International Approaches to Stem Cell Research
International Approaches to Stem Cell Research

 

Neuronal stem cell
http://www.flickr.com/photos/xhyragraf/361255623/

Many believe that curing Parkinson’s disease, spinal cord injuries, heart disease, blindness, cancer, and many other ailments is possible through the use of stem cells. While not yet proven, stem cell research is one of the hottest areas of scientific research around the world.

In December 2009, the Obama administration approved the first new lines of human embryonic stem cells for research to be carried out by federally-funded scientists. This approval marks a major departure from the Bush administration, which limited federally-funded research to 21 stem cell lines that were already in existence. Obama signed an executive order lifting the Bush administration restrictions and he put into effect new guidelines by the National Institute of Health, which limited new lines to those created by excess fertility clinic embryos.

In November 2009, the U.S. Federal Drug Administration (FDA) approved the first human embryonic stem cell treatment for human testing. The treatment has been shown to restore limb function in rats with neck spinal cord injuries. Human clinical trials will be starting in 2010.1

With many ethical and religious dilemmas, governments around the world debate and legislate different approaches to monitoring and controlling stem cell research carried out within their borders.

What are the different types of stem cells?

Stem cells are unspecialized cells that can, even after long periods of inactivity, divide and be induced to differentiate into another type of cell with a more specialized function, such as a muscle cell, a red-blood cell or a brain cell.2

There are two main types of stem cells: embryonic stem cell and somatic or adult stem cells. In a 3-5 day embryo, also known as a blastocyst, the cells differentiate to become all of the specialized cells. Embryonic stem cells are usually harvested from 4-5 day-old embryos not used in in-vitro fertilization procedures.3 Embryonic cells easily grow and differentiate in the lab, unlike adult stem cells.

Adult stem cells, which regenerate throughout a person’s lifetime, can be found amongst bone marrow, muscle, brain cells and in other organs and tissues. There are only a small number of stem cells in each organ and, once removed from the body, these cells can only divide a limited number of times. Usually, adult stem cells cannot differentiate into cells from another tissue/organ. For example, adult stem cells from bone marrow cannot differentiate into kidney cells or cells of another organ.4

Adult stem cells can be very helpful though for regenerating bones, creating insulin-producing cells for diabetes, and for repairing damaged muscles after a heart attack. Adult stem cells are very helpful for injection after transplantation, especially when taken from the patient itself, as the body is less likely to reject these cells.5 Bone marrow transplants using adult stem cells have been used for decades to help treat patients suffering from certain types of cancer.

A 2006 study found that some specialized adult cells could be reprogrammed to have a stem cell-like state; these cells are called induced pluripotent stem cells (iPSCs).6 iPSCS can act like embryonic stem cells. iPSCs have been very helpful for drug development and modeling of diseases.7

Ethical/Religious Debates Concerning Stem Cells

One of the biggest moral quagmires associated with embryonic stem cell research, but not adult stem cell research, is the destruction of the embryo. For some religious groups, such as Catholics, this is considered murder, as they believe life begins at conception.

There are a range of opinions amongst Protestant sects. Southern Baptists hold that embryos cannot be destroyed for research, while the American Presbyterian Church allows embryonic stem cell research.8

In Judaism, embryonic stem cell research is encouraged because it falls under the precept of “pikuach nefesh” (saving a life); this precept requires all actions to be taken necessary to save another’s life, including medical research.9 Islam holds similar positions, allowing the use of embryos (until the 40th day of life) for research and therapeutic purposes.10

Confucians also believe the life begins at birth and that the needs of the community should supersede those of the individual.11 Hindus believe that personhood begins at between three and five months of gestation, while Buddhists believe that personhood begins at conception.12 Religious views play an important role in deciding a country’s stem cell policies.

Other issues of controversy are paying women for their eggs and human/animal chimeras. The first international, non-binding guidelines were released in 2007, calling for a ban on human reproductive cloning, but allow women to be paid for donating eggs for research and allow human/animal chimeras. Human/animal chimeras are forbidden in some countries because of fears that a human embryo might be created inside another animal or that other hybrid species could be developed.13

Recently, news methods have been developed, including altered nuclear transfer and blastomere extraction, to remove the stem cells from the embryo, without destroying it. These new methods may placate those who are against embryonic stem cell research.

European Stem Cell Policy

Within Europe, there is a range of positions toward stem cell research. Belgium, Sweden and the United Kingdom have the most flexible policies; while Austria, Germany, Ireland, Italy, Norway, and Poland have the most restrictive policies.14 The European Union itself does not directly fund stem cell research that results in embryonic destruction.15

In the United Kingdom, researchers can create embryos and use human embryos that are younger than 14 days old. Therapeutic cloning is allowed.16 The Human Fertilization and Embryology Authority (HFEA) is in charge of human embryonic stem cell policies. A committee of scientists and lay people review applications to work with embryonic stem cells. The Guild of Catholic Doctors in Britain says those committees are not balanced since they do not include members who disagree with the practice of embryonic stem cell research.17

In Spain, originally scientists could only use embryos frozen prior to 2003, now they can use embryos frozen within two weeks of conception. Spanish parents of children with incurable diseases can conceive to use the embryo’s stem cells, thereby providing a tissue donor (only as a last resort).18

