Two Successful Paths in Stem Cell Therapy

Shinya Yamanaka discovered a way to reprogram adult skin cells back to embryonic stem cells (photo from BBC news)

Stem cells from cord blood injected into the heart

Two paths in stem cell therapy

Research in stem cell research is fast advancing. However, applications in the way of therapy have not kept pace.

The public, in terms of becoming knowledgeable about stem cells and stem cell therapy, has not kept abreast of developments either. Three ethical paths in stem cell therapy have emerged. These are based on results of research. These paths are as follows:

Path I: reprogram adult cells

Path II. Use stem cells from the body

Path I. Reprogram adult cells

You may review the basics of stem cells in my Hubs like “How one stem cell turns into a human being,” and “Stem Cell Therapy Based on Stem cell-organism theory.”

We know that one stem cell, the result of the union of the sperm from the father and the egg from the mother is one stem cell, called zygote. This will turn into an embryo, that will turn into a fetus, that will turn into a full term, that will be born as a baby.

In terms of stages of stem cells, the progress is from totipotent stem cell (zygote), to pluripotent stem cells, to multipotent stem cells, to unipotent stem cells, to adult stem cells, to adult cells.Examples of adult cells are blood, heart, skin, eyes, ears, brain, liver, lungs, arms, legs, bone, and many more.

Before 2006, we knew that this progression was irreversible. In 2006 it was discovered by Shinya Yamanaka that the process can be reversed. That is, an adult skin cell can be reprogrammed back to pluripotent stem cells. Yamanaka tracked down factors that could reverse the process: from a thousand factors, down to 100 factors, down to 24 factors, down to 4 factors. The four factors are Oct4, Sox2, Klf44, and c-Myc.

He took a small patch of skin, placed it in a dish, nourished it with feeder stem cells, then added the four factors. Embryonic stem cells came out of the skin cells, called induced pluripotent stem cells (iPS). When grown further, these iPS gave rise to multipotent stem cells, to unipotent stem cells, to adult stem cells, then to adult skin cells. This procedure was first tried on mice that was successful. Then it was tried on cells of a human being that was also successful.

Other scientists replicated Yamanaka’ s procedure to see if his claim was true. Yamanaka’s procedure of reprogramming adult cells has been verified.

Up until this time, to use such embryonic stem cells in research is tantamount to killing the embryo. This has raised an ethical issue; it is immoral to use embryonic stem cells. Yamanaka was able to override the use of embryonic stem cells that come from the union of sperm cell and egg.

So, there is no ethical issue in the use of iPS. In fact, any adult cell can be reprogrammed back to embryonic stem cells.

Application in healing

For example, a burned skin. A small part of a healthy skin of the same person is reprogrammed to grow adult skin cells. Then this new skin is grafted on the burned part of the body. The healing is not complete though. The reprogrammed skin does not have sweat glands and cannot grow hair.

Risks

There are risks in using reprogrammed adult cells. One, the genes of the feeder stem cells can contaminate the adult cells being cultured. Usually, the feeder stem cells come from mice. So the new tissue that grows from this culture adult cells will have genes of the mouse. The result is still unknown.

Two, some changes in the genes of cultured adult cells occur. That is, it is probable that such cultured cells will grow into cancer.

In fact, it was found that the factor c-Myc is a proto-oncogene which promotes cancer. In subsequent research, new lines of factors were used: Oct3/4, Sox1/2/3/15/18, Klf1/2/4/5 and Nanog. C-Myc was dropped, according to a stem cell researcher at the Stanford University in California, USA.

Another ethical issue

There has emerged another unexpected ethical issue. iPS can give rise to totipotent stem cell, like the zygote. That is, by means of reprogramming, a human being can be created. We will not tackle this issue now.

Path II. Use stem cells from the body

Another method is the use of stem cells from a part of body taken directly from the body or use of stem cells from the cord blood.

For an ailing heart cord blood is used. Stem cells from the cord blood are grown in dish. These stem cells are injected directly into the heart.

For leukemia cord blood is used. Again, stem cells from the cord blood are grown in dish. Then injected to the patient who grows blood cells that replace the diseased cells.

The liver with one-third of it decapitated owing to injury, like cirrhosis, can be regrown to its original size. Also, stem cells from the cord blood are used.

In the case of blindness owing to burning. Stem cells from the healthy eye are grown in dish and injected to the same person. The damaged eye regrows including the cornea. Vision is restored.

Stem cells from the cord blood are used to cure several diseases.

No ethical issue is involved in this path of stem cell therapy.

Costs compared

These three paths in stem cell therapy must be compared with each other in terms of cost. i have not had stem cell therapy but from what I hear one treatment, in Path I and Path III, cost a lot.

For example, skin graft that uses reprogrammed adult skin cells. A small part of the healthy skin of a person is taken. It is cultured in a dish done in the laboratory. The new skin mat is grafted on the burned skin. This procedure takes some period of time and involves experts.

In nutrition supplement, Path II, a product is already available, at least in USA marketed by RBC Life. You can access its website with search entry, RBC Life Stem-Kine. There are price tags; a bottle of Stem-Kine costs less than US$100.

Further research and theory-making

The theory of stem cell-organism has yet to be refined. In fact, researchers and doctors are not yet agreed as to theory, even in their vocabulary, I saw one video where the difference between mitosis and differentiation is not adequately explained.

One researcher said it is not yet known what makes a stem cell decide to go on mitosis or to differentiate.

In a situation when an adult cell must originate from a pluripotent stem cell a reprogrammed adult cell is needed. In a situation when an adult cell must originate from a multipotent stem cells the cord blood is used. In this case, reprogramming is not needed.

I have forwarded my own theory which is: "A trigger induces a stem cell to differentiate into a multi-celled organism." I have about three Hubs on this theory. I have explained the difference between mitosis and differentiation in my Hub, "How one stem cell turns into a human being."

However, lack of theory is not a deterrent in application research. Dr. Jonas Salk did not publish a formal theory of how his killed poliovirus vaccine worked (in 1948 to 1999). There was a rivalry with Dr. Albert Sabin who advocated that only live and attenuated virus could work as vaccine. Yet the Salk vaccine is effective. Pasteur or Koch proceeded with vaccination even when they could not explain how vaccination worked. It was only later on that the mechanism of vaccination was elaborated.

Nitroglycerin had been in use to alleviate angina and heart attack for a long time but its mechanism was not understood. It was only after the researches done by Robert Futchgott, Ferid Murad and Louis Ignarro were interpreted together that the mechanism was understood. They shared the Nobel Prize in medicine in 1998.

One good thing is that research on stem cell and stem cell therapy is advancing very fast. A consortium of European countries is pooling results of member countries. A professor at Stanford University in California, USA said they are ahead in stem cell research.


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