All Things Stem Cell

“STEM CELL REVOLUTIONS” is an informative and engaging documentary recently distributed by the Scottish Documentary Institute. It’s a very useful film to see if you want to learn more about the history of stem cells, and where the clinical, cutting-edge technology is at currently. The documentary gives an overview of international stem cell history, starting with the discovery of stem cells and ending with the newest members of the ever-growing stem cell family. To summarize such a wealth of research, research that has been going on for over half a century, the film tells the story of a few key stem cell discoveries and applications. Each story is described through interviews with stem cell researchers who were directly involved or appeared on the scene later but can knowledgably discuss the event’s impact. The first group of stories is related to adult stem cells (although this is not explicitly stated or explained): the discovery of stem cells during WWII, the amazing rescue of two boys in the early 1980s using stem cell-based skin grafts, and the present-day treatment of blind patients in a stem cell clinic in India. The final group of stories is related to pluripotent stem cells: the discovery of embryonic stem cells (ESCs) in mice in 1981 by Martin Evans (it was a treat to see Evans, who won the Nobel Prize in 2007 for the research he discusses in the film!) and of human ESCs (hESCs) in 1998 by Jamie Thomson, present-day use of hESCs to treat patients with retinal disorders in London (although I shuddered a little when Pete Coffee handled a flask of cells without gloves on!), and the creation of induced pluripotent stem cells (iPSCs) by Shinya Yamanaka in 2006.

The science presented in the film is well-explained and even though the focus of the film is on medical breakthroughs accomplished using stem cells, the scientists interviewed do not try to over-hype current stem cell applications. Most helpful in making the technical information accessible are several short, accurate, and intriguing animations (made by Cameron Duguid). During a segment on Yamanaka’s research, one of these animations is particularly useful in explaining how chromatin regulation of gene expression is different in different types of tissues. However, it is repeatedly jarring when the interviews with down-to-earth stem cell scientists, who mostly do not over-hype their research, are bookended by interviews with Margaret Atwood (a writer who is confusingly repeatedly interviewed in a laboratory setting). She makes repeated references to The Fountain of Youth – at odds with the scientists’ messages. Similarly, repeatedly interspersed videos of a topless man doing what looked to be the Brazilian martial art of Capoeira seemed out of place.

Perhaps the only shortcoming of the film, if a bit minor, is that it shies away from getting into some of the nitty-gritty of why iPSCs may be better than hESCs or vice versa, but instead falls back upon the standard argument that hESCs are surrounded by ethical concerns. For a 71-minute-long film, it only makes sense that some issues be simplified, but additional details may have helped viewers better understand this important and hotly-debated topic. Specifically, a lot of the ethical arguments against hESCs are outdated or ill-founded. Probably most importantly, in 2006, Irina Klimanskaya and colleagues found how to isolate hESCs while leaving the donor embryo intact and potentially able to develop normally, weakening the argument against the generation of hESC lines on the grounds that they require the destruction of a potential embryo. Additionally, many researchers use blastocysts that would have been discarded by the in vitro fertilization clinic because the embryos were damaged in some way and would never develop properly. However, a significant strike against using hESCs in treatments, which the film does not touch upon, is the potential for immune rejection. Human iPSCs, on the other hand, are very appealing because they potentially may not have immune rejection problems in treatments, as mentioned in the film. However, human iPSCs are much newer to the stem cell scene and have similarities with cancer cells that researchers should probably better understand before iPSCs are widely used clinically. It is also a little surprising that Jamie Thomson is not mentioned in the human iPSC segment, as his group independently created human iPSCs at the same time as Yamanaka’s group.

The researchers interviewed in the film emphasize the importance of striking a balance between regulation and progress, but then the film seems to not take its own advice and gets bogged down in the regulation of stem cells in the very last segment of the film, when it may have been more useful to focus on the near-future applications of these cells. There’s a surprising focus on the hypothetical ethical arguments that would arise should human iPSCs be made into function eggs and sperm (which has not been done yet, and may not even be possible). However, it may be more useful to first focus on whether human iPSCs can even be successfully used in the clinic before diverting attention to this hypothetical ethical argument, which is much further down the road. It would also have been nice to see a mention of direct reprogramming, the latest stem cell technology that may one day make even iPSCs obsolete.

