Stem cell therapy holds promise for treating various diseases but also raises ethical issues. There are two main types of stem cells - embryonic stem cells which are pluripotent but obtaining them requires destroying embryos, and adult stem cells which are multipotent but more limited in use. While research aims to develop stem cells to heal illnesses, debates center around when personhood begins and how to balance research with diverse religious views. Guidelines in India allow certain fetal and adult stem cell research but prohibit human cloning or using stem cells for financial gain.

1. Stem Cell therapy:
Status and Ethics
ARIJIT BHATTACHARJEE
WORKSHOP ON
EMERGING AREAS OF MOLECULAR BIOLOGY AND IMMUNOLOGY, 21ST MAY- 26TH MAY , 2012,.KARIMGANJ COLLEGE , KARIMGANJ, ASSAM.

2. Stem celldifferentiate (develop)
A cell that has the ability to continuously divide and
into various other kind(s) of cells/tissues . In mammals there are two broad
kinds of stem cells: Embryonic stem cells and Adult stem cells. The stem
cells and progenitor cells acts as a repair system for the body replenishing
adult tissues.
Stem cell Stem cell
SELF-RENEWAL DIFFERENTIATION
(copying) (specializing)
Identical stem cells Specialized cells

3. Comparison of Embryonic and Adult stem cells
Embryonic stem cell Adult stem cells
Derived from the inner cell mass They produce cells specific to the
tissue in which they are found.
Pluripotent
They are relatively unspecialized
Can develop into more than 200
different cells However they are predetermined to
give rise to specific cell types when
Differentiate into cells of the 3 they differentiate
germ cell layers e.g: haematopoietic, bone marrow,
neural
Because of their capacity of
unlimited expansion and
pluripotency – useful in
regenerative medicine

4. Stem Cell Properties:
Self renewal - the ability to go through numerous cycles of cell division while
maintaining the undifferentiated state.
Potency – the capacity to differentiate into specialized cell types.
Totipotent stem cells -cells produced by the first few divisions of the cell . So can
form any cell of the embryo as well as the placenta.
Pluripotent – these cells differentiate into cells derived from the three germ cell
layers. e. g. haematopoietic stem cells, neural and mesenchymal stem cells.
Multipotent – these cells can produce cells of a closely related family of cells. e.g.:
haematopoietic stem cells, neural and mesenchymal stem cells.
Unipotent – these cells only produce one cell type., but have the property of self
renewal which distinguishes them from the non stem cells.

5. Why self-renew AND differentiate?
1 stem cell
1 stem cell 4 specialized cells
Self renewal - maintains the Differentiation - replaces dead or damaged
stem cell pool cells throughout your life

6. Kinds of Stem Cells/ stem cell jargon
Stem cell
type Description Examples
Each cell can develop into a Cells from early (1-3
Totipotent
new individual days) embryos
Some cells of
Cells can form any (over 200)
Pluripotent blastocyst (5 to 14
cell types
days)
Fetal tissue, cord
Cells differentiated, but can
Multipotent blood, and adult stem
form a number of other tissues
cells

7. Stem Cell Differentiation

8. TYPES OF STEM CELLS:
 EMBRYONIC STEM CELL:FOUND IN INNER LAYER OF
BLASTOCYST- Differentiates into specialized cells.
 TISSUE STEM CELL: FOUND IN DIFFERENT TISSUES
LIKE BONE MARROW, MUSCLE, ETC. Differentiates into
various specialized cell types like blood cells.
 INDUCED PLURIPOTENT(iPS) STEM CELLS: Adult
cells which genetically reprogrammed to add certain genes, they
behave like embryonic stem cell and differentiate into specialized
cells.
 ADVANTAGES OF iPS CELLS: No Need for
Embryos!!!!!!!!!!!

9. WORKSHOP ON EMERGING AREAS ON
MOLECULAR BIOLOGY AND IMMUNOLOGY,MAY 21-
MAY 26, 2012, KARIMGANJ COLLEGE , KARIMGANJ

10. WORKSHOP ON EMERGING AREAS ON
MOLECULAR BIOLOGY AND IMMUNOLOGY,MAY 21-
MAY 26, 2012, KARIMGANJ COLLEGE , KARIMGANJ

11. Where are stem cells found?
embryonic stem cells tissue stem cells
blastocyst - a very early embryo fetus, baby and throughout life

12. Stem cell niches
Niche stem cell
Microenvironment around stem cells that provides support
and signals regulating self-renewal and differentiation
niche
Direct contact Soluble factors Intermediate cell

13. Tens of thousands of frozen
embryos are routinely
destroyed when couples finish
their treatment.
These surplus embryos can
be used to produce stem cells.
Regenerative medical
research aims to develop these
cells into new, healthy tissue
to heal severe illnesses.

14. Tissue stem cells:
Principles of renewing tissues
Stem cell
stem cell:
- self renew
- divide rarely
committed progenitors:
- high potency
- “transient amplifying cells” specialized cells:
- rare
- multipotent - work
- divide rapidly - no division
- no self-renewal
EXAMPLES OF SUCH STEM CELL INCLUDE HSCs, NSCs AND GSCs, etc.

