I have developed a somewhat romantic relationship with my stem cells.
The sharp contrast between the patient, contemplative, snail-paced world of research and the rapid, consummate, expeditious world of acute medicine; makes a lot of people think you are either a researcher or an acute medic, very rarely both.
There is no trial and error when you are diagnosing a pneumothorax next to a busy road or when a child is gradually turning blue before your eyes. Unlike in the laboratory, you can't throw the cells away and try it another way. You HAVE to keep the pressure on that wound in the back of the helicopter even though you are tired and your arms hurt, you can't try again the next day, there are no spare parts in the deep freezer.
But for me, this antithesis seemed to have helped me grow; both as a physician and as a person. I've had time to reflect, to study and to write. At first, the time spent waiting for the centrifuge to stop spinning, for my PCR to process or painstaking filling at 96 wells with 10 microliters of PBS+TRYSPIN was boring to me.
However, I have learned that things don't always have to be adrenaline-fuelled to be amazing.
When my christian and muslim friends/family learned that I was doing stem cell research they expressed a great deal of concern about the ethical implications of my work. There has been a lot of controversy about stem cells research, so in this blog posting I hope to clarify some of the presumptions about stem cells and stem cell research and explore some of the associated ethical issues more closely.
Firstly, let me explain what is so special about stem cells. Well, stem cells have the remarkable potential to develop into many different cell types in the body during early life and growth. In addition, in many tissues they serve as a sort of internal repair system, dividing essentially without limit to replenish other cells as long as the person or animal is still alive.
When a stem cell divides, each new cell has the potential either to remain a stem cell or become another type of cell with a more specialized function, such as a muscle cell, a red blood cell, or a brain cell. Stem cells are distinguished from other cell types by two important characteristics. First, they are unspecialized cells capable of renewing themselves through cell division, sometimes after long periods of inactivity. Second, under certain physiologic or experimental conditions.(Ref: http://stemcells.nih.gov/info/basics/basics1.asp)
Perhaps the most important potential application of human stem cells is the generation of cells and tissues that could be used for cell-based therapies. Today, donated organs and tissues are often used to replace ailing or destroyed tissue, but the need for transplantable tissues and organs far outweighs the available supply. Stem cells, directed to differentiate into specific cell types, offer the possibility of a renewable source of replacement cells and tissues to treat diseases including Alzheimer's diseases, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis, and rheumatoid arthritis.
Stem cells are largely divided into two categories: i) Embroyonic stem cells ii)Somatic/Adult stem cells
The term adult stem cell refers to any cell which is found in a developed organism that has two properties: the ability to divide and create another cell like itself and also divide and create a cell more differentiated than itself.They can be found in children, as well as adults.
Pluripotent adult stem cells are rare and generally small in number but can be found in a number of tissues including umbilical cord blood. A great deal of adult stem cell research has focused on clarifying their capacity to divide or self-renew indefinitely and their differentiation potential.
The use of adult stem cells in research and therapy is not as controversial as embryonic stem cells, because the production of adult stem cells does not require the destruction of an embryo.
The controversy, for the most part surrounds embryonic stem cells the central question comes at the intersection of two primary opposing viewpoints: the high esteem for human life and the right to it, on the one hand; and the desire to alleviate human suffering on the other. While these two ideas are not in themselves contradictory, in this particular case it is impossible to satisfy one without violating the other.
One evening , some time ago, I was working in the emergency room, when I heard news that a child had been badly burnt in a fire and the paramedics were bringing him to our hospital. Nothing prepared me for what I saw. In the UK, I think because junior doctors don't generally do as many nights/long hours we are shielded somewhat from these things.
I received my baptism of fire as the smell of burnt flesh filled my nostrils, screams from a hysterical mother pierced through my eardrums chilling me to my very soul, I helped assess the patient on ALTS autopilot as my trembling hands brushed against his hard, charred broken skin. He was only 4 years old. Children are fighters. He survived after over 5 months in hospital/burns unit. But the resultant deformity was devastating.
The stem cell research done in our lab, has helped to Japanese pharmaceutical company JTEC develop a novel cultured epidermis that can be used to save the lives of patients with severe burns and reduce the resultant deformity.
When 1 in 3 embryo's are lost due to chance anyway, is it is justifiable to use cells derived from an embryo with a 30% percent chance of developing into a baby to safe the life of this beautiful child, the victim of a catastrophic accident?
I have a 7 year old on the ward that needs a heart. She has a rare form of cardiomyopathy. She is native Japanese and therefore according to some research genetically superior to me. I'm in my 20's therefore by some standards have lived a good life. She hasn't had a chance yet. We are a tissue match. If her parents used these justifications to ambush me on my way home from work and steal my heart (of course this is an extreme factious example to demonstrate a point) for their daughter, everyone would say it was a crime.
Is this really tantamount to what we are doing when we kill embryo's for embryonic stem cell research?
Food For Thought.
For the record, my research is with adult stem cells and induced pluripotent stem cells. I have never used embryonic stems cells, but I do believe they have a role to play in medical research.
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