Malaysia: A Quality Healthcare Destination

Malaysia has long ranked among the world's top travel destinations. Every year, almost 30 million tourists arrive, attracted to the warm beaches and cool highland forest resorts or the bustling, cosmopolitan cities with their multicultural traditions, gastronomical experiences and world-class amenities. The Travel and Tourism Competitiveness Report 2019 ranks Malaysia in the top 30 out of 140 countries overall.
In recent years, an increasingly sophisticated domestic healthcare industry has seen growing numbers of overseas travellers arriving for medical and wellness treatment, in recognition of the quality and affordability of services on offer.

Malaysia is now listed in the top 10 wellness tourism markets in Asia Pacific, and with strong government support, is expected to strengthen and grow in this sector in the coming years. As the first country in Southeast Asia to implement a regulatory framework for newly emerging cell and gene therapies, Malaysia is fast taking its place as a hub for regenerative medicine, with stringent guidelines by the Ministry of Health on safety, manufacturing facilities and clinical applications.

"Malaysia has gained international recognition for having world-class quality, easily accessible and affordable healthcare. International Living, a US-based organisation, ranked Malaysia as the top country for healthcare in the Global Retirement Index for four years in a row from 2015 to 2018. International Medical Travel Journal, UK has also recently ranked Malaysia as the top destination for healthcare travel in its Medical Tourism Facts and Figures 2018: Report.

This is thanks to the strong foundation our healthcare system is based on, formed by the concerted effort put in place by both the private and public sectors to promote Malaysia as a leading global destination for healthcare."
- Yahoo Finance, Sept 2019
About Stem Cells
Stem cells are different from other cell types in two important characteristics. First, they are unspecialised cells with no specific function that are capable of renewing themselves through cell division. Second, under certain physiologic or experimental conditions, they can be induced to become tissue-or organ-specific cells with special functions (1).


Mesenchymal stem cells (MSCs) are adult stem cells that can be derived from different sources such as fat, bone marrow, milk teeth, placenta, amniotic fluid, umbilical cord blood (UCB) and Wharton's jelly (WJ). Wharton's Jelly is a part of the umbilical cord which has become a valuable source of MSCs due to ease of isolation, lack of ethical issues, multi-differentiation potential, immunomodulatory features and long-term survivability of extracted MSC which presents patients and researchers with a good choice for their use in therapeutic applications (2).

The MSCs themselves are desirable due to their ability to adapt and multiply quickly without forming tumours or growths. They are multipotent cells which means that they are ready to specialise into many different tissue or cell types. The viability of stem cells plays a critical role as it will determine the effectiveness of the therapy. Besides that MSCs are termed as "immunoprivileged cells" meaning that they can be introduced into a recipient without causing an immune response, such as rejection, without the need for donor-recipient matching.
MSC transplantation has been demonstrated to be safe and no observed adverse side effects including tumour growth or transfer of genetic diseases have been reported (3). Systematic review of clinical trials has indicated a relative safety in both intravascular and intra-articular injections (4).

Early passage MSCs (Passage 2-3) exhibit a higher DNA damage repair capacity than late passage cells. Cells beyond Passage 5 multiply at a much slower rate than early passage cells. At Cytonex and Stem Cell Therapy Asia, our priority is achieving high standards in research and client satisfaction hence, we only produce premium grade human mesenchymal stem cells at Passage 2 (5).

Potential Benefits of Mesenchymal Stem Cells
Ageing is reflected in structural changes and reduced function. As we age, the ageing of stem cells in human tissues is a major cause of the decline in tissue regeneration capacity. MSCs can produce health benefits through several mechanisms of action. They can induce angiogenesis, which is the growth of new blood vessels, to improve blood circulation to tissue and organs.

They also produce secretory factors (secretome) which reduce cell death and stimulate growth of new tissues. MSCs can directly differentiate into specific organ and tissue type cells in order to repair and replace damaged organs. MSCs can modulate the immune system to reduce inflammation and promote healing. These mechanisms of action allow for the reversal of damage seen in the normal ageing process as well as several conditions such as heart failure, nerve damage, autoimmune diseases, diabetes mellitus, osteoarthritis and many more (6,7,8,9,10).
MSCs, a subset of nonhematopoietic cells, possess pluripotent features and can be obtained from different sources such as umbilical cord, umbilical cord blood and adipose tissue of the human body. They represent an advantageous cell type for cell-based therapies, due to their multi-lineage differentiation potential, immunosuppressive activities owing to their paracrine effects and interaction with different immune cells. These properties of MSCs have offered a new strategy in treatment of numerous autoimmune inflammatory diseases and have demonstrated promising results in safety and efficacy (11).

