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COMMENTARY | DR. VAN STITT JR.

Stem cell basics, minus opinions



There are few controversies that polarize individuals as does the one
surrounding stem cell research. I will attempt to take a very difficult
subject and educate readers about it.

The human body is made of approximately 220 different types of cells. Each
is the foundation for the development of all of our tissues and organs. Once
these different cells develop into specific tissues and organs, we have an
embryo.

A stem cell is essentially the building block of the human body. The stem
cells inside an embryo will eventually give rise to every cell, organ and
tissue in the fetus' body. Unlike a regular cell, which can only replicate
to create more of its own kind of cell, a stem cell has the capability of
reproducing itself many times over.

There are two types of stem cells: embryonic stem cells and adult stem
cells. Embryonic stem cells come from an embryo. When the embryo is between
three and five days old, it contains stem cells, which work to create the
various organs and tissues that will make up the fetus.

Adults have stem cells also. These cells are located in the heart, brain,
bone marrow, lungs and some other organs. They are regenerating cells
damaged by disease, injury and everyday wear and tear.

Scientists remove stem cells from the embryo and grow them in a
nutrient-rich solution in the laboratory. This growth and re-implantation of
these cells continues until, in just a few months, several stem cells can
become millions of stem cells. Embryonic stem cells can then be frozen and
used at a different time. Although I have made this sound simple, the
process is very difficult and time consuming.

As difficult as embryonic stem cells are to work with, adult stem cells are
much more difficult for scientists to develop. Stem cells are not only
harder to find in adult tissue, but scientists also have difficulty getting
them to replicate in the laboratory. Embryonic and adult stem cells are hard
for scientists to grow into specific tissue types.

If scientists can ultimately learn how to direct stem cells to become
different cells and thus form different types of tissue, they can use them
to replace diseased tissue. This has not happened because scientists still
haven't learned how to have the stem cells become a specific tissue or cell
type (heart vs. brain, for example).

A real issue that stands in the way of stem cell use is the problem of
rejection. If a person is injected with stem cells taken from a donated
embryo, his or her immune system may see the cells as foreign invaders and
launch an attack against them.

Eventually, scientists would like to be able to grow entire organs in a
laboratory to replace ones that have been damaged by disease. Based on this
theory, a biodegradable reproduction of the organ would be implanted or
attached to the individual and the organ specific stem cells would seed the
new organ. As the tissue grew from the stem cells, the implanted or attached
part would degrade, leaving a complete ear, liver or other organ.

Some of the conditions that may one day be treated with cell-based therapy
are: Parkinson's disease, diabetes, heart disease, spinal cord injury,
burns, Alzheimer's disease and vision loss.

Stem cell research has become one of the biggest issues dividing the
scientific and religious communities around the world. At the core of the
issue is one central question: When does life begin?

Even as scientists move forward in their understanding of stem cells and
their ability to manipulate them, the ethical and political debates rage on.
As would be expected, stem cell research is extremely expensive, and thus
many governments have placed tight restrictions on it.

Stem cell research is controversial because in order to get stem cells,
scientists either have to use an embryo that has already been conceived or
clone an embryo using a cell from a patient's body and a donated egg. Either
way, to harvest an embryo's stem cells, scientists must destroy it. Some
individuals say that destroying it is the equivalent of taking a human life,
though it may only have four or five cells.

Also at issue is the idea of cloning. Cloning is the process of making a
genetically identical organism through nonsexual means. The idea of human
cloning brings to mind frightening scenarios of babies genetically
engineered to be "super humans'' with top IQs and super-hero-like physical
capabilities, or babies created solely for the purpose of harvesting their
organs.

Cloning has been used for many years to produce plants (even growing a plant
from a cutting is a type of cloning). In 1997, animal cloning garnered a lot
of attention with the birth of the first cloned mammal, a sheep named Dolly.
Since Dolly, several scientists have cloned other animals, including cows
and mice.

The recent success in cloning animals has sparked fierce debates among
scientists, politicians and the general public about the use and morality of
cloning plants, animals and possibly humans.

To bridge the debate, scientists are exploring less controversial avenues of
research, using adult stem cells that are trained to act like embryonic stem
cells. Even if the outcome of the debate favors the use of stem cells, it
will likely be at least a few more decades until stem cell therapies come
into widespread use.

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Dr. Van Stitt Jr. is vice president and chief medical officer of Gaston
Memorial Hospital.




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