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Stem cell research

Abstract

The use of embryonic stem cells for the purpose of research has become one of the most controversial issues to this day. Stem cells can function as cells that have the ability to repair certain systems in the body, and they can also repair other damaged cells. The six major forms of stem cells known to researchers currently include embryonic stem cells, fetal stem cells, adult stem cells, embryonic germ cells, and amniotic and umbilical cord stem cells. Stem cell research has more than enough benefits to healthcare, that it should be highly considered in the treatment of diseases as well as being utilized in the research setting. Currently, in the United States, federal funding for embryonic stem cell research is restricted by congressional legislation. However, there are currently no federal regulations or limitations on the research involving adult stem cells. What the community that struggles for the legislation on stem cell research needs to do is assess the individual and community needs, serve as an education resource person, and advocate for education about stem cell research.

Stem Cell Research

The use of embryonic stem cells for the purpose of research has become one of the most controversial issues to this day. It is believed that stem cells are actually one of the greatest untouched resources that can be used to identify, prevent and treat many diseases (Eve, Marty, McDermott, Klasko, Sandberg, 2008). Not only has the government and community struggled with the idea of understanding what goes into stem cell research, but they have also had issues accepting the idea as a whole. The media has set out to make stem cell research look as though it has many moral and ethical controversies, while it has failed to recognize the more important issue at stake. Utilizing embryonic stem cells for research can be used for not only the education of healthcare professionals and the community, but it may be able to prevent, aid or even cure some fatal diseases and health conditions. The purpose of this paper is to discuss not only the benefits of stem cell research, but it will also discuss the moral and ethical issues involved as well as how an individual can overcome them to better the healthcare community.

Stem cells, also known as self-renewing cells, are small cells that can be found throughout the human body that are actually model cells. They eventually learn to grow with specialized functions in the body. What happens is that these stem cells replicate and produce more of their own cells that are either more stem cells or other specialized cells that can play a vital role in the body (Eve et al., 2008). Some examples of the functions that these stem cells can have include becoming blood, bone, brain or even skin cells (Eve et al., 2008). It has been noted that stem cells can actually function as cells that have the ability to repair certain systems in the body, and they can also repair other damaged cells. These discoveries have led to the idea of "regenerative medicine" for stem cells. This has become the most recent goal of the utilization of stem cells for research purposes. What happens in this process is the stem cells differentiate from one area of the body into another. A signal is given to the stem cells so that they know which type they are to assume later. They first take on the role of progenerator cells and later become the mature cell of choice (Eve et al., 2008).

There are six major forms of stem cells known to researchers currently. They include embryonic stem cells, which are the most plastic for differentiating into other types of cells, fetal stem cells, adult stem cells, embryonic germ cells, and amniotic and umbilical cord stem cells (Eve et al., 2008). When an egg and sperm unite and a blastocyte is created, there are said to be three layers to that blastocyte from outer to inner: the trophoblast, the blastocoels and the inner-most cell mass which is composed of many stem cells. Up until the two week stage, these cells are considered to be the embryonic stem cells, and the following eight weeks they are considered fetal stem cells (Eve et al., 2008). These embryonic cells are said to be the most valuable to the researching community to the plasticity of the cells to differentiate, but due to current federal regulations, they are off limits for study and research in the healthcare field (Eve et al., 2008). The reason that this is so controversial is because the embryonic cell mass must be removed from its nature and grown in a culturally based environment. The result is a destroyed embryo leading to the destruction of a potential new life (Eve et al., 2008). Because fetal cells are typically gathered after miscarriage or abortion, the death of the life has already occurred which explains why this idea is not quite as controversial as taking embryonic stem cells instead. The current use of fetal cells for research has ended up in the United Kingdom at a company named Reneuron, Inc. They are currently working with the idea of treating specific neurodegenerative disorders such as Parkinson's Disease, Cerebral Vascular Accidents and also the much disputed Alzheimer's disease (Eve et al., 2008). Also, according to Bernard Lo, "Transplantation of cells derived through manipulation of pluripotent cells offers great therapeutic promise in conditions such as spinal cord injury, neurological and cardiac diseases, and diabetes" (Lo, Kriegstein, Grady, 2008). The idea that these precious cells could someday lead to finding a cure to such devastating health conditions sparks the interest of many people in the research field as well and many members of the community. If more education was put out to the world about the benefits to the research, maybe the community would not have so many personal issues with the idea.

