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Stem cells: What they are and what they do Print

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You've heard about stem cells in the news, and perhaps you've Mayo Clinic Marketplace
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variety of health topics. Stem cells are the body's raw Simple, effective home remedies
materials — cells from which
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functions are generated. Under
the right conditions in the body
or a laboratory, stem cells
divide to form more cells called
daughter cells.

These daughter cells either

become new stem cells (self- Stem cells: The body's master cells
renewal) or become
specialized cells (differentiation) with a more specific function,
such as blood cells, brain cells, heart muscle cells or bone cells.
No other cell in the body has the natural ability to generate new
cell types.

Why is there such an interest in stem cells?

Researchers and doctors hope stem cell studies can help to:

Increase understanding of how diseases occur. By

watching stem cells mature into cells in bones, heart muscle,
nerves, and other organs and tissue, researchers and doctors
may better understand how diseases and conditions develop.
Generate healthy cells to replace diseased cells
(regenerative medicine). Stem cells can be guided into
becoming specific cells that can be used to regenerate and
repair diseased or damaged tissues in people.

People who might benefit from stem cell therapies include

those with spinal cord injuries, type 1 diabetes, Parkinson's
disease, amyotrophic lateral sclerosis, Alzheimer's disease,
heart disease, stroke, burns, cancer and osteoarthritis.

Stem cells may have the potential to be grown to become new

tissue for use in transplant and regenerative medicine.
Researchers continue to advance the knowledge on stem cells
and their applications in transplant and regenerative medicine.

Test new drugs for safety and effectiveness. Before using

investigational drugs in people, researchers can use some
types of stem cells to test the drugs for safety and quality. This
type of testing will most likely first have a direct impact on drug
development first for cardiac toxicity testing.

New areas of study include the effectiveness of using human

stem cells that have been programmed into tissue-specific
cells to test new drugs. For the testing of new drugs to be
accurate, the cells must be programmed to acquire properties
of the type of cells targeted by the drug. Techniques to
program cells into specific cells continue to be studied.

For instance, nerve cells could be generated to test a new

drug for a nerve disease. Tests could show whether the new
drug had any effect on the cells and whether the cells were
harmed.

Where do stem cells come from?

Researchers have discovered several sources of stem cells:

Embryonic stem cells. These stem cells come from embryos

that are three to five days old. At this stage, an embryo is
called a blastocyst and has about 150 cells.

These are pluripotent (ploo-RIP-uh-tunt) stem cells, meaning

they can divide into more stem cells or can become any type
of cell in the body. This versatility allows embryonic stem cells
to be used to regenerate or repair diseased tissue and organs.

Adult stem cells. These stem cells are found in small

numbers in most adult tissues, such as bone marrow or fat.
Compared with embryonic stem cells, adult stem cells have a
more limited ability to give rise to various cells of the body.

Until recently, researchers thought adult stem cells could

create only similar types of cells. For instance, researchers
thought that stem cells residing in the bone marrow could give
rise only to blood cells.

However, emerging evidence suggests that adult stem cells

may be able to create various types of cells. For instance,
 bone marrow stem cells may be able to create bone or heart
muscle cells.

This research has led to early-stage clinical trials to test

usefulness and safety in people. For example, adult stem cells
are currently being tested in people with neurological or heart
disease.

Adult cells altered to have properties of embryonic stem

cells (induced pluripotent stem cells). Scientists have
successfully transformed regular adult cells into stem cells
using genetic reprogramming. By altering the genes in the
adult cells, researchers can reprogram the cells to act similarly
to embryonic stem cells.

This new technique may allow researchers to use

reprogrammed cells instead of embryonic stem cells and
prevent immune system rejection of the new stem cells.
However, scientists don't yet know whether using altered adult
cells will cause adverse effects in humans.

Researchers have been able to take regular connective tissue

cells and reprogram them to become functional heart cells. In
studies, animals with heart failure that were injected with new
heart cells experienced improved heart function and survival
time.

Perinatal stem cells. Researchers have discovered stem

cells in amniotic fluid as well as umbilical cord blood. These
stem cells also have the ability to change into specialized
cells.

Amniotic fluid fills the sac that surrounds and protects a

developing fetus in the uterus. Researchers have identified
stem cells in samples of amniotic fluid drawn from pregnant
women to test for abnormalities — a procedure called
amniocentesis.

More study of amniotic fluid stem cells is needed to

understand their potential.

Why is there a controversy about using

embryonic stem cells?
Embryonic stem cells are obtained from early-stage embryos — a
group of cells that forms when a woman's egg is fertilized with a
man's sperm in an in vitro fertilization clinic. Because human
embryonic stem cells are extracted from human embryos, several
questions and issues have been raised about the ethics of
embryonic stem cell research.

