Stem Cell Research:  The Impact on Public Health

 

What Are Stem Cells?

            The Issue of stem cell research burst on to the scientific scene in November of 1998 when researchers first reported that they had successfully isolated human embryonic stem cells[1].  Unique properties of stem cells include that they are unspecialized, or they have the potential to make many different types of cells, are capable of dividing and renewing themselves for long periods of time, and they can also turn into specialized cells[2].  Unspecialized cells transform into specialized cells such as neurons, muscle cells, or red blood cells through a process known as differentiation.  Stem cells are either harvested from adults or embryos, and growing these cells outside the body requires the right mix of nutrients, hormones, growth factors, and blood serums.  Undifferentiated cells are considered pluripotent when they have the potential to become any type of cell provided when the right conditions.  Once researchers isolate stem cells and allow for them to proliferate in a culture for six or more months without differentiating, a stem cell line has been created[3].

              Adult stem cells are undifferentiated cells found among differentiated tissue or organs, and they have the potential to renew itself or differentiate into major specialized cell types[4].The role of adult stem cells in the body is to maintain and repair the tissues in which they are found.  Adult stem cells are thought to reside in a specific area of each tissue where they remain quiesecent, or no-dividing, for years until they are activated by either disease or tissue injury[5].  Tissues that house stem cells include brain, bone marrow, peripheral blood, blood vessels, muscles, skin and liver[6].  Adult stem cells are generally tissue specific, for instance, hematopoietic stem cells are blood-forming cells that are found in bone marrow.  While adult stem cells have the potential to differentiate into mature tissue when isolated from the body, they are extremely difficult to multiply in the lab[7].  In the past, scientists believed that adult stem cells from one type of tissue can only yield that same type of tissue when cultured in a laboratory, but recent experiments have raised the possibility that stem cells from one tissue may be able to create cell types of completely different tissue types, also known as plasticity[8].  While adult stem cells are free of ethical concerns, they are surrounded with numerous scientific challenges[9].

            Human embryonic stem cells have the potential to develop into essentially any type of cell in the human body (they are pluripotent).  In theory, scientists believe that embryonic stem cells have the potential to theoretically divide without limit to replenish or create other cells.  Embryonic stem cells also have the potential to either remain a stem cell or to develop into a specialized cell such as a red blood cell or a muscle cell[10].  Embryonic stem cells are primarily obtained from frozen embryos that are donated through In Vitro Fertilization (IVF) programs from extra embryos that were created for infertile couples to use during fertility treatments[11].  A surplus of embryos are usually created and kept frozen for future use by the couple.  When couples no longer need their frozen embryos for reproductive purposes, depending on the laws of that particular country, the embryos are used for stem cell research.  Cell lines are grown by isolating human embryonic stem cells from the inner cell mass of a human blastocyst, or a 5-day embryo.  With the help of fibroblast feeder layers, embryonic stem cells can be cultured indefinitely[12].

            Human embryonic stem cells (HESC) can also be obtained by a method referred to as somatic cell nuclear transfer (SCNT), or therapeutic cloning.  During SCNT, a nucleus is removed; removing the nuclear genome of an oocyte, and it is replaced with the nucleus of an adult cell[13].  The egg is then activated to form a blastocyst, containing fewer than 100 cells, which contains genetic material identical to the adult donor cell[14].  Scientist can either remove stem cells from the blastocyst or place the blastocyst into a uterus where it would have the potential to develop into a fetus[15].  By using SCNT, researchers are able to control the genotype of HESCs which eliminates the probability of tissue rejection[16].  While a cloned animal is abnormal, cloned stem cells are perfectly normal.  If a gene is active in a fertilized stem cell, it is also active in a cloned stem cell at the same activity level[17].  Research shows that there is no significant molecular difference between cloned and non-cloned stem cells[18].

            While embryonic stem cells and adult stem cells are both sources of undifferentiated cells, they both have several differences.  Because embryonic stem cells are pluripotent, they have the ability to become all types of cells whereas adult tem cells are limited to developing into cell types of the tissue or organ that they originated from[19].  Another difference between the two cells is the ease of growth in a culture.  It is relatively easy for researchers to grow a large number of embryonic stem cells in culture compared to adult stem cells which  are relatively rare and have no methods for greatly expanding the number in cultures[20].  Finally, if a patient’s own cells are used to create adult stem cells, there is little risk that they would be rejected by the individual’s immune system, but because HESC clinical trials have not been conducted, scientist are unsure of the risk of rejection in the use of embryonic stem cells[21].