Ireland forbids research with human embryos19 and, in Germany, there is a ban on creating and working on human embryonic stem cell lines, however, scientists can import stem cell lines that were harvested prior to May 1, 2007, allowing German scientists to collaborate with scientists from abroad.20

Middle East Stem Cell Policy

In the Middle East, Israel has the most permissive stem cells policies, although research is conducted throughout the region. Israeli scientists have to get committee approval before starting a new stem cell research study and cannot pay women to give their eggs for research. Israelis have developed a stem-cell-based biological pacemaker, which may one day replace the current electronic pacemakers. Other Israeli advances include regenerating livers from stem cells and turning embryonic stem cells into brain cells.21

In Iran, the government invested heavily in stem cell research. Iran has been one of the top ten countries for producing, culturing and freezing human embryonic stem cells. The first cloned sheep in the Middle East was born in Iran. Human cloning though is forbidden.22

Asian Stem Cell Policy

Within Asia, there is also a range of positions toward stem cell research. China, India, Japan, Singapore, and South Korea have the most “permissive” policies in the region.23

South Korea has been in the news quite a bit for its controversial stem cell research programs. South Korean researchers made false claims about producing human embryonic stem cell lines from unfertilised human eggs.24 South Korean researchers though have made significant progress in therapeutic cloning, creating stem cells to match patients’ race and gender.25

China is on the forefront of stem cell research, investing hundreds of millions of dollars into adult and embryonic stem cell research. Therapeutic cloning is allowed, while reproductive cloning is not. China permits the use of spontaneously aborted fetuses (with donor consent) as a source of cells for research.26

In 2005 the Chinese Academy of Medical Sciences ran its first approved human study treating leukemia patients.27 Many of China’s stem cell therapies are not offered world-wide because some scientists believe there have not been enough studies on these treatments. For example, a new stem cell therapy was recently used to give sight to a blind British child. The $60,000 treatment included transplanting umbilical cord stem cells into the child’s forehead. Western scientists have never heard of or even tested this type of treatment.28

Stem cell tourism is a booming industry in China, with at least 50 institutions offering treatments. European and Chinese researchers have jointly published ethical guidelines to discourage Chinese doctors from offering fake treatments. As of May 2009, Chinese scientists are forbidden from commercializing treatments that have not undergone proper clinical trials. Scientists fear a lack of oversight over stem cell sources. Enforcement has proven to be quite a challenge.29

Conclusion

Despite all of the ethical challenges and controversies concerning stem cell research, many countries view research as an innovation and competitiveness issue. Even countries, such as Germany, with very strict laws about embryonic stem cell research, have eased restrictions to allow scientists to collaborate with scientists from abroad. As China has shown, stem cell tourism can be quite lucrative, as many are willing to pay top dollar/pound/euro/etc for cures. However, just because something is achievable, does it mean that ethical and moral boundaries should be crossed?


1 “Embryonic Stem Cells Restore Walking Ability In Rats With Neck Injuries.” Stem Cell Research News. November 10, 2009.
2 Introduction: What are stem cells, and why are they important?” National Institute of Health.
3 Ibid.
4 “What are adult stem cells?.” National Institute of Health.
5 “What are the similarities and differences between embryonic and adult stem cells?” National Institute of Health.
6 “Introduction: What are stem cells, and why are they important?” National Institute of Health.
7 “What are induced pluripotent stem cells?.” National Institute of Health.
8 “General Positions on Stem Cell Research and When Personhood Begins.” May 15, 2005.
9 “Part 4 – Stem Cell Research in Israel.” Public Radio International. April 29, 2005.
10 “General Positions on Stem Cell Research and When Personhood Begins.” May 15, 2005.
11 Wang, Yanguang. “Chinese Ethical Views on Embryo Stem (ES) Cell Research.” Chapter 3.
12 “General Positions on Stem Cell Research and When Personhood Begins.” May 15, 2005.
13 Pearson, Aria. “New international guidelines for stem cell science.” New Scientist. February 2007.
14 http://www.mbbnet.umn.edu/scmap.html
15 “Stem Cell Research Around the World.”
16 “CHAPTER 6 INTERNATIONAL PERSPECTIVES.”
17 “Part 2 – Stem Cell Research in Britain.” Public Radio International. April 27, 2005.
18 “Stem Cell Research Around the World.”
19 “CHAPTER 6 INTERNATIONAL PERSPECTIVES.”
20 “German parliament passes amendment to Stem Cell Act.” EuroStemCell. June 26, 2008.
21 “Part 4 – Stem Cell Research in Israel.” Public Radio International. April 29, 2005.
22 Jafarzadeh, Suad. “Iran at forefront of stem cell research.” Washington Times. April 15, 2009.
23 http://www.mbbnet.umn.edu/scmap.html
24 “History of Stem Cell Research.”
25 “Stem Cell Research Around the World.”
26 Liao, Lianming and Lingsong Li and Robert Chunhua Zhao. “Stem cell research in China.” Philos Trans R Soc Lond B Biol Sci. 2007 June 29; 362(1482): 1107–1112.
27 “Part 3 – Stem Cell Research in China.” Public Radio International. April 28, 2005.
28 Balik, Rachel. “China’s Controversial Stem Cell Treatment Helps Blind Girl See.” March 5, 2009.
29 Coghlan, Andy. “China cracks down on stem cell tourism.” New Scientist. September 4, 2009.

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