Running head: UNIT 7 ASSESSMENT: STEM CELL RESEARCH 1 Unit 7 Assessment: Stem Cell Research Ashley DeKind Herzing University 02/16/2020 UNIT 7 ASSESSMENT: STEM CELL RESEARCH 2 Abstract Stem cells have the ability to differentiate into specific cell types. The two defining characteristics of a stem cell are perpetual self-renewal and the ability to differentiate into a specialized adult cell type. There are two major classes of stem cells: pluripotent cells, which can become any cell in the adult body and multipotent cells, which are restricted to becoming a more limited population of cells. Stem cells have great potential in tissue regeneration and repair, but much still needs to be learned about their biology, manipulation and safety before their full therapeutic potential can be achieved. UNIT 7 ASSESSMENT: STEM CELL RESEARCH 3 Introduction Stem cell research has said to do many amazing things, but can still be in the beginning stages. Without proper funding and trained researchers, further research could come to a halt. Stem cells promise further cures for many diseases, which are currently considered to be incurable, but are we prepared to deal with the harm that this process can also cause. As research continues, do we promise outcomes that might not occur or if stem cell research was more understood, could more people have a better chance with their health. Although controversial, both adult and embryonic stem cells have important benefits that can advance medicine. Stem cell research has offered a new therapeutic option for debilitating diseases, injuries and other conditions. The scope of stem cell-based treatment has grown in recent years due to advances in stem cell research and technologies. Now, stem cell-based treatments have been established as standard clinical care in certain disorders like use of hematopoietic stem cells in leukemia or use of limbal stem cells in corneal disease. Stem cell research has also advanced over the years. Stem cells have done so many good things and as time goes by, research has grown significantly. With stem cell research being a controversial issue, this topic is divisive among people all over the world. Stem cells have great medical benefits and it’s important for people to understand the research process to have some clarity on the benefits. What are stem cells you ask? They are special human cells that have the ability to develop into many different cell types, from muscle cells to brain cell. In some cases, they also can repair damaged tissues. Researchers believe that stem cell-based therapies may one day be used to treat devastating ailments like paralysis and Alzheimer’s disease. UNIT 7 ASSESSMENT: STEM CELL RESEARCH 4 The History of Stem Cell Research It’s hard to pinpoint exactly when or by whom what we now call “stem cells” were first discovered, the consensus is that the first scientists to rigorously define the key properties of a stem cell were Ernest McCulloch and James Till. In their pioneering work in mice in the 1960s, they discovered the blood-forming stem cell, the hematopoietic stem cell. By definition, a stem cell must be capable of both self-renewal and differentiation into mature cell types. HSCs are said to be multipotent, as they can still give rise to multiple cell types, but only to other types of blood cells. They are one of the many examples of adult stem cells, which are tissue-specific stem cells that are essential for organ maintenance and repair in the adult body. Muscle for instance, also possesses a population of adult stem cells. Satellite cells are unipotent as they can give rise to just one cell type, muscle cells. Therefore, the foundations of stem cell research lie not with the famous or infamous human embryonic stem cells, but with HSCs which have been used for decades in human therapy, such as bone marrow transplants. Still, what ultimately fueled the enormous impact that the stem cell research field has today, is undoubtedly the isolation and generation of pluripotent stem cells. Martin Evans and Matt Kauffman were the first to identify, isolate and successfully culture ES cells using mouse blastocysts in 1981. This discovery opened the doors to the creation of “murine genetic models”, which are mice that have had one or several of their genes deleted or otherwise modified to study their function in disease. This is possible because scientists can modify the genome of a mouse in its ES cells and then inject those modified cells into mouse blastocysts. This means that when the blastocyst develops into an adult mouse, every cell in its body will have the modification of interest. UNIT 7 ASSESSMENT: STEM CELL RESEARCH 5 How to Prepare for Stem Cell Transplantation There are many steps and procedures someone undergoing a stem cell transplantation must endure. Stem cell transplantation is a rigorous medical procedure. Before undergoing transplantation, patients will be given a number of medical tests to ensure that they are healthy enough for the procedure. Examples of these medical tests would be an EKG to measure heart function, a pulmonary function test to measure the health of your lungs, chest x-ray or CT scan to check lungs for problems or signs of infection, blood work and urine tests to measure blood counts, kidney function, liver function and past exposure to infectious diseases, tests to check the status of your disease and a full physical exam and health history. The cost of stem cell transplantation is a very expensive procedure. As soon as a stem cell transplant is being considered as a treatment option, patients should discuss financial issues with their treatment team. Transplant centers have staff members who can help patients to get answers for financial questions concerning health insurance and financial assistance. Most