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Raelee Schulz

Professor Barnes

ENG 1201

22 March, 2019

Stem Cell Transplants and Autoimmune Diseases

Millions of people around the world have some kind of autoimmune disease.

Autoimmune diseases can be as mild as just getting a rash every so often or they can be as severe

as being paralyzed. When most people hear the word autoimmune, they think of cancer or HIV.

Researchers have studied the different types of cells, the effectiveness, the side effects, and the

overall process of stem cell transplants. Stem cells can be formed into any type of cells, such as;

blood cells, organ cell, or tissue cell. Stem cell treatments should be more accessible for people

with autoimmune diseases. To make stem cell transplants more accessible, healthy people should

donate stem cells. There are a lot of positive on why you should get a stem cell transplants. There

are several risks that need to be considered before someone receives a stem cell transplants. Stem

cells should be used to treat autoimmune diseases because stem cells can be changed into any

cell needed to help a patient.

People who donate stem cells usually donate because they know someone that needed a

match. Stem cells could be more accessible in several ways. Healthy people who want to help

others can donate bone marrow with relatively no side effect and low pain. After mothers give

birth, the umbilical cord is cut. Most of the time it is thrown away. One of the easiest ways to
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collect stem cells is from the umbilical cord. Mothers can make arrangements for the umbilical

cord to be used for stem cells before the third trimester. These stem cells are called mesenchymal

stem cells and/or allogeneic/mesenchymal umbilical cord tissue derived stem cells. Donating

stem cells is easy. You can search on the internet for the closest cancer or bone marrow center.

For expecting mothers, they should contact the doctor before they enter the third trimester.

Getting a stem cell transplant can be scary to some people. In the article “Stem Cell

Therapy for Autoimmune Diseases,” explains the stem cell transplants protocol. If the patient is

getting the mesenchymal stem cells, an example treatment could be, “ …[treatment] 4 days and 5

nights, physical examination, and 3 IV injections of expanded allogeneic mesenchymal stem

cells,” this is an example of what a treatment could be for a patient getting a stem cell

transplants.

Stem cells transplants are also called stem cell therapy. For cell based therapies they are

categorized into regenerative or reparative. Regenerative therapy is to help make a damaged cell

healthy. Reparative is to help repair a cell. There are two types of treatment plans used for the

treatment of cancer. In an article from the Dana- Farber Cancer Institute it states, “Myeloablative

(high-intensity) stem cell transplant uses high doses of chemotherapy and may use radiation

therapy to destroy cancer cells. In this process, bone marrow/stem cells are also destroyed.

Patients receive an infusion of new stem cells to rebuild blood and the immune system.” The

patient will get a transplant of either their stem cells or a donors. For Non-myeloablative

treatment it says, “Non-myeloablative (reduced-intensity) transplant uses a lower dose of

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chemotherapy and no radiation, followed by an infusion of disease-fighting stem cells from a

donor whose tissue type matches your own.” There is a high risk of graft-versus-host-disease.

In the article, “Adult stem cell therapy for autoimmune disease,” author Eun Wha Choi,

talks about the history and the clinical trials of stem cell transplants. Choi explains the different

types of stem cells and how easy they are to manipulate. “The major immunosuppressive drugs

of the last three decades in treatment of autoimmune disease have been corticosteroids,

cyclophosphamide, azathioprine and methotrexate.” While these are effective at helping to

control the autoimmune diseases, most of the time these medications can only help and not treat

the disease itself.

Stem cells can be derived from several places. In the article, “Immune System: Diseases,

Disorders and Function,” author Kim Zimmerman, talks about the different types of stem cells

and where they are taken from in the body. Zimmerman explains the difference between innate

and adaptive immunity. “Innate immunity is the immune system you’re born with, and mainly

consists of barriers on and in the body that keep foreign threats out,” in this statement

Zimmerman explains what innate immunity is and what it does for the body. “Adaptive, or

acquired, immunity targets specific threats to the body…the threat must be processed and

recognized by the body, and then the immune system creates antibodies specifically designed to

the threat. After the threat is neutralized, the adaptive immune system “remembers” it, which

makes future responses to the same germ more efficient.” The body remembering the threat

makes fighting that type of cell easier and more efficient the next time that cell is in the body.
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Stem cells can come from many parts of the body. Some of the most accessible spots are

the lymph nodes, spleen, bone marrow, leukocytes, and the thymus. The lymphatic

system consists of bone marrow, spleen, thymus, and the lymph nodes. Lymph nodes are

bean-shaped structures that help fight infections. The spleen contains white blood cells

that help fight infections. Bone marrow is yellow tissue inside of bones. Lymphocytes

are white blood cells. There are two types of lymphocytes, B-cells and T-cells. The

thymus is the organ where the T-cells

mature. Leukocytes are disease

fighting white blood cells.

