Large Michael Dr. Glenn Kessler Capstone Proseminar ISPS 399 Fall 2005 June 22, 2009 COULD THE AMNIOTIC EPITHELIAL CELL BE A NON-CONTROVERSIAL ALTERNATIVE TO EMBRYONIC STEM CELL RESEARCH? According to the Parkinson's Disease Foundation "As many as one million Americans suffer from Parkinson's disease, which is more than the combined number of people diagnosed with multiple sclerosis, muscular dystrophy and Lou Gehrig's disease. Approximately 40,000 Americans are diagnosed with Parkinson's disease each year, and this number does not reflect the thousands of cases that go undetected. Incidence of Parkinson's increases with age, but an estimated 15 percent of people with PD are diagnosed before the age of 50."1 The Alzheimer's Disease Education & Referral Center ADEAR stated, "Scientists think that up to 4.5 million Americans suffer from AD. The disease usually begins after age 60, and risk goes up with age. While younger people also may get AD, it is much less common. About 5 percent of men and women ages 65 to 74 have AD, and nearly half of those age 85 and older may have the disease. It is important to note, however, that AD is not a normal part of aging."2 To make matters worse the American Heart Association reports "Nearly 5 million Americans are living with heart failure, and 550,000 new cases are diagnosed each year."3 They continue by saying "Diabetes contributes to nearly 200,000 U.S. deaths per year. However, many people with type 2 diabetes are not aware they have the disease and may already have developed various complications associated
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http://www.pdf.org/Publications/factsheets/PDF_Fact_Sheet_1.0_Final.pdf http://www.alzheimers.org/generalinfo.htm#howmany http://www.americanheart.org/presenter.jhtml?identifier=1486
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Michael Large Dr. Glenn Kessler Capstone Proseminar ISPS 399 Fall 2005 June 22, 2009 with it."4 Odds are that most of us will have to deal with one or more of these diseases in our lifetime, either through our own experiences, or dealing with these diseases through our loved ones and/or friends. What should be interesting to all of us is that each disease mentioned has the hope of being cured through stem cell research. According to the Biotech Dictionary, a stem cell is "A cell that can replicate indefinitely and which can differentiate into other cells; stem cells serve as a continuous source of new cells. Specifically, this refers to the self-regenerating cells in bone marrow, testes, embryos and umbilical cords."5 "Stem cells are of interest for two major reasons, the one scientific, the other medical. First, stem cells provide a wonderful tool for the study of cellular and developmental processes, both normal and abnormal. With them, scientists hope to be able to figure out the molecular mechanisms of differentiation through which cells become specialized and organized into tissues and organs."6 "Second, stem cells and their derivatives may prove a valuable source of transplantable cells and tissues for repair and regeneration. If these healing powers could be harnessed, the medical benefits for humankind would be immense, perhaps ushering in an era of truly regenerative medicine."7 This means that these cells could be genetically cultured and coerced under laboratory conditions (in vitro) into becoming "specialized
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http://www.s2mw.com/heartofdiabetes/two.html http://www.thebiotechdictionary.com/term/stem_cell Monitoring Stem Cell Research A Report of the President's Council on Bioethics Washington, D.C., January 2004, p.3 ibid.
