Cord Blood Serum (CBS) also known as Umbilical Cord Blood Serum (UCB): References in its use in Ocular Conditions

Umbilical cord serum has been shown to be safe and effective in the treatment of neurotrophic keratitis, dry eye syndrome, persistent epithelial defects, and chemical burns (Ref 1-11). Both autologous serum and umbilical cord serum contain multiple growth factors like epidermal growth factor (EGF), acidic and basic fibroblast growth factor (FGF), platelet-derived growth factor, hepatocyte growth factor, vitamin A, transforming growth factor (TGF)-β, substance P, insulin-like growth factor (IGF)-1, nerve growth factor (NGF), fibronectin, and serum antiproteases such as α2-macroglobulin (Ref 4-8) The concentrations of EGF, TGF-β, and NGF are several times higher in umbilical cord serum than the peripheral blood serum (more references below). 


Below are good reviews on the published literature on using CBS for ocular surface diseases.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196109/#!po=38.8889


https://drcremers.com/2018/07/umbilical-cord-blood-for-dry-eyes-cord.html


CBS drops are not FDA-approved. 


References:

1. Vajpayee RB Mukerji N Tandon R . Evaluation of umbilical cord serum therapy for persistent corneal epithelial defects. Br J Ophthalmol. 2003;87:1312–1316. [CrossRef] [PubMed
2. Yoon KC Heo H Im SK You IC Kim YH Park YG . Comparison of autologous serum and umbilical cord serum eye drops for dry eye syndrome. Am J Ophthalmol. 2007;144:86–92. [CrossRef] [PubMed]
3. Yoon KC You IC Im SK Jeong TS Park YG Choi J . Application of umbilical cord serum eyedrops for the treatment of neurotrophic keratitis. Ophthalmology. 2007;114:1637–1642. [CrossRef] [PubMed]
4. Yoon KC Jeong IY Im SK Park YG Kim HJ Choi J . Therapeutic effect of umbilical cord serum eyedrops for the treatment of dry eye associated with graft-versus-host disease. Bone Marrow Transplant. 2007;39:231–235. [CrossRef] [PubMed]
5. Yoon KC Im SK Park YG Jung YD Yang SY Choi J . Application of umbilical cord serum eyedrops for the treatment of dry eye syndrome. Cornea. 2006;25:268–272. [CrossRef] [PubMed]
6. Poon AC Geerling G Dart JK Fraenkel GE Daniels JT . Autologous serum eyedrops for dry eyes and epithelial defects: clinical and in vitro toxicity studies. Br J Ophthalmol. 2001;85:1188–1197. [CrossRef] [PubMed]
7. Liu L Hartwig D Harloff S Herminghaus P Wedel T Geerling G . An optimized protocol for the production of autologous serum eye drops. Graefes Arch Clin Exp Ophthalmol. 2005;243:706–714. [CrossRef] [PubMed]88

Sharma N, et al. Invest Ophthalmol Vis Sci. 2011. PMID: 20538982 Clinical Trial.
9. Treatment of acute ocular chemical burns.

Sharma N, Kaur M, Agarwal T, Sangwan VS, Vajpayee RB.Surv Ophthalmol. 2018 Mar-Apr;63(2):214-235. doi: 10.1016/j.survophthal.2017.09.005. Epub 2017 Sep 19.10. Evaluation of umbilical cord serum therapy in acute ocular chemical burns.

Sharma N, Goel M, Velpandian T, Titiyal JS, Tandon R, Vajpayee RB.Invest Ophthalmol Vis Sci. 2011 Feb 25;52(2):1087-92. doi: 10.1167/iovs.09-4170.11. Comparison of umbilical cord serum and amniotic membrane transplantation in acute ocular chemical burns.

Sharma N, Lathi SS, Sehra SV, Agarwal T, Sinha R, Titiyal JS, Velpandian T, Tandon R, Vajpayee RB.Br J Ophthalmol. 2015 May;99(5):669-73. doi: 10.1136/bjophthalmol-2014-305760. Epub 2014 Nov 4.PMID: 25370084


——

Clinical Trial

 

2013 Apr;32(4):412-8.

 doi: 10.1097/ICO.0b013e3182580762.

Efficacy of standardized and quality-controlled cord blood serum eye drop therapy in the healing of severe corneal epithelial damage in dry eye

Affiliations 

Affiliation

  • 1Ophthalmology Unit, University of Bologna and S. Orsola-Malpighi Hospital, Bologna, Italy. piera.versura@unibo.it

Abstract

Purpose: We standardized quality-controlled cord blood serum (CBS)-based eye drops and evaluated the efficacy of 1-month CBS treatment in the healing of diseased corneal epithelium in severe dry eye (DE) patients.

Methods: Seventeen graft-versus-host disease (GVHD) and 13 Sjogren syndrome patients with severe persistent corneal defects were enrolled in the framework of a registered clinical trial (ClinicalTrials.gov NCT01234623). Sterile CBS eye drops were prepared to supply 0.15 ng per eye per day epithelial growth factor and administered for 1 month in a 1-day dose dispensing. The extent of epithelial defect was evaluated in square millimeters area, and subjective symptom score (Ocular Surface Disease Index score), Schirmer test I, break-up time, tear osmolarity, corneal esthesiometry (Cochet-Bonnet esthesiometer), conjunctival scraping, and imprint cytology with goblet cell count were performed at baseline (V0) and after 15 (V1) and 30 (V2, endpoint) days of treatment. Satisfaction and tolerability questionnaires were evaluated at V1 and V2.

