The face of health care keeps on getting a makeover with each passing day, the result being the availability of newer solutions to the problems that have nagged mankind for centuries. Stem cell research as regards the condition of pregnancy in women has yielded some special results in the recent past. Stem cells have been pretty aptly named, as these are the holding blocks of human life. These cells build the human body and play an important role in the treatment of ravaging diseases like childhood leukemia and some cancer conditions. Apart from this, stem cells have been the center of attraction as far as contemporary pregnancy related medical research is concerned, with conclusive evidence for scientists to believe that stem cells can also be employed in successfully tackling several diseases in the distant future of a human life.
The relation between stem cells and pregnancy is pretty evident from the fact that in just a matter of nine months, stem cells let the embryo progress into a grown baby! These stem cells are mostly found in appreciable counts in the blood flowing through the umbilical cord. The contribution to disease treatment results from the practice of harvesting stem cells at the time of the birth of the baby, separating them from the blood samples, deep storing them for periods as long as two decades and then using these stored stem cells as and when the concerned person falls prey to a disease through the course of his/her lifetime.
During the pregnancy when a woman is 10 weeks pregnant and especially in the last stages of pregnancy, they have some blood tests conducted on them so that the medical experts can determine whether the baby’s stem cells would be healthy enough to be stored. Also, the medical examiners and analysts have to determine whether there would be chances of cross contamination of blood samples and decide thereafter. Generally, these tests are conducted around a month before the expected delivery date of the child. If the doctors opine that storage of the stem cells of the baby would be fine, then the stem cell storage company you pick sends in a sterile collection kit. Your midwife uses this kit to collect blood from the umbilical cord. This sample is sent over to the laboratory where the stem cells are separated from the blood, frozen and stored as per the established guidelines.
Pregnant ladies find a lot of comfort in the thought that a little consideration at the time of pregnancy could help them guard their babies against the possibilities of being afflicted by serious diseases in the future. Naturally, stem cell storage banks are required to store the baby’s stem cells for such a long period. The fact that the few cells taken from the baby’s cord blood can possibly save the life of the baby, a sibling and even the parents at some point in time in the future means that stem cell banks are flourishing. Among the diseases that stored stem cells can work against are acute leukemias, autoimmune diseases, chronic leukemias, congenital immune system disorders and histiocrytic disorders.
Stem cells hold much promise in bringing about medical breakthroughs in form of treatment for previously incurable diseases and conditions like cancer, Alzheimer’s disease, Parkinson’s disease or paralysis. These “blank” cells are capable of self-rejuvenation and also transforming into a functional cell; it is these attributes of a stem cell that make them invaluable to scientists. However, to experiment on the stem cells, they must at first be obtained and the mode of collection is where the controversy originates. There are two main types of stem cells, embryonic and adult stem cells. In order to collect the pluripotent embryonic stem cells, the human embryo must be killed as it can only be extracted from the innermost cellular layers of the blastocyst after just four days of fertilization. It is therefore not hard to understand as why killing a human embryo, which could have otherwise been borne as a human baby, is considered equivalent to murder by a lot of people. Even people who would not go as far as calling it murder, usually admit to the procedure being disturbing in terms of ethics at least.
Adult stem cells come from various sources and contrary to what the name may suggest, it does not only come from fully grown human beings. It is just that they are comparatively grown and different than the embryonic stem cells. The placenta and the umbilical cord blood are both rich sources of adult stem cells, the former being even richer than the latter. Our bone marrow contains multipotent stem cells and it is possible to extract these cells clinically, but the procedure is immensely painful for the donor and may even be considered risky. Unlike the extraction of the embryonic stem cells, extracting adult stem cells is not controversial. Ethicists do not support the killing of an embryo for the sake of medical progress, however bright the future may seem, but bio ethicists do understand the importance of stem cell experimentation and thus do not consider extraction of adult stem cells from various sources to be unethical as long as it is agreed upon voluntarily by the donor or the guardian of the concerned source.
