Kelsey D.

Brixey

Professor Russell Thomas

English 1201.525

April 2, 2019

The Future of Medicine

Parkinson’s disease affects thousands of people every year. Spinal cord injuries can be a

killer. Alzheimer's takes so many family members away from us, yet what if there was a

solution. Stem cells are a kind of cell that hasn’t decided what part of the body it is going to be

specific to. Scientists believe this could be a monumental discovery for people with diseases that

result from a cell deficiency. However, there are still millions of questions to be answered. For

example, how would a successful stem cell transplant occur, are there any harmful aspects, and

how do we obtain stem cells? Although there are currently trials being conducted to help us

understand these questions, some people have a lot to say about the issue. By looking at the facts,

stem cells can ultimately help treat diseases, are not harmful to transplant or take from people,

and can help change the face of medicine in the near future.

Before starting off with what stem cells are, it is important to understand that right now,

stem cells are mostly just being researched. There is a whole myriad of new possibilities that

could be introduced with the help of stem cells. As said above, stem cells could potentially give

us cures to diseases we thought were incurable. That is a huge step in medicine. The reason

scientists have been stuck in this research period for such a long time is because it is very

controversial. After learning about everything that stem cells can do in place of medicine or other

treatments, people might start to change their minds.

 Stem cells can be defined as cells that have not yet chosen a specialty, or are able to go

back and change what their main job is. The article “Stem Cell Research” introduces the readers

to the two different kinds of stem cells. Typically the two different kinds are referred to as

embryonic or adult stem cells. Embryonic stem cells can be given two titles, one being totipotent

and one being pluripotent. The totipotent cells are the ones that have the ability to choose what

kind of cell they would like to be in the body. These are the most ideal cells because scientists

are potentially able to manipulate them to become the kind of cell they want. Pluripotent cells are

basically the same thing, except they do not have the potential to become the cells that form a

baby. Adult stem cells are different just because the person housing the cells have matured past

the fetal stage. The American Association of Neurological Surgeons (AANS) writes, “adult stem

cells are called multipotent because they can become one kind of a certain type of cell, but not

any type of cell.” This means that a cell that is specialized in the blood, specifically a red blood

cell, can become a white blood cell, but not a brain cell. All of these different kinds of stem cells

are vital to the understanding of stem cell research.

In 2009 Barack Obama lifted the ban President Bush set on stem cell research. This was a

memorable day for scientists all over the world because they now had the freedom to conduct the

research they wanted again. In 2005 the National Institutes of Health spent $693 million on stem

cell research, compared to a growing $938 million in 2009 (Svoboda). This just goes to show

how hard scientists are trying to find a way to use stem cells in humans. Also in 2009, the

number of Americans in favor of stem cell research was an astonishing seventy-three percent

(Svoboda). This is a growing number compared to the fifty-eight percent of people in 2005

(Majority of Americans). Just as the amount of money being put into stem cell research is
growing, the amount of support for the research is also growing. More and more people are

becoming aware and seeing the beneficial side to stem cells.

So far a very successful and very common transplant of stem cells is also called a bone

marrow transplant. These transplants are often done on children with cancer or people with

sickle cell disease. Bone marrow transplants have been around a long time and have helped so

many people. It is a painful process, to both the donor and the patient, but proves to be beneficial

in the end. This process is done by giving the patient a high dose of chemo/radiation and then the

stem cell transplant. The cells are injected into the blood and then make their way to the bone.

The blood “is delivered through a catheter — a thin flexible tube — into a large blood vessel,

usually in your chest” (Stem Cell Transplantation). A bone marrow transplant is similar to the

stem cell transplants talked about in this essay because the cells injected into the patient are

originally blood cells that make immune cells. Being that these transplants are so successful,

there is hope in the future for other kinds of stem cell transplants.

There have been several recent trials dedicated to finding ways to transplant stem cells.

Most of these trials are done on test subjects that have incurable diseases, and otherwise have no

hope. One example of a successful trial was done by Dr. Yamanaka. Dr. Yamanaka is a professor

and scientist at Kyoto University, located in Japan. Ravven interviewed Yamanaka and found out

that there has been a successful transplant on a seventy-year-old woman with retinal failure. The

patient was blind. She could not see out of either eye so she figured that she would partake in this

trial, at least there was some hope. The doctors took skin cells from the patient and went through

a process to turn them into adult retinal cells. Yamanaka says, “that was a huge success. She sees

much brighter now” (Ravven). Although this happened in Japan, Yamanaka partners with the

San Francisco State University, and could potentially bring more successful trials to the United
States. Just think of all the other life-changing transplants that can be done when doctors get a

better grip on the way stem cells work.