            Scientist believe that stem cell research is important to the future of medicine because with adequate research, stem cells have the potential to treat disease by transplanting human stem cells into patients suffering from  degenerative diseases such as Parkinson’s disease, diabetes, traumatic spinal cord injury, Purkinje cell degeneration, Duchenne’s muscular dystrophy, heart disease, and hearing and vision loss[22].  With gene therapy, a genetic defect would be corrected by giving a healthy version of the gene to a patient[23].  A physician would isolate stem cells from the patient and introduce a harmless viruses into the stem cells that express the correct version of the mutated gene and readminister the stem cells back to the patient[24]. SCNT could potentially be used to generate disease-specific stem cell lines to treat specific disorders[25].  By using SCNT,  scientists may also be able to revert diseased cells to their primordial form and then monitor them to determine how and why abnormalities develop[26].  Once scientists have an understanding of diseased cells, the will be more successful creating treatment options.

            While the untapped possibilities leave many members of the medical research community excited, there are numerous obstacles that may impede human stem cell research.  Issues such as morality, funding, and national regulation impede scientists across the world from pursuing research possibilities related to gene therapy and stem cell research.  While stem cell research is a vivacious field of science, it is an ethical, political, social and legal war zone, and in this paper I hope to address ethical and moral issues surrounding stem cell research, current National and International Laws and Policies, and the progress of current research.

 

Ethical and Moral Issues Surround Stem Cell Research

            With increasing press coverage on stem cell research there have been two distinctive groups: those who are opponents of human embryonic stem cell research and those who are proponents of human embryonic stem cell research.  Many difficult questions engulf the morality of destroying embryos or using remnants of aborted fetuses to improve the medical wellbeing of other human beings[27].  Opponents of embryonic stem cell research argue that human life begins when an egg is fertilized; therefore, a human embryo is equivalent to a human being[28].  Proponents of embryonic stem cell research argue that during the natural reproductive process human eggs often fertilize, but fail to implant in the uterus.  While a fertilized egg has the potential to form a human life, it is not equal to a human being until it has at least successfully implanted in a woman’s uterus[29].  In Vitro fertilization (IVF) clinics often create more embryos than needed over the course of fertility treatments and the excess frozen embryos are discarded[30].  Opponents state that research on these embryos still condones the destruction of embryos, while proponents believe that it is morally permissive to use these embryos for potentially life saving biomedical research[31]. 

            Another hot topic surrounding stem cell research is the morality of cloning humans to improve the efficacy of techniques used to create stem cell lines[32].  Different methods of creating  human embryonic stem cells without “destroying” embryos, such as removing cells from blastocysts or altered nuclear transfer, involves implanting DNA  from a donor’s cell into a human egg that has had it’s nucleus removed and then the egg is stimulated  to divide[33].  This method of cloning embryos is also called SCNT and was described in detail in the previous section.  In a study, Understanding Australians’ Perceptions of Controversial Scientific Research, the results indicated that a majority of Australians polled were comfortable with research using adult cells, but they were not comfortable with scientist using cells created through cloning[34].

            Other crucial ethical concerns involving issues related to stem cell donors still need to be answered.  Because the U.S. FDA wants as much information as possible about the health of a stem cell donor, especially issues related to possible pathogens and diseases with genetic or family links, anonymity of stem cell donors can not be guaranteed[35].  Another hot ethical issue is how new stem cell lines are derived[36].  Finally there are issues of property related to stem cell research discoveries.  How would intellectual and personal property be divided once scientists  have discovered new techniques related to stem cell therapies is an issue that has not been completely tackled[37].

           

Current National and International Laws and Policies

            Initially, stem cell research was ineligible for public funding due to a ban placed on NIH-funded human research by Congress. In 1995 U.S. Congress attached a ban to the bill appropriating funding for the National Institute of Health (NIH)[38]. In December of 1999, NIH released draft guidelines allowing federally funded research on embryonic stem cells derived in the public sector.  Under these guidelines only embryos leftover from fertility clinics that were donated with the consent of the pogenitors and resulted in  no profit to the fertility clinics for the donated embryos are acceptable[39].

