STEM CELLS 

NINA & GUSTAVO

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 Types of stem cell What are stem cells? - Craig A. Kohn 

STEM cells are unspecialized cells = they are " capable of developing into
cells that serve numerous functions in different parts of the body. " 1

There are different types of STEM cells that can be used for differently and
for different purposes. 

1 - Embryonic stem cells = Totipotent and Pluripotent stem cells

Embryonic stem cells originate from human embryos after  they are three to
five days old. This type of STEM cell can  be harvested using a process called
in-vitro fertilization, where an embryo is not fertilized in a female body but
in laboratory instead. 

2 - Adult body tissue 

  Adult stem cells = Multipotent stem cells 

 Cord blood and amniotic fluid stem cells = Multipotent stem cells

3 - Scientifically created

- Mesenchymal stem cells (MSCs)

- Induced pluripotent stem cells (iPS)

 Ethical implications The biggest question regarding stem cell research, especially in the United States, is "when does human life begin?"

Usage of STEM cells for research. 

Measures taken:​
 People have different beliefs regarding the stage of when the cells in the women's uterus should be •The “14-day rule” -  forbids the use of embryonic stem cells two weeks post-
considered a babe (very similar to the debate on abortion).   fertilization. 

Con Stem Cell research 

 Some people think that “human life begins at conception” and that embryos, no matter how old, are
people; therefore, they have interests and rights that must be respected. According to this  perspective,
getting a blastocyst and removing its embryonic stem cell line is considered murder - making the
scientists the murderers. 

Pro Stem Cell research 

 Other people believe that for an embryo to be considered a real 'person,' a certain amount of time and
development must occur. This view is the middle ground between both the previous example and the
idea that embryos or blastocysts are just lots of cells clumped together, that can be utilized for all
researches without restrictions. This middle ground usually consists of people who think that embryos
should not be treated as 'not humans' and without respect, yet they can be used for researches with
certain requirements: "good scientific justification, careful oversight, and informed consent from the
woman or couple for donating the embryo for research." 2

 Also, as the stem cells are harvested from the embryo at an early stage, as the embryo has not  yet
developed a nervous system, it is not likely to feel any pain, another reason why some people approve
of their presence in researches.
 Type 1
Diabetes

Definitions:

Type 1 Diabetes is a pancreatic condition

which causes it (the pancreas) to produce little
to no insulin.

The cause of the disease is unknown.

Insulin

 The two major roles of insulin are:

 The regulation of blood sugar levels, after eating your body breaks down carbohydrates into
glucose which then enters your blood stream. The pancreas then starts producing insulin which
makes it possible for glucose to enter and power the cells in your body.

 In addition to facilitating the possibility of blood sugar regulation insulin also makes it possible
for you to store excess glucose to be used when your blood sugar is low. This is achieved by
storing excess glucose in the liver in the form of glycogen whenever blood sugar is high which is
normally after a meal. Then when blood sugar is low the liver releases it back into the blood
stream which further helps with blood sugar regulation.
 Insulin Manufacturing 

Initially, insulin was taken from pigs and used to help patients suffering from
diabetes but due to the strikingly large amount of diabetic people, there was a
need for larger-scale production of insulin. The solution found was to use
genetically modified bacteria that had the insulin production gene implanted
into them. The way that scientists achieved this is by removing the plasmid
from a bacteria cell and cutting it open with restriction enzymes, then  they
would locate and remove the human insulin production gene using the same
restriction enzyme used when cutting open the plasmid, then the human DNA
is combined with the plasmid using ligase. After that the bacteria are
incubated with the genetically modified plasmid, finally, the bacteria will take
up the plasmid and start producing insulin .
Major Symptoms & Conventional treatments  

Symptoms: Conventional treatments:

 Increased urination, often at night  Taking insulin injections 

 Increased thirst   Monitoring intake of carbohydrates, fats, and proteins

 Frequently monitoring blood sugar levels

 Uninetntional weight loss
 Regular exercise
 Increased hunger
 Healthy eating
 Blured vision
A potential cure:
 Numbness on the hands or feet
 A potential cure for both type one and two diabetes could be
 Increased fatigueness
a pancreas transplant though it is unlikely to be done since
 Dry skin there is a small number of pancreases available for

 transplant and the transplant surgery itself comes with.

