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Stem Cells as a Treatment

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Stem Cells as a Treatment
Overview: Stem cell research is a highly promising field of study. Its most important applications include medicine and therapy. These will be the focus of this paper. To begin: an overview of stem cells, alternatives to embryonic stem cells, and recent advances.

Stem cells are amazing for their capacity for self-renewal and, most of all, the ability to become any of millions of cell types in the human body. There are various types of stem cells, each with different potential. This includes embryonic stem cells. These totipotent cell lines come from the inside of the cell mass of a human embryo. These embryos are taken specifically from fertilized eggs not used by in-vitro fertilization (1). At this point, they are just a blastocyst, meaning an embryo composed of approximately one hundred cells. The cells on the inside of the blastocyst are undifferentiated but eventually will multiply and differentiate extensively to make all of the different required cells. Adult stem cells cells also have this same ability. They are found throughout the body and are able to dived to replenish dying cells and regenerate damaged tissues (1). Adult stem cells are able to renew themselves and create a variety of cells, but are usually multipotent, meaning that they only are able to specialize into a small selection of cells.

‘Totipotent’ stem cells can be transformed into any type of cell in the human body, however, there is a great amount of controversy surrounding stem cell research (2). Because the use of embryonic stem cells requires the destruction of human embryos, many people are against their use. The potential of that human embryo to become a human life is squandered when stem cells are harvested.

Possible Alternatives: However, embryonic stem cells are not the only option. Alternatives focus mainly on getting the main characteristics of an embryonic stem cell while minimizing the destruction of embryos. Alternatives are mainly divided into two groups (3). The first includes embryos, but includes procedures that would reduce the ethical concerns of embryonic destruction. These alternatives are pursued to avoid the ethical problems of destroying embryos. The second uses adult stem cells (4). Adult stem cells however are only multipotent and are already committed to a certain line of cell. Nevertheless, adult stem cells are being used to treat the tissue of origin or closely related tissues. These alternatives are pursued to find a more readily available source of totipotent stem cells.

It has been proposed that surplus embryos resulting from in vitro fertilization be used (5), specifically the embryos that are never going to be used. Embryos are still destroyed, however, even though they weren’t going to be used. Blastocysts that have been genetically altered so that it has no chance of implantation or growth is an option as well (5).

Induction of Pluripotency: One of the most promising routes, recently discovered, is the induction of pluripotency. Discoveries made by Yamanaka and his collaborators have made this possible (6). Their successful reprogramming of genes within already differentiated human somatic cells allow for the creation of more specific-use stem cells. By introducing four genes, Oct3/4, Sox2, c-Myc, and Klf4, pluripotency is induced (6). The result is the creation induced pluripotent celss, or iPS cells, that resemble embryonic stem cells. The initial cells used in this technique can be any cell int he entire human body, which provides an unlimited supply of potentially pluripotent cells. This makes it useful in medical recovery or therapy.

Possible Applications: The applications include disease modeling in a patient-specific context which eventually could lead to the development of individually tailored pharmaceutical therapy (7). As well, stem cells could be used to develop and screen candidate drugs and deliver cell-replacement therapy to help regenerate diseased areas. Stem cells, iPS or embryonic, could potentially treat many diseases, including Alzheimer’s disease, Parkinson’s disease, cardiovascular disease, diabetes, and ALS, or Lou Gehrig’s disease (8). In theory cell types could be taken from a patient and reprogrammed, getting rid of the patient’s disease in a culture dish. Because the cells are from the patient’s body, there is no danger of rejection of the cells by the patient’s immune system. Drugs to suppress the immune system wouldn’t be needed. Induced cells can be directed to differentiate into a specific cell that would be used for a specific treatment. For example, sick heart tissue of a person with liver disease could be reverted into healthy liver cells that could replace the sick liver tissue (9).

Specific Focus on Treatment for Acute Respiratory Distress Syndrome (ARDS): ARDS is a pulmonary condition that leads to low oxygen levels in the blood. When a person breathes, air goes through the nose and mouth, through the windpipe, then into the lungs’ air sacs, or alveoli. Small blood vessels, capillaries, lace the walls of the alveoli. Oxygen goes through here to the bloodstream, where it is carried to the rest of the body. ARDS cause fluid to accumulate in the air sacs. The lungs are impeded from filling with air and filling bloodstream with oxygen. Of course, without oxygen, you die. In recent years, the frequency and mortality of ARDS has increased (11).

As of now, there is no therapy to restore lung function to ARDS patients. However, studies have shown that stem cells can help (12). Stem cells taken from bone marrow or other locations can be inserted into the lungs. These stem cells then target the injured or infected alveoli at a very high rate. They are then able to activate cells in the immune system that will fight the ARDS, as well, they decrease the permeability of the lung wall, and increase antioxidants in the area, all of which are beneficial in the treatment of ARDS. Treatment of ARDS from any cause by stem cells showed massive improvement over any other treatment. When treated within 24 hours of a lung injury, there was a decrease in lung injury, decrease in excess lung water, increase in antimicrobial activity, less inflammatory responses, and ultimately reduced mortality (13). Stem cells have become a fantastic candidate for promising therapies for patients with ARDS.

