Intrauterine stem cell therapy (IUSCT) refers to treatment of a variety of fetal genetic disorders thought transplantation of either allogenic or genetically modified autologous stem cells. Stem cells become incorporated into the recipient tissue to start proliferation and differentiation through their pluripotent or multipotent potential to compensate for the missing or defective protein. This could be useful in treating fetal genetic disorders which are considered to be perinatally lethal or associated with significant disability and morbidity if intervention is delayed to postnatal period (1).
Recent advances in prenatal diagnostic techniques have enabled early prenatal diagnosis of a wide variety of genetic disorders. IUSCT has the following advantages over postnatal therapy: the immune system of the fetus at early gestation is still immature; which is the basis for the unique immunologic tolerance phenomenon described many years ago (2). Such tolerance allows incorporation of the donor stem cells (engraftment) without need for myeloablation or use of immunosuppressors. Also, the sterile environment inside the uterus facilitates remodeling of the fetal immune system (3). Another major advantage of IUSCT is small size of the fetus at early gestation compared to postnatal size allowing transfusion of higher concentrations of stem cells (4). These factors contribute to the promising potential of IUSCT in managing wide variety of genetic disorders.
Two main routes have been
The first type of stem cell, an embryonic stem cell, is known for being able to continuously multiply, as well as for being pluripotent. They can be “derived in vitro from the blastocyst of an embryo usually left over from in vitro fertilization” (Forraz & McGuckin, 2011, p.61). Unlike other types of stem cells, embryonic stem cells have yet to be used in any kind of clinical treatment of patients. The high risks of “immune rejection” or “teratoma formation” are serious obstacles (Harris, 2009, p.182). The second type of stem cell, adult stem cells, is primarily considered to be multipotent and may be found in “specific adult human tissues” such as the skin or bone marrow, just to name a few. Over the last twenty years, the amount of scientific research and trials using adult stem cells has grown significantly, despite their lower potency than embryonic stem cells (Forraz & McGuckin, 2011, p.61). Lastly, cord blood stem cells, are technically considered to be a special type of adult stem cell, but their youthful properties give them “greater restorative and regenerative potential.” Directly following the birth of a child, these stem cells can be collected from the blood in the umbilical cord (Steenblock & Payne, 2006, p.9). Embryonic, adult, and cord blood stem cells
Stem cells are grown on Petri dishes in a laboratory and are never implanted in a woman’s uterus. These cells can be used to create stem cell lines that can grow indefinitely under optimal conditions (“Stem cells and diseases,” 2011). Embryonic stem cells can be obtained from existing stem cell lines (any group of cells that came from the same original embryo), aborted or miscarried embryos, unused in vitro fertilized embryos, and cloned embryos created from somatic cell nuclear transfer (the nucleus from an unfertilized egg is removed and replaced with a nucleus from an adult stem cell). This technique would be used for therapeutic cloning, which could grow organs or skin grafts for patients. However, the only research that is federally funded are a few embryonic stem cell lines created from unused embryos at in vitro fertilization (IVF) clinics before 2001 (Dunn, 2005; “Embryonic & fetal research laws,” 2008; Therapeutic cloning, 2009). These lines are not enough to allow scientists to fully explore and take advantage of potential findings.
As technology advances, the use of embryonic stem cell research has also expanded. Stem cells have shown promise in personalized medicine as they are undifferentiated and easily conform with the surrounding cells. There are two areas of research that stem cells are showing massive potential, cell regeneration and organ transplantation. It is thought that stem cells have the capability to “model genetic disorders in a reliable fashion such that no other method allows. It seems likely that we could use stem cells to model cells with genetic disorders and figure out how to mute certain genes, thus eliminating or drastically reducing the effects of the disease,” (1). Although embryonic stem cells (ESC) are showing great potential towards medical advancements, there are many people who are opposed to the idea of using these cells due to the aggressive nature in which we extract ESC.
There exist many reasons why a couple would be unable to have a child. A significant factor in this sterility is uterine factor infertility, affects 3-5% of women, rendering them unable to bear their own children (Caplan 682). Uterine factor infertility can come about as the result of any number of conditions, ranging from complications in previous pregnancies to infection to congenital disorders such as Mullerian Agenesis, in which a woman is born without internal reproductive organs (Lftkowitz et al. 440). In the past, persons affected by this condition would have few options apart from adoption or surrogacy. Now there is a new option available to these women. Recent advances in medicine have created the possibility of transplantation of many organs that used to be considered difficult or impossible to transplant, such as hands and faces. Doctors in Sweden have pioneered a technique to transplant a uterus from a healthy patient into one who is unable to bear children (BBC). They have successfully transplanted healthy uteri from donors into patients with uterine factor
Unexplained infertility and recurrent spontaneous abortion (RSA) are current problems in healthcare. Infertility, which is the inability to produce a child over a one-year period while living with one’s spouse or significant other, is increasing and can be due to delayed childbearing, increased pelvic infections, and lower quality of sperm (Isaksson & Tiitinen, 2004). Many women turn to in vitro fertilization (IVF) to aid in pregnancy; however, with a 30% live birth rate, even women treated with IVF experience repeated inability to become pregnant (Li, J., Chen, Liu, Hu, & Li, 2013). This is defined as failed implantation following the transfer of an embryo (Li, J., Chen, Liu, Hu, & Li, 2013). Some women successfully become pregnant following IVF, but experience spontaneous abortion during the pregnancy. Treatments for unexplained infertility and RSA have surfaced, but questions arise as to whether or not the treatments truly affect pregnancy outcomes. Intravenous immunoglobulin (IVIG) is a treatment that has been used to aid in successful pregnancy during IVF cycles (Virro, Winger, & Reed, 2012). Therefore, the question
How is the therapy done? Cellular therapy is usually performed in one of two ways. First, fetal animal cells (either fresh or frozen) can be injected or administered intravenously directly into the patient. If the fetal cells have been freshly removed from the animal, then they are suspended in an isotonic salt solution and injected into the patient. Frozen cells, which have been either lyophilized or frozen in liquid nitrogen, are generally screened for viruses and bacteria before they are injected since they do not have to be used immediately (U.S. Congress, 1990). Medra, Inc. refers to this method as Fetal Stem Cell Therapy, and claims that "rarely has a single treatment modality offered so much
It's true that this stem cells cure damaged cells. But it comes with a price. Why kill embryo to cure other human being. We should consider that that embryo is another human too. There should be another alternative as always. We should start thinking and try to come up with another solution, so that both the embryo and the person could survive.
