Getting to Know
In the first of a series of blogs designed to share the thoughts and work of our partners we talk to Professor Aleksandar Ljubic, President of Forever Young Holdings which includes the SEGOVA ovarian rejuvenation programme. Professor Ljubic is a past President of the World Congress of Perinatal Medicine and is visiting professor at Weill Cornell Medical School, USA.
Will the Covid-19 pandemic change IVF as we know it?
After the stabilization of the pandemic, it is necessary to re-establish IVF cycles. Infertility is a disease that requires active treatment, therefore, according to the advice of world and European human reproductions it will continue albeit with additional prevention and precautionary measures attached to its undertaking.
We have adopted new recommendations issues by professional associations which define the manner of selection and preparation of patients, as well as working conditions during the process of in vitro fertilization. This means that the process is allowed once more, but with strict adherence to the instructions.
It is recommended that treatments for patients at high risk (for instance those with diabetes, hypertension, patients on immunosuppressive therapy, pulmonary and renal patients) be delayed at the present time.
What do you see as the latest innovations in your field?
There are numerous, exciting innovations taking place in the field of reproduction which relate to the application of biotechnology and information technology. The development of biotechnology, for example, is working to create artificial eggs or seeds, which can develop from any cell in the body. Attempts to construct an artificial uterus have advanced greatly.
Advances in certain branches of medicine, such as molecular genetics or understanding the importance of the microbiota (the comprehensiveness of microorganisms), are also of great importance for understanding human reproduction. A large number of analyzes of genes, epigenetics and various products of cell metabolism, using IT – artificial intelligence and big data, try to help create and select the highest quality cells and embryos.
An important part of these innovative technologies relates to the application of biological therapies – therapies for cells and their products. In my country, Serbia very advanced biological therapies are being successfully implemented, which are currently used in reproduction, the fight against sterility, neurological diseases and injuries, hormonal disorders, diseases of the cardiovascular system, as well as in aesthetic medicine. An important segment of the application of biologically innovative therapies is the fight against aging and increasing the quality of life.
What is the current situation regarding the use of stem cells?
Stem cells and their products (microvesicles, exosomes) are an important part of biological therapies, which is increasingly used in human medicine. These cells and their products can be autologous (of their own origin) or allogeneic (of another person’s origin), which are usually propagated and manipulated in laboratory conditions.
The storage of blood or umbilical cord elements enables the use of these cells (autologous) in certain diseases (primarily diseases of the blood and immune system) during later life.
Propagated stem cells are much more widely used, which are used in laboratory conditions for the treatment of certain diseases. There are numerous clinical studies that examine the application of stem cells in various branches of medicine. The application of mesenchymal stem cells and their products are currently being used in the fight against Sars-CoV 2, for instance in severe forms of COVID-19 infection. The use of stem cells, along with other forms of therapy, has been shown to lead to a significant reduction in mortality and faster recovery from disease. A large number of studies examine these cells in the fight against cancer, immune, endocrine, surgical diseases and others. So it has a very wide application.
This does not apply, however, to cells derived from umbilical cord blood. For this application, it is necessary to process and multiply them in strictly controlled laboratory conditions. In addition, there are other ways to get mesenchymal stem cells later in life. What, however, cannot be compensated for is the fact that the youngest stem cells are the most potent and of the highest quality. They can be safely obtained from the umbilical cord or fetal blood. So, if you have the conditions, it is wise to have the baby’s blood and umbilical cord frozen in safe conditions.
What problems do biobanks deal with in general?
Biobanks are generally viewed as institutions whose only task is to preserve biological tissue. However, in reality they are a type of biorepository (biological repository) in which biological samples and related information are stored for research and therapeutic purposes. So they store samples and information related to those samples. They are responsible for the ethical and legal part of the collection, storage and use of biological material.
As far as the storage of samples and information is concerned, the rules and conditions are strictly defined, which enable safe storage, and possible application of these tissues.
Continuous innovation in biomedical research has given new value to sample collection. This also refers to their use in the prevention, diagnosis and treatment of diseases, as well as the development of new biotechnological products and procedures.
Currently in Serbia there are no legal frameworks that apply to biobanking, but there is a strong will for significant progress on the ground. Our goal is to build a legal and infrastructural system that will include all potentials, public and private centers that will enable us to become a driver of innovation in the life sciences, especially in biotechnology, genetics and regenerative medicine.
Will the pandemic significantly change certain aspects of the health segments you are dealing with, be it reproductive health, fertility, childbirth, anti-aging medicine, etc.
It will certainly change the approach in everyday practice, which will be with more caution. Since we still have a lot to learn about the virus, medicine and everyday clinical practice will have to adapt to new knowledge.