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Not obsolete by Cynthia B. Cohen
August 15, 2008 4:11 PM
Not obsolete
Human embryonic stem cell research still needed
By Cynthia B. Cohen

[Episcopal Life] Recent news that scientists in Japan and the United States 
have converted skin cells into stem cells that are similar to human 
embryonic stem cells surprised the world. Drawing from information derived 
from human embryonic stem cells, these researchers found that they could 
reprogram certain genes in these skin cells to produce cells they have 
termed "induced pluripotent stem cells."
Their hope is that specific kinds of cells -- for example, bone, muscle, 
blood, kidney -- can be developed from such cells and used to treat patients 
with serious diseases.

Does this mean that research on human embryonic stem cells now can be ended? 
Some maintain that this is the case. Stem cell scientists, however, respond 
that the era of human embryonic research cell is not over. They give several 
reasons why it should continue.
First, there is concern that induced pluripotent cells might produce 
cancerous cells in patients to whom they were transferred.
This is because one of the genes inserted into the skin cells to induce them 
to change into these new sorts of cells is associated with cancerous tumors.
Moreover, the retroviruses used to insert these genes into the skin cells 
also are associated with cancer. It is unclear at this time whether there is 
a way of getting around these obstacles so that induced pluripotent stem 
cells could be used safely in patients.

Second, stem cell scientists believe that we need to use human embryonic 
stem cells as a control against which to compare and assess the capabilities 
and safety of induced pluripotent stem cells.

Third, scientists do not know yet whether these new cells have the capacity 
to change into as wide a range of specialized cells as human embryonic stem 
cells. If not, they clearly would not make a satisfactory substitute for the 
latter cells.

Fourth, while induced pluripotent stem cells would provide immunological 
matches for the specific patients from whom they were derived, it might be 
very expensive to develop the millions of such cells that would be needed to 
allow the individual treatment of each of the multitude of patients in the 
United States.

Finally, scientists estimate that in five to 10 years they will have refined 
and improved their knowledge of human embryonic stem cells to a point where 
they can transplant cells derived from them to patients safely. It will take 
even more time, some believe, to assess the capabilities of induced 
pluripotent stem cells.

In addition, human embryonic stem cells are needed for certain kinds of 
research for which induced pluripotent stem cells are not suitable, such as 
that into the development of human embryos. This sort of research is needed 
if we are to learn about the causes of serious diseases and disabilities in 
newborn babies.
The real impetus behind calls to drop human embryonic stem cell research 
lies in the concerns of some about the destruction of early human embryos 
that it entails. Such embryos, which have been developed outside the body in 
a glass dish during in vitro fertilization (IVF), are four to five days old 
and have about 50 to 150 cells. More of them are developed than will be used 
in one IVF cycle so that women will not have to go through the discomforting 
and sometimes risky procedures of ovarian stimulation and extraction again 
in the future.

Spare embryos of good quality can be frozen for later IVF attempts. However, 
some are of poor quality and therefore never will be used in future attempts 
at IVF; others will not be used because those for whom they were developed 
have succeeded in becoming pregnant and do not plan to use these spare 
embryos to have more children.

There is considerable debate about whether such early embryos should be 
viewed as individual human beings who must be transferred to a woman's body 
in order to be saved from destruction. Yet no one argues that women should 
be forced to accept these embryos into their bodies.

Couples and individuals who do not believe that these early embryos are 
individual human beings, and who do not plan to have additional children, 
have donated them for stem cell research instead of discarding them or 
donating them to others. Scientists at several research centers have found 
that they can derive human embryonic stem cells from such embryos, even 
those of poor quality.

Stem cell oversight committees have developed specific guidelines about the 
sorts of information that should be provided to those considering the 
donation of their spare embryos for stem cell research and about measures 
that must be taken to ensure that they give such embryos voluntarily.
Those who do believe that these spare embryos are individual living human 
beings have sought to donate them to others, with some success, rather than 
to give them to stem cell research.

The discovery of induced pluripotent stem cells has not made human embryonic 
cells a relic whose time has passed.

There is a need for extensive research using both kinds of cells if we are 
to develop new treatments for those who are desperately ill and to learn 
more about why certain roadblocks to healthy growth appear during embryonic 
development.

-- Cynthia B. Cohen, a parishioner at St. Alban's in Washington, D.C., is at 
the Kennedy Institute of Ethics at Georgetown University and is the author 
of Renewing the Stuff of Life: Stem Cells, Ethics, and Public Policy (Oxford 
2007). She served on the Canadian Stem Cell Oversight Committee for three 
years. To respond to this commentary, e-mail [log in to unmask] 
We welcome your own commentary.
____________________________________________________________________________
Episcopal Life Daily, July 29, 2008
Episcopal Life Daily provides information and resources

Rayilyn Brown
Director AZNPF
Arizona Chapter National Parkinson Foundation
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