Reading 'Stem cell and its controversy'

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  What are stem cells, and why are they important?

 Stem cells have the remarkable potential to develop into many different cell types in the body during early life and growth. In addition, in many tissues they serve as a sort of internal repair system, dividing essentially without limit to replenish other cells as long as the person or animal is still alive. When a stem cell divides, each new cell has the potential either to remain a stem cell or become another type of cell with a more specialized function, such as a muscle cell, a red blood cell, or a brain cell.

Stem cells are distinguished from other cell types by two important characteristics. First, they are unspecialized cells capable of renewing themselves through cell division, sometimes after long periods of inactivity. Second, under certain physiologic or experimental conditions, they can be induced to become tissue- or organ-specific cells with special functions. In some organs, such as the gut and bone marrow, stem cells regularly divide to repair and replace worn out or damaged tissues. In other organs, however, such as the pancreas and the heart, stem cells only divide under special conditions.

Until recently, scientists primarily worked with two kinds of stem cells from animals and humans: embryonic stem cells and non-embryonic "somatic" or "adult" stem cells. The functions and characteristics of these cells will be explained in this document. Scientists discovered ways to derive embryonic stem cells from early mouse embryos nearly 30 years ago, in 1981. The detailed study of the biology of mouse stem cells led to the discovery, in 1998, of a method to derive stem cells from human embryos and grow the cells in the laboratory. These cells are called human embryonic stem cells. The embryos used in these studies were created for reproductive purposes through in vitro fertilization procedures. When they were no longer needed for that purpose, they were donated for research with the informed consent of the donor. In 2006, researchers made another breakthrough by identifying conditions that would allow some specialized adult cells to be "reprogrammed" genetically to assume a stem cell-like state. This new type of stem cell, called induced pluripotent stem cells (iPSCs), will be discussed in a later section of this document.

Stem cells are important for living organisms for many reasons. In the 3- to 5-day-old embryo, called a blastocyst, the inner cells give rise to the entire body of the organism, including all of the many specialized cell types and organs such as the heart, lungs, skin, sperm, eggs and other tissues. In some adult tissues, such as bone marrow, muscle, and brain, discrete populations of adult stem cells generate replacements for cells that are lost through normal wear and tear, injury, or disease.

Given their unique regenerative abilities, stem cells offer new potentials for treating diseases such as diabetes, and heart disease. However, much work remains to be done in the laboratory and the clinic to understand how to use these cells for cell-based therapies to treat disease, which is also referred to as regenerative or reparative medicine.

Laboratory studies of stem cells enable scientists to learn about the cells’ essential properties and what makes them different from specialized cell types. Scientists are already using stem cells in the laboratory to screen new drugs and to develop model systems to study normal growth and identify the causes of birth defects.

Research on stem cells continues to advance knowledge about how an organism develops from a single cell and how healthy cells replace damaged cells in adult organisms. Stem cell research is one of the most fascinating areas of contemporary biology, but, as with many expanding fields of scientific inquiry, research on stem cells raises scientific questions as rapidly as it generates new discoveries.


What are the potential uses of human stem cells and the obstacles that must be overcome before these potential uses will be realized?

There are many ways in which human stem cells can be used in research and the clinic. Studies of human embryonic stem cells will yield information about the complex events that occur during human development. A primary goal of this work is to identify how undifferentiated stem cells become the differentiated cells that form the tissues and organs. Scientists know that turning genes on and off is central to this process. Some of the most serious medical conditions, such as cancer and birth defects, are due to abnormal cell division and differentiation. A more complete understanding of the genetic and molecular controls of these processes may yield information about how such diseases arise and suggest new strategies for therapy. Predictably controlling cell proliferation and differentiation requires additional basic research on the molecular and genetic signals that regulate cell division and specialization. While recent developments with iPS cells suggest some of the specific factors that may be involved, techniques must be devised to introduce these factors safely into the cells and control the processes that are induced by these factors.

Human stem cells are currently being used to test new drugs. New medications are tested for safety on differentiated cells generated from human pluripotent cell lines. Other kinds of cell lines have a long history of being used in this way. Cancer cell lines, for example, are used to screen potential anti-tumor drugs. The availability of pluripotent stem cells would allow drug testing in a wider range of cell types. However, to screen drugs effectively, the conditions must be identical when comparing different drugs. Therefore, scientists must be able to precisely control the differentiation of stem cells into the specific cell type on which drugs will be tested. For some cell types and tissues, current knowledge of the signals controlling differentiation falls short of being able to mimic these conditions precisely to generate pure populations of differentiated cells for each drug being tested.