The National Institutes of Health created guidelines for human

stem cell research in 2009. The guidelines define embryonic stem
cells and how they may be used in research, and include
recommendations for the donation of embryonic stem cells. Also,
the guidelines state embryonic stem cells from embryos created
by in vitro fertilization can be used only when the embryo is no
longer needed.

Where do these embryos come from?

The embryos being used in embryonic stem cell research come
from eggs that were fertilized at in vitro fertilization clinics but
never implanted in a woman's uterus. The stem cells are donated
with informed consent from donors. The stem cells can live and
grow in special solutions in test tubes or petri dishes in
laboratories.

Why can't researchers use adult stem cells

instead?
Although research into adult stem cells is promising, adult stem
cells may not be as versatile and durable as are embryonic stem
cells. Adult stem cells may not be able to be manipulated to
produce all cell types, which limits how adult stem cells can be
used to treat diseases.

Adult stem cells also are more likely to contain abnormalities due
to environmental hazards, such as toxins, or from errors acquired
by the cells during replication. However, researchers have found
that adult stem cells are more adaptable than was first thought.

What are stem cell lines and why do

researchers want to use them?
A stem cell line is a group of cells that all descend from a single
original stem cell and are grown in a lab. Cells in a stem cell line
keep growing but don't differentiate into specialized cells. Ideally,
they remain free of genetic defects and continue to create more
stem cells. Clusters of cells can be taken from a stem cell line and
frozen for storage or shared with other researchers.

What is stem cell therapy (regenerative

medicine) and how does it work?
Stem cell therapy, also known as regenerative medicine,
promotes the repair response of diseased, dysfunctional or
injured tissue using stem cells or their derivatives. It is the next
chapter in organ transplantation and uses cells instead of donor
organs, which are limited in supply.

Researchers grow stem cells in a lab. These stem cells are

manipulated to specialize into specific types of cells, such as
heart muscle cells, blood cells or nerve cells.

The specialized cells can then be implanted into a person. For

example, if the person has heart disease, the cells could be
injected into the heart muscle. The healthy transplanted heart
muscle cells could then contribute to repairing defective heart
muscle.

Researchers have already shown that adult bone marrow cells

guided to become heart-like cells can repair heart tissue in
people, and more research is ongoing.

Have stem cells already been used to treat

diseases?
Yes. Doctors have performed stem cell transplants, also known as
bone marrow transplants. In stem cell transplants, stem cells
replace cells damaged by chemotherapy or disease or serve as a
way for the donor's immune system to fight some types of cancer
and blood-related diseases, such as leukemia, lymphoma,
neuroblastoma and multiple myeloma. These transplants use
adult stem cells or umbilical cord blood.
Researchers are testing adult stem cells to treat other conditions,
including a number of degenerative diseases such as heart
failure.

What are the potential problems with using

embryonic stem cells in humans?
For embryonic stem cells to be useful in people, researchers must
be certain that the stem cells will differentiate into the specific cell
types desired.

Researchers have discovered ways to direct stem cells to

become specific types of cells, such as directing embryonic stem
cells to become heart cells. Research is ongoing in this area.

Embryonic stem cells can also grow irregularly or specialize in

different cell types spontaneously. Researchers are studying how
to control the growth and differentiation of embryonic stem cells.

Embryonic stem cells might also trigger an immune response in

which the recipient's body attacks the stem cells as foreign
invaders, or the stem cells might simply fail to function normally,
with unknown consequences. Researchers continue to study how
to avoid these possible complications.

What is therapeutic cloning, and what benefits

might it offer?
Therapeutic cloning, also called somatic cell nuclear transfer, is a
technique to create versatile stem cells independent of fertilized
eggs. In this technique, the nucleus, which contains the genetic
material, is removed from an unfertilized egg. The nucleus is also
removed from the cell of a donor.

This donor nucleus is then injected into the egg, replacing the
nucleus that was removed, in a process called nuclear transfer.
The egg is allowed to divide and soon forms a blastocyst. This
process creates a line of stem cells that is genetically identical to
the donor's cells — in essence, a clone.

Some researchers believe that stem cells derived from

therapeutic cloning may offer benefits over those from fertilized
eggs because cloned cells are less likely to be rejected once
transplanted back into the donor and may allow researchers to
see exactly how a disease develops.

Has therapeutic cloning in people been

successful?
No. Researchers haven't been able to successfully perform
therapeutic cloning with humans despite success in a number of
other species.

However, in recent studies, researchers have created human

pluripotent stem cells by modifying the therapeutic cloning
process. Researchers continue to study the potential of
therapeutic cloning in people.

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June 08, 2019

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