Stem Cells Basics, Ethics and use in Regenerative

Technology

On the cutting edge of biology, researchers are on a discovery of an extraordinary type of cell,
that could resolve many of the health issues humans and other organisms on this earth are
faced with. The stem cell, existent in 3 different forms totipotent, which can differentiate into both
embryonic and nonembryonic cells (exists only in the very stages of embryonic development,
more specifically during cleavage) multipotent, which are limited to specific cell types depending
on location in the body, for example hematopoietic stem cells give rise to only blood cells and
pluripotent, which exist in the early stages of the embryos development as embryonic stem
cells, that can, in theory, divide indefinitely and differentiate into any of the 200+ specialized cells
that our body is constructed of. However, this work will focus mainly on pluripotent stem cells
and iPS cells (induced Pluripotent Stem Cells), their uses for Regenerative Applications and the
ethicalandmoralquestionstheygiveriseto,astheyareofsuchasensitivenature.

How do stem cells specialize? When a cell becomes specialized, certain parts of the genetic
code (the DNA) become inactive, or unreadable. Although not fully understood, several factors,
such as the state of histone proteins that block certain parts of the DNA by making it
unreachable for transcription or the methylation of promoter areas of a gene, cause parts of DNA
to be untranscribable, hence hindering the production of some proteins and promoting the
production of others. This process is called differentiation. Different proteins allow cells to
perform different tasks and have specific characteristics that make them different from other
cells. It should be noted that the differentiation process is oneway, meaning that if an
unspecializedcellbecomesspecialized,itwill,undernaturalcircumstances,notundifferentiate.

Discovered in 1981, stem cells have become an important part of contemporary biology,
because of their incredible capabilities to grow into virtually any organ or tissue of a patients
needs. The interest in human embryonic stem cells for cell therapy is driven largely by the
shortage of donor organs. (Mummery, pg 90) Cellbased therapies involve, as the name
suggests, the use of stem cells that differentiate into specialized cells in order to replace
damaged tissue or even entire organs in patients. For example, in Japan, researchers have been
able to generate retinal pigment epithelial (RPE) cells from iPSC lines (cultures of induced
pluripotent stem cells that are grown in vitro, otherwise know as outside of their normal
environment).These cells can be implanted into patients, that have a destroyed epithelium which
causes partial blindness. By implantation into the patients eyes, these cells may restore vision,
henceenhancingpatientsqualityoflife.

Although the process for RPE cell generation and implantation has been fairly successful, other
therapies are still in the works, that involve more complex processes, but which could yield
incredible results if successful. For example, mice embryonic stem cells were differentiated into
oligodendrocytes, the cells that form the insulating cover of nerve cells (Mummery, pg 91),
essentially allowing paralyzed mice to regain their motor capabilities and eventually allowing
them to walk again. However, this process has not proven successful on humans and further
studies remain. If, through some discovery, researchers can successfully implant these cells
into a human being, military veterans that were subject to spinal injuries during war could
potentially regain the ability to walk. This is only the beginning. In the future, a patient could, using
Stem Cell Lines from his own iPSCs (that can be derived from skin tissue for example, more on
that later), create a multitude of organs that would integrate perfectly into the body, creating no
maliciousresponsesfromtheimmunesystem.

Human Embryonic Stem Cells, or hESC, raise a lot of ethical and moral questions. Perhaps one
of the biggest holdback from mainstream acceptance of embryonic stem cell research is that
the generation of embryonic stem cells involves destruction (or at least manipulation) of the
preimplantation stage embryo (Klimanskaya, pg 1). This means that every time a new stem cell
line is created, a potential human life is destroyed. However, on the other hand, through the
research brought fore by the use of stem cells, prevention or alleviation of suffering becomes the
countering moral principle. Is one human life worth destroying, to possible save millions of
others?Couldoneevenconsiderhumanembryosashumanlife?