Adult stem cells are able to be pulled from adult bodies rather than the fetal or embryonic stage. They can be (Eve et al., 2008). The problem with this is that contrary to embryonic cells, the exact location of the adult stem cell is not quite known. Because of this conception, it was always thought that the brain was the only organ that had the inability to replicate its damaged cells. However, it is now thought that because of endogenous stem cells, the brain and other neurogenic organs can actually replace cells that are damaged under certain health conditions and trauma (Eve et al., 2008). The problem with adult stem cells is that they are said to enter a sleep-like state in which they are actually dormant in the human body. It is not until they are given a signal from damaged cells that they wake up from their state and begin to replicate and differentiate once again. The stem cells' ability to locate the triggering signal is absolutely critical in maximizing the benefits of replication and differentiation (Eve et al., 2008). Previously, it was thought that these cells were harder to manipulate since they could only differentiate into the specific type that they were found. For example, bone marrow stem cells were thought to only be able to differentiate into further bone cells. Also, it was thought that the adult stem cells were exposed to multiple viruses and other health conditions over the lifespan, consequently making them less useful. However, it has been found that they are actually beneficial in their own way. For one, the cells can be removed from the human source, grown in a cultural environment, and then placed back into the body in which they were pulled from. This lessens the chance of immune system rejection by the body compared to placing someone else's embryonic cells into another human body (Eve et al., 2008). Another benefit of using adult stem cells is that there is much less controversy in regards to receiving federal funding for this precious scientific research (Eve et al., 2008).

Embryonic germ cells, amniotic fluid or placental and umbilical cord blood stem cells are the next to be discussed. The germ cells are those that can be found in the testes and ovaries of the adult body. While they are thought to be as good as embryonic stem cells in the sense that they have to ability to differentiate into multiple types of tissue, they are also thought to differentiate spontaneously causing science to have much less control over them (Eve et al., 2008). The amniotic fluid from the mother's womb has been found to contain stem cells recently, so there is scientific thought that it can be saved from an amniocentesis procedure to conduct research with the stem cells within it. It is believed that the fluid contains both embryonic and adult stem cells, but research has also been limited as of recent science. It is also not known whether the cells differentiate into various or singular types of cells as of yet, but it has apparently been thought to aid in the treatment of diabetes (Eve et al., 2008). Umbilical cord blood, on the other hand, is thought to only contain small numbers of stem cells. Currently, the researchers are using cord blood to treat disorders such as acute myocardial infarction, cerebral vascular accidents and other blood- related disorders, but it is unknown whether the success rate is due to stem cells or if it is actually because of the growth factors (Eve et al., 2008).

There are many potential uses of stem cells in science today. For the most part, the adult stem cells that are pulled from bone marrow have been used to treat the blood-based disorders such as blood cancers and nuclear radiation exposure. As of 2008, there were more that 1,200 clinical trials being explored, all of which were non-embryonic. It is not that there is no sufficient evidence or efficacy for the use of embryonic stem cell, but rather it is the lack of federal funding that has led to this statistic (Eve et al., 2008). Also, reviewers should be aware that stem cell research using embryonic cells was never made illegal, but instead it is more because there is only recent evidence behind it compared to the three decade long research of adult stem cells (Eve et al., 2008).

There are currently innumerable amounts of research going on throughout the nation and world on not only the non-embryonic stem cells but also the embryonic stem cells that come from other sources. The research is completed through treatment processes of disorders such as organ regeneration, cardiovascular dysfunction and improvements, diabetes, and neurodegenerative conditions as well (Eve et al., 2008). The research currently covers not only the preliminary explorative studies, but also the preclinical and clinical trials. "Promising results include the promotion of liver regeneration by bone marrow stem cells in patients with hepatic malignancies, the formation of blood vessels in mice from human embryonic stem cells that have been made to differentiate into endothelial precursor cells, the treatment of stroke and heart ischemia animal models by human umbilical cord transplants in rats, and the ability of embryonic stem cells to differentiate into functioning heart tissue (myocytes)" (Eve et al., 2008).

Trials have attempted to use adult stem cells for the use in functioning heart tissue rather than the embryonic stem cells, but it has been found that once they differentiate, they actually impaired heart function rather than repairing it (Eve et al., 2008). Other medical studies have attempted to use fetal neural stem cells, and they have been successful in showing that retinal cells could be rescued after injury or disease. This shows that the fetal neural stem cells hold a restorative capability (Eve et al., 2008). "In general, considerable research is underway to ensure that the development of treatments involves only those cell types being sought, and that it includes ways of ensuring desired outcomes-i.e., controlling the stem cells so that they form the desired cells and do not proliferate indefinitely, which would lead to malignancy once transplanted" (Eve et al., 2008). This, however, might just be one of the largest hurdles that scientific research has had to overcome with handing stem cells in their studies.

