Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Stem Cells. Aug 26, 2019; 11(8): 506-518
Published online Aug 26, 2019. doi: 10.4252/wjsc.v11.i8.506
Tonsil-derived stem cells as a new source of adult stem cells
Kyung-Ah Cho, Hyun Jung Lee, Hansaem Jeong, Miri Kim, Soo Yeon Jung, Hae Sang Park, Kyung-Ha Ryu, Seung Jin Lee, Byeongmoon Jeong, Hyukjin Lee, Han Su Kim
Kyung-Ah Cho, Department of Microbiology, College of Medicine, Ewha Womans University, Seoul 07985, South Korea
Hyun Jung Lee, Byeongmoon Jeong, Department of Chemistry and Nano Science, Ewha Womans University, Seoul 03760, South Korea
Hansaem Jeong, Miri Kim, Seung Jin Lee, Hyukjin Lee, College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul 03760, South Korea
Soo Yeon Jung, Han Su Kim, Department of Otorhinolaryngology, College of Medicine, Ewha Womans University, Seoul 07985, South Korea
Hae Sang Park, Department of Otorhinolaryngology, College of Medicine, Hallym University, Chuncheon 24252, South Korea
Kyung-Ha Ryu, Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul 07985, South Korea
Author contributions: Cho KA and Lee HJ contributed equally to writing this paper as the first authors; Jeong H, Kim M, Jung SY and Park HS contributed to the literature review, analysis, and artwork.; Ryu KH and Lee S contributed to the conception and design of the study. Jeong B, Lee H, and Kim HS equally contributed to the drafting, revision, and editing of the manuscript, and gave approval to the final version as corresponding authors.
Supported by the Korea Health Technology RD Project through the Korea Health Industry Development Institute; the Ministry of Health and Welfare, No. HI16C- 2207; the Basic Science Research Program through the NRF, No. NRF-2018R1D1A1A09083264; Ewha Womans University, No. RP-grant 2017.
Conflict-of-interest statement: There are no potential conflicts of interest to report.
Open-Access: This is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Han Su Kim, MD, PhD, Professor, Department of Otorhinolaryngology, College of Medicine, Ewha Womans University, Ahnyangcheon-ro 1071 Seoul 07985, South Korea.
Telephone: +82-10-87185316 Fax: +82-2-26535135
Received: February 13, 2019
Peer-review started: February 15, 2019
First decision: March 26, 2019
Revised: May 31, 2019
Accepted: July 29, 2019
Article in press: July 29, 2019
Published online: August 26, 2019

Located near the oropharynx, the tonsils are the primary mucosal immune organ. Tonsil tissue is a promising alternative source for the high-yield isolation of adult stem cells, and recent studies have reported the identification and isolation of tonsil-derived stem cells (T-SCs) from waste surgical tissue following tonsillectomies in relatively young donors (i.e., under 10 years old). As such, T-SCs offer several advantages, including superior proliferation and a shorter doubling time compared to bone marrow-derived mesenchymal stem cells (MSCs). T-SCs also exhibit multi-lineage differentiation, including mesodermal, endodermal (e.g., hepatocytes and parathyroid-like cells), and even ectodermal cells (e.g., Schwann cells). To this end, numbers of researchers have evaluated the practical use of T-SCs as an alternative source of autologous or allogenic MSCs. In this review, we summarize the details of T-SC isolation and identification and provide an overview of their application in cell therapy and regenerative medicine.

Keywords: Stem cell, Tonsil-derived stem cell, Differentiation, Endoderm, Mesoderm, Ectoderm, Cell therapy

Core tip: The use of adult stem cells is often limited by the lack of differentiation among stem cells isolated from certain germ layers. However, tonsil-derived stem cells (T-SCs) were able to differentiate into various tissue types from the three germ layers, which is the most advantageous feature of this new stem cell source. T-SCs can also be used as native cells in the treatment of various immune-related diseases. As a result, it can be concluded that T-SCs have great potential for clinical applications in cell therapy and regenerative medicine.