Does a human embryo have the status of a person? Should it be treated as such. Answering
this question ultimately eliminates one of the many ethical problems with embryonic stem cells.
There are two sides to this dilemma. One point of view argues that since it will become a
person (Hug, pg 1), it should be given the respect and dignity of a person (Hug, pg 1). On the
other hand, an embryo does not have the psychological, emotional or physical properties that
we associate with being a person (Hug, pg 1) and hence it should not be treated as such. It
does not have any interest of self preservation, an important characteristic of conscious beings.
Hug also argues that before a 14 day mark, the human embryo could be considered as not
being human since they Central Nervous System has not yet begun to develop and hence the
embryo has no senses (Hug, pg 1). Moreover the real reason that makes stem cell harvesting
acceptable, is the fact that they have the potential to cure millions of people with organ failures.
Does this benefit outweigh the cost of losing a potential human being? There is no real answer to
the question and that is precisely the reason why it stays an ethical issue, that can cause
limitationsinthescientificresearch.

However, researchers have found ways to circumvent some of those ethical issues, by a new
form of stem cell: the induced Pluripotent Stem Cell (iPSC). Discovered by a Japanese
researcher by the name of Shinya Yamanaka (Nobel Prize in Medicine, 2012), as perhaps one of
the most important discoveries in the field, him and his team were able to create cells iPS cells
from genetically reprogrammed adult cells (e.g. skin cells, nerve cells) that behave like
embryonic stem cells, but do not pose the same ethical questions as embryonic stem cells, as
they can be derived from any healthy, postnatal human being. Using 4 different proteins that
were injected into the cell, it regained its despecialization, gradually developing into a pluripotent
stem cell over several divisions. These proteins are called Reprogramming Factors, and are
what causes the regulations that cause a cell to be specialized to be undone. As Yamanaka
points out however, iPSC are able to create both sperm and egg, meaning that one day, entire
human beings could be created, just from a single skin cell (Stem Cells the future: an
introduction to iPS cells, Time: 12m:30s). This raises a new ethical problem, just as quick as the
old one has been eliminated. However, this issue is not immediate and iPSC provide a much
betteralternativetohumanembryonicstemcells.

To conclude, the research in the field of Stem Cells is far from complete. We are only touching
down on the basics and much more remains to be learnt. Stem Cells show incredible potential.
They could one day allow us to increase our lifespan by decades, if not centuries. The ability to
test human drugs, without endangering an actual human being. Perhaps they do give rise to
ethical issues, but doesnt their potential to save lives and improve our living quality outweigh that
cost so many times? I personally intend to study Genetics, so this research is of great interest to
me. The discoveries made in these last decades have built the grounds for development of
cellbased treatment for diseases such Parkison or diabetes. They will allow us to one day
create a second pair of lungs or a new heart, in case the old one fails. Reverse Aging?
Maybe...thepossibilitiesareendless.

WorksCited
Mummery,Christine,andAnjaVanDeStolpe.StemCells:ScientificFactsandFiction.
Burlington:ElsevierScience,2014.Print.

"StemCellBasics."StemCellBasics[StemCellInformation].NationalInstitutesofHealth,28
Apr.2009.Web.7Sept.2014.<http://stemcells.nih.gov/info/basics/Pages/Default.aspx>.

Klimanskaya,Irina."Humanembryonicstemcelllinesderivedfromsingleblastomeres:
Abstract:Nature."Humanembryonicstemcelllinesderivedfromsingleblastomeres.
NatureJournal,23Aug.2006.Web.7Sept.2014.
<http://www.nature.com/nature/journal/v444/n7118/abs/nature05142.html>.

Hug,Kristina."Embryonicstemcellresearch:anethicaldilemma."EuroStemCell.N.p.,23Mar.
2011.Web.7Sept.2014.
<http://www.eurostemcell.org/factsheet/embyronicstemcellresearchethicaldilemma>.

Stemcellsthefuture:anintroductiontoiPScells.Dir.AmyHardie.Perf.ShinyaYamanaka.
EuroStemCell(Youtube),2012.Film.