Defying suspicion
For all the controversy surrounding stem cell therapy and a recent confession on the use of unethical practices, Kolkata now has a cord blood bank where a rich source of stem cells can be harvested and cryo preserved for use to treat ‘more than 75 serious ailments’NEW endeavours, whether of a technological or scientific nature, are often looked upon with suspicion and attract controversy. Stem cell therapy is no exception, more so after Dr Hwang Woo Suk confessed to unethical practices. Recently, nearer home in Kolkata, Asia Cryo-Cell Private Ltd, a well-known family cord blood bank, launched LifeCell.
To begin with, one must understand the concept of stem cells. They are unique in their ability to self-renew: to divide and create two cells, each identical to the original. "They are cells that have the remarkable potential to develop into many different cell types in the body. Serving as a sort of repair system for the body, they can theoretically divide without limit to replenish other cells for as long as the person or animal is alive. When a stem cell divides, each ‘daughter’ cell has the potential to either remain a stem cell or become another type of cell with a more specialised function, such as a muscle cell, a red blood cell, or a brain cell.
"There are three classes of stem cells: totipotent, multipotent and pluripotent. A fertilised egg is considered totipotent, meaning that its potential is total; it gives rise to all the different types of cells in the body. Stem cells that can give rise to a small number of different cell types are generally called multipotent. Pluripotent stem cells can give rise to any type of cell in the body except those needed to develop a foetus," explains Dr Milan Chhetri, consultant in internal medicine, Apollo-Gleneagles Hospital, Kolkata.
The most promising use of stem cells derives from their ability to be modified into different functional adult cell types and serve as a potential source of replacement cells to treat numerous diseases. Thus, any disease in which there is tissue degeneration can be a potential candidate for stem cell therapy, including conditions and disabilities like Parkinson’s and Alzheimer’s diseases, spinal cord injury, strokes, burns, heart disease, Type 1 diabetes, osteoarthritis, rheumatoid arthritis, muscular dystrophies and liver diseases.
So why does so much controversy surround embryonic stem cell research? Heather Rooke, science editor, International Society for Stem Cell Research, says, "Human embryonic stem cell research and therapy is debated as these stem cells are isolated from the five- six-day-old embryo, a ball of cells called the blastocyst. Not all people agree that use of the embryo for research and therapy is ethical."
Taking the point further, Dr Chhetri adds, "Opponents of ES cell research hold that human life begins as soon as an egg is fertilised, and they consider a human embryo to be a human being. They, therefore, consider any research that necessitates the destruction of a human embryo to be morally abhorrent. Proponents of ES cell research, meanwhile, point out that in the natural reproductive process, human eggs are often fertilised but fail to implant in the uterus. A fertilised egg, they argue, while it may have the potential for human life, cannot be considered equivalent to a human being until it has at least been successfully implanted in a woman’s uterus."
In the early 1900s, scientists found that blood cells came from a particular "stem cell". Bone marrow transplants, actually a transplant of stem cells, are currently used to treat a variety of diseases. Adult stem cell research on humans began in the 1960s, first achieving success in the treatment of a patient with severe combined immunodeficiency disorder in 1968. Since the early 1970s, adult stem cells have been successfully used for treatment of immunodeficiency and leukemia. In 1998, researchers at the University of Wisconsin led by James Thomson isolated and grew stem cells from human embryos, and researchers from John Hopkins University led by John Gearhart did the same for human germ cells.
Several countries are considering legislation on stem cell research. Dr Chettri continues, "For example, the Japanese government has said it is likely to approve research on clone embryos and embryonic stem cells within a year, while the British parliament has voted in favour of allowing stem cell research using early human embryos in December last year, so each country is likely to have its own policies."
Policies in Britain and the USA are not poles apart. Referring to a report by Nicola Perrin, Rooke adds, "UK legislation allows work with both adult and embryonic stem cells, and is considered to be among the most clear, comprehensive and responsible in the world. The position was reached after a period of lengthy debate, begun in 1990 with the Warnock Committee. The system of effective regulation, described as pragmatic rather than permissive, has been adopted as a model in other countries. The UK is one of only a few countries that allows the use of embryos created specifically for research purposes. The Human Fertilisation and Embryology Act (1990) allowed research on human embryos to promote advances in the treatment of infertility and to develop methods for detecting the presence of gene or chromosome abnormalities. In 2001, the Act was extended to allow the use of embryos for research to increase knowledge of, or to develop treatment for, serious diseases. Research is permitted with surplus embryos remaining after IVF, or created specifically for the purpose using SCNT. All work must be licensed by the Human Fertilisation and Embryology Authority, and embryos may only be used for up to 14 days after fertilisation. Reproductive cloning is strictly prohibited by the Human Reproductive Cloning Act (2001), making it illegal to implant in a woman a human embryo created other than by fertilisation."