Increase in frequency of infections
 STEM CELL therapy

Currently there is no proven to work treatment for diabetes

which includes the use of stem cells. But this does not mean
that treatment using stem cells is impossible, there currently is
research focusing on the production of βcells via the use
of Induced pluripotent stem cells and if the on-going clinical
trials come back with positive results, it could potentially solve
the problem of needing to source the right number of
functional islets (cluster of βcells ) for future transplantation
needs.
 Leukemia 

Definitions:

Leukemia is a cancer that causes the White Blood

cells (WBC) to divide/multiply too quickly and
eventually crowd out other cells like Red Blood
cells and Platelets from the blood.
 What is Leukemia?
 There are 4 different types of Leukemia. In all four cases, there are too many
white blood cells (also known as leukocytes) being produced and these leukemic
cells are not able to perform their normal function as WBC: defend the body
against disease and infection, because they are immature (defected),
 resembling normal immature cells called blasts. 

 In acute leukemia cases, these leukemic blasts are formed very quickly (faster
than all other cell formation) to a point where they begin to accumulate in the
blood and in the bone marrow, decreasing the space for other cells, including
functional WBCs. 

 Types of Leukemia:

 Acute myelogenous leukemia (AML) 

 Acute lymphocytic leukemia (ALL) 

 Chronic myelogenous leukemia (CML) 

 Chronic lymphocytic leukemia (CLL)

Acute (sudden development) - cancer cells multiply rapidly

Chronic (slow development) - cancer cells multiply slowly

Two cell types that can develop Leukemia: Myelogenous and Lymphocytic

 Risk Factors and Conventional Treatments

Risk factors for leukemia Conventional Treatments

What causes Leukemia is unknown. But there are factors that

Leukemia is usually treated by doctors specialized in blood disorders and cancer
can increase its possibility:
=  hematologist-oncologist. There is no standardized treatment, they
 Someone in your family that had Leukemia normally depend on the stage and type of the cancer:

 Smoking •Chemotherapy = drugs used to kill Leukemic cancer cells.

 Genetic Disorders – Ex. Down Syndrome  •Radiation therapy = utilizes high-energy radiation to damage leukemia cells and
control/decrease their growth.
 Blood Disorders, like "preleukemia" (Offi cial name:
•Bone Marrow transplant/ Stem cell transplantation = Replacement of the
Myelodysplastic syndrome) diseased bone marrow with healthy bone marrow.

 Previous contact with chemotherapy (possibly while •Immune or Biological therapy =  "Uses treatments that help your immune
system recognize and attack cancer cells.​"3
treating other cancers)
•Targeted therapy = "Uses medications that take advantage of vulnerabilities in
 When exposed to high levels of radiation  cancer cells."3

 When exposed to strong chemicals – Ex. Benzene

 Major Symptoms  
Leukemia can spread to other organs by
infiltration/spreading of cancer cells. These are the
parts of the bodies that the cancer can spread to:
 Lungs
 Testes
 Heart
 Kidneys 
 Gastrointestinal tract
 Central Nervous system

If the cancer spreads to other body parts, it

can cause other symptoms that are 'exclusive' to
that specific area. Example – when Leukemia
spreads to the central nervous system it can cause
headaches, confusion, muscle control loss, seizures
and nausea/vomiting. 3
 Source and Treatment of STEM
cells 

Leukemia is one of the first diseases to have a successful treatment that uses Stem Cells. 

 The treatment is called Bone Marrow Transplant. This approach involves

harvesting multipotent stem cells known as hematopoietic stem cells (HSCs) that can be
taken from bone marrow, umbilical cord blood and peripheral blood of the own patient
or a suitable/compatible donor. 

