise therapeutic outcomes, and further experimental studies and clinical trials are needed to validate MenSC cryopreservation protocols and their efficacy in treating various conditions.
Establishing menstrual blood stem cell banking for clinical applications involves careful examination of collection procedures, stem cell heterogeneity, safety measures, donor age, stem cell quality, and quality control protocols. Addressing these challenges is vital to harnessing the therapeutic potential of MenSC-based therapies. Standardised protocols for menstrual blood collection, processing, and isolation of MenSCs are crucial to minimise variability between samples and ensure reproducibility.
In Malaysia, the ethical considerations of stem cell technology highlight the need for thoughtful theological discussions to guide decisions on research methods, regulation, policy, and legislation. Stem cells primarily come from two sources: adult stem cells and embryonic stem cells, each with its own ethical issues.
Islamic scholars fully support using adult stem cells for medical treatments and research. However, they disagree on using embryonic stem cells due to different interpretations of the legal status of a miscarriage fetus before 40 days of gestation, based on the four Islamic schools of thought.
The Islamic view on stem cells depends on their source and purpose. Adult stem cells are generally accepted for research and therapy, but embryonic stem cells, whether from aborted embryos or those fertilised in vitro, are more controversial. This debate hinges on the concept of ensoulment, which, according to a Hadith of Prophet Muhammed (PBUH), occurs 120 days after conception. Before this period, the human embryo is not considered a person in Islamic law.
To understand the use of MenSCs from an Islamic perspective, we need to consider how Islam views menstrual blood. Menstrual blood is considered impure in Islam, preventing women from performing prayers and fasting during menstruation. This raises the question of how MenSCs, derived from menstrual blood, are viewed. Despite their impure origin, MenSCs are purified to isolate stem cells for medical use.
Islam allows the use of impure or doubtful sources in cases of necessity, especially for life-saving treatments. The key question is whether MenSCs are critically essential for therapy or if other sources, like cord blood, dental pulp, and adipose-derived stem cells, can be used instead. These alternatives are available and can be stored for future personalised treatments, potentially reducing the need for MenSCs.
While MenSCs have significant therapeutic potential, other stem cell sources offer viable options, especially for those following Islamic guidelines. Muslims need to consider the religious implications of using MenSCs and explore alternatives that align with their beliefs. For those not bound by Islamic rules, MenSCs are a practical option for stem cell banking, particularly for individuals unable to bank cord blood or who are beyond childbearing age. Thus, MenSCs present a valuable option in clinical medicine for those seeking alternative stem cell sources for therapeutic purposes.
In conclusion, the growing interest in MenSCs underscores their potential to revolutionise regenerative medicine. Their unique properties, including non-invasive collection methods, high proliferation rates, and broad differentiation capacity, position them as a promising alternative to traditional stem cell sources. MenSCs show significant therapeutic promise across various medical disciplines.
As research and clinical applications advance, establishing standardised protocols for menstrual blood banking and addressing ethical considerations within diverse cultural contexts will be critical. Integrating MenSCs into clinical practice holds the potential to transform treatment approaches and enhance personalised medicine, making it an exciting field of research and development for the future.
For all the women out there, MenSCs have shown significant potential for treating various diseases. Instead of letting your menstrual blood go to waste each month, would you consider banking it for future medical use?
* The author is a Senior Lecturer at Department of Biomedical Sciences, and Head, Breast Cancer Translational Research Programme (BCTRP@IPPT), Advanced Medical and Dental Institute (IPPT), Universiti Sains Malaysia. He may be reached at [email protected]
** This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.