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Michael Large Dr. Glenn Kessler Capstone Proseminar ISPS 399 Fall 2005 June 22, 2009 cells" such as liver cells, nerve cells, brain cells, kidney cells, and etc. The cells could then be used to treat patients with degenerative diseases affecting these areas, thereby becoming a specified organ ready for transplantation, should an organ transplant be needed. "Embryonic stem cells are undifferentiated cells that are unlike any specific adult cell. However, they have the ability to form any adult cell. However, because adult cells are already specialized, their potential to regenerate damaged tissue is very limited: skin cells will only become skin and cartilage cells will only become cartilage. Adults do not have stem cells in many vital organs, so when those tissues are damaged, scar tissue develops. Only embryonic stem cells, which have the capacity to become any kind of human tissue, have the potential to repair vital organs. Another limitation of adult stem cells is their inability to proliferate in culture. Unlike embryonic stem cells, which have a capacity to reproduce indefinitely in the laboratory, adult stem cells are difficult to grow in the lab and their potential to reproduce diminishes with age. Therefore, obtaining clinically significant amounts of adult stem cells may prove to be difficult."8 Dr. Stephen C. Strom, a faculty member at the University of Pittsburgh's McGowan Institute of Regenerative Medicine and associate professor of cellular and molecular pathology at the University of Pittsburgh's School of Medicine, along with Dr.Yoshio Miki have discovered that amniotic cells in the human placenta have similar characteristics to embryonic stem cells. Amniotic cells therefore could be used as another
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http://www.news.wisc.edu/packages/stemcells/facts.html#1
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Michael Large Dr. Glenn Kessler Capstone Proseminar ISPS 399 Fall 2005 June 22, 2009 means of research besides embryonic stem cell research, which has now become widely used. According to the University of Pittsburgh Medical Center News Bureau, "... amniotic epithelial cells are not stem cells per se, because they can't grow indefinitely. This may be due to the fact that these amnion-derived cells do not express a certain enzyme, called telomerase, that is important for normal DNA and chromosome replication, and by extension, ultimately, cell division."9
"Perhaps it's to their advantage that the amnion epithelial cells lack telomerase expression, because telomerase is associated with many cancers and one of the main concerns about stem cell therapies is that transplanted stem cells would replicate in the recipient to form tumors"10, said Dr. Yoshio Miki. "Placenta is abundantly available as a discard tissue following normal delivery. Current statistics from the Census bureau indicate that there are over 4 million total births and over 1 million cesarean sections performed in the US per year. With an average yield of over 100 million AE cells per amnion in our initial investigations... large numbers of cells could be available from this source. We estimate that 100 million cells AE could be expanded to 10-60 billion cells .... Optimization of the culture conditions may allow even greater expansion."11
"If we could develop efficient methods that would allow amnion9
http://newsbureau.upmc.com/Print/PrintStromPlacentaStudy.htm ibid. 11 Stem Cells Express "Stem Cell Characteristics of Amniotic Epithelial Cells" Aug. 9, 2005; p.18
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Michael Large Dr. Glenn Kessler Capstone Proseminar ISPS 399 Fall 2005 June 22, 2009 derived cells to differentiate into specific cell types, then placentas would no longer be relegated to the trashcan. Instead, we'd have a useful source of cells for transplantation and regenerative medicine,"12 said Dr. Strom. There are controversies surrounding the research being conducted using embryonic stem cells. The main problem and root of most controversies is that in order for scientists to extract these stem cells, the embryo is destroyed during the extraction process. The most significant sides to this particular debate are the religious beliefs for some and the need for medical advancement for others. Determining what is socially correct and medically ethical is not going to be debated in this Capstone. For example, some people believe that an embryo is a human being in the earliest stages of development. Therefore, by destroying the embryo, scientists are killing a human being in the name of medical research. The other sides 1. Object to the notion that an embryo is a human being, or 2. Even if an embryo is a human being in the early stages of development, the potential breakthroughs (i.e. cures) offered through the scientific and medical research associated with embryonic stem cell research, the death of the embryo is justifiable accordingly. I do intend to investigate the scientific and medical benefits that the amniotic epithelial cell may possess as an alternative to embryonic stem cell research. By doing so could bypass most of the controversies surrounding embryonic stem cell research. The bulk of my research will come from reading journal articles concerning embryonic and amniotic cells in order to find similarities and differences between embryonic and
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http://newsbureau.upmc.com/Print/PrintStromPlacentaStudy.htm
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Michael Large Dr. Glenn Kessler Capstone Proseminar ISPS 399 Fall 2005 June 22, 2009 amniotic cells. I will also be in contact with my mentor Dr. Kenneth Beals who is a professor and bioethicist here at the University of Virginia throughout my researching to inform him of my findings and for his guidance and any suggestions. I believe that my research findings will help us to understand regenerative medicine more, and if amniotic epithelial cells prove to be just as beneficial to regenerative medicine as embryonic stem cells. This field of regenerative medicine is constantly changing and information is difficult to obtain quickly. Books and other forms of literature are outdated by the time they reach library shelves. Following reliable online journal articles I believe will be the quickest and best way to obtain information. My research question is this; "If the amniotic epithelial cell can offer the potential scientific and medical benefits as embryonic stem cell research, could it provide a noncontroversial alternative to embryonic stem cell research?" My thesis is this not attempt to resolve this controversy in this Capstone, but it is my hope to present a possible alternative through science and research that will allow us to avoid the moral dilemma of the fetal viability timeframe, and consequently may lead researchers to consider this alternative avenue of focus for their research. I also believe that utilizing an alternative research field such as the amniotic epithelial cell could gain researchers financial support in terms of federal loans and grants, because the research would no longer be controversial in terms whether or not a fetus is a person because they would no longer being used for research. My particular interest in this project stemmed from fam...