There was also a patient named Timothy Ray Brown that was cured of HIV using stem

cells. The way this works is that the patient's immune system is replaced with one that the HIV

virus cannot effect. Someone who was unable to contract HIV donated bone marrow, which

Brown was then able to use for his transplant. How can someone be resistant to HIV? Well, “The

person who donated the bone marrow had a genetic mutation in a gene called CCR5, which

makes a protein that is required for HIV to enter cells” (HIV). Without having that gene, the

virus was not able to infect the immune cells. The fact that Brown was able to go off of his

medication is a huge success. More success stories like these are expected in the future with the

developments that have been made in science.

Just like all medications and surgeries, there is some risk. With stem cell transplants, and

any transplant, there is always the chance for infection. Bacterial infections are the most

common, but any infection can easily become dangerous, given the immune system is

compromised for about six weeks after transplants (Stem Cell Transplant). Another thing to keep

in mind after a stem cell transplant is bleeding, because the body stops making platelets due to

the chemo and radiation therapy. Platelets are what causes the blood to clot. Without these, even

a paper cut could become a serious emergency. The solution to this is to simply follow

precautionary procedures to make sure you’re not doing any heavy lifting, vigorous physical

activity, etc. There are simple measures that can be taken to decrease your risk of complications

after the transplant. A list of things to avoid doing will be given out by the doctor and will be

thoroughly discussed before the patient is allowed to leave the hospital.

 Before having the option for a stem cell transplant, the patient will be evaluated to see if

they meet a list of requirements. Things such as age, severity of the disease, and previous

treatment plays a big role in determining the eligibility of a patient for a transplant (Stem Cell

Transplant). Some say the worst part of preparing for a transplant is the chemotherapy and

radiation. However, there are reasons for this. Some of the reasons include: making some space

in the bone marrow for the cells, overpowering the immune system to decrease the chance that

the body rejects the transplant, and to get rid of any of the bad cells in the body. After all of this,

the patient is finally ready for the transplant. Something that surprises a lot of people is that they

are awake for this transplant, however, it is not painful. Instead of this being a scary experience,

many people are filled with joy as they are cured of their disease.

Embryos play a big role in stem cell research. Human embryos are one of the most

plentiful sources of stem cells. However, this leads to some controversy. The reason stem cells

are so abundant in embryos is because there has been nothing to make it a fetus yet, therefore

embryos do not have any specialized cells. Now of course doctors will only take embryos with

the permission of the parents, but some people are still against it. The idea that human embryos

need to be destroyed in order to more accurately research them, makes peoples stomachs turn.

Well, the fact of the matter is that if someone is not O.K with donating their embryos to science,

then they don’t need to. The whole process is only something that should be done if that family

is sure in their decision to do so. Machin and Williams write,

“When patients undergo fertility treatment, it is likely that a surplus of embryos will be

created. The majority opt to store these surplus embryos, which creates responsibilities

for the clinics where they are stored and for the people who own them. Each year, the

owners of the surplus embryos are contacted by the clinic to ask whether they wish to
 continue storing the embryos, or dispose of them, or donate to another couple to be used

in fertility treatment.”

All doctors, nurses, and other physicians will be supportive in the patient’s decision, no matter

what it is. There are plenty of informational brochures and people to talk to if someone is

struggling with making that decision.

There are so many professionals in this field of work that can help council patient’s and

their families when making the decision of what to do with their excess embryos. Some of these

professionals include: nurses, scientists, and embryologists. These careers are very valuable

because not only do these professionals treat people, they also help them in making their

treatment decisions. These people are the ones who may suggest stem cell transplants, may ask

you to donate embryos, or ask patients to give their own stem cells to science.

Besides getting stem cells from human embryos, getting stem cells from the umbilical

cord is also very common. This also makes the topic controversial because some people believe

that the cells in the umbilical cord should be stored and preserved for future use if ever needed.