Specific Focus on Treatment of Diabetes: Diabetes is is a disease in which the person has a high blood sugar, either because insulin production is insufficient, or because the cells in the body don’t respond to insulin in the correct way. Symptoms include excessive thirst and appetite, increased urination, weight gain, fatigue, nausea, blurred vision, and slow-healing sores or cuts. The current strategy for medication for diabetes is an increase in the supply of insulin, which will decrease the blood glucose level. However, medical insulin cannot completely mimic the secreted insulin from cells in the pancreas, which is tightly regulated fro maintaining the optimum level of blood. As well, it sometimes causes hypoglycemic coma. Therefore, a strategy that will increase the the existing necessary pancreatic cells would provide more future treatment options. Because stem cells are self-renewing, they have huge potential for the treatment of diabetes by replacing or regenerating any diseased in the pancreas. Recently, there has been success in achieving this goal, and has effectively mitigated the high blood sugar. Also, it has been suggested by studies that it can repopulate the damaged pancreas cells. Stem cells were able to improve heart function and decrease hyperglycemia (14).

Conclusion: Stem cell research is a highly active branch of science that has incredible potential. Recent improvements and advances have been made in the areas of Acute Respiratory Distress Syndrome and diabetes. Stem cell research definitely needs to be pursued, as well as the induction of pluripotent cells. There is hope for the treatment of many untreatable diseases with stem cells.

Works Cited
1. Carvalho, A., & Ramalho-Santos, J. (n.d.). How can ethics relate to science? The case of stem cell research. European Journal of Human Genetics, 21(6), 591-595. Retrieved from Web of Science.
2. Habets, M., Van Delden, J., & Bredenoord, A. (2014). The inherent ethical challenge of first-in-human pluripotent stem cell trials. Regenerative Medicine, 9(1), 1-3. Retrieved April 1, 2015, from Web of Science.
3. McGee, A. (2014). The Potentiality of the Embryo and the Somatic Cell. Metaphilosophy, 45(4-5), 689-706. Retrieved April 1, 2015, from Web of Science.
4. Samorinha, C., Pereira, M., Machado, H., Figueiredo, B., & Silva, S. (2014). Factors associated with the donation and non-donation of embryos for research: A systematic review. Human Reproduction Update, 20(5), 641-655. Retrieved April 1, 2015, from Web of Science.
5. King, N., & Perrin, J. (2014). Ethical issues in stem cell research and therapy. Stem Cell Research & Therapy, 5, 85-85. Retrieved April 1, 2015, from Web of Science.
6. Hefferman, C., Liu, J., Sumer, H., Malaver-Ortega, L., Verma, R., Carvalho, E., & Verma, P. (2013). Induction of Pluripotency. Transcriptional and Translational Regulation of Stem Cells, 786, 5-25. Retrieved April 1, 2015, from Web of Science.
7. Curley, G., & McAuley, D. (2015). Stem cells for respiratory failure. Current Opinion in Critical Care, 21(1), 42-49. Retrieved April 1, 2015, from Web of Science.
8. Liebau, S., Stockmann, M., Illing, A., Seufferlein, T., & Kleger, A. (2014). Induced pluripotent stem cells. A new resource in modern medicine. Internist, 55(4), 460-460. Retrieved April 1, 2015, from Web of Science.
9. Walmsley, G., Hyun, J., McArdle, A., Senarath-Yapa, K., Hu, M., Chung, M., . . . Wan, D. (2014). Induced Pluripotent Stem Cells in Regenerative Medicine and Disease Modeling. Current Stem Cell Research & Therapy, 9(2), 73-81. Retrieved April 1, 2015, from Web of Science.
10. Gharaee-Kermani, M., Gyetko, M., Hu, B., & Phan, S. (2007). New insights into the pathogenesis and treatment of idiopathic pulmonary fibrosis: A potential role for stem cells in the lung parenchyma and implications for therapy. Pharmaceutical Research, 24(5), 819-841. Retrieved April 1, 2015, from Web of Science.
11. Parimon, T., Madtes, D., Au, D., Clark, J., & Chien, J. (2005). Pretransplant lung function, respiratory failure, and mortality after stem cell transplantation. American Journal of Respiratory and Critical Care Medicine, 172(3), 384-390. Retrieved April 1, 2015, from Web of Science.
12. Cardenes, N., Caceres, E., Romagnoli, M., & Rojas, M. (2013). Mesenchymal Stem Cells: A Promising Therapy for the Acute Respiratory Distress Syndrome. Respiration, 85(4), 267-278. Retrieved April 1, 2015, from Web of Science.
13. Akiyama K, et al: Mesenchymal-stem-cell-induced immunoregulation involves FAS-ligand-/FAS-mediated T cell apoptosis. Cell Stem Cell 2012;10:544-555.
14. Mishra, P., Singh, S., Joshua, I., & Tyagi, S. (2010). Stem cells as a therapeutic target for Diabetes. Frontiers in Bioscience, 15, 461-477. Retrieved April 1, 2015, from Web of Science.

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