If the question is read as an inquiry to the origin and the natural location of stem cells, then the answer would be that it comes from various tissues of the human body. Stem cells in an adult human being are found in the heart, blood, bone marrow, skeletal muscles, skin and fat as well. After a baby is born, the placenta and the umbilical cord are also found to be rich in stem cells. The placenta however, is much richer in stem cell count than the umbilical cord blood. Embryonic stem cells are among the first cells to develop because it is these that construct all the other tissues and thus the organs, bones, nerves and everything else in our body eventually, by converting into specifically functional cells.
The key factor about stem cells is that they are capable of constant rejuvenation through mitotic cell division and since they are not functional cells, they can transform into any specific type of functional cell, depending on the requirement of the body. Studies related to the possible uses of stem cells in various medical procedures is achieving greater importance with every passing year as scientists keep publishing journals on how the progress is going to improve treatment facilities dramatically. From the ability to repair almost any damaged organ to eliminating previously incurable diseases like cancer or Parkinson’s disease, it all seems to be in our reach in the near future. In order for the experiments to be successful, scientists must collect necessary amounts of stem cells from various sources. Embryonic stem cells are collected directly from the inside of the blastocyst, roughly a week or so after the egg cell is fertilized, and it is for that reason it is called unethical and have given rise to controversies regarding the extraction of embryonic stem cells. The germline tissues of the abandoned fetus are also a source of stem cell collection. Umbilical cord blood and placenta are the two other sources for collecting adult stem cells. Although not as pluripotent as the stem cells inside an embryo, the adult stem cells are also extracted by scientists from tissues and bone marrow of individuals for different purposes.
Magnetic stem cells are one of the latest breakthroughs in the field of medical science as they are believed to hold the potential for next generation cell-level treatment procedures. Stem cells would soon be injected into the patient’s blood stream to treat and cure heart diseases and vascular problems and the theory is to deliver the special stem cells to the area of the injury or disease by guiding them from outside. The magnetism of the cells is what will allow the experts to control the movement of the reparative cells with the help of magnets, once they are injected into the patient’s body. Scientists have already been successful at directing the magnetized stem cells to the exact area of damage in animals, but the technology is yet to be tried on human beings.
The first part of the procedure involves applying sufficient magnetic nanoparticles on the stem cells to magnetize them, and thus make them controllable. Secondly, these special stem cells are now inserted into the blood stream of the subject with the help of an injection. The final and the most important part of the medical procedure begins next as experts now try to control the direction of the injected magnetic stem cells with the help of a magnet in order to lead them towards the accurate area of the heart damage or anywhere else inside the vascular system for recovery. MRI scans in the USA make use of the same nanomagnets to attain better results already. It is to be noted that the use of magnetic stem cells has a very broad spectrum as far as medical prowess is concerned. From cell therapy to targeting cancerous growths, the scope of using the nanomagnets on stem cells is plenty for repairing the diseased and the injured tissues from inside the body.
Before going ahead and explaining the possibilities that are on the verge of development based on the regenerative capabilities of a stem cell, let us first understand what a stem cell is actually. Stem cells are the basic group of cells that have the extremely potent capability of regenerating themselves. The process through which they regenerate themselves is known as mitotic cell division and after the division, the previously unspecialized cells turn into specialized cells for specific organs through cellular differentiation. These cells are not found in unicellular organisms, but are found in varying quantities within all multi cellular organisms. Embryonic stem cells and adult stem cells are the two types of stem cells that are present inside all mammals naturally. The function of the embryonic stem cells is to differentiate and form all of the embryonic organs and tissues. As adult stem cells, they are more given towards repairing organ cells, but they constantly contribute to regeneration by helping the natural renewal of skin and blood.
As the stem cells in a human being possess regenerative properties along with the ability to form specialized cells, they have been a great prospect for achieving ground breaking technological progress in the field of medical science since 1960, when Ernest A. McCulloch and James E. Till started it all in the University of Toronto. The study on cell culture has allowed us at the moment, to control both the growth and differentiating property of certain stem cells, which subsequently can be used to create specialized muscle and nerve cells. Now that medical science is able to incorporate autologous transplantations and stem cell culture successfully up to a small extent, the prospects in the next decade look bright for the field.