1. How much time and money should be spent on a therapy that may only work after “years of intensive research”? Would this money be better spent on therapies that have a higher likelihood of success?
When parents have a child that has some type of life threatening disease, they want to do everything possible to save their child’s life. Stem cells from umbilical cord blood offer a last resort for many parents in order to save their child. To obtain the genetically matched stem cells, parents look toward medical technology in the shape of pre-implantation genetics disease. Pre-implantation genetics is where there is a genetic survey of embryonic cells prior to their implantation into a uterus. Its advantage is to screen for genetic diseases prior to implantation to prevent abortion. Many parents of critically ill children look to pre-implantation genetics to provide biological material to effect a treatment or cure of the older sibling. The pre-implantation genetic egg will become a donor sibling. The donor sibling is intended to save the life of the sick child by donating umbilical cord blood or bone marrow. The donor sibling is like a savior sibling.
Advances in medical technology are making it possible for people to get treatment for conditions that were previously either difficult to treat or that required highly invasive surgery. Now, minimally invasive methods of treatment are being developed so that patients who do not have severe or life-threatening health conditions may be able to find relief without the risks and rehabilitation that accompany surgery. One example of a technology that is revolutionizing the field of orthopedics is stem cell therapy, which is a form of regenerative medicine.
Human embryonic stem cells (ESCs) are pluripotent cells isolated from blastocysts, and are highly useful in studying human development (Itzkovitz-Eldor et al., 2000 p. 88). Although the National Institute of Health states that “it is not known if iPSCs and embryonic stem cells differ in clinically significant ways”, iPSCs are already being used to achieve the same results as ESCs in some applications without the use of embryos, removing the ethical concern associated with ESCs (National Institutes of Health, 2009). ESCs are capable of differentiating into all cell types, and can be used as a source of differentiated cells. In the report by Itskovitz-Eldor et al., they discuss the induced differentiation of ESCs in suspension into embryoid bodies, including the three embryonic germ layers. The authors state that “the ability to induce formation of human embryoid bodies that contain cells of neuronal, hematopoietic and cardiac origins will be useful in studying early human embryonic development” (Itzkovitz-Eldor et al., 2000 p. 88).
Research on stem cells has indicated new possible therapies and treatment for people with conditions that were once considered terminal. Parkinson’s disease, Alzheimer 's disease, and multiple sclerosis are a few of the many diseases that stem cells might be able to treat. Stem cells have the capability to repair heart muscle and neural tissues, improving the overall prognosis of the patient. For example, hematopoietic stem cell transplantation and mesenchymal stem cell therapy have shown promising results in clinical trials in reducing the effects of multiple sclerosis (Holloman, Ho, Hukki, Huntley, & Gallicano, 2013). Although stem cells show potential in their capability to treat diseases, the cells are delicate, limiting the success of research and clinical trials. Meanwhile, stem cells need to be differentiated from the other tissues of the body, presenting a challenge of marking the cell while also maintaining their viability. Several imaging technologies are being utilized to progress stem cell therapies. Such modalities include “positron emission tomography (PET), computed tomography (CT), single photon emission CT (SPECT), ultrasound (US), bioluminescence imaging (BLI), fluorescence imaging (FLI), [and] magnetic resonance imaging (MRI),”(Cho, Wang, Mao, & Chan, 2016) while “MRI and PET are the most widely investigated and developed”(Cho et al., 2016). Each imaging modality has their own advantages and disadvantages for delivering and tracking stem cells. Tracking
The human body is full of hundreds of special types of cells that are essential for ones every day health. These special cells are accountable for keeping our bodies going daily for instance making our brains think, hearts beat and, restoring our skin cells as they shed off. Stem cells are the provider for the development of new cells. “Stem cells have the amazing potential to expand into many different cell types in the body during early life and growth” (stemcells,2015). These cells in fact can also work as repair cells in many tissues helping repair cells in any living animal or human. As the stem cells eventually divide they will either remain a stem cell or convert into a
Birth defects are the most common issues that face while conduction In-Vitro fertilization. The Controversies are whether this process contributes to sick babies or malformed babies. “Women who give