            Until 2001, public funding was never provided for human embryonic stem cell research in the United States.  On August, 9, 2001, President George Bush announced that the U.S. government would allow federal funding of embryonic stem cell research, but funding would be limited to stem cell lines already in existence[40].  Stem cell lines already in existence were permissible because the destruction of the embryo had already occurred, and by not funding future stem cell lines, the federal government would not be encouraging the destruction of embryos[41].  NIH determined that there were a total of 64 embryonic stem cell lines world-wide as of August, 9, 2001, but many scientists doubted how many of the 64 lines would be useful to the researchers while meeting the ethical requirements established by NIH guidelines and enforced by most universities[42].  Of the 64 stem cell lines, NIH claimed that 19 stem cell lines were created at the Goteborg University in Sweden.  Of those 19 cell lines, 12 were in “early stages”, 4 were “being studied and described” and only 3 were “established”[43].  As of August 14, 2002 NIH stem cell registry listed 78 eligible cell lines  that meet the president’s criteria for publicly funded research and only 16 of the 78 embryonic stem cell lines are available for distribution[44].  The NIH Human Embryonic Stem Cell Registry was launched in November of 2001. The registry lists all cell lines that are eligible for federally funded research.  The President’s Council on bioethics oversees all federally funded embryonic stem cell research[45].

            Scientist have raised concerns  about the cells approved for federal funding under the Bush administration based on the following five questions:  1) Whether cell lines are robust stem cell colonies 2)  whether procedures used to create the cells are consistent with  high ethical standards 3) whether the different cell lines  have sufficient genetic diversity 4)  whether the cells produced from cell lines are safe for human implantation and 5) whether the  owners of the cell lines will make them available to researchers in a timely fashion and at a reasonable cost[46].  The safety of existing stem cell lines are of concern because most were grown in cultures with the help of mouse  stem cells which introduces the possibility of animal viruses that are potentially dangerous to humans[47].  Transplantation with existing cells would be classified as “xenotransplants” or transplants of animal tissue[48].  Existing lines have been shown to accumulate genetic mutations that make the lines questionable for future therapeutic use[49].  Additional lines need to be  created in order to ensure a broad diversity that would better match patients with cells and to gain a comprehensive understanding of  diseases as it affects people with different genetic backgrounds[50].  Scientists in the United States are also concerned that the slow pace of research in the U.S. will allow other countries to assume the leadership role in the field[51].

            The National Academy of Sciences is creating a privately funded committee to regulate human embryonic stem cell research. The committee was established to update guidelines on research and provide guidance to local groups on related issues.  NIH usually handles all oversights on biomedical research , but Bush’s stance on human embryonic stem cells has left the agency unable to define “ethically acceptable” methods of stem cell research.  This group will also make sure that the private sector doesn’t “call all of the shots”[52].  Researchers involved with stem cell research are barred from serving on the National Academy of Sciences panel[53].

            Bush signed a bill (HR2520) on December 20, 2005 which authorized $79 million in federal funding for collection and storage of umbilical cord blood.  Umbilical cord blood contains hematopoeitic progenitor cells which are stem cells found in adult bone marrow and could potentially be used to treat leukemia, lymphoma, sickle cell anemia, and other diseases[54].  The bill establishes and authorizes funding for a cord blood bank network for the purpose of stem cell research and the treatment of diseases[55]. 

            Many policies on stem cell research vary from state-to-state.  In Illinois, the state house and senate are considering a bill that imposes a surcharge on elective cosmetic surgery in order to raise US$1 billion for stem cell research over the next 10 years[56].  New Jersey’s legislature has also approved US$150 million in state funding to build a stem cell institute[57].

            In California, Proposition 71 was passed in November of 2004 which promised $3 billion in funding for human embryonic stem cell research over the next 10 years[58].  Proposition 71 also established the California Institute for Regenerative Medicine to regulate and oversee stem cell research, a mission that entails managing ethical research practices and awards grants through a peer review of out-of-state scientists to prevent conflicts of  interest.  Under Proposition 71, derivation of new human embryonic stem cell lines is permitted along with SCNT[59].  Experts believe that Proposition  71 has shifted the debate from moral to economic as states are now concerned that they will be losing jobs to neighboring states that allow the stem cell industry[60].  In other parts of California, The University of Southern California has received $25 million from the Broad Foundation to create the Broad Institute for Integrative Biology and Stem Cell Research, the largest stem cell research center in California[61].  Also, the California Institute for Regenerative Medicine (CIRM) is authorized to spend $3 billion to support human stem cell research[62]. 

