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• A stem cell is a special kind of cell that has a unique capacity to renew itself and to
give rise to specialized cell types. Although most cells of the body, such as heart
cells or skin cells, are committed to conduct a specific function, a stem cell is
uncommitted and remains uncommitted, until it receives a signal to develop into a
specialized cells
• In 1998, for the first time, investigators were able to isolate this class of pluripotent
stem cell from early human embryos and grow them in culture.At about the same
time as scientists were beginning to explore human pluripotent stem cells from
embryos and fetal tissue, a flurry of new information was emerging about a class of
stem cells that have been in clinical use for years—so-called adult stem cells. An
adult stem cell is an undifferentiated cell that is found in a differentiated
(specialized) tissue in the adult, such as blood. It can yield the specialized cell types
of the tissue from which it originated. In the body, it too, can renew itself
• The one-cell embryo develops into a fully formed human being through a process
called cell differentiation. As an embryo develops, embryonic stem cells form the
different cells that make up our bodies. As they go further along the developmental
pathway, they become more and more specialised until they are only able to
perform one function..
• To be able to harness the therapeutic potential of stem cells, scientists need to learn
how to direct them to differentiate appropriately, for example, to generate muscle
cells for damaged hearts or neurones for damaged brains. Another challenge is to
ensure they do not continue to multiply in an uncontrolled way and not form a
tumour.
• Current science indicates that, although both of these cell types hold enormous
promise, adult and embryonic stem cells differ in important ways. What is not
known is the extent to which these different cell types will be useful for the
development of cell-based therapies to treat disease.
What Are Stem Cells?
Stem cells are found in a number of areas of the body and occur at the earliest stages of
human development through to adulthood. Whether they come from an early embryo, a
fetus or an adult, stem cells have two key properties. :
Firstly, they have the ability to reproduce themselves almost indefinitely through cell
division. (Self renewal).
Secondly, Regulated by intrinsic signals and the external microenvironment .they can
be directed to generate cells with special functions that make up the tissues and organs
of the body, such as the beating cells of the heart or the insulin-producing cells of the
pancreas (unlimited potency).
This capacity to both proliferate and form different types of cells makes them ideal for
replacing tissue that is lost. They are 'all-purpose' cells.
1. The extent to which they can differentiate into different cell types,
Stem cells are cells that divide by mitosis to form two stem cells, thus increasing the
size of the stem cell "pool",
the body, excluding a placenta. Only the morula's cells are totipotent, able to become all tissues and a placenta.
1. Totipotent cells.
The only totipotent cells are the fertilized egg and the first 4 or so cells produced by its
cleavage (as shown by the ability of mammals to produce identical twins, triplets, etc.).
These are true stem cells, with the potential to make any differentiated cell in the body
(but probably not all those of the extra-embryonic membranes, which are derived from
the trophoblast).
Three types of pluripotent stem cells have been found
o Embryonic Stem (ES) Cells. These can be isolated from the inner cell mass (ICM)
of the blastocyst — the stage of embryonic development when implantation occurs. For
humans, excess embryos produced during in vitro fertilization (IVF) procedures are
used. Harvesting ES cells from human blastocysts is controversial because it destroys
the embryo, which could have been implanted to produce another baby (but often was
simply going to be discarded).
o Embryonic Germ (EG) Cells. These can be isolated from the precursor to the
gonads in aborted fetuses. .
o Embryonic Carcinoma (EC) Cells. These can be isolated from teratocarcinomas, a
tumor that occasionally occurs in a gonad of a fetus. Unlike the other two, they are
usually aneuploid.
- can be grown in culture, but only with special methods to prevent them from
differentiating.
These are true stem cells but can only differentiate into a limited number of types. For
example, the bone marrow contains multipotent stem cells that give rise to all the cells
of the blood but not to other types of cells.
Multipotent stem cells are found in adult animals; perhaps most organs in the body
(e.g., brain, liver) contain them where they can replace dead or damaged cells. These
adult stem cells may also be the cells that — when one accumulates sufficient
mutations — produce a clone of cancer cells.