 The cancer patient first needs to undergo radiotherapy and chemotherapy to kill the
diseased white blood cells, so that the HSCs can be transplanted back into the bone
marrow, where they will multiply to form new healthy white blood cells (not damaged
blasts).

 This approach is already widely used, unlike other Stem Cell treatments, as the source
of the SCs (multipotent) are not ethically concerning compared to the harvesting of
Pluripotent and Totipotent cells. 3

Blasts
 Spinal Cord
Injury

Definition:

"Spinal cord injury (SCI) is the damage to the

spinal cord that can lead to temporary or
permanent loss of "(motor or sensory) "function
due to injury to the nerve." 4
Spinal Cord 

What is the spinal cord? And why is it so important?

 "The spinal cord is the delicate tissue encased in and protected

by the hard vertebrae of the spinal column. Together the brain
and spinal cord form the body’s central nervous system."5

 The cord is made up of millions of nerve cells carrying signals

and information from the brain to the body – with these
signals we can sit, run, go to the toilet and breathe, the signals
carry instructions to be carried out by the body. 
Generally, there are two broad chronological phases of the Spinal cord injuries:​

•Primary mechanism of injuries ​

•Secondary mechanism of injuries ​

The spine has different sections, when hit, they have different results like different level of paralysis depending
on the location:​

•Tetraplegia. "Also known as quadriplegia, this means that your arms, hands, trunk, legs and pelvic organs are all
affected by your spinal cord injury.​
•Paraplegia. This paralysis affects all or part of the trunk, legs and pelvic organs.​

The lowest normal part of your spinal cord is referred to as the neurological level of your injury. The severity of
the injury is often called "the completeness" and is classified as either of the following:​

•Complete. If all feeling (sensory) and all ability to control movement (motor function) are lost below the spinal
cord injury, your injury is called complete.​
•Incomplete. If you have some motor or sensory function below the affected area, your injury is called
incomplete."
from " -> " was taken from = 6
 Causes
Common causes of spinal cord injuries (United States):

 Motor vehicle accidents - leading cause –  50% 

 Falls - 31% 

 Acts of violence - 13% 

 Sports and recreation injuries - 10% 

 Alcohol -  1 out of every 4 

 Other - Cancer, arthritis, osteoporosis and inflammation of the spinal cord also can cause
spinal cord injuries.

Risk factors

 Being male, being between the ages of 16 and 30, being older than 65, engaging in risky
behavior or having a bone or joint disorder.

- Traumatic         - Nontraumatic NOTE - The percentages represent the cause's approximate prevalence in causing the disease
 Major Symptoms
All types of spinal Cord injuries may have the following symptoms:

• Loss of movement

• Loss or altered sensation, including the ability to feel heat, cold and touch

• Loss of bowel or bladder control

• Exaggerated reflex activities or spasms

• Changes in sexual function, sexual sensitivity and fertility

• Pain or an intense stinging sensation caused by damage to the nerve fibers in your spinal
cord

• Diffi culty breathing, coughing or clearing secretions from your lungs

• Extreme back pain or pressure in your neck, head or back

• Weakness, incoordination or paralysis in any part of your body

• Numbness, tingling or loss of sensation in your hands, fingers, feet or toes Extreme symptoms
• Loss of bladder or bowel control

• Diffi culty with balance and walking

• Impaired breathing after injury

• An oddly positioned or twisted neck or back

Majority of information retrieved from 6

 Conventional treatment
After an accident, the medics/doctors must take emergency actions to prevent further damage to the body, for example, to prevent the progression of the spinal cord injury.  In
the emergency room, doctors focus on:

 Maintaining your ability to breathe

 Preventing shock

 Immobilizing your neck to prevent further spinal cord damage

 Avoiding possible complications, such as stool or urine retention, respiratory or cardiovascular diffi culty, and formation of deep vein blood clots in the extremities

 Intensive care unit for treatment. 

When you have SCI, the treatments are:

Medications. Intravenous (IV) methylprednisolone (Solu-Medrol) were used in the past but due to side effects: blood clots and pneumonia, this method is no longer utilised.
Other types of medications may be prescribed to control pain and muscle spasticity, bladder control, bowel control and sexual functioning.