15. Tissue stem cells:
Haematopoietic stem cells (HSCs)
NK cell
T cell
B cell
dendritic cell
megakaryocyte platelets
HSC erythrocytes
macrophage
neutrophil
bone marrow
eosinophil
basophil
specialized cells
committed progenitors

16. Tissue stem cells:
Neural stem cells (NSCs)
Neurons
Interneurons
Oligodendrocytes
NSC
Type 2 Astrocytes
Type 1 Astrocytes
brain
committed progenitors specialized cells

17. Tissue stem cells:
Gut stem cells (GSCs)
Islet cells
Goblet cells
GSC
Endocrine cells
Columnar cells
Small intestine specialized cells
committed progenitors

18. Tissue stem cells:
Mesenchymal stem cells (MSCs)
Bone (osteoblasts)
MSC Cartilage (chondrocytes)
bone marrow
Fat (adipocytes)
committed progenitors specialized cells

19. APPLICATIONS OF STEM CELL IN
BIOMEDICAL RESEARCH AND
REGENERATIVE MEDICINE

20. Derivation and Use of Embryonic Stem Cell
Lines
Isolate inner cell mass
Outer cells (destroys embryo)
(forms placenta)
Inner cells
(forms fetus)
Culture cells
Day 5-6
Blastocyst
“Special sauce”
Liver
Heart
repaired
Kidney Heart muscle

21. Somatic Cell Nuclear Transfer
The nucleus of a donated
egg is removed and replaced
with the nucleus of a mature,
"somatic cell" (a skin cell, for
example).
No sperm is involved in this
process, and no embryo is
created to be implanted in a
woman’s womb.
The resulting stem cells can
potentially develop into
specialized cells that are useful
for treating severe illnesses.

22. SCNT CONT…
WORKSHOP ON EMERGING AREAS ON
MOLECULAR BIOLOGY AND IMMUNOLOGY,MAY 21-
MAY 26, 2012, KARIMGANJ COLLEGE , KARIMGANJ

23. Stem Cell Cultivation

24. Production

25. Possible Uses of Stem Cell
Therapy
 Replaceable tissues/organs
 Repair of defective cell types
 Delivery of genetic therapies
 Delivery chemotherapeutic agents
In theory, stem cell technology could be used to produce replaceable tissues or organs.
Defective tissues/organs could be repaired using healthy cells. It would also be possible to
genetically engineer stem cells to accomplish activities that they would not ordinarily be
programmed to do. Part of this engineering could involve the delivery of chemotherapeutic
agents for treatment of cancers and tumors.

26. Potential application of fetal stem cells In
the field of fetal medicine:
 Non invasive prenatal diagnosis
 Intrauterine stem cell transplantation
 Gene therapy
Therapeutic applications of embryonic stem
cells –ES cell
 The potential to form 200 or more cells.
 Hence used in regenerative medicine in cases like cardiac failure,
Parkinson's disease, diabetes.
 These cells are being coaxed to differentiate into cardiomyocytes, neural
stem cells, insulin producing cell and even germ cells.

27. Induced Pluripotent Stem (iPS) cell in Regenerative
medicine
Fig.

29.  Blood is collected
from umbilical cord
immediately after
delivery about 100-
150cc
 The number of cells
in 1 ml is 40,000
 They are stored in
blood banks at
-196deg celsius in a
state of suspended
animation and
restart their activity
on thawing.

30. Advantages over bone marrow cells
1. High rate of engraftment
2. More tolerant to tissue matches
3. Less severe GVHD
4. Rarely contaminated with latent virus
5. Easy to collect, not painful
6. Superior proliferative capacity
7. Greater immunological naievity
8. Unlimited supply
9. Lower cost

31. Ailments for which stem cells
are being used now
 Acute leukemias
 Chronic
leukemias
 Myelodysplastic
syndromes
 Marrow failure
 Myeloproliferative
disorders
 Lymphoproliferati
ve disorders

32.  Phagocyte disorders
 Inherited disorders like Lesch Nyhan syndrome, beta
Thallesemia etc
 Inherited platelet abnormalities
 Inherited metabolic disorders like Mucopolysaccharidosis,
Hurler’s syndrome, Krabbe disease, Niemann- pick disease
etc.
 Histocytic disorders
 Inherited erythrocyte abnormalities
 Inherited immune system disorders like ataxia
telangectesia, DiGeorge syndrome, SCID etc
 Plasma cell disorder
 Malignancies like neuroblastoma, Ewing sarcoma, Renal
cell CA etc

33. Future stem cell application
 Alzheimer’s Disease
 Lupus
 Rheumatoid arthritis

34. The Ethical Debate
In favor of ESCR:
Embryonic stem cell research (ESCR) fulfills the ethical obligation to alleviate
human suffering.
 Since excess IVF embryos will be discarded anyway, isn’t it better that they be used
in valuable research?
 SCNT (Therapeutic Cloning) produces cells in a Petri dish, not a pregnancy.
Against ESCR:
In ESCR, stem cells are taken from a human blastocyst, which is then destroyed.
This amounts to “murder.”
 There is a risk of commercial exploitation of the human participants in ESCR.
 Slippery slope argument: ESCR will lead to reproductive cloning.

35. Key Ethical Issues
 The blastocyst used in stem cell research is
microscopically small and has no nervous system. Does
it count as a “person” who has a right to life?
 What do various religions say about when personhood
begins? Does science have a view on this?
 In a society where citizens hold diverse religious views,
how can we democratically make humane public policy?

36. Guidelines for stem cell research in India
 Compulsory registration of the existing cell lines to be registered under
specific apex bodies in the field
 Genetic research dealing with human egg or sperm and genetic engineering
and then transfer of human blastocysts will not be allowed
 Research and therapy using fetal/placental stem cell will be allowed
 Termination of pregnancy cannot be sought for donating fetal tissue for
therapeutic or financial benefits
 All the umbilical cord blood banks should be registered with Drug Controller
General of India
 Research into human cloning is not to be done
 These guidelines are aimed to encourage development of sound research and
therapy, prevent any misuse of human embryos and fetuses and protect
patients from fraudulent treatments in the name of stem cell research.