On the basis of source:
(ESCs) are derived from 4- to 5-day-old embryos. At this stage, the embryos are
spherical and are known as blastocysts. Each blastocyst consists of 50 to 150 cells and
includes three structures: an outer layer of cells, a fluid-filled cavity, and a group of
about 30 pluripotent cells at one end of the cavity, called the inner cell mass.
Derived from the inner cell mass/epiblast of the blastocyst. Can be induced to continue
proliferating or to differentiate.
Clonogenic i.e. a single ES cell can give rise to a colony of genetically identical cells,
or clones, which have the same properties as the original cell.
Pluripotent ES cells can give rise to differentiated cell types that are derived from all
three primary germ layers of the embryo (endoderm, mesoderm, and ectoderm).
2. Embryonic (or fetal) germ cells
Embryonic germ cells are pluripotent stem cells derived from so-called primordial germ
cells, which are the cells that give rise to the gametes (sperm and eggs) in adults.
Scientists obtain primordial germ cells from the area in a 5- to 9-week-old embryo/fetus
destined to become either the testicles or the ovaries (the dividing line between embryo
and fetus is the end of the 8th week).
Like ESCs, the primordial germ cells are transferred into a specially treated plastic
culture dish, where they form germ cell colonies.
Less research has been performed using embryonic germ (EG) cells than ESCs, mostly
because the embryos used for deriving EG cells are deliberately aborted, while the
blastocysts used for deriving ESCs are produced through in vitro fertilization in a
fertility clinic. EG cells are also difficult to maintain in cell culture because they have a
tendency to differentiate spontaneously.
• First, they can make identical copies of themselves for long periods of time; this
ability to proliferate is referred to as long-term self-renewal.
• Second, they can give rise to mature cell types that have characteristic
morphologies (shapes) and specialized functions.
However, they are also found in children and can be extracted from umbilical cord
blood.
The primary roles of adult stem cells in the body are to maintain and repair the tissues
in which they are found. They are usually thought of as multipotent cells, giving rise to
a closely related family of cells within the tissue.
A potential advantage of using adult stem cells from a patient is that the patient’s own
cells could be expanded in culture, treated to differentiate into the desired cells, and
then reintroduced into the patient.
The use of the patient’s own cells would eliminate any possibility that they might be
rejected by the immune system.
Disadvantages of using adult stem cells are that they are rare in mature tissues and it is
more difficult to expand their numbers in cell culture, compared with ESCs.
Differentiation
Adult stem cell differentiation
Figure 2. Hematopoietic and stromal stem cell differentiation. Click here for larger
image.
As indicated above, scientists have reported that adult stem cells occur in many tissues
and that they enter normal differentiation pathways to form the specialized cell types of
the tissue in which they reside. Adult stem cells may also exhibit the ability to form
specialized cell types of other tissues, which is known as transdifferentiation or
plasticity.The following are examples of differentiation pathways of adult stem cells
(Figure 2).
Hematopoietic stem cells give rise to all the types of blood cells: red blood cells, B
lymphocytes, T lymphocytes, natural killer cells, neutrophils, basophils, eosinophils,
monocytes, macrophages, and platelets.
Bone marrow stromal cells (mesenchymal stem cells) give rise to a variety of cell
types: bone cells (osteocytes), cartilage cells (chondrocytes), fat cells (adipocytes), and
other kinds of connective tissue cells such as those in tendons.
neural stem cells in the brain give rise to its three major cell types: nerve cells (neurons)
and two categories of non-neuronal cells—astrocytes and oligodendrocytes.
Epithelial stem cells in the lining of the digestive tract occur in deep crypts and give
rise to several cell types: absorptive cells, goblet cells, Paneth cells, and
enteroendocrine cells.
Skin stem cells occur in the basal layer of the epidermis and at the base of hair follicles.
The epidermal stem cells give rise to keratinocytes, which migrate to the surface of the
skin and form a protective layer. The follicular stem cells can give rise to both the hair
follicle and to the epidermis.
Hematopoietic stem cells may differentiate into: three major types of brain cells
(neurons, oligodendrocytes, and astrocytes); skeletal muscle cells; cardiac muscle cells;
and liver cells.
Bone marrow stromal cells may differentiate into: cardiac muscle cells and skeletal
muscle cells.