The exact laws in the USA depend on the state. However, federal money may not be used for stem cell research except on a limited number of existing stem cell lines. For human embryonic stem cell research, the National Academies of Science have produced a set of guidelines but largely this is not federally mandated.
So what about India? In this country, donating cord blood is allowed. Says S Abhaya Kumar, CEO, Asia Cryo-Cell, "Cord blood, discarded after childbirth, is a rich source of stem cells, which can be harvested and cryo preserved for use to treat more than 75 serious ailments." LifeCell’s 21,000 sq. ft. stem cell processing and banking facility conforms to the standards of the American Association of Blood Banks and US FDA. The facility has the capacity to store over 100,000 samples and the technical team has been trained by Cryo-Cell International. Kumar adds, "We have invested Rs 14 crore in this facility and expect enrollments to shoot up to 15,000 by the end of next year. We have plans to launch India’s first exclusive stem cell transplant centre in collaboration with Sri Ramachandra Medical College and Research Institute in Chennai." LifeCell’s services come at a fixed price: an enrollment fee of Rs 5,000, a processing fee of Rs 22,000 and an annual storage fee of Rs 2,900.
Adult somatic stem cells such as blood-forming stem cells in bone marrow are currently the only type of stem cell commonly used to treat human disease. Doctors have been transferring HSCs in bone marrow transplants for over 40 years. The clinical potential of adult somatic stem cells has now also been demonstrated in the treatment of some other diseases, including diabetes, Parkinson’s disease and advanced kidney cancer. According to the International Stem Cell Forum, "In 1999, scientists in the USA removed 10-15 neural stem cells from a Parkinson’s disease patient and used these to reproduce six million dopaminergic neural stem cells in culture. These were reintroduced into the patient’s brain tissue, producing a 62 per cent increase in dopamine uptake and a 40-50 per cent improvement in certain motor tasks."
— Mathures Paul.
To begin with, one must understand the concept of stem cells. They are unique in their ability to self-renew: to divide and create two cells, each identical to the original. "They are cells that have the remarkable potential to develop into many different cell types in the body. Serving as a sort of repair system for the body, they can theoretically divide without limit to replenish other cells for as long as the person or animal is alive. When a stem cell divides, each ‘daughter’ cell has the potential to either remain a stem cell or become another type of cell with a more specialised function, such as a muscle cell, a red blood cell, or a brain cell.
"There are three classes of stem cells: totipotent, multipotent and pluripotent. A fertilised egg is considered totipotent, meaning that its potential is total; it gives rise to all the different types of cells in the body. Stem cells that can give rise to a small number of different cell types are generally called multipotent. Pluripotent stem cells can give rise to any type of cell in the body except those needed to develop a foetus," explains Dr Milan Chhetri, consultant in internal medicine, Apollo-Gleneagles Hospital, Kolkata.
The most promising use of stem cells derives from their ability to be modified into different functional adult cell types and serve as a potential source of replacement cells to treat numerous diseases. Thus, any disease in which there is tissue degeneration can be a potential candidate for stem cell therapy, including conditions and disabilities like Parkinson’s and Alzheimer’s diseases, spinal cord injury, strokes, burns, heart disease, Type 1 diabetes, osteoarthritis, rheumatoid arthritis, muscular dystrophies and liver diseases.
So why does so much controversy surround embryonic stem cell research? Heather Rooke, science editor, International Society for Stem Cell Research, says, "Human embryonic stem cell research and therapy is debated as these stem cells are isolated from the five- six-day-old embryo, a ball of cells called the blastocyst. Not all people agree that use of the embryo for research and therapy is ethical."