insurance plans cover some of the costs of transplantation for certain cancers or diseases. Before undergoing transplantation, patients should contact their medical insurance providers and determine which costs the insurance provider will cover. High doses of chemotherapy and radiation can affect cells in both male and female reproductive systems. Recovery of stem cell transplantation may take months to years and patients of childbearing age may not be physically or psychologically ready to think about parenthood for several years after transplantation. Patients who may want to have children in the future should discuss options to preserve fertility before transplantation. UNIT 7 ASSESSMENT: STEM CELL RESEARCH 6 Bone Marrow Transplants A bone marrow transplant is a procedure to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Bone marrow is the soft, fatty tissue inside your bones. The bone marrow produces blood cells. Stem cells are immature cells in the bone marrow that give rise to all of your different blood cells. Before the transplant, chemotherapy, radiation or both may be given. This can be done in one of two ways, ablative (myeloablative) treatment or reduced intensity treatment, also called a mini transplant. In ablative (myeloablative) treatment, high-dose chemo, radiation or both are given to kill any cancer cells. This also kills healthy bone marrow that remains and allows new stem cells to grow in the bone marrow. In reduced intensity treatment, lower doses of chemo and radiation are given before a transplant. This allows older people and those with other health problems to have a transplant. The three kinds of bone marrow transplants are autologous bone marrow transplant, allogeneic bone marrow transplant and umbilical cord blood transplant. Autologous bone marrow transplant, the term “auto” means self. Stem cells are removed from you before you receive high-dose chemo or radiation treatment and stored in a freezer. After high-dose chemo or radiation treatments, your stem cells are put back in your body to create normal blood cells. Allogeneic bone marrow transplant, the term “allo” means other. Stem cells are removed from another person who donated their cells. Most times, the donor’s genes must at least partly match your genes, such as a brother or sister. Sometimes parents, children and other relatives are good matches. Special tests are done to see if a donor is a good match for you. Umbilical cord blood transplant is a type of allogeneic transplant. Stem cells are removed from a newborn baby’s umbilical cord right after birth. The stem cells are frozen and stored until they’re needed for a UNIT 7 ASSESSMENT: STEM CELL RESEARCH 7 transplant. Umbilical cord blood cells are very immature, so there’s less of a need for perfect matching. Due to the smaller number of stem cells, blood counts take much longer to recover. UNIT 7 ASSESSMENT: STEM CELL RESEARCH 8 Benefits of Stem Cell Research Research with embryonic stem cells may lead to new, more effective treatments for serious human ailments and alleviate the suffering of thousands of people. Diseases such as juvenile diabetes, Parkinson’s disease, heart failure and spinal cord injuries are just some examples. Bone marrow transplants have been performed for decades and involve the infusion of adult stem cells. Research based on embryonic and adult stem cells has yielded promising results for the treatment of Parkinson’s disease and diabetes. Stem cell research has also generated new knowledge about basic cell mechanisms that’s critical to understanding the causes of disease, such as cancer. 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 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. Lab 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 lab to screen new drugs and to develop model systems to study normal growth and identify the causes of birth defects. UNIT 7 ASSESSMENT: STEM CELL RESEARCH 9 The Ethical Issues & Risks Surrounding Stem Cell Research Historically, the use of stem cells in medical research has been controversial. This is because when the therapeutic use of stem cells first came to the public’s attention in the late 1990s, scientists were deriving human stem cells from embryos. Many people disagree with using human embryonic cells for medical research because extracting the stem means destroying the embryo. This creates complex issues as people have different beliefs about what constitutes the start of human life. For some people, life starts when a baby is born or when an embryo develops into a fetus. Others believe that human life begins at conception, so an embryo has the same moral status and rights as a human or child. President George W. Bush had strong, pro-life religious views and he banned funding for human stem cell research in 2001. However, President Obama’s administration allowed for a partial rolling back of these research restrictions. By 2006, scientists had already started using pluripotent stem cells. Scientists don’t derive these stem cells from embryonic stem cells. As a result, this technique doesn’t have the same ethical concerns. With this and other recent advances in stem cell technology, attitudes toward stem cell research are slowly beginning to change. Stem cells have been called everything from cure-alls to miracle treatment, but the U.S. Food and Drug Administration is concerned that some patients seeking cures and remedies are vulnerable to stem cell treatments that are illegal and potentially harmful. The FDA is increasing oversight and enforcement to protect people from dishonest and unscrupulous stem cell clinics, while continuing to encourage innovation so that the medical industry can properly harness the potential of stem cell products. All medical treatments have benefits and risk, but unproven