By this people mean that they could potentially use the cells and the blood to be a perfect match

for someone else in their family, or even themselves. It has been found that “cord blood

transplants have distinct advantages over more traditional bone marrow transplants in stimulating

the growth of healthy white blood cells” (Stem Cell Research). This goes to show how

advantageous stem cell transplants can be.

Jenn Darby is a former RN at Baylor Hospital in Texas. She herself has gone through

IVF fertility treatments and has come out of it with a beautiful set of twins. The journey, which is

still continuing, has been long and hard. During an interview she was asked to share some of her
thoughts on the stem cell research of human embryos. When asked how she feels about the

controversy behind stem cell research, she responded with,

“It’s horrifying to me. My husband and I knew when we began the IVF process that we

would be given choices regarding what to do with leftover embryos when we are feel our

family is complete. You can use them yourself, dominate them to couples struggling with

infertility, or donate them to science and allow them to be broken apart, tested, and

researched. Donating to science is not an option to me because my babies were meant for

life, not death” (Darby).

Jenn views taking human embryos, even with permission, as something that is completely

wrong. Some people may choose to look at it this way: once stem cell research has reached a

certain level, stem cells can be used to save lives that otherwise would be lost. Stem cells open

up a whole new door in medicine, it just depends on how one looks at it.

There have been some successful trials, however when it comes to the brain, it’s a whole

different story. Being that the brain is so complex, there are a million factors to consider when

trying to manipulate the cells inside of it. There was one study where

“twenty years ago neurosurgeons tried to overcome the brain's limited regenerative

ability by slicing up sheets of fetal brain tissue and grafting them onto a diseased brain to

replace dead neurons with new ones. The resulting clinical trials were disappointing, but

some investigators think they have now worked out how to make the treatment safer and

more reliable” (Jabr).

The new information researchers think they have found it stem cells is astonishing. Instead of

trying to manipulate the neurons in the brain, they can change the identity of the cells to do a

different job. This just goes to show that all research is important. Without failures like these,
science would not be as far along as it is today. We are constantly learning from things that

didn’t work out.

Something else scientists have been working on is a gene editing system called CRISPR.

CRISPR works like this: CRISPR and its partner Cas9 is put into the body and is able to cut and

delete parts of RNA that is bad. Since stem cells have the ability to become any cell of their

choice, CRISPR can go in and take out the bad part of RNA, while stem cells are injected to

compensate for the bad piece(s) of RNA. This is a perfect tag team approach to helping to treat

all kinds of disorders. Another way that stem cells play a role in CRISPR is,

“stem cells can be generated from people with a particular condition, and then used to

produce the specialised cell types in which the disease genes have their effects (e.g. beta

globin in sickle cell anaemia ). Researchers can then investigate the influence of the

disease gene on cell function. Sometime the cells can be directly used in chemical

screens, searching for new small molecules - potential drugs - that could prevent the

disease” (Dong).

This simply means that stem cells can also aid CRISPR and Cas9 in finding the parts of the RNA

that need cut. All kinds of cool things are happening in the science world, but at the core of it all,

is stem cells.

As it was talked about before, there is a lot of controversy behind stem cell research.

Some people are all for it, others, not so much. A huge reason to why this is such a big deal is

because of religion. People believe that God wants every life to grow, even if it is just an

embryo. Everyone has a right to their own opinion and no one is here to judge. Doctors make it

very clear when suggesting donating excess embryos, that in no way are they pressuring the

families. It is actually a very prestigious process. It is said that,

 “every participant was sent a consent form and a participant information sheet via email

before the interview took place to ensure that they were aware what the interview

involved and give them the opportunity to ask any questions regarding the study or their

participation” (Machin).

During the interview, patients are allowed to withdraw consent at anytime. Doctors and other

physicians really just want what is best for their patient. If the patient is willing to donate to

science so that they could potentially help other people in the future, that’s great. If not, that is

perfectly fine too, it is all up to the patient.

One thing that is really important to understanding stem cell research is that as of right

now, it is mostly research. The people researching all of this stuff can only research. They can

not force anyone to take part in a trial, they cannot just pull money out of the air to conduct

research, this is a something that involves communities. It takes people willing to take risks and

sign up for trials. It takes people willing to donate money to research. This has always been

about the people. The whole reason stem cell transplants are being looked into is so that

physicians can help more people with more serious issues. Stem cell research can only lead to

bigger and better things.