The other side of what remains important in stem cell research is ensuring that body will be able to accept the new tissue and cells. Usually, when a patient's body is induced with something that is not their own, an intense immunological response will occur, causing the patient to actually reject the new cells that have been implanted (Eve et al., 2008). There have been few but enough studies to suggest that using embryonic stem cells and umbilical stem cells is actually better than using adult stem cells, because they are less likely to induce that same immunological response (Eve et al., 2008). "Not only does stem cell research provide direct cell replacement benefits or improve the survivability of 'sick' or 'injured' cells, it also offers considerable insight on what causes cells to proliferate and differentiate-an important phenomenon to understand in the fight against cancers and in general research dedicated to the development and normal life cycle of cells" (Eve et al., 2008). Overall, stem cell research has more than enough benefits to healthcare, that it should be highly considered in the treatment of diseases as well as being utilized in the research setting.

Controversy surrounding the idea of stem cell research is endless. The most popular to date is the moral values that lie behind the research. Much like the fight with abortion, this battle is about the individual person and what their perception of the beginning of life is. To some people, life begins at the time of conception and uniting of the egg and sperm (Eve et al., 2008). For them, it is hard to understand how one other person can have the right to destroy a life to use the stem cells for research. With religious views and moral backgrounds, many people find this act to be strongly immoral and believe that it goes against their values, beliefs and religion (Eve et al., 2008). To them, it is equivalent to committing an abortion. After Barack Obama, at the time Senator, made a dramatic speech regarding reproductive freedom, many people viewed stem cell research in regards that it should be a choice, much like abortion is today (Adashi, West, 2008). In many countries, embryonic stem cell research is completely restricted (Eve et al., 2008). However, as stated in The Journal of Law, Medicine & Ethics, "scientific and technological change has begun to reshape the debate on the issue of stem cell research. In hope of avoiding the moral dilemma altogether, scientists and ethicists are proposing methods to harvest stem cells without destroying embryos" (Robertson, 2005).

A second controversy that is seen with stem cell research was caused by a group of scientists in South Korea that claimed to have taken embryonic stem cells and replaced the egg's nucleus. One year later, they claimed that "they were able to generate patient-specific immune-matched embryonic stem cells for the treatments of diseases" (Eve et al., 2008). However, not only was this information falsely presented, but the females involved in the research study used their own eggs, which was a major ethical violation (Eve et al., 2008). One of the third controversies revolves around the idea that once the embryonic stem cells are implanted, they will mutate into cancerous cells and form tumors that continuously proliferate with no control (Eve et al., 2008). The idea that using stem cells for treating a disease, which can actually cause a problem much more devastating, makes the public weary of the idea to use embryonic stem cells for research (Eve et al., 2008). This is why adult stem cells have been used more frequently than embryonic stem cells. "Adult stem cells are normally quiescent, meaning that identification of the process by which mutations occur could prove to be vitally important in preventing transplant tumorigenicity or in preventing cancers altogether" (Eve et al., 2008). The fourth main controversy is, of course, the idea that adult stem cells will never be of the same benefit that the embryonic stem cells are. Since embryonic stem cells can differentiate into anything, whereas adult stem cells cannot, the uses are limited, causing the public to disagree with researching further treatment options with stem cells (Eve et al., 2008).

Currently, "in the United States, federal funding for embryonic stem cell research from sources such as the National Institutes of Health is restricted by congressional legislation, which mandates that only cell lines from August 2001 be used in funded research" (Eve et al., 2008). However, there are currently no federal regulations or limitations on the research involving adult stem cells. In 2006, researchers were able to propose a congressional bill that allowed research on discarded embryos from in vitro fertilizations. This bill, however, was vetoed due to the numerous unethical and unmoral values as well as many religious concerns (Eve et al., 2008). It has been suggested by the International Society for Stem Cell Research that there be some kind of uniform research system compiled for embryonic cell tissue. "At the core of these guidelines is that embryonic research should be rigorously overseen by sponsoring organizations or regulatory bodies with specific policies and procedures that conform to the recommendations of the scientific community" (Eve et al., 2008). Also, cloning of human being will never be permitted. Fiona Murray suggests that "human embryonic stem cells, with their potential both for expanding our understanding of biology and for commercial use, represent a classic example of knowledge that should be accessible to both academia and industry" (Murray, 2007). Without funding from the federal legislation, the issue of embryonic cell research will remain dormant.

What the community that struggles for the legislation on stem cell research needs to do is assess the individual and community needs, serve as an education resource person, and advocate for education about stem cell research (Eve et al., 2008). Since former President Bush signed an executive order limiting research with embryonic cells, more states have been trying to move forward in the fight for research utilizing stem cells (Finklestein, 2007). It is the community that we are trying to reach to get approval for these types of research. If we do not get ourselves out there and try to educate the public about the many benefits to utilizing stem cell research, then we many never get anywhere with it. There are countless treatment options for devastating diseases that could come out of this research, and many people of the community are simply unaware of this. The moral and ethical issues can be understood, but does the public realize that it may also be seen as immoral to let someone else die of a devastating illness? Education will be the key in getting this approved for further research, hopefully benefiting many people someday.

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