There are three main types of adult

stem cells in the body. Hematopoietic

Fig. 1
stem cells are used to make every

blood cell in a persons body. Mesenchymal stem cells are used to make bones and

cartilage. These cells are found in tissues, bone marrow, and embryos. Stromal stem

cells are used to make fat cells and the formation of blood and fibrous connective tissue

in the body. Other types of stem cells found in the body are neural stem cells, epithelial

stem cells, and skin stem cells. Neural stem cells help the brain develop new cells.

Epithelial stem cells are in the lining of the digestive tract and turn into cells needed in

the digestive tract. Skin stem cells are found in the basal layer of the epidermis and hair

follicles.
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Stem cells can be rejected from the body. Medicines, genes, and the type of cells can be

factors of rejection. Luckily, the rejection rate is very low. Some types of stem cells the

body cannot recognize that it is not its own cells. One type of stem cell that is not

rejected is umbilical cord-derived mesenchymal cells. The most rejected type of stem

cells are human embryonic stem cells. This stem cells transplants is much related to

having an organ transplant. Studies on the human embryonic stem cells have not been

FDA approved in North America. In the article “Body May Reject Transplanted Human

Embryonic Stem Cells,” by Nikhil Swaminathan states, “Raw cells have the potential to

become cancerous.” If scientists were to inject embryonic stem cells into a human body,

the cells would be seen as a foreign object. Whereas other types of stem cells are nearly

unnoticed in the body.

Stem cell transplants give a new point of view on modern medicine. Stem cells can self

regenerate themselves in a body. This gives the potential to do unlimited things.

Scientists studying stem cells on the effect on the human body can help them understand

how human life works. Studying stem cells can give scientists insights on life

expectancy, diseases, and medical treatments. Knowing what is causing cells to react in

a certain way can help scientists cure diseases and could possibly lower the cost of

medical treatments. For example, scientists could transplant stem cells to help a diabetic

with insulin production. This could make a diabetic patient healthier to where they

would not have to use a insulin pump or shots.

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After a patient receives a stem cell transplant, there could be some not so pleasant side

effects. Some potential side effects could be; Mucositis (mouth and throat pain),

nausea/vomiting, infection, easy bleed/bruising, blood transfusions, pneumonitis (lung

infection), Graft-versus-host-disease (GVHD), hepatic veno-occlusive disease (VOD),

and graft failure. Also most people that receive stem cell transplants become infertile.

Most people know that stem cell transplants can cost $10,000 at a minimum. Some

estimates say $350,000 to $800,000. The reason stem cell transplants are so expensive is

because the experimentation on stem cell transplants is not as well known as

chemotherapy and other medications, because of this the overall effects on stem cell

transplants is unknown. To have a successful stem cell transplant there needs to be a

donor that matches the patient, especially if it consists of tissue or organ cells that are

being transplanted. Also most insurances do not cover the cost of stem cell transplants

because the transplant is considered experimental.

Stem cells have a huge amount of regulations in the United States. Other countries such

as Europe and Panama have far less strict regulations. Many patients who are wanting a

stem cell transplants often travel out of the United States to receive one. For a doctor or

scientist to obtain stem cells from a person they must have a written consent to be able to

harvest stem cells from that person. The donor should also be screened for any health

issues that could potentially cause harm such as; blood or genetic diseases and risk

factors. One example of a foundation not following regulations in in this statement from

the article, “From Bench to FDA to Bedside: US Regulatory Trends for New Stem Cell
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Therapies,” author Paul Knoepfler states, “The Stamina Foundation in Italy began

experimental stem cell treatments on many patients including children under the rubric

of compassionate use. This led to the explosion of a political and social controversy that

continues to this day even though the Italian health ministry's national institute (ISS) and

the Italian Medicines Agency (AIFA) recently prohibited Stamina treatments because of

safety concerns.” The Italian authorities stepped in and took action to protect the

patients. Italy does not have as strict regulations and problems like this can occur. The

Unites States wants to make sure that patients and others are not hurt in the research of

stem cell therapy. The United States put strict regulations on the use and testing of stem

cells because they did not want any subject or experimenter to be injured or in severe

cases, dead.