Taking the point further, Dr Chhetri adds, "Opponents of ES cell research hold that human life begins as soon as an egg is fertilised, and they consider a human embryo to be a human being. They, therefore, consider any research that necessitates the destruction of a human embryo to be morally abhorrent. Proponents of ES cell research, meanwhile, point out that in the natural reproductive process, human eggs are often fertilised but fail to implant in the uterus. A fertilised egg, they argue, while it may have the potential for human life, cannot be considered equivalent to a human being until it has at least been successfully implanted in a woman’s uterus."
In the early 1900s, scientists found that blood cells came from a particular "stem cell". Bone marrow transplants, actually a transplant of stem cells, are currently used to treat a variety of diseases. Adult stem cell research on humans began in the 1960s, first achieving success in the treatment of a patient with severe combined immunodeficiency disorder in 1968. Since the early 1970s, adult stem cells have been successfully used for treatment of immunodeficiency and leukemia. In 1998, researchers at the University of Wisconsin led by James Thomson isolated and grew stem cells from human embryos, and researchers from John Hopkins University led by John Gearhart did the same for human germ cells.
Several countries are considering legislation on stem cell research. Dr Chettri continues, "For example, the Japanese government has said it is likely to approve research on clone embryos and embryonic stem cells within a year, while the British parliament has voted in favour of allowing stem cell research using early human embryos in December last year, so each country is likely to have its own policies."
Policies in Britain and the USA are not poles apart. Referring to a report by Nicola Perrin, Rooke adds, "UK legislation allows work with both adult and embryonic stem cells, and is considered to be among the most clear, comprehensive and responsible in the world. The position was reached after a period of lengthy debate, begun in 1990 with the Warnock Committee. The system of effective regulation, described as pragmatic rather than permissive, has been adopted as a model in other countries. The UK is one of only a few countries that allows the use of embryos created specifically for research purposes. The Human Fertilisation and Embryology Act (1990) allowed research on human embryos to promote advances in the treatment of infertility and to develop methods for detecting the presence of gene or chromosome abnormalities. In 2001, the Act was extended to allow the use of embryos for research to increase knowledge of, or to develop treatment for, serious diseases. Research is permitted with surplus embryos remaining after IVF, or created specifically for the purpose using SCNT. All work must be licensed by the Human Fertilisation and Embryology Authority, and embryos may only be used for up to 14 days after fertilisation. Reproductive cloning is strictly prohibited by the Human Reproductive Cloning Act (2001), making it illegal to implant in a woman a human embryo created other than by fertilisation."
The exact laws in the USA depend on the state. However, federal money may not be used for stem cell research except on a limited number of existing stem cell lines. For human embryonic stem cell research, the National Academies of Science have produced a set of guidelines but largely this is not federally mandated.
So what about India? In this country, donating cord blood is allowed. Says S Abhaya Kumar, CEO, Asia Cryo-Cell, "Cord blood, discarded after childbirth, is a rich source of stem cells, which can be harvested and cryo preserved for use to treat more than 75 serious ailments." LifeCell’s 21,000 sq. ft. stem cell processing and banking facility conforms to the standards of the American Association of Blood Banks and US FDA. The facility has the capacity to store over 100,000 samples and the technical team has been trained by Cryo-Cell International. Kumar adds, "We have invested Rs 14 crore in this facility and expect enrollments to shoot up to 15,000 by the end of next year. We have plans to launch India’s first exclusive stem cell transplant centre in collaboration with Sri Ramachandra Medical College and Research Institute in Chennai." LifeCell’s services come at a fixed price: an enrollment fee of Rs 5,000, a processing fee of Rs 22,000 and an annual storage fee of Rs 2,900.
Adult somatic stem cells such as blood-forming stem cells in bone marrow are currently the only type of stem cell commonly used to treat human disease. Doctors have been transferring HSCs in bone marrow transplants for over 40 years. The clinical potential of adult somatic stem cells has now also been demonstrated in the treatment of some other diseases, including diabetes, Parkinson’s disease and advanced kidney cancer. According to the International Stem Cell Forum, "In 1999, scientists in the USA removed 10-15 neural stem cells from a Parkinson’s disease patient and used these to reproduce six million dopaminergic neural stem cells in culture. These were reintroduced into the patient’s brain tissue, producing a 62 per cent increase in dopamine uptake and a 40-50 per cent improvement in certain motor tasks."
— Mathures Paul.
Comments