            Countries like the United Kingdom, Sweden, and Singapore have the most liberal laws related to stem cell research.  In the United Kingdom, researchers are allowed to use embryonic stem cells from discarded embryos and to create embryos for research purposes.  The approval process, however, can be laborious as a researcher must first get approval from the local hospital ethical board, and then apply for a license from the Human Fertilization & Embryology Authority(HFEA)[63].  HFEA inspects the quality of the science, the researcher’s reason to use embryos, if the scientist is compiling with the law, and if the researcher is following correct patient consent procedures[64].  HFEA also conducts yearly inspections to ensure that every embryo is accounted for[65].  The U.K. also runs a Stem Cell Bank, the first in the world to curate standard human adult, fetal and embryo stem cell lines on a single site[66].  The Human Tissue Act of 2004 (UK)  ensures that individual have the opportunity to choose if tissue that  is lawfully taken from their bodies can be retained or used for medical research[67].  Under the Human Tissue Act of 2004 it is a criminal offence to use human tissue with out prior consent of individuals.  The Human Tissue Act of 2004 does not apply to stem cell lines due to the clause that excludes tissue “created outside of the human body”[68].

            In Sweden, many of the human embryonic stem cell protections are similar to that of the UK.  In April of 2005, the government approved of the production of embryonic stem cell lines using SCNT[69].  Human embryonic stem cells from leftover embryos were already allowed to be used.[70]

            In Singapore, research on surplus IVF embryos is allowed using federal funding, and SCNT is allowed on a case-by-case basis[71].  Reproductive cloning; however, is prohibited and there is a fine of $100,000 and up to 10 years in jail for anyone found guilty of reproductive cloning[72].  In order for researchers in Singapore to derive human embryonic stem cells, researchers must go to the hospital’s Institutional Review Board, then to the government ministry of health, and finally to a government advisory bioethical council[73].

            Australian laws, like the United States, vary state-to-state.  Cell lines are only harvested from IVF embryos frozen prior to 2002[74].  They are now allowed research on any frozen embryos with proper consent and ethical review[75].  In Israel, researchers can use embryonic stem cells from frozen embryos, but egg donation and SCNT is not allowed[76].

            Austria and Germany contains much more restrictive laws.  Religious views, a legacy of eugenics, and negative attitudes towards new technology are believed to be responsible for these restrictions[77].  German scientist can only work on human embryonic stem cell lines derived in labs outside of Germany that were derived prior to 2002, and Federal law prohibits the derivation of any new human embryonic stem cell lines[78]. Germany’s European Commission on stem cell research contributions end up funneled into countries with more liberal policies, meaning that they are indirectly funding research in other countries that is illegal in Germany[79]. 

            With such a great variation in international and even national policies, it can be confusing as to what scientific practices are allowed within in any given geographical boundary.  The Hixton Group comprised of 60 bioethicists and stem cell researchers from 14 countries are advocating for consistent policies between nations[80].  The group believes that it is vital to address restrictions placed on stem cell research and fears that these restrictions are hampering the progress of science and complicating the ability for scientists to conduct stem cell research across national boundaries.  For instance, a German stem cell researcher working in the U.K. “would be committing a criminal act under German law” because such research is prohibited in Germany[81].  The purpose of ethical guidelines for stem cell research released by the group is to clarify conflicting international policies[82].  The Hixton group asks journals to require researchers to confirm findings and to correspond with national guidelines as well as establishing a public website for researchers to share their findings.  While the Hixton group guidelines would not replace laws already set in place, they would “codify basic rules of acceptable behavior in many jurisdictions that lack stem cell laws[83]. 

 

Current Research

            One of the most exciting breakthroughs in stem cell research is that scientists at WiCell Research Institute, a private lab affiliated with the University of Wisconsin- Madison, recently developed a precisely defined stem cell culture system that is completely free of animal cells.  Using this new culture system, the WiCell Research Institute created two new human embryonic stem cell lines.  By completely ridding the culture medium that stem cells are grown in of animal products, the chance of harboring dangerous viruses or deleterious agents in the animal cells are completely eliminated.  The ability to grow stem cells in cultures free of animal products has been a topic of debate over the federal funding for additional stem cell lines, and by having this new culture medium available, stem cells have become closer to a clinical reality.  “Derivation and culture of serum-free, animal product-free, feeder-independent conditions mean new human (embryonic stem) cell lines could be qualitatively different from the original lines, and makes current public policy in the U.S. increasingly unsound,”  authors of Nature Biotechnology Report conclude[84].  Currently 2 new stem cell lines using the WiCell Research Institute medium have survived from more than 7 months[85].