Immobilization. You may need traction to stabilize your spine (rigid neck collar may work  or special bed to help immobilize your body and minimize nerve cell damage), to bring
the spine into proper alignment or both. 

Surgery. Surgery might be needed to remove 'unwanted objects' that are exerting pressure on the spine. Surgery may also be needed to stabilize the spine to prevent future
pain or deformity.

Experimental treatments. Scientists are trying to figure out ways to stop cell death, control inflammation and promote nerve regeneration. For example, doctors may lower the
body temperature significantly — a condition known as hypothermia — for 24 to 48 hours to help prevent damaging inflammation. STEM Cells.

Ongoing care - preventing possible secondary problems: deconditioning, muscle contractures, pressure ulcers, bowel and bladder issues, respiratory infections, and blood
clots. 

Rehabilitation – Given advice of how to live with the condition – how to prevent further complications, exercises to  strengthen existing muscle function and redevelop motor
skills learn techniques to accomplish day-to-day tasks.

New technology - Modern wheelchairs, Computer adaptations, Electronic aids to daily living, Electrical stimulation devices and Robotic gait training. 

Not a treatment for the disease itself but for its consequences - therapy  Info from - 6
 STEM CELL therapy and source
Trying to treat spinal cord injury is very diffi cult because it involves  different kinds of damage
to different types of cells. "The environment of the spinal cord changes drastically during the
first few weeks after injury (immune cells flow in, toxic substances are released, a scar is
formed). A combination of therapies is needed, acting at the appropriate time-point and on the
correct targets." 5

Stem cells can help treat SPI (shown by  studies in animals) by:

 Replacing the nerve cells that have died as a result of the injury;

 Generating new supporting cells that will re-form the insulating nerve sheath (myelin)
and act as a bridge across the injury to stimulate re-growth of damaged axons;

 Protecting the cells at the injury site from further damage by releasing protective
substances such as growth factors, and soaking up toxins such as free radicals, when
introduced into the spinal cord shortly after injury.

 Preventing spread of the injury by suppressing the damaging inflammation that can occur
after injury

Tests have been made using different cells – mostly carried out in studies using rats – but none
of them completely work, no result produced was more than a partial recovery. Scientists are
constantly trying to improve and develop their skills/understanding of this topic.  

 Added to the ethical implications – people against animal testing  

 EXTRA information  Neural stem cells (mouse)

Stem cells are very useful in treating many diseases, including  spinal cord
"Allogeneic (single donor) neural stem cells are being
injury. There are no proven or approved treatments that use Stem Cells for SCI
investigated for their potential in treating spinal cord injuries.
patients, but there are researches in development phases and even clinical  trials.
There are several clinical trials examining human neural stem
   cells in spinal cord injuries (see clinicaltrials.gov ). These trials

Stem Cell technology is very new and therefore still being explored:
 Japan is the first country to approve a stem-cell treatment for spinal-cord
injuries. This event marks a significant advance in science, especially in
the health care section. 
inject neural stem cells directly into the spinal cord with the
hope that the cells help re-establish some of the connections
between neurons and create the necessary cells to support both
the old and new neurons."5

 Some scientists are a bit concerned that the approval was premature and
purely 'structured' but others believe that even if there are struggles now,
the near future holds revolutionary discoveries. 7

Click here for more clinical trials http://icord.org/research/iccp-clinical-trials-information/ 

Bibliography 

1. https://www.healthline.com/health/stem-cell-research#uses 

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2726839/ 

3. https://www.healthline.com/health/leukemia 

4. https://cellandbioscience.biomedcentral.com/articles/10.1186/s13578-020-00475-3 

5.  https://www.eurostemcell.org/spinal-cord-injuries-how-could-stem-cells-help  

6. https://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/symptoms-causes/syc-20377890 

7. https://www.nature.com/articles/d41586-019-00178-x#:~:text=The%20team%20thinks%20the%20stem,those%20damage
d%20in%20the%20injury
 

8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2678281/