Cytonex & Stem Cell Therapy Asia - Cutting-edge research and development

Cytonex is a Malaysian biotechnology company which was founded in 2016 by a group of scientists. We are an ISO 9001 certified organisation that operates a cutting-edge laboratory in Kuala Lumpur. Our products are manufactured in a certified clean room environment (EU-GMP Grade / ISO Class 7 BS EN ISO 14664-1:1999), equipped with state-of-the-art cell culture, genomic and proteomic analyses equipment. Our laboratory cleanroom facility has been certified as Grade C compliant by the National Environmental Balancing Bureau and our cells are manufactured following stringent operational procedures to ensure sterility and absence of potential infectious diseases. This is to ensure that our clients receive safe stem cells of good quality.

When it comes to stem cell therapy, it is not only the type of cell that is important but the quality of the cell that is administered is also very crucial. This is why cell grading needs to be emphasised. It is not enough to extract stem cells and inject them. You need to assess the quality of the cells based on passage number, mitochondrial density and expression of biomarkers. As passage number increases, the quality of the stem cells begin to decline. Passage 2 is that optimal zone where the quality of cells are at their prime and practical for large-scale expansion with minimal effects from in vitro cellular ageing compared from cells from higher passage. The mitochondrial density and expression of specific biomarkers are also optimum for regenerative process, expected to be initiated by the transplanted cells.

Cytonex has been awarded BioNexus status by the Malaysian government as a qualified company undertaking value-added biotechnology and/or life sciences activities.

Stem Cell Therapy Asia is the marketing arm of Cytonex. Our team of highly experienced consultants is on hand to guide you every step of the way through the whole process. Our commitment is to help you make the best, and safest choices, in experiencing stem cell therapy to look, feel and stay healthy.

For more information, visit: www.stemcelltherapy.asia

References
1.    Stem cells and the future of regenerative medicine (2002). USA: National Academy of Sciences.
2.    D.Bharti1 & S.B. Shivakumar (2018). Comparative analysis of human Wharton's jelly mesenchymal stem cells derived from different parts of the same umbilical cord.
3.    L.T. Dang., N.K Phan., K.D Truong (2017). Mesenchymal stem cells for diabetes mellitus treatment: New Advances Biomedical Research and Therapy 4(1):1062-1081.
4.    J.Freitag., D.Bates., R.Boyd., K.Shah., A.Barnard., L.Huguenin and A.Tenen (2016) Mesenchymal stem cell therapy in the treatment of osteoarthritis: reparative pathways, safety and efficacy - a review (Freitag et al. BMC Musculoskeletal Disorders 17:23)
5.    P.K.Wu, J.Y.Wang, C.Fong (2017). Stem Cells Translational Medicine. Early Passage Mesenchymal Stem Cells Display Decreased Radiosensitivity And Increased DNA Repair Activity; 6:1504-1514.
6.    Carvello, M., Lightner, A., Yamamoto, T., Kotze, P. and Spinelli, A. (2019). Mesenchymal Stem Cells for Perianal Crohn's Disease. Cells, 8(7), p.764.
7.    Kim, H., J. Kim, J. and Yoon, Y. (2012). Emerging Therapy for Diabetic Neuropathy: Cell Therapy Targeting Vessels and Nerves. Endocrine, Metabolic & Immune Disorders - Drug Targets, 12(2), pp.168-178.
8.    Mabed, M. and Shahin, M. (2012). Mesenchymal Stem Cell-Based Therapy for the Treatment of Type 1 Diabetes Mellitus. Current Stem Cell Research & Therapy, 7(3), pp.179-190.
9.    Nguyen, P., Rhee, J. and Wu, J. (2016). Adult Stem Cell Therapy and Heart Failure, 2000 to 2016. JAMA Cardiology, 1(7), p.831.
10.    Wang, Z. (2018). Ageing and ageing-related diseases. Singapore: Springer.
11.    Liang J, Li X, Zhang H et al. (2012) Allogeneic mesenchymal stem cells transplantation in patients with refractory RA. Clin Rheumatol 31 (1), 157-61.