            Other research that is leading scientists closer to understanding stem cells has occurred at the University of Edinburg.  Edinburgh scientists have shown that a protein Mbd3 plays a crucial role in the process that causes embryonic stem cells to become specialized cells.  This new information helps scientists understand how embryonic stem cells can be made to become a specific type of cell within the body.  Mbd3 is part of a large complex of proteins called Nucleosome Remodeling and Histone Deacetylation Complex, or NuRd, which is known as an epigenetic silencer as its role in cells is to turn genes off.  Edinburgh scientists made mouse embryonic stem cells lacking Mbd3 protein, and the Mbd3 lacking cells failed to form different cell types, leaving the stem cells in an uncommitted state.  If Mbd3 is absent, cells remain in an embryonic stem cell-like state[86].  With additional research, scientist may be able to use this information in the creation of therapeutic treatments using adult stem cells where embryonic stem cells were traditionally believed to be the best. 

            At the University of Rochester Medical Center, a study was launched on January 26, 2006 to investigate whether transplanted stem cells can be safely used to treat damaged heart muscle after a patient’s first heart attack.  Researchers are optimistic that cellular cardiomyopatsty, the use of stem cells to replace lost heart muscle cells, will prevent the loss of heart muscles after a heart attack.  The treatment is measuring the efficacy of 3 IV doses of adult human stem cells versus placebo in decreasing the damage to heart muscle within 10 days of a first heart attack and has been approved for a new study.  The study seeks to ensure that stem cell therapy is safe in treating heart failure.  The new study is a randomized, double-blind, placebo-controlled Phase I clinical trial with patients randomized to receive injections of either .5 million, 1.6 million, or 5.0 million cultured adult mesenchymal stem cells per kilogram of body weight or the placebo.  The trial is being conducted according to US FDA guidelines to evaluate the safety of treatment of stem cells obtained from healthy, unrelated adult donors.  Experts think that mesenchymal stem cells or MSCs have the potential to be a powerful new treatment in cardiology.  MSCs, like Blood Type O, are universally compatible and are transplanted without the risk of rejection.  Generating MSCs can be expensive, time-consuming, and produce a limited number of cells in culture, however, MSCs can be donated by other humans leaving the possibility for storage of stem cell supplies that would be ready for use as heart attack patients arrive at hospitals.  At this time MSCs are already used in the treatment of some cancers.  While MSCs do offer some hope to heart attack victims, there are still several complications that may keep them from being a standard treatment offered in hospital emergency rooms.  The MSCs hone in on damage for only a short period of time following the injury, so treatment must be administered as soon as possible after a heart attack.  Also, implanted stem cells are shown to only partly differentiate and the end result lacks some characteristics of mature heart muscle cells.   Finally, most implanted MSCs either re-enter the circulatory system or die rather than engraft to the heart muscle wall[87].

 

Current Obstacles

            The potential to treat degenerative disease using stem cell technologies seems to be very promising, which may leave many people to question why the scientific community isn’t pouring more time and resources into stem cell research.  In addition to ethical and moral issues and current legislative restrictions as mentioned previously in this chapter, there are other issues that leave the scientific industry hesitant to dedicate more time to stem cell research.  The issue of intellectual property within stem cell research has been an issue that has not been addressed[88].  One of the most frustrating aspects of stem cell research is the recent and expected explosion of patents in the stem cell field which may block scientists from developing new treatments.  Restrictions resulting from new patents discourage researchers from pursuing particular line of inquire and slows the pace of stem cell research[89].  It has been suggested that institutions such as the California Institute for Regenerative Medicine (CIRM) require all grant recipients to agree to donate exclusive license to any “insights, materials and technologies” that they discover through their research and patent them to a common open source patent pool that would be administered by a new non-profit organization[90].  The patent pool would then serve as a one-stop shop for investigators to obtain no-cost or low-cost licenses for new research.  These open source patent pools would stimulate innovative stem cell research[91].

            Currently there has been little discussion of the regulation that will govern the results of research as the medical field attempts to move stem cell therapies from the laboratory to physician’s offices.   Any future regulation must reassure the end-users, both patients and health care providers that the stem cell products reliably satisfy a medical need without creating unnecessary cost or moral concerns[92]. End-users will also need to be reassured that treatments are not detrimental to their health and that the treatments do not carry any infectious diseases.   It is also important that new regulations reassure those who supply raw materials and labor for stem cell research that this industry is beneficial for them to participate in while encouraging responsible manufacturing[93].  