Brain stem cells may differentiate into: blood cells and skeletal muscle cells.
• The cells divide and spread over the surface of the dish. The inner surface of
the culture dish is typically coated with mouse embryonic skin cells that have
been treated so they will not divide. This coating layer of cells is called a feeder
layer. The reason for having the mouse cells in the bottom of the culture dish is
to give the inner cell mass cells a sticky surface to which they can attach. Also,
the feeder cells release nutrients into the culture medium. Recently, scientists
have begun to devise ways of growing embryonic stem cells without the mouse
feeder cells. This is a significant scientific advancement because of the risk that
viruses or other macromolecules in the mouse cells may be transmitted to the
human cells.
• Over the course of several days, the cells of the inner cell mass proliferate and
begin to crowd the culture dish. When this occurs, they are removed gently and
plated into several fresh culture dishes. The process of replating the cells is
repeated many times and for many months, and is called subculturing. Each
cycle of subculturing the cells is referred to as a passage.
• After six months or more, the original 30 cells of the inner cell mass yield
millions of embryonic stem cells. Embryonic stem cells that have proliferated in
cell culture for six or more months without differentiating, are pluripotent, and
appear genetically normal are referred to as an embryonic stem cell line.
Once cell lines are established, or even before that stage, batches of them can be frozen
and shipped to other laboratories for further culture and experimentation.
Similarities and differences between embryonic, adult and fetal stem cells
Adult and embryonic stem cells differ in the number and type of differentiated cells
types they can become.
• Embryonic stem cells are the most versatile because they can become any cell in
the body including fetal stem cells and adult stem cells (pluripotent). Adult stem
cells are more specialized since they are assigned to a specific cell family such as
blood cells, nerve cells etc.. These are generally limited to differentiating into
different cell types of their tissue of origin
• Large numbers of embryonic stem cells can be relatively easily grown in culture,
while adult stem cells are rare in mature tissues and methods for expanding their
numbers in cell culture have not yet been worked out. This is an important
distinction, as large numbers of cells are needed for stem cell replacement
therapies.
• A potential advantage of using stem cells from an adult is that the patient's own
cells could be expanded in culture and then reintroduced into the patient. The use
of the patient's own adult stem cells would mean that the cells would not be
rejected by the immune system. This represents a significant advantage as
immune rejection is a difficult problem that can only be circumvented with
immunosuppressive drugs.Embryonic stem cells from a donor introduced into a
patient could cause transplant rejection. However, whether the recipient would
reject donor embryonic stem cells has not been determined in human experiments.
Advantages, Disadvantages and Ethical Issues of Stem Cells
Advantages
• Because they have the potential to become any cell in the human body,
embryonic stem cells are commonly considered to hold the most promise for
treating disease and replacing tissue and cells
• Large numbers can be easily grown in the laboratory
Disadvantages
Ethical Issues
• Many people oppose embryonic stem cell research because they believe that
once formed, the embryo is a human life that should not be destroyed. This is a
very significant political, moral, and religious issue for many
Advantages
Disadvantages
Ethical Issues
[1] For simplicity, this fact sheet treats umbilical cord blood stem cells and fetal
stem cells as adult stem cells and embryonic stem cells respectively.
While "stem cells" have become a commonplace term in the news today, many people
only have a vague idea of what stem cells are, where they come from and what they do.
Below, we have put together a simple guide on stem cells.
Application
Stem cells may hold the key to replacing cells lost in many devastating diseases
like Parkinson's disease, diabetes, chronic heart disease, end-stage kidney
disease, liver failure, and cancer are just a few for which stem cells have
therapeutic potential. Today, science has brought us to a point where the
immune response can be subdued, so that organs from one person can be used to
replace the diseased organs and tissues of another.
The use of stem cells to generate replacement tissues for treating neurological
diseases is a major focus of research. Spinal cord injury, multiple sclerosis,
Parkinson's disease, and Alzheimer's disease are among those diseases for
which the concept of replacing destroyed or dysfunctional cells in the brain or
spinal cord is a practical goal.