Results: A significant reduction was shown at the endpoint versus baseline in corneal epithelial damage (mean ± SD, 16.1 ± 13.7 vs. 40.9 ± 30 mm²/area, respectively), discomfort symptoms (Ocular Surface Disease Index score, 22.3 ± 10.3 vs. 39.3 ± 16.9), scraping cytology score (3.8 ± 1.2 vs. 6.6 ± 2.1), and tear osmolarity (312.5 ± 7 vs. 322 ± 9.1 mOsm/L), whereas a significant improvement was shown in corneal esthesiometry (48.2 ± 2.1 vs. 49.7 ± 2.1 nylon/mm/length, P < 0.05). All patients reported a high degree of satisfaction upon drop instillation.

Conclusions: Heterologous CBS-based eye drops represent a promising therapeutic approach in the healing of severely injured corneal epithelium and in subjective symptom relief. These drops can be obtained as readily available and quality-controlled blood derivative from cord blood banks on a routine basis.

Clinical Trials  |   February 2011

Evaluation of Umbilical Cord Serum Therapy in Acute Ocular Chemical Burns
 Author Affiliations & Notes
  • Namrata Sharma
    From the Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India;
  • Manik Goel
    From the Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India;
  • Thirumurthy Velpandian
    From the Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India;
  • Jeewan S. Titiyal
    From the Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India;
  • Radhika Tandon
    From the Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India;
  • Rasik B. Vajpayee
    From the Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India;
    the Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia; and
    the Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
  • Corresponding author: Rasik B. Vajpayee, Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, 32 Gisborne Street, East Melbourne, Victoria 3002, Australia; rvajpayee@gmail.com
Investigative Ophthalmology & Visual Science February 2011, Vol.52, 1087-1092. doi:https://doi.org/10.1167/iovs.09-4170
Abstract

Purpose.To evaluate the role of umbilical cord serum therapy in cases of acute ocular chemical burns.

Methods.In a double-blind prospective randomized controlled clinical study, 33 eyes of 32 patients with acute ocular chemical burns of grade III, IV, and V severity were randomized into three groups: umbilical cord serum (n = 12), autologous serum (n = 11), and artificial tears (0.5% HPMC+0.3% glycerin; n = 10). In addition, all eyes received standard medical therapy. The parameters evaluated were pain score, size, and area of epithelial defect, extent of limbal ischemia, corneal clarity, and symblepharon formation. The patients were followed up at day1, 3, 7, 14, and 21 and at the end of months 1, 2, and 3.

Results.Mean time to complete epithelialization was 21.16 ± 26.81, 56.6 ± 35.5, and 40.13 ± 35.79 days in cord serum, autologous serum, and artificial tears groups respectively (P = 0.02). By day 21, the mean percentage decrease in epithelial defect diameter was 94.63 ± 11.99 with cord serum compared with 53.17 ± 34.81 and 64.22 ± 42.43 with autologous serum and artificial tears, respectively (P = 0.01). By month 3, the extent of limbal ischemia with cord serum showed a mean percentage decrease of 73.43 ± 25.51 compared with 35.64 ± 25.60 and 43.71 ± 28.71 with autologous serum and artificial tears, respectively (P = 0.008). More patients had clear corneas with cord serum compared with autologous serum and artificial tears (P = 0.048). No significant difference was seen between the groups with regard to symblepharon formation (P = 0.07).

Conclusions.Umbilical cord serum therapy is more effective than autologous serum eye drops or artificial tears in ocular surface restoration after acute chemical injuries. (www.controlled-trials.com number, ISRCTN08131903.)



Other CBS Uses:

Human umbilical cord blood serum can replace fetal bovine serum in the culture of mesenchymal stem cells

First published: 02 January 2013

 

Citations: 57

Abstract

The potential of mesenchymal stem cells (MSC) to differentiate into different cell types has opened up the possibility of using these cells clinically to treat a variety of disorders. In this study we describe the use of human umbilical cord blood serum (CBS) as a replacement for fetal bovine serum (FBS) for culturing MSC from different sources. MSC from human and swine bone marrow and human umbilical cord blood were cultured in the presence of DMEM/F12 containing either FBS or CBS. Human MSC cultured in presence of FBS or CBS showed typical fibroblast‐like morphology, which is characteristic of MSC. 99% of the cells cultured in FBS had a CD73+/CD105+/CD45− phenotype compared to 96% of cells cultured in CBS. Cells cultured in CBS had a significantly higher cell count as compared to cells cultured in FBS. Swine Bone Marrow MSC cultured in the presence of FBS and CBS were morphologically and phenotypically similar. Human umbilical cord blood serum supports the growth of MSC. While no significant differences were observed in the MSC numbers in swine cells cultured in the presence of FBS or CBS, human cells showed a greater proliferation potential in the presence of CBS as compared to FBS. Therefore, CBS can be used as an effective substitute to FBS for developing clinically useful protocols for culturing MSC

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