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What is a stem cell?
A layman's guide to 21st century bio-ethical dilemma

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By Julie Foster
© 2001 WorldNetDaily.com

As Americans consider recent medical discoveries pertaining to stem-cell
research and the ethical and political issues surrounding it, conversations
on the news, around water coolers and even at dinner tables have begun
including such complex terms as "DNA abnormalities," "cell differentiation"
and "somatic cell nuclear transfer."

Even President George W. Bush joined the conversation this month when he
entered living rooms around the nation via television to outline his decision
on the controversial issue of embryonic stem-cell research. The federal
government will fund research of the approximately 60 existing stem-cell
lines created by privately funded scientists.

Americans are told stem-cell research holds great promise for the curing of
such debilitating and life-threatening diseases as Parkinson's and
Alzheimer's. But how? Just what are stem cells? Where do they come from, and
how do scientists think they can help improve medical treatments?

In basic terms, a stem cell is one that can be formed into virtually any
human cell found in the body. To understand the origin of the cells, a review
of human development is necessary.

Human life is created when an ovum – the egg from a female – is fertilized
by a sperm. When joined, the two "gametes" create a single-cell organism that
eventually develops into a baby. The fertilized egg is "totipotent," meaning
its potential is total. The single cell splits within hours of fertilization,
forming two identical totipotent cells. Either of these cells has the
potential to become a fully developed baby. Indeed, identical twins are
formed from two totipotent cells that develop separately into genetically
identical individuals. Click here to see a diagram of the basic development
of a human, courtesy of the National Institutes of Health.

After several days of continued cell division, the totipotent cells begin to
"differentiate," or specialize. An outer, hollow sphere of cells encompasses
a cluster of cells inside, known as the "inner-cell mass." Together, the
cells are known as a "blastocyst." The blastocyst's outer layer of cells will
go on to become the placenta and other tissues necessary in nurturing the
growth of a human baby. The cells comprising the inner-cell mass can form
virtually every type of cell found in the human body, but they are unable to
fully develop into a baby without the outer layer. If pluripotent cells alone
were implanted into a woman's uterus, they would not form into a baby.
Because of this, the inner-cell mass cells are not totipotent, but rather are
called "pluripotent."

Over time and more cell division, pluripotent cells continue to
differentiate, forming into cells that perform specific functions. These
specialized cells are called "multipotent." While the inner-cell mass cells
of a blastocyst go on to become various organs, nerves and tissues, some of
the multipotent cells always remain as they are to create replacement cells
for their specific functions. They can be found in children and adults. For
example, blood multipotent cells continually replenish the body's blood
supply. While multipotent cells have been found in various areas of adults,
they have not yet been found for all human tissues, but progress is being
made, according to the National Institutes of Health. This diagram from NIH
shows the progress of totipotent cells to multipotent cells.

Pluripotent and multipotent cells are both refereed to as "stem cells" and
are the subject of controversial research making headlines.

Because pluripotent stem cells – the precursors to multipotent stem cells –
eventually develop into nearly all the cells required by humans, scientists
say they have great medical-treatment applications. Through various
experiments with animals, scientists have shown they can direct the
specialization of pluripotent stem cells. In other words, the cells can be
manipulated into virtually any specialized cell.

The process of manipulating stem cells into more specialized cells has many
potential medical applications. According to the NIH, simply studying the
cells' development can aid in understanding certain genetic diseases.

"A primary goal of this work would be the identification of the factors
involved in the cellular decision-making process that results in cell
specialization," the NIH explains. "We know that turning genes on and off is
central to this process, but we do not know much about these
'decision-making' genes or what turns them on or off. Some of our most
serious medical conditions, such as cancer and birth defects, are due to
abnormal cell specialization and cell division. A better understanding of
normal cell processes will allow us to further delineate the fundamental
errors that cause these often deadly illnesses."

But the most hoped-for application of stem-cell research by advocates of the
practice is the creation of cures to various diseases. By directing the
specialization of pluripotent stem cells, scientists hope to create "cell
therapies."

"Many diseases and disorders result from disruption of cellular function or
destruction of tissues of the body. Today, donated organs and tissues are
often used to replace ailing or destroyed tissue. Unfortunately, the number
of people suffering from these disorders far outstrips the number of organs
available for transplantation. Pluripotent stem cells, stimulated to develop
into specialized cells, offer the possibility of a renewable source of
replacement cells and tissue to treat a myriad of diseases, conditions, and
disabilities including Parkinson's and Alzheimer's diseases, spinal cord
injury, stroke, burns, heart disease, diabetes, osteoarthritis and rheumatoid
arthritis. There is almost no realm of medicine that might not be touched by
this innovation," the NIH states.

But how are stem cells obtained? As stated earlier, multipotent stem cells
can be found in children and adults. The NIH says multipotent stem cells have
not been found for all types of adult tissue, but more discoveries are being
made. Others claim adult stem cells are not the best specimens from which to
create stem-cell lines because the cells have aged and may have suffered
damage.

Such scientists advocate pluripotent stem-cell research. But those cells can
only be found in a developing embryo, which is where the cells are created.
To obtain the cells, left-over embryos from in-vitro fertilization clinics
are used. A blastocyst's outer- and inner-cell layers are separated,
destroying the embryo.

Many arguments exist on both sides of the embryonic stem-cell research
debate. Because the process of obtaining the cells destroys a human embryo,
many oppose the research. Others counter that the embryos were destined to be
destroyed anyway, since they are "leftovers" from a couple's efforts to
become pregnant.

At a recent congressional hearing on stem-cell research, two couples asked
members of the joint committee to consider alternative fates for leftover IVF
embryos. The couples brought their children, who were adopted as embryos and
implanted into the women's uteruses, enabling infertile women to carry and
give birth to their adopted children.

But proponents of embryonic stem-cell research say adoption of that sort is a
rarity and that the potential benefits from the research outweighs any moral
objections to destroying leftover embryos. Besides, some argue, the embryo is
only the potential for human life and is not actual human yet.

To those who believe life begins at conception, destruction of a fertilized
human egg at any stage of the growth process is immoral. And that immoral
action cannot be mitigated by any potential good that may come from the
research.

There is a third method of obtaining stem cells: from aborted fetuses. Cells
from an aborted fetus's reproductive tissues have been manipulated by
scientists, producing the same result as experiments on pluripotent stem
cells. But this method of obtaining research material is objectionable to
abortion opponents.

True, the fetus is already dead when the cell extraction takes place, but the
method of the baby's death is still immoral – even evil. Participating in
research that uses aborted fetal tissue is, by association, participating in
evil, they argue.

Questionable ethics is exactly what research proponents say they are trying
to avoid through federal funding and regulation of the experiments. By
funding the research, the U.S. government will be in a position to control
the way the research is conducted. However, privately-funded scientists will
not be affected by government restrictions, unless the restrictions are made
law for the general public.

In its recommendations to former President Bill Clinton, the National
Bioethics Advisory Commission outlined what it believed should be the future
of embryonic stem-cell research. The commission expressed its belief that
government should prohibit the creation of embryos specifically for research
purposes. Established by a Clinton-signed executive order in 1995, the panel
made a total of 13 recommendations in its 1999 report.

As stem-cell research progresses – now with federal funding – more is being
learned about adult stem cells. Scientists in Seattle, Wash., and Milan,
Italy, discovered in 1999 that adult neural stem cells in mice had the
ability to de-differentiate and could then be manipulated into other cells.
While results with human cells has been more limited, according to the NIH,
successful development of the research could eliminate the need for fetal
cells in stem-cell experiments.





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