            Once stem cell therapies have been created, additional hurdles will remain.  Before any new medical treatments can be used in the U.S. they must first be approved by the FDA.  The safety and effectiveness of new treatments must be proved through clinical trials that demonstrate that the drug or treatment performs as it is claimed to do.  Clinical trials are costly to conduct, and require the funding of private sectors[94].  During a recent clinical trial, a virus activated a cancer-causing gene, and as a result, the FDA is not currently approving gene-therapy clinical trials[95].

            Scientists are also concerned that existing stem cell lines have been shown to accumulate genetic mutations with time.  With these genetic mutations, it is very questionable that stem lines currently available would be eligible for therapeutic use[96].  Additional concern is the social impact that stem cell technologies may have around the world.  Minority and ethnic groups are unlikely to benefit equally from stem cells as stem cell banks do not include less common tissue haplotypes[97].  More stem cell lines need to be created in order to ensure a broad diversity that will better match patients appropriate stem cells, and  for scientists to gain a more comprehensive understanding of human disease as it affects people with different genetic backgrounds[98].

 

Potential Impact on Public Health

            Scientists think that stem cell research is important to the future of medicine because with adequate research, stem cells have the potential to treat degenerative conditions by transplanting human stem cells into patients.  Presently, many of these chronic conditions have no cure and are managed by treating the symptoms.  While the initial cost of receiving stem cell therapy may be high, it has the potential to outweigh the life long costs encured through daily medications and hospitalizations.  By making disease management easier, the quality of life for those diagnosed with this diseases and their family members would be greatly included.  With sufficient development of stem cell medicine, chronic diseases such as diabetes, heart disease, and Parkinson’s disease will be effectively managed.

            Diabetes is a chronic disease with severe complications including increased risk for limb amputations and vision loss ,and currently there is no cure.  The world-wide estimate of individuals with diabetes in 200 was 177 million people, and that number is expected to reach 300 million by 2025.  Deaths attributed to diabetes is reported to be over 800,000 but many experts argue that this figure is grossly underestimated and should be closer to 4 million deaths per year which is nearly 9% of the world population[99].  Managing the disease often involves drastic changes in lifestyle in additions to daily medication and medical monitoring.  It was estimated that the total annual economic cost of diabetes in 2002 was approximately US$132 billion or approximately 1 out of 10 health care dollars spent in the U.S.[100].  With more research, future treatments may include transplanting insulin-producing pancreatic beta cells, eliminating the need for daily medications and reducing the risk of diabetes related complications.

            Nearly 1 in a million people in the U.S. are diagnosed with Parkinson’s disease.  Parkinson’s disease is a movement disorder with symptoms that include debilitating tremors that continue and worsen with time.  Patients diagnosed with Parkinson’s disease take a variety of medications in different doses to manage the symptoms of the disease.  The varieties of medications are often confusing, causing individuals to miss doses.  While the surgical option of Deep Brain Stimulation has been shown to decrease the severity of the symptoms, the treatment is not successful for all patients[101].  Stem cell therapy may reduce and prevent the progression of Parkinson’s symptoms when destroyed dopamine-secreting neurons are replaced, improving the patient’s quality of life and reducing drug costs. 

            More than ½ million Americans suffer have their first heart attack every year, resulting in injury to the heart and scarring that contributes to the gradual loss of the heart’s pumping strength[102].  Of the 1.5 million heart attacks per year in the U.S., approximately 500,000 result in fatalities. If that number doesn’t open your eyes, nearly 14 million Americans have a history of heart attack or angina, and the costs related to heart attacks exceed US$60 billion per year[103].  While stem cell research has not yet proposed that they will be able to reduce the occurrence of heart attacks, it is believed with refinement of current research, doctors may be able to someday reduce damage to the heart muscles is stem cells are administered after a heart attack.

 

Conclusion

            While the benefits of stem cell research may seem to be out of reach for the immediate future, with continued research , stem cell therapies are predicted to one day be a common treatment for degenerative diseases.  In order for this field to be successful, researchers must collaborate and share limited resources.  With increases in funding and continued interest from private investors, stem cell research is expected to evolve rapidly in the next decade.