Somatic Cell Nuclear Transfer is commonly called “cloning” and it is with cloning that some of the greatest medical breakthroughs of the future might rest. This is a laboratory process which involves removing the nucleus of both the somatic cell and the egg cell, but the difference lies in the fact that in case of the non-reproductive cell, only the nucleus is retained, while in case of the egg cell, only the nucleus is discarded. The nucleus of the somatic cell is now entered inside the egg cell as a replacement for the nucleus that was removed earlier. On accepting the nucleus, the fertilized cell starts to divide after the required stimulation. The blastocyst that forms through the series of mitotic divisions can now be called a “clone” or a genetic duplicate of the host. The use of this procedure is multifaceted and holds great promise for the future. If the SCNT procedure was performed successfully to create the stem cells responsible for a particular type of disease, then it would be so much easier to study the disease and know almost everything that there is to know about it. This extensive knowledge gained could then be used to device a cure for that particular disease or genetic disorder. If it is possible to create customized cells, then a very important step could be taken in matters of medical transplantation. The most common problem with cell-based treatments is that there remains a chance that the immune system of the patient may reject the procedure, but if SCNT is implemented successfully in the near future, even entire organ transplants would not be rejected as it would be made from the stem cells of the patient itself. Human cloning does come to mind while observing the pattern of the procedure but it is a far more complex process than cloning a sheep (Dolly). Although it is considered by some to be too complicated, others believe that stem cells hold the key to human cloning in the coming years. It all seems unreal, but it will be a reality in the future in many branches of medicine, including dentistry.
“Induced pluripotent stem cells” or iPSCs is another technology that is based on the ongoing research about possible uses of the stem cell’s properties now and in the future. This is a technique that involves making a somatic cell of the body; behave like a pluripotent stem cell by genetically manipulating it. The iPSCs have most things in common with the natural stem cells in terms of teratoma structure, chimera structure, embryoid structure along with the differentiability and the ability to regenerate. One problem that might arise while using the iPSCs is the chance of these converted pluripotent cells turning out to be cancerous in nature because of the genetic engineering that they go through. This is one of the biggest barriers that stand in front of therapeutic initiation of iPSCs in human beings, but in 2008, a scientific journal suggested ways of countering and completely removing oncogenes. The appropriate implementation of the technique as well as the entire procedure is still a few years away, but hopes are that by 2020, medical experts will be able to do all of this successfully.
We have touched a portion of the popular forms of research on stem cells that is going on today to yield results for tomorrow, let us now consider some final adaptations of those techniques in medical science that we can expect by the year 2020.
1. Alopecia or Baldness – Hair loss is a common problem that men and women suffer from all over the world, but the reasons may differ from individual to individual though. As premature baldness is a seriously undesirable effect, entire industries of hair care products and hair treatment centers have come into being, but the technology to initiate dependable hair growth is yet not available to us. It is believed that by the year 2020, growth of new hair from the scalp and restoration of old malfunctioning hair follicles can be made possible through developments on stem cell research.
2. Regeneration of external body parts (limbs) – It may sound farfetched at this moment, but due to the discovery of the P21 gene, it might just be possible in the year 2020. The function of this cell is to prevent cancerous growth when the DNA of the cell is damaged, but by controlling P21, it might be possible in the future to make the cells grow in a regenerative fashion, instead of growing in a cancerous manner. It may even be possible to repair brain cells with this procedure.
3. Regeneration of hearing abilities and teeth – Deafness is a result of malfunctioning or damaged cochlear and vestibular hair cells that are found within our inner ears. It might be possible to repair or re-grow these hair cells through inducing stem cells with proper stimulation. Although it is a success with mice already, human beings might have to wait till the year 2020 to actually benefit from this method. Expected also by 2020, is tooth regeneration. Fillings will no longer be necessary and artificial teeth will become obsolete as well, because stem cells and scaffold matter, with the assistance of signaling molecules, should allow doctors to grow perfect teeth that can replace old and rotting ones from the gum.