Perhaps the most important potential application of human stem cells is the generation of cells and tissues that could be used for cell-based therapies. Today, donated organs and tissues are often used to replace ailing or destroyed tissue, but the need for transplantable tissues and organs far outweighs the available supply. Stem cells, directed to differentiate into specific cell types, offer the possibility of a renewable source of replacement cells and tissues to treat diseases including macular degeneration, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis, and rheumatoid arthritis.

For example, it may become possible to generate healthy heart muscle cells in the laboratory and then transplant those cells into patients with chronic heart disease. Preliminary research in mice and other animals indicates that bone marrow stromal cells, transplanted into a damaged heart, can have beneficial effects. Whether these cells can generate heart muscle cells or stimulate the growth of new blood vessels that repopulate the heart tissue, or help via some other mechanism is actively under investigation. For example, injected cells may accomplish repair by secreting growth factors, rather than actually incorporating into the heart. Promising results from animal studies have served as the basis for a small number of exploratory studies in humans (for discussion, see call-out box, "Can Stem Cells Mend a Broken Heart?"). Other recent studies in cell culture systems indicate that it may be possible to direct the differentiation of embryonic stem cells or adult bone marrow cells into heart muscle cells.


Stem cell controversy

Good and Bad of the Stem Cell Debate

Opponents of embryonic stem cell research compare the destruction of an embryo to an abortion. They believe that the embryo constitutes life because it has the potential to fully develop into a human being. Those against embryonic stem cell use believe that is it immoral and unethical to destroy one life to save another.

By using stem cells and discarding the embryo, it is thought that human life is ultimately de-valued by this act and is paving a slippery slope for further scientific procedures that similarly de-value life. In particular, many religious groups who are adamantly pro-life have condemned embryonic stem cell research and all of its applications. Other arguments against embryonic stem cells cite the fact that adult stem cells are the ones currently being used in therapies and thus, there is no need to even venture into embryonic stem cell territory.

Those who support embryonic stem cell research believe that an embryo is not equivalent to human life because it is inside the womb. Supporters also contend that the societal costs of many diseases and conditions, both in monetary and suffering aspects, means that the ethical concerns regarding embryonic stem cell usage are not sufficient to warrant discontinuation of this promising therapy.

Another argument for embryonic stem cell research is that the embryos are leftover from in-vitro fertilisation and would otherwise be destroyed, so they should instead be put to greater use. Even further down the line in development is the belief that those embryos from legal abortions, which have already been destroyed, would be better used to advance human health rather than simply discarded.

Any Solutions to this Conundrum?

Fortunately, there are alternatives but they are far from perfect and they do still require further research before they can be used with an acceptable level of success. Two new embryonic stem cell treatments avoid the foetal destruction by either:

•Deriving embryonic stem cells without destructing the foetus

•Obtaining embryonic stem cells without actually creating a foetus

In altered nuclear transfer (ANT), an embryo is not created. A derivative of somatic cell nuclear transfer (SCNT), the nucleus of the somatic cell (any body cell other than an egg) is altered, or genetically reprogrammed, prior to being transferred into the egg. The alteration consequence is that the somatic cell DNA still produces stem cells but does not generate an embryo.

In blastomere extraction, an embryo is created but not destroyed. This procedure is performed on a two-day old embryo, following the division of the fertilised egg into eight blastomeres or cells. Previously, the techniques used for harvesting involving the derivation of embryonic stem cells at a later developmental stage, when the embryo is made up of approximately 150 cells. When these cells were harvested, the embryo was destroyed. Embryonic stem cells can instead be extracted from blastomeres, therefore preventing embryo destruction and allowing use of stem cells for research and therapeutic treatment of disease.

The other alternative is to strictly use adult stem cells because these are derived from adult tissues. The therapeutic potential is lower, however, because adult stem cells can't differentiate into as many different types of cells as can embryonic stem cells. They are also more likely to have developed genetic abnormalities over time and they don't tend to replicate as efficiently.

It is unlikely that a comprehensive solution will be found for the embryonic stem cell debate anytime soon. In the meantime, both national and international policies along with collective public views will likely guide the research and therapy efforts for Embryonic Stem Cells. There is no doubt that stem cells have great potential for treating disease but there unfortunately still remain doubts as to the ethical and moral ramifications of pursuing this potential.



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