 

 

For More Information

These websites and journals are helpful in obtaining more information about stem cell research:

Institute for Stem Cell Research (ISCR)- www.iscr.edu.ac.uk

The Journal Regenerative Medicine www.futuremedicine.com

NIH Stem Cell Information Home Page: www.stemcells.nih.gov

American Association for the Advancement of Science:  www.aaas.org

Stem Cell Policy: World-wide Stem Cell map: http://mbbnet.umn.edu/scmap.html

 



[1] http://www.aaas.org/spp/cstc/briefs/stemcells/index.shtml

[2] Ibid

[3] Ibid

[4] www.stemcells.nih.gov

[5] www.stemcells.nih.gov

[6] Ibid

[7] Powerful Technique For Multiplying Adult Stem Cells May Aid Therapies.  January 23, 2006.  Retrieved from :  www.medicalnewstoday.com

[8] Russo E (2005) Follow the Money- The Politics of Embryonic Stem Cell Research.  PLoS Biol 3(7): e234

[9] Powerful Technique For Multiplying Adult Stem Cells May Aid Therapies.  January 23, 2006.  Retrieved from :  www.medicalnewstoday.com

[10] www.stemcell.nih.gov

[11] Russo E (2005) Follow the Money- The Politics of Embryonic Stem Cell Research.  PLoS Biol 3(7):e234

[12] Russo E (2005) Follow the Money- The Politics of Embryonic Stem Cell Research.  PLoS Biol 3(7):e234

[13] Ibid

[14] Ibid

[15] Cloned Stem Cells and Fertilized Stem Cells Identical.  January 17, 2006.  Retrieved from: www.medicalnewstoday.com

[16] Russo E (2005) Follow the Money- The Politics of Embryonic Stem Cell Research.  PLoS Biol 3(7):e234

[17] Cloned Stem Cells and Fertilized Stem Cells Identical.  January 17, 2006.  Retrieved from: www.medicalnewstoday.com

[18] Ibid

[20] Ibid

[21] Ibid

[22] Ibid

[23] Powerful Technique For Multiplying Adult Stem Cells May Aid Therapies.  January 23, 2006.  Retrieved from :  www.medicalnewstoday.com

[24] Ibid

[25] Cloned Stem Cells and Fertilized Stem Cells Identical.  January 17, 2006.  Retrieved from: www.medicalnewstoday.com

[26]  Cloned Stem Cells and Fertilized Stem Cells Identical.  January 17, 2006.  Retrieved from: www.medicalnewstoday.com

[27] Liddell, Kathleen and Susan Wallace.  Emerging Regulatory Issues for Human Stem Cell Medicine.”  Genomics, society and Policy 1.1. (2005) : 54-73.

[28] http://www.aaas.org/spp/cstc/briefs/stemcells/index.shtml

[29] http://www.aaas.org/spp/cstc/briefs/stemcells/index.shtml

[30] Ibid

[31] Ibid

[32] Liddell, Kathleen and Susan Wallace.  Emerging Regulatory Issues for Human Stem Cell Medicine.”  Genomics, society and Policy 1.1. (2005) : 54-73.

[33] Group Releases Ethical Guidelines on Stem Cell Research to Clarify Conflicting International Policies.  March 2, 2006.  Retrieved from:  www.medicalnewstoday.com

[34] Critchley, Christine and Lyn Turney.  “Understanding Australians’ Perceptions of Controversial Scientific Research.” Australian Journal of Emerging Technologies and Society 2.2 (2004) ; 79-140.

[35] Stem Cell Research: Legal and Ethical Questions.  March 1, 2006. Retrieved from www.medicalnewstoday.com

[36] Ibid

[37] Ibid

[38] http://www.aaas.org/spp/cstc/briefs/stemcells/index.shtml

[39] Ibid

[40] Ibid

[41] http://www.aaas.org/spp/cstc/briefs/stemcells/index.shtml

[42] Ibid

[43] Ibid

[44] Ibid

[45] Ibid

[46] http://www.aaas.org/spp/cstc/briefs/stemcells/index.shtml

[47] Ibid

[48] Ibid

[49] Wisconsin Scientists Grow Two New Stem Cell Lines in Animal Cell-free Culture.  January 2, 2006.  Retrieved from:  www.medicalnewstoday.com

[50] Ibid

[51] http://www.aaas.org/spp/cstc/briefs/stemcells/index.shtml

[52] National Academy Of Sciences To Create Privately Funded Embryonic Stem Cell Research Committee.  February 20, 2006.  Retrieved from:  www.medicalnewstoday.com