4. Organ transplantation – The most anticipated breakthrough that medical science hopes to achieve by 2020, is the ability to grow an entire organ fit for transplantation to the patient. Heart is the priority, but liver, kidney, lungs and other organs will also be safely transplantable once the stem cell technology reaches such a level that medical science is not limited to only growing specific tissues, tendons and cartilages. If growing an organ using the stem cells of the patient itself becomes possible, then the results could be globally influential. No one will need to donate their organs to save someone and the costs of transplantation would also come down to a more affordable level. Furthermore, the possibility of immune system rejection will also be nullified. Naturally, this would bring down the death rate among human beings due to organ failure to a remarkable minimum.
A study conducted by Italian scientists at several institutes has shown that stem cells derived form fat have a major potential in reconstructive and plastic surgery. The Italian researchers have shown that stem cells derived from fatty have the potency of other stem cells which could also make them useful for other applications including treatment of a large number of conditions. The research has been conducted on stem cells derived from adult fat tissue that was obtained from patients who underwent a lipoaspiration (removal of fat deposits by surgery).
The Italian scientists are very excited about their discovery not only because they were able to show that adult fat cells could be an important source for stem cells but also due to the fact that they can be found in large quantities and easily obtained from patients who undergo lipoaspiration. Dr. Stefami Bucher (San Gallicano Institute) and Dr. Rita Falconi (Regina Elena Cancer Institute) have concluded that fatty tissue is very similar to bone marrow in many biological aspects which can make stem cells derived from adult fat cells useful for reconstructive and plastic surgery. Dr. Falconi emphasized that therapy with stem cells from fatty tissue could be particularly helpful for cancer patients who undergo mastectomy (surgical removal of one or both breasts). Dr. Faconi believes that this method could significantly shorten the period of recovery and subsequently improve the patient’s quality of life (no constipation issues like green poop or black poop).
Dr. Camillo Ricordi (University of Miami’s Cell Transplant Center and Diabetes Research Institute) has also said that stem cells derived from fatty tissue have the potentials for applications other than plastic and reconstructive surgery implying that they may be very useful for treatment of many conditions including those affecting the muscle, kidney, liver, cardiovascular system, bones, pancreas and the nerves. However, Dr. Ricordi also emphasized that further studies are required before treatment with stem cells derived from fatty tissue will become available in clinics.
The President and CEO of Emerging Healthcare Solutions Inc. (EHSI) Cindy Morrissey has stated that China is slowly becoming the world’s leading power in research and development of stem cell technology. Chinese authorities have been supporting and encouraging both research and development of stem cell technology over the recent years which is why some of the most revolutionary achievements in the field of stem cells are reported from China rather than Western countries.
Early in December 2010, a four year old girl named Izabelle Evans from the United Kingdom has returned from China where she has received a stem cell therapy. Izabelle suffers from a rare disease acquired at birth that causes blindness. Instead of million nerves that are necessary to see, Izabelle had few hundred only. Her parents have taken her to China where she received stem cells derived from umbilical cord from healthy babies. Izabelle, that was completely blind before receiving stem cell treatment can today see three feet in front, while her parents believe that another stem cell therapy could additionally improve the sight of their 4 year old daughter.
Morrissey has stated that she intends to visit China soon in order to meet with Chinese leading scientists in the field of stem cell technology and perhaps even open an office in China. In this case, the EHSI could significantly increase its global influence. Recently, it has acquired Celulas Genetica – the leading stem cell company in Central America and opened its offices in Germany and Poland in October 2010. The company is currently also working on gaining of a license for a NASA bioreactor that enables multiplication of stem cell derived from adult tissue. The company is convinced that stem cells from obtained from NASA bioreactor could be used to treat tissue damaged by a disease or injury.