While there are amazing advances being made with stem cell technology, the film rightly cautions viewers about the dangers of going to a stem cell clinic abroad. A great resource for those considering stem cell treatments abroad is A Closer Look at Stem Cell Treatments, a website made by the reputable International Society for Stem Cell Research.

Overall, “STEM CELL REVOLUTIONS” is a great film for anyone wanting to learn more about the history of stem cells, hear legendary researchers talk about their ground-breaking work and patients talk about how stem cell therapies have changed their lives, and still get a down-to-earth idea of what is realistically being accomplished with these cells.

admin Bioengineering, Embryonic Stem Cells, Hematopoietic Stem Cells, Reprogramming, Review adult, clinical trials, embryonic, history, regenerative medicine, review

Recently, a patient with leukemia and human immunodeficiency virus (HIV) had apparent remission of both after stem cell transplants (Hütter et al., 2009). As discussed earlier, hematopoietic stem cells have been used in transplants to rescue patients with leukemia, but this method has not previously been as successful for treating HIV, the virus that causes acquired immunodeficiency syndrome (AIDS).

Once in the body, HIV primarily attacks the immune system, such as T cells, though some individuals have T cells that are naturally resistant to HIV infection. Over a decade ago, this resistance was found to be due to a mutation in a receptor that is normally on the cell surface of T cells, called chemokine receptor 5 (CCR5) (Liu et al., 1996). CCR5 is a chemokine receptor, meaning it normally binds and receives signals from chemokines, which are molecules cells can release and receive to cause an immune system response. CCR5 is thought to normally be involved in causing a response to infection, though its exact function is not fully understood. HIV normally interacts with CCR5 to gain entry into the target T cell, but some individuals have a mutation in the CCR5 gene, specifically a 32 base-pair deletion, that renders the resultant receptor completely nonfunctional and consequently prevents HIV from being taken into these cells (Liu et al., 1996).

The T cell membrane (shown as the purple, semicircle double line) allows entry of HIV (in pink) into the cell through multiple cell receptors anchored on the membrane, including CCR5.

admin Hematopoietic Stem Cells adult, clinical trials, gene therapy, hematopoietic, news

Promising cures for blood-related diseases, such as leukemia and lymphoma, hematopoietic stem cells (HSCs) have been heavily researched for decades. However, like many significant findings in science, their discovery was not made in search for such a cure, but stumbled upon while dealing with another serious medical issue of the time: radiation. While trying to treat people exposed to lethal doses of radiation during World War II, transplants from the spleen and bone marrow were found to rescue these victims (Ford et al., 1956). It was not until later that scientists determined that the HSCs present in these tissues were what was restoring the damaged tissues, observed by performing transplants using lethally irradiated mouse and rat models (Becker et al., 1963). HSCs in humans were further characterized and cultured in the 1980s (Morstyn et al., 1980; Sutherland et al., 1989; Sutherland et al., 1990). The formation of the National Marrow Donor Program during this time also greatly improved the availability of these cells for research. Not only have HSCs been successfully used clinically in humans since the 1950s, but to this day they are still one of the few adult stem cells to be tested for clinical uses.

It is now not only better understood how HSCs from a donor animal can save a lethally irradiated recipient animal, but how HSCs can be used in many other medical applications as well. HSCs are able to give rise to all cells in the hematopoietic system, which includes myeloid elements (i.e. red blood cells, white blood cells, platelets) and the lymphatic system (i.e. T-Cells) (Regenerative Medicine, 2006). Because radiation generally targets rapidly dividing cells, including bone marrow cells and cells in the lymphatic system, HSCs have the ability to replenish the supply of cells most damaged by radiation. While HSCs can be collected from adult bone marrow, some fetal tissues (liver, spleen, thymus), umbilical chords, and peripheral blood, in recent years there has been a great shift towards obtaining HSCs mainly from peripheral blood, using a much simpler and less controversial procedure, though achieving a large enough number of HSCs for transplants is still an obstacle to overcome (Stem Cells, 2001). HSCs are now being used to treat cancers of the hematopoietic system (leukemia and lymphomas), replenish cells lost to high-doses of chemotherapy, and fight against autoimmune diseases, in addition to other medical applications (Regenerative Medicine, 2006).

Hematopoietic stem cells give rise to two major progenitor cell lineages, myeloid and lymphoid progenitors (Regenerative Medicine, 2006).

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admin Hematopoietic Stem Cells adult, clinical trials, hematopoietic, history