Ready For A Clinical Setting?

Upon searching for more sources on EBSCOhost, I found two more very intriguing journal articles discussing new ways in developing embryonic stem cells and how this may bring an end to the ethical issues, and the problems that may be presented when going from animal to clinical application.

The article “Will Cell Reprogramming Resolve the Embryonic Stem Cell Controversy?”, written by John Rasko and Carl Power, addressed the ongoing developments of cell reprogramming. This is where “adult” stem cells are reprogrammed to enter an embryonic stem cell state. They are deemed “pluripotent stem cells” and many scientists feel these will help break away from the ethical controversy regarding embryonic stem cells. Cell reprogramming, to some, seems to be the new way to use embryonic stem cells clinically and the future of regenerative medicine. However the article also emphasizes that pluripotent stem cells may also cause more ethical problems and complicate the stem cell controversy even further.

Given that there is really no conclusion to this ongoing controversy of embryonic stem cell use, the President’s Council on Bioethics stated that the best “ethical alternative” at this point, is cell reprogramming. It has been very successful in the lab, where researchers turned human skin cells into red blood cells. Not to mention, induced pluripotent stem cells can be collected from any individual and differentiate into any cell type just like embryonic stem cells. Yet problems can still occur depending on the age of the donor cells, as they are less efficient the older they are. I don’t sense any bias in this source but I do question if this alternative, could bring an end to the ethical controversy attached to this topic, given there are still minor problems associated with it.

                         http://www.stemcellresearchfoundation.org/WhatsNew/Pluripotent.htm

I also find myself wondering; could induced pluripotent stem cells be just as effective, if not better, then embryonic stem cells? What concerns, if any, are attached to iPS cells? Will the government decide to fund this new form of regenerative medicine? At this point, it is hard to say but if iPS cells prove to differentiate just as well as embryonic stem cells, will this ultimately become the new direction of regenerative medicine?

I also explored the problems that may develop when taking embryonic stem cells from the lab setting, with animals, to the clinical setting. “New Perspectives in Stem Cell Research: Beyond Embryonic Stem Cells,” written by L. Keller, discussed the current state of stem cell technology and applying embryonic stem cells to disease treatment and cell replacement therapy. The article also addresses the problems faced when applying them in a clinical setting. Embryonic stem cells were recently cleared to be used, clinically, in a trial to treat spinal cord injuries; however it is now on hold due to some minor issues that arose in the final tests in the lab.

Although “adult” stem cells have continually been used in the clinical setting, the real question is how embryonic stem cells will transition to the clinical setting. Yes human embryonic stem cells have been tested in the lab, but I think the lack of funding by the government may ultimately determine just how effective they are in the clinical setting.

As noted in the article, there is also major concern with the transition of embryonic stem cells to a clinical setting, in that although they have unlimited reproduction, this may end up causing tumors. Another problem arises in that cells from an embryo, injected into a sick patient, may be rejected given the cells are no the genetically the same as the patient. Not to mention, human embryos are not an unlimited “resource,” so this may slow down large-scale treatment. However until they are allowed to be used clinically, and not just “here-and-there” in a lab, it is difficult to come to a conclusion of just how successful embryonic stem cells may or may not be.

The beginning of organ transplants had similar concerns attached, those being if it could be done in the clinical setting as well and the fear of patient rejection. Many were reluctant to attempt or even allow it to be done. Though once proven to work, and the “kinks” sort of worked out, organ transplants became widely accepted. I realize there are not ethical issues related to this, as there are with embryonic stem cell use, but I feel both can be looked at in the same light. If embryonic stem cells work clinically, will this new disease treatment be accepted medically?

If proven to work in the clinical setting, will the government fund more research and trials? How will success rate affect individual concerns regarding this topic? Will more ethical issues arise if proven to work? Again coming to conclusions about success and individual morals is not something that can really be determined. However I’m looking forward to seeing what new disease treatments regenerative medicine may lead to in the future, once some laboratory and clinical hurdles are cleared.

Works Cited

L. Kenner, et al. "New Perspectives In Stem Cell Research: Beyond Embryonic Stem Cells." Cell Proliferation 44.(2011): 9-14. Academic Search Premier. Web. 14 July 2012.

Power, Carl, and John E. J. Rasko. "Will Cell Reprogramming Resolve The Embryonic Stem Cell Controversy? A Narrative Review." Annals Of Internal Medicine 155.2 (2011): 114-W43. Academic Search Premier. Web. 14 July 2012.