stem cell therapies can be particularly unsafe. UNIT 7 ASSESSMENT: STEM CELL RESEARCH 10 Conclusion Stem cell research could generate knowledge that would allow certain individuals to live longer and better lives. It would be a happy event if in the future stem cell research produced relief for at least some individuals with illnesses or injuries that aren’t currently curable. There are no guarantees that this happy future will happen. Although we may support and admire the scientists devoted to developing a better understanding of human health and disease, we should also be aware that no one can ensure that effective treatments will emerge. The therapeutic benefits of stem cell research are possible, but uncertain and many other areas of biomedical science fit this description. Stem cell research isn’t the only field in which exciting discoveries are occurring and future patients may benefit from investments in these areas as well. This isn’t a reason to deny support to stem cell research, but it’s a reason to consider it in a larger context. Advocates weaken their case when they portray stem cell research as if it were the only promising research around. More government support for stem cell research could help patients in the future, but so could support for research in other biomedical fields. Participants in the stem cell debate should also recognize deficiencies in the health system denying patients the benefits of past research. Advocacy for stem cell research should include advocacy for a better health system. Without improvements in this system, any therapeutic benefits developed through stem cell research will be unjustly limited to patients fortunate enough to have access to the best health care. Moreover, the stem cell controversy should press us to reexamine existing research and health care priorities. Should officials devote more funds to research aimed at translating lab discoveries into actual clinical benefits? Should they channel more funds to studies that could UNIT 7 ASSESSMENT: STEM CELL RESEARCH 11 have a significant public health impact? What level of investment should the United States make in programs aimed at developing and delivering affordable care to disadvantaged people in this nation and around the world? These are all ethical questions with great significance, but they are often overlooked amid the excitement over specific research discoveries like those involving stem cell research. Lastly, ethical considerations sometimes justify setting limits on scientific innovation. For example, there’s nearly universal agreement that people shouldn’t be forced to participate in research, even though a forceful research policy could generate extremely valuable knowledge. Some people believe there should also be severe limits on research involving human embryos, while others disagree. These aren’t disputes that science can settle. They are value conflicts to be expected in pluralistic society like ours. In struggling with these conflicts, we should maintain respect for those holding differing views and we should look for policies that are consistent with as many of those views as possible. UNIT 7 ASSESSMENT: STEM CELL RESEARCH 12 References Concannon, J. P., Siegel, M. A., Halverson, K., & Freyermuth, S. (2010). College students’ conceptions of stem cells, stem cell research, and cloning. Journal of Science Education and Technology, 19(2), 177-186. doi:http://dx.doi.org/10.1007/s10956-009-9190-2 Eve, D.J., Marty, P.J., McDermott, R.J., Klasko, S.K., & Sanberg, P.R. (2008). Stem Cell Research and Health Education. American journal of health education, 39(3), 167-179 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2723780/ Gincel, D. (2012). The Maryland stem cell research fund: promoting stem cell research and cures. Stem cells translational medicine, 1(7), 521-522. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659721/ Glazier, E., & Ko, E. (2019, Apr 10). Stem cell therapy needs more research stem cell therapy needs more research. Bismarck Tribune Retrieved from https://prx-herzing.lirn.net/login? url=https://search.proquest.com/docview/2206337776?accountid=167104 Karen Rivedal Wisconsin, S. J. (2004, Jul 04). ADULT STEM-CELL RESEARCH KEY, SOME SAY (FIRST EDITION) ; ADULT STEM-CELL RESEARCH AN ALTERNATIVE (SECOND AND THIRD EDITIONS): [ALL EDITION]. Wisconsin State Journal Retrieved from https://prx-herzing.lirn.net/login? url=https://search.proquest.com/docview/391371163?accountid=167104 UNIT 7 ASSESSMENT: STEM CELL RESEARCH 13 NIH Stem Cell Task Force Examines Barriers to Embryonic Stem Cell Research, and Other Stem Cell Research-related News. Journal of Investigative Medicine 2002;50:394-396. Retrieved from https://jim.bmj.com/content/50/6/394 Sansom, D. L., P.H.D. (2010). HOW MUCH RESPECT DO WE OWE THE EMBRYO? LIMITS TO EMBRYONIC STEM CELL RESEARCH. Ethics & Medicine, 26(3), 161173,131. Retrieved from https://6o3241o91-mp02-y-https-search-proquest-com.prxherzing.lirn.net/central/docview/748831162/18961C0E0C1D4AB5PQ/1? accountid=167104 Sedivy-Haley, K. (2019, September 8). Stem Cell Treatments: Miracle Cures or Dangerous Experiments? Retrieved from http://theconversation.com/stem-cell-treatments-miraclecures-or-dangerous-experiments-120880 Sen, R. S. (2005, Sep 26). What is the best way to go about stem-cell research? ; stem-cell research has options. Roll Call Retrieved from https://prx-herzing.lirn.net/login? url=https://search.proquest.com/docview/324351728?accountid=16710 The, M. C. (2005, Oct 20). Stem-cell research ** even with limited federal support, the pace of stem-cell research quickens: [FIFTH edition]. Morning Call Retrieved from https://prxherzing.lirn.net/login?url=https://search.proquest.com/docview/393179471? accountid=167104
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