[53] Ibid

[54] President Bush Signs Bill Authorizing Funding for Establishment of Umbilical Cord Blood Network.  December 22, 2005.  Retrieved from:  www.medicalnewstoday.com

[55] Ibid

[56] Russo E (2005) Follow the Money- The Politics of Embryonic Stem Cell Research.  PLoS Biol 3(7):e234

[57] Ibid

[58] Ibid

[59] Russo E (2005) Follow the Money- The Politics of Embryonic Stem Cell Research.  PLoS Biol 3(7):e234

[60] Ibid

[61] Broad Foundation Donates $25 Million to Create New Stem Cell Institute at USC.   February 25, 2006.  Retrieved from: www.medicalnews.com

[62] Radical Proposal to Speed Development of Stem Cell Therapies.  March 1, 2006.  Retrieved from : www.medicalnewstoday.com

[63] Russo E (2005) Follow the Money- The Politics of Embryonic Stem Cell Research.  PLoS Biol 3(7):e234

[64] Ibid

[65] Ibid

[66] Liddell, Kathleen and Susan Wallace.  Emerging Regulatory Issues for Human Stem Cell Medicine.”  Genomics, society and Policy 1.1. (2005) : 54-73.

[67] Ibid

[68] Ibid

[69] Russo E (2005) Follow the Money- The Politics of Embryonic Stem Cell Research.  PLoS Biol 3(7):e234

[70] Ibid

[71] Ibid

[72] Ibid

[73] Ibid

[74] Russo E (2005) Follow the Money- The Politics of Embryonic Stem Cell Research.  PLoS Biol 3(7):e234

[75] Ibid

[76] Ibid

[77] Ibid

[78] Ibid

[79] Ibid

[80] Group Releases Ethical Guidelines on Stem Cell Research to Clarify Conflicting International Policies.  March 2, 2006.  Retrieved from:  www.medicalnewstoday.com

[81] Group Releases Ethical Guidelines on Stem Cell Research to Clarify Conflicting International Policies.  March 2, 2006.  Retrieved from:  www.medicalnewstoday.com

[82] Washington Post Examines Scientists, Ethicists Proposing International Stem Cell Research Guidelines.  March 6, 2006.  Retrieved from: www.medicalnewstoday.com

[83] Ibid

[84] Wisconsin Scientists Grow Two New Stem Cell Lines in Animal Cell-free Culture.  January 2, 2006.  Retrieved from:  www.medicalnewstoday.com

[85] Ibid

[86] Edinburgh Scientists Identify a Key Player in Making Specialized Cells From Embryonic Stem Cells.  February 8, 2006.

[87] Stem Cell Study Seeks to Prevent Heart Failure.  January 26, 2006.  Retrieved from: www.medicalnewstoday.com

[88] Stem Cell Research: Legal and Ethical Questions.  March 1, 2006. Retrieved from www.medicalnewstoday.com

[89] Radical Proposal to Speed Development of Stem Cell Therapies.  March 1, 2006.  Retrieved from : www.medicalnewstoday.com

[90] Ibid

[91] Radical Proposal to Speed Development of Stem Cell Therapies.  March 1, 2006.  Retrieved from : www.medicalnewstoday.com

[92] Liddell, Kathleen and Susan Wallace.  Emerging Regulatory Issues for Human Stem Cell Medicine.”  Genomics, society and Policy 1.1. (2005) : 54-73.

[93] Ibid

[94] Radical Proposal to Speed Development of Stem Cell Therapies.  March 1, 2006.  Retrieved from : www.medicalnewstoday.com

[95] Powerful Technique For Multiplying Adult Stem Cells May Aid Therapies.  January 23, 2006.  Retrieved from :  www.medicalnewstoday.com

[96] Wisconsin Scientists Grow Two New Stem Cell Lines in Animal Cell-free Culture.  January 2, 2006.  Retrieved from:  www.medicalnewstoday.com

[97] Liddell, Kathleen and Susan Wallace.  Emerging Regulatory Issues for Human Stem Cell Medicine.”  Genomics, society and Policy 1.1. (2005) : 54-73.

[98] Wisconsin Scientists Grow Two New Stem Cell Lines in Animal Cell-free Culture.  January 2, 2006.  Retrieved from:  www.medicalnewstoday.com

[99] www.who.int/mediacentre/factsheets/fs236/en

[100] www.diabetes.org

[101] www.pdf.org

[102] Stem Cell Study Seeks to Prevent Heart Failure.  January 26, 2006.  Retrieved from:

www.medicalnewstoday.com