Blood can be divided into two parts basically, the plasma and the blood cells, each of which constitutes about half of the total blood volume. The two parts are defined as follows:
1. Plasma – Plasma constitutes about 55% of the total blood volume and comprises of 92% water roughly. The rest includes dissolved proteins, salts, sugar, lipids, vitamins, fat, minerals, enzymes, antibodies, hormones and coagulants. Plasma provides mobility to the blood cells that remain suspended in it and it is due to the mobility which the plasma provides blood with, that the cells are able to receive oxygen and other nutrients from blood constantly, while excreting carbon dioxide and other wastes into it at the same time. Without the blood cells, plasma itself is a mostly clear, yellowish liquid.
2. Blood Cells – Blood cells can be divided into three major types, white blood cells, red blood cells and platelets.
a) White Blood Cells – White blood cells or leukocytes are rare in number and constitute approximately 1% of the total blood volume. There is more than one type of white blood cell and all of them together make up our immune system. Unlike the red blood cells which are found in blood only, the leukocytes are also found in the spleen, liver and the lymph glands.
b) Red Blood Cells – Erythrocytes (RBC) constitute almost half of the blood volume and their main function is to use the hemoglobin in them to carry dissolved oxygen to the cells and also to carry carbon dioxide from the cells for elimination.
c) Platelets – Like the erythrocytes, platelets do not have nuclei either, and their main function is to stop blood from flowing out of the vessels by releasing coagulating agents near the rupture. Release of proteins that help the immune system to fight with germs is also found to be a function of these cellular fragments recently.
Blood lactate can be defined simply as the lactate that is found dissolved in blood. Exercise that forces anaerobic metabolism instead of aerobic metabolism in an individual’s muscles and tissues due to inadequate supply of oxygen is usually responsible for the formation of blood lactate. Lactic acid is part of a system that helps the body to synthesis Adenosine Triphosphate (ATP) during extremely strenuous and long sessions of physical exercise, which is required for energy production. Through anaerobic glycolysis, it is possible to produce the energy that the body needs immediately, but is not getting through aerobic glycolysis due to lack of oxygen supply. After the glycolysis, pyruvic acid and hydronium ions (H+) are formed, but since there is a deficiency of adequate oxygen, the hydronium ions never combine with oxygen to form water. As a result the Hydronium ions deposited by the NADH remain in the mitochondria of the cell and accumulate as long as the anaerobic glycolysis continues. As the hydronium ion accumulates, the acidity of the cells also increases and in order to counter the effect, pyruvic acid and the hydronium reacts with each other forming lactic acid that dissociate into lactate and hydronium ions again. In order to reduce acidic activity, the lactate carries of a portion of the hydronium ions as it enters blood and it is this lactate that on diffusing into the blood flow with some of the excess hydronium ions is known as blood lactate. As a direct result of hydronium ion accumulation, the pH level in the cells go down from the standard 7.1 to 6.5 or even lower. This is the reason why we cannot move the particular muscle properly after heavy endurance training and also experience pain in the form of a burning sensation on reaching our anaerobic threshold.
Fat is a form of stored energy reserve and our body breaks down fat globules when there is no immediate supply of carbohydrates or energy. When our body taps into our reserved energy source, ketone bodies are formed as a result of the break down and the manufacturing is scientifically termed as ketogenesis. Lack of carbohydrates in our daily dietary schedule can result in the usage of fat and thus the formation of ketones. Ketones are also formed in blood when our system is unable to utilize the sugar in our blood and thus it must resort to breaking down fat stores. Kidney and liver are the two organs where this process of fat breaking occurs and therefore ketones are also primarily found in these two organs, while they are used mostly by the heart and the brain. Acetone and acetoacetic acid are the two main forms of ketone but beta-hydroxybutyric acid is also considered to be a ketone up to an extent. The main function of the ketone bodies is to supply the brain and the heart with energy after the fat is broken down.
A test which determines the amount of ketones present in the blood of the person is called the serum ketones test. The test is mainly done to check whether the ketogenesis within the person’s body is above the normal level, which may indicate ketosis. Ketosis is not harmful at the beginning, but there remains a chance that the frequency of ketogenesis in blood may increase further to a point when the patient’s blood might turn acidic due to a very low pH level. Such an advanced stage is termed as ketoacidosis. The chances of ketoacidosis are high among diabetic patients and thus they check their blood often for increased ketone formation.