Alternatives in Embryology

The media often gives the impression that only embryonic stem cells will cure disease. Ethical alternatives such as bone marrow or blood stem cells are often completely ignored by the media.

Looking purely at the science, the truth is that embryonic stem cells have not led to any advances so far. In fact, all the advances have been with adult stem cells, taken from bone marrow, blood, skin etc – something which the media often fail to mention.

How many members of the public will know that embryonic stem cells have been shown to cause cancer, as the cells grow out of control, and are a mixture of hair, skin and muscle? Or that injecting embryonic stem cells into a patient will cause the patient’s body to reject the cells?

In contrast, adult stem cells taken from the patient’s own bone marrow, skin, nose or fat, or umbilical cord blood stem cells or stem cells from the placenta, provide a perfectly ethical alternative. Adult or umbilical cord blood stem cells are superior, because they can be implanted into a patient without being rejected.

Below is a selection of some of the recent breakthroughs using adult stem cells. Although the use of adult stem cell therapies is some way off, the research below demonstrates that adult stem cells provide a practical alternative to embryonic stem cells:

Heart disease
Doctors have regenerated a patient’s failing heart using stem cells taken from his bone marrow and injected into arteries near his heart. The bone marrow stem cells migrated to areas damaged by a heart attack and turned into healthy muscle cells which began to beat. Prof Bodo Eckehard Strauer carried out the treatment at the Dusseldorf University Cardiac Clinic where he is director. He said: “Ten weeks after the transplantation the size of the damage has reduced by nearly a third and the capacity of the heart itself has clearly improved. The Telegraph reports that trials using bone marrow stem cells to regenerate heart tissue are expected within a year. There have already been successful reports of patients being treated at Barts and the London.

Multiple sclerosis
The Lancet Neurology reported that 21 adults with relapsing-remitting multiple sclerosis who had stem cells transplanted from their own bone marrow deteriorated over three years. 81% improved by at least one point on a scale of neurological disability. The study was reported on BBC NewsOnline.

15 young patients with newly diagnosed type 1 diabetes were given drugs to suppress their immune systems followed by transfusions of stem cells drawn from their own blood. All but two of the volunteers in the trial, details of which are published in the Journal of the American Medical Association (JAMA), did not need daily insulin injections up to three years after stopping their treatment regimes. The JAMA study provides the first clinical evidence for the efficacy of stem cells in type 1 diabetes.

A two year old girl who was born blind is able to see for the first time after having umbilical cord stem cells injected into her forehead. After just three weeks of stem cell treatment she can now see, her eyes are tracking together for the first time, and she is able to recognise people and objects without touching them. A team of British specialists have treated more than a dozen patients with impaired corneas by transplanting human stem cells into their eyes.

Researchers at the Whitehead Institute in Cambridge, Mass., have converted skin cells from people with Parkinson’s disease into the general type of neuron that the disease destroys. The new approach, though it requires further work, would in principle allow the brain cells that are lost in Parkinson’s to be replaced with cells that carried no risk of immune rejection, since they would be the patients’ own. The research was reported in the journal Cell in March 2009, and the New York Times

Doctors at the International Neuroscience-Institute in Hanover have restored speech in a stroke victim using stem cells, taken from bone marrow and genetically engineered to make a drug that protects brain cells from dying. Six weeks after surgery the patient has returned almost to normal. Further tests are required to confirm that the therapy works and is safe.

A toddler was cured using umbilical cord stem cells stored in Japan, after diagnosed with a rare form of acute myeloid leukaemia was diagnosed. The transplant was carried out at the Bristol Royal Hospital for Children in 2007

Liver failure
Researchers at Massachusetts General Hospital regenerated livers using bone marrow stem cells, suggesting that thousands of patients who currently die on transplant waiting lists, could be saved in the future.

Hip fracture
Researchers based at the University of Southampton have treated four patients with hip joint problems using stem cell therapy. The technique combines the patients own bone marrow stem cells with donor bone cells to patch-repair damaged bones that would otherwise need treatment with metal plates and pins. They say it is only a matter of years before their method could be used routinely to treat some of the 60,000 people who fracture a hip in the UK each year.

Gut failure
Great Ormond Street Hospital in London has performed a world first by treating children dying from gut failure with a bone marrow transplant. Dr Neil Shah, consultant paediatric gastroenterologist at GOSH, said the stem cells in the marrow seemed to mend the damaged gut and correct the initial imbalance with the immune system.

Urinary incontinence
Women with urinary incontinence have been successfully treated with stem cells taken from their own muscles The procedure involves removing stem cells from the muscle in a patient’s arm, culturing them in a laboratory for six weeks and then injecting them into the wall of the urethra and into the sphincter muscle. Dr Ferdinand Frauscher, the radiologist who presented the results at a meeting of the Radiological Society of North America in Chicago, described the cells as “very intelligent”, forming new muscle cells and then ceasing automatically once the muscle has reached the correct mass.

Scientists in Canada have created brain cells from skin cells which could eventually form the basis of a treatment for Alzheimers. Further research is needed before the cells can be used for clinical treatments.