In conclusion, stem cells can do so many things for this world. All it takes to make it

happen is research. Research means saying yes when the outcomes aren’t clear. It means saying

yes when all the answers are pointing to no. Scientists have that brain power, and in order for the

public to help them, everyone needs to get in that mindset too. Stem cells have the potential to

change the world. When looking at how stem cells can be used to treat diseases, are not a major

risk, and the ability for it to change the face of medicine, how can people not be in favor? The

only thing holding researchers back, is the controversy. As discussed before, stem cells cannot be
fully explored without the donations patients make to the research. If there are people that are

against it, that is perfectly fine, however, don’t try and talk others out of it. Stem cells can be

used to treat major diseases. There have already been successful trials, and scientists are now

working to transplant stem cells to the brain. With a few more years of research, there could be

something very big in our future. As someone once said about the movie Evolution of Stem Cell

Research, directed by Mark Davis, “in a place invisible to the naked eye, lies the cornerstone of

human life.”

(Stem Cell Therapy)

 This picture accurately shows the significance of the different kinds of stem cells.

Totipotent stem cells are the most resourceful, all the way down to the different kinds of

pluripotent stem cells.

Works Cited
Carvalho, Ana Sofia, and João Ramalho-Santos. “How Can Ethics Relate to Science? The Case

of Stem Cell Research.” European Journal of Human Genetics, vol. 21, no. 6, June 2013,

pp. 591–595. EBSCOhost, doi:10.1038/ejhg.2012.232.

Darby, Jenn. Personal Interview. 28 February 2019.

Davis, Mark. The Evolution of Stem Cell Research, directed by Mark Davis. Imdb.com, 2014,

https://www.imdb.com/title/tt1713545/.

Gknation. “Stem Cell Transplantation.” Stem Cell Transplantation | Leukemia and Lymphoma

Society, 26 Feb. 2015,

www.lls.org/treatment/types-of-treatment/stem-cell-transplantation.

“HIV/AIDS Fact Sheet.” California's Stem Cell Agency, 26 Mar. 2018,

www.cirm.ca.gov/our-progress/disease-information/hivaids-fact-sheet.

Jabr, Ferris. “Replanting the Brain’s Forest.” Scientific American, vol. 308, no. 4, Apr. 2013, pp.

55–57. EBSCOhost, doi:10.1038/scientificamerican0413-55.

Liu, Dong. “CRISPR - Changing the Gene Editing Landscape.” Eurostemcell, 1 Oct. 2015,

www.eurostemcell.org/crispr-changing-gene-editing-landscape.

Machin, Laura L., and R. A. Williams. “Interprofessional Spanning and Building Boundaries

When Supporting Potential Embryo Donors to Stem Cell Research.” Journal of

Interprofessional Care, vol. 31, no. 3, May 2017, pp. 342–350. EBSCOhost,

doi:10.1080/13561820.2016.1253546.

“Majority of Americans Back Embryonic Stem Cell Research.” Research!America, 17 Mar.

2015,

www.researchamerica.org/news-events/news/majority-americans-back-embryonic-stem-c

ell-research.
“Medicine.” Chicago : World Book, 2009.

Ravven, Wallace. “The Stem-Cell Revolution Is Coming - Slowly.” The New York Times, The

New York Times, 22 Dec. 2017,

www.nytimes.com/2017/01/16/science/shinya-yamanaka-stem-cells.html.

“Stem Cell Research.” AANS,

www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Stem-Cell-Research.

“Stem Cell Therapy | Arizona Pain Regenerative Institute - Scottsdale.” Arizona Pain

Regenerative Institute, arizonapain.com/regenerative/treatments/stem-cell-therapy/.

“Stem Cell Transplant Side Effects.” American Cancer Society,

www.cancer.org/treatment/treatments-and-side-effects/treatment-types/stem-cell-transpla

nt/transplant-side-effects.html.

Svoboda, Elizabeth. “THE ESSENTIAL Guide to Stem Cells.” Popular Science, vol. 274, no. 6,

June 2009, pp. 60–66. EBSCOhost,

sinclair.ohionet.org:80/login?url=https://search.ebscohost.com/login.aspx?direct=true&d

b=hxh&AN=39363877&site=ehost-live.