Another major discovery frontier for research on adult and embryonic stem cells
is the development of transplantable pancreatic tissues that can be used to treat
diabetes. Scientists in academic and industrial research are vigorously pursuing
all possible avenues of research, including ways to direct the specialization of
adult and embryonic stem cells to become pancreatic islet-like cells that produce
insulin and can be used to control blood glucose levels. Researchers have
recently shown that human embryonic stem cells to be directly differentiated
into cells that produce insulin.
Stem cell-based therapies are a major area of investigation in cancer research. For many
years, restoration of blood and immune system function has been used as a component
in the care of cancer patients who have been treated with chemotherapeutic agents.
Now, researchers are trying to devise more ways to use specialized cells derived from
stem cells to target specific cancerous cells and directly deliver treatments that will
destroy or modify them.
Cell nuclear transfer is a technique, which has the potential to create copies of healthy
cells to replace or repair damaged or diseased tissues and organs. It involves removing
the nucleus from a donated egg and fusing it with a healthy adult cell. The egg-cell
combination is then stimulated to develop into a blastocyst, from which embryonic
stem cells can be extracted after five days of growth. Obtaining stem cells for potential
therapies this way is known as therapeutic cloning.
Cell therapy
Cell therapy can be defined as a group of new techniques, or technologies, that rely on
replacing diseased or dysfunctional cells with healthy, functioning ones. These new
techniques are being applied to a wide range of human diseases, including many types
of cancer, neurological diseases such as Parkinson's and Lou Gehrig's Disease, spinal
cord injuries, and diabetes. Replacing dead cells in the retina with new ones may
someday cure even presently incurable eye diseases such as glaucoma and macular
degeneration. To understand how cell therapy works, it helps to understand the role of
cells in the body.
Immune rejection
Patients receiving a graft of embryonic stem cells or adult stem cells sourced from
cadavers would probably be treated in much the same way that organ transplant
recipients are treated. The grafts would be matched to the individual patient and anti-
rejection drugs would be used. Patients receiving brain cells may not need these drugs;
the brain seems to get away with less surveillance by the immune system than other
parts of the body. And there is one type of stem cell known as a mesenchymal stem
cell that seems to evade detection by the immune system. Everyone carries
mesenchymal stem cells in their bone marrow; they normally give rise to cartilage,
bone or muscle cells. If these cells do not trigger immune rejection they could be used
in future treatments of bone and joint diseases or repair heart muscle damaged during a
heart attack.
If patients provide their own stem cells, then of course immune rejection is no problem.
Leukaemia patients routinely rely on their own stem cells. A reserve of their blood-
forming stem cells (found in bone marrow, but different from mesenchymal stem cells)
is stored away. After cancer therapy, which destroys stem cells, patients rely on the
stored stem cells to rapidly restore their red and white blood cell counts to normal.
Burn patients rely on the stem cells present in a tiny square patch of skin to seed the
growth of metres of new skin in the culture dish.
Cancer
Any stem cell, adult or embryonic, has the ammunition it needs to give rise to cancer:
an explosive ability to grow and to change into other types of cells. In fact, researchers
now realise that at the heart of many common cancers lies an adult stem cell gone awry.
Any stem cell lines injected into patients have to be carefully tested first in animals to
see if they give rise to cancer. Though cautious, researchers believe they will be able to
tame the tendency of stem cells to form cancers.
One way to avoid the problem of rejection is to use stem cells that are genetically
identical to the host. This is already possible in the rare situations when the patient has
healthy stem cells in an undamaged part of the body (like the stem cells being used to
replace damaged corneas).
But even where no "autologous" stems cells are available, there may be a solution:
using somatic-cell nuclear transfer (but with no goal of attempting to implant the
resulting blastocyst in a uterus).
In this technique,
• Imprinted Genes.
Sperm and eggs each contain certain genes that carry an "imprint" identifying
them later in the fertilized egg as being derived from the father or mother
respectively.
Creating an egg with a nucleus taken from an adult cell may not allow a proper
pattern of imprinting to be established.
When the diploid adult nucleus is inserted into the enucleated egg (at least those
of sheep and mice), the new nucleus becomes "reprogrammed". What
reprogramming actually means still must be learned, but perhaps it involves the
proper methylation and demethylation of imprinted genes. For example, the
inactive X chromosome in adult female cells must be reactivated in the egg, and
this actually seems to happen.
