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STEM CELLS: NEW ERA MEDICINE by Ihor Magun, M.D., F.A.C.P. The dawn of a new branch of medicine, regenerative medicine, has been a dream come true for many research scientists and medical practi tioners who have recognized the enormous benefits of using living, viable organ replacements as cura tive, healing measures that were once unimaginable. As with any new medical development, stem cell research has created political and religious contro versy. Notwithstanding the arguments, stem cell research, like other medical revolutions that have been fiercely debated over the centuries, has the potential of saving millions of lives. This article provides some details about its potential and at tempts to clear up some frequently misunderstood aspects of the research and its implications. There are two types of stem cells: embry onic stem cells and adult stem cells. Embryonic stem cells are extracted from embryos created for routine fertility treatments. (The excess embryos would normally be discarded.) This extraction de stroys the early embryo—an act considered by many to be the destruction of a human life. Hence, the controversy. Five days after extraction, a group of cells are formed, a mass of stem cells that can be come any of 220 tissue types. Many weeks later, the original stem cells number in the millions. They are healthy cells capable of indefinite reproduction without becoming specialized cells (like nerve cells or a heart cells). These nonspecialized cells are what is known as an embryonic stem cell line, and the cells for this line are relatively easy to harvest. The greatest challenge lies in how to direct indi vidual cells to become skin, bone, eye or liver. The natural human cell-generating process involves a complex combination of chemical and genetic signals. Artificially directing a cell to produce a "body part" is somewhat different, and research on how this can be accomplished is in its infancy. Such research, moreover, is highly dependent on financial and legislative support. Adult stem cells are found in all humans. They are found in various organs—blood, brain, bone marrow, cornea, retina, skin, fat, skeletal tis sue, dental pulp, and intestines. Stem cells harvested from a newborn's cord blood are considered adult stem cells (only because they are not harvested from an embryo). Cord blood is the remaining blood from a baby's umbilical cord and placenta after birth. The difference between embryonic stem cells and adult stem cells lies not only the method of harvesting, but also in the fact that adult stem cells can become only the same types of cell as those they originated from. Large numbers of cells are needed for therapeutic benefit; these cells are more difficult to culture and, at the present time, newborn's cord blood can produce only blood cells. Facilities for those who choose to "freeze" their children’s cord blood at birth already exist, and this has helped the very children from whom the blood was obtained. The preservation process is very expensive, how ever, and to date has helped only a small number of individuals. We are far from knowing all the answers, consequences, and possible miracles that can result from using stem cells. There is also no way to predict whether the future hold the promise of potential answers to curing now incurable diseases or whether we risk creating new diseases. This certainly is something to ponder, but mere specu lation will not provide the answers. These can be found only through diligent, accurate, and scrupu lous scientific research by dedicated individuals whose “science” is conducted meticulously while adhering to the physician’s ethical code of “Do no harm.”
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