Scientist do not know about the long term effects of stem cell transplants because stem

cell transplants are in the experimental phase. The restrictions made by the FDA make it

hard for scientists to study stem cells for a long period of time.

Stem cells can take a long time to mature. This is how long from the time it is harvested

to the time that the stem cell can be used for therapy. Some stem cells can live for five

months. Others can live for more than three years. Embryonic stem cells can take

months to mature where they can start to be used for therapy.

The biggest controversy in stem cell transplants is the ethics and morals of stem cell

transplants. Some people believe that manipulating cells could be an ethical concern for
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some Christians. They believe that scientists are taking over the role of God. Also to

harvest embryonic stem cells they have to do with drawing the stem cells by in-vitro.

This causes the embryos to be destroyed and in some cases can cause death to the fetus.

There is no law in place to protect the mother or the fetus. This can cause people to think

that deriving stem cells from an embryo is an abortion. There is no set laws across the

United States for abortion as it is a controversial topic.

Stem cell transplants could save an unlimited number of lives of people who have

autoimmune diseases. There are positives and negatives of stem cells transplants. They

can save numerous lives because stem cells are so universal. Every person has stem

cells. Stem cells can be derived from several places in the body. Donating is easy with

minimum pain and free. Since stem cells can be derived from several places in the body,

stem cells can be transformed into any type of cell. There are also a numerous amount of

regulations in the United States to protect the health and safety of the patients and

experimenters.

There are some negatives of stem cells and stem cell transplants. After a transplants

there could be some serious side effects that could possibly be life threatening. There is

not enough knowledge about the long term effects of stem cell transplants. A lot of

people believe that stem cells are unethical because the manipulation of acting as God.

Also taking embryonic stem cells can count as abortion. This could possibly harm the

mother.
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Overall stem cell transplants should be used to treat autoimmune diseases. There is more

advantages than there are disadvantages. There are many types of stem cells and they can be

used for many different diseases because stem cells can be so diverse. Stem cell is a revolution in

modern medicine.

Works Cited
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Ayres, Crystal. “19 Advantages and Disadvantages of Stem Cell Research.” Vittana.org,

vittana.org/19-advantages-and-disadvantages-of-stem-cell-research.

Choi, Eun Wha. “Adult stem cell therapy for autoimmune disease” International

journal of stem cells vol. 2,2 (2009): 122-8.

“Health Library.” Dana, www.dana-farber.org/health-library/articles/types-of-stem-cell-

transplant/.

“Hematopoietic Stem Cell Therapy for Autoimmune Diseases – Clinical Experience and

Mechanisms.” NeuroImage, Academic Press, 20 June 2018,

www.sciencedirect.com/science/article/pii/S0896841118301823.

Knoepfler, Paul S. “From Bench to FDA to Bedside: US Regulatory Trends for New Stem Cell

Therapies.” Advanced Drug Delivery Reviews, U.S. National Library of Medicine, Mar. 2015,

www.ncbi.nlm.nih.gov/pmc/articles/PMC4398607/

“Pros and Cons | Stem Cells | University of Nebraska Medical Center.” UNMC,

www.unmc.edu/stemcells/educational-resources/prosandcons.html.

Renno, Samer. “Stem Cell Transplants, ‘Only Cure, Only Help.’” Stem Cell Transplants, "Only

Cure, Only Help", www.chihealth.com/en/about-us/press-

room/publications/microscope/oncology/only-cure-only-help.html.
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“Stem Cell Basics IV.” National Institutes of Health, U.S. Department of Health and Human

Services, stemcells.nih.gov/info/basics/4.htm.

“Stem Cell Therapy for Autoimmune Diseases.” Stem Cell Institute,

www.cellmedicine.com/stem-cell-therapy-for-autoimmune-diseases/.

Swaminathan, Nikhil. “Body May Reject Transplanted Human Embryonic Stem Cells.”

Scientific American, 19 Aug. 2008, www.scientificamerican.com/article/body-rejects-transplant-

human-embryonic-stem-cells/.

Zimmermann, Kim Ann. “Immune System: Diseases, Disorders & Function.”

LiveScience, Purch, 17 Oct. 2018, www.livescience.com/26579-immune-system.html.