• Aneuploidy.
In primates (in contrast to sheep, cattle, and mice), the process of removing the
resident nucleus causes molecules associated with the centrosome to be lost as
well. Although injecting a donor nucleus allows mitosis to begin, spindle
formation may be disrupted, and the resulting cells fail to get the correct
complement of chromosomes (aneuploidy).
• Somatic Mutations. This procedure also raises the spectre of amplifying the
effect(s) of somatic mutations.
Two important points about embryonic and adult stem cells have emerged so far: the
cells are different and present immense research opportunities for potential therapy. As
research goes forward, scientists will undoubtedly find other similarities and
differences between adult and embryonic stem cells. During the next several years, it
will be important to compare embryonic stem cells and adult stem cells in terms of their
ability to proliferate, differentiate, survive and function after transplant, and avoid
immune rejection. Investigators have shown that differentiated cells generated from
both adult and embryonic stem cells can repair or replace damaged cells and tissues in
animal studies.
Scientists upon making new discoveries often verify reported results in different
laboratories and under different conditions. Similarly, they will often conduct
experiments with different animal models or, in this case, different cell lines. However,
there have been very few studies that compare various stem cell lines with each other. It
may be that one source proves better for certain applications, and a different cell source
proves better for others.
For researchers and patients, there are many practical questions about stem cells that
cannot yet be answered. How long will it take to develop therapies for Parkinson's
Disease and diabetes with and without human pluripotent stem cells? Can the full range
of new therapeutic approaches be developed using only adult stem cells? How many
different sources of stem cells will be needed to generate the best treatments in the
shortest period of time?
Predicting the future of stem cell applications is impossible, particularly given the very
early stage of the science of stem cell biology. To date, it is impossible to predict which
stem cells—those derived from the embryo, the fetus, or the adult—or which methods
for manipulating the cells, will best meet the needs of basic research and clinical
applications. The answers clearly lie in conducting more research.
Key Achievements in Stem Cell Research
1978 First IVF baby born, following fertilisation of human eggs outside the body by
scientists at Cambridge University, UK.
1981 Successful cultivation of mouse embryonic stem (ES) cells from explanted inner
cell mass cells, at the University of California, USA, and Cambridge University,
UK.
1992 Development of methods for culturing embryonic germ (EG) cells developed at
Vanderbilt University and National Cancer Institute, USA.
1996 A sheep is cloned through cell nuclear replacement techniques at the Roslin
Institute, Edinburgh University, Scotland.
1996 Primate ES cell lines derived at the Wisconsin Primate Research Center, USA.
1998 First human ES cell lines are derived from human blastocysts at the Wisconsin
Primate Research Center.
1998 Researchers at the John Hopkins University, USA, culture human EG cells taken
from fetal tissue.
1999 Researchers at the Cedars-Sinai Medical Center in Los Angeles, USA, remove
10 – 15 neural stem cells from a Parkinson’s disease patient and used them to
reproduce 6 million dopaminergic neural stem cells. These were reintroduced
into the patient’s brain tissue, producing a 62% increase in dopamine uptake and
a 40–50% improvement in certain motor tasks.
1999 Researchers at the Baylor College of Medicine, USA, turn adult somatic stem
cells derived from skeletal muscle into blood cells.
1999 Canadian researchers generate a variety of blood cell types, including myeloid,
lymphoid and early hematopoietic, from adult somatic neural stem cells.
2002 Research at the University of Minnesota Medical School shows that adult
somatic stem cells, previously thought to have very limited potential for
specialisation, can differentiate into unrelated cell types, such as nerve and blood
cells in some circumstances.
2003 Researchers at King’s College London generate the UK’s first human ES cell
line.
2004 The ISCF begins a review of ethics and regulation relating to stem cell research
across the globe.
2006 On behalf of the ISCF, the Australian National Health and Medical Research
Council begins a review of intellectual property rights related to stem cell
research across the world, which will be key in encouraging further research and
development worldwide.
2006 Led by the UK Medical Research Council, the International Stem Cell Forum
(ISCF) sponsors an international project coordinated by Sheffield University to
characterise 59 human embryonic stem cell lines.