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Stem Cells:Promises to Keep?

Original case by:Lauren E. YaichUniversity of Pittsburgh at Bradford

Updated and adapted for “clickers” by:William D. RogersBall State University

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• One in 10 American couples are infertile.

• More than 177,000 babies have been born through in vitro fertilization (IVF) in the United States.

Source: American Society for Reproductive Medicine (2005).

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Samantha watched as the drop of water on the tip of the icicle finally plummeted to the ground below as a brisk wind disturbed its equilibrium. She shivered as she turned away from the wintry landscape outside, but then immediately smiled as her gaze came to rest upon her pre-school twins Anna and Mark dozing in front of a Disney movie.

Samantha felt doubly blessed to have these two kids. She and her husband Brad had tried for over 10 years to have children before they turned to Dr. Billings for help.

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Anna and Mark had been conceived with the help of IVF treatments. Samantha laughed softly, thinking of all the adjustments they had made after the arrival of the twins. No more quiet dinners or lazy Sundays for years to come, she thought to herself, not altogether unhappily.

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In Vitro Fertilization (IVF)(test tube babies)

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CQ#1: An embryo is allowed to develop for around five days before it is inserted into a uterus. Why?

A. The zygote does not begin to develop until a few days after fertilization.

B. Doctors want the placenta to begin to develop before inserting the embryo.

C. Doctors are trying to simulate natural conditions of human development.

D. It takes several days for a sperm cell to penetrate an egg cell.

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Courtesy of the National Institutes of Health

Early Development

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Source: National Institutes of Health

“Preimplantation genetic diagnosis (PGD) is a test that screens for genetic flaws among embryos used in in vitro fertilization. With PGD, DNA samples from embryos created in vitro by the combination of a mother’s egg and a father’s sperm are analyzed for gene abnormalities that can cause disorders. Fertility specialists can use the results of this analysis to select only mutation-free embryos for implantation into the mother’s uterus.”

Screening for Disease

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CQ#2: Should preimplantation genetic diagnosis be allowed?

A. Yes, it is the right of the parents

B. Yes, but only under circumstances

C. No

D. I am uncertain

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Adam Nash was born on August 29, 2000. Adam was conceived for a purpose. Adam’s older sister, Molly, was seriously ill. Doctors and researchers felt that the best way to save Molly’s life was a stem cell transplant.

Using the technique of in vitro fertilization, multiple embryos were conceived using gametes from Molly’s parents. The embryo that would develop into the baby named Adam was selected based on genetic analysis. Stem cells from Adam’s umbilical cord were transplanted into Molly, saving her life.

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Samantha clicked the remote, switching from The Lion King to PBS. A few minutes later she heard the back door open and her husband Brad calling out, “Hey, Sam!” as he came in from the cold, stomping the snow off of his boots.

“Shh,” hushed Samantha, seeing Anna stir in her sleep. “The twins just dozed off. It’s the first minute of peace I’ve had all day.” She rose from the couch and gave him a quick hug.

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“I’m so glad to be home. Work is starting to drive me nuts. They want us to do more and more in less and less time. And then, to top it off, I hit a major traffic jam on the Loop. I’m sorry I’m late again.” Brad looked into Samantha’s eyes to make sure she wasn’t upset.

“No problem … gotta pay the bills, right? Come and sit with me. There’s an interesting show on PBS that just came on,” said Samantha, settling back down on the couch and patting the cushion next to her.

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Brad sat down and Sam rested her head on his shoulder. The PBS program was about stem cells and their potential medical uses. Brad looked over at Samantha as the show went on. She seemed very engrossed by the story. Occasionally she would smile and nod her head. Out of the corner of her eye, Samantha noted that Brad had a frown on his face through most of the show. Maybe he was still upset about work. A half-hour later, the program ended. Samantha stood up to stretch and then turned to Brad with a big smile.

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“Wasn’t that fantastic? Look at all the things that stem cells could be used for. They might be able to help people with Parkinson’s disease or even heart attacks. It’s amazing what scientists are coming up with these days. I’d like to help out. We still have those embryos frozen away at the clinic from back when we were doing the IVF treatments. I wonder if we could donate them?” Samantha mused.

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The richest source of embryonic stem cells is tissue formed during the first five days after the egg has started to divide. At this stage of development, called the blastocyst, the embryo consists of a cluster of about 100 cells that can become any cell type. Stem cells are harvested from that cluster at this stage of development, in the process destroying the embryo while it is still in the test tube.

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Embryonic Stem Cells

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Courtesy of the National Institutes of Health

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CQ#3: Do you support or oppose embryonic stem cell research?

A. Support

B. Oppose

C. No opinion

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“Are you nuts?” Brad scowled. “Didn’t you get the gist of that show? They are destroying babies to get those stem cells. And you want to give them our children!”

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“Our children? Our children are sleeping right here in this room. I’m talking about some clumps of cells that we will never use. We’ve talked about this before, Brad. We decided that Anna and Mark are enough. We aren’t planning to have any more kids, especially since I’m going back to work soon. Why not put those cells to good use? There are so many people who are suffering who could benefit from them.”

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CQ#4: Do embryonic stem cells represent a human life?

A. Yes

B. No

C. I am uncertain

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“Didn’t your Aunt Regina die from diabetes complications last year?” asked Samantha? “People like her might have a chance for a better life through the use of stem cells. My cousin Jackie, who was paralyzed in that car accident, might be able to walk again! In fact, our own children might benefit from those cells someday.”

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Animation

Stem Cells

Link to: http://www.sumanasinc.comSumanas, Inc

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What is “therapeutic cloning”?

Therapeutic cloning creates a cloned embryo for the sole purpose of producing embryonic stem cells with the same DNA as the donor cell. These stem cells can be used in experiments aimed at understanding disease and developing new treatments for disease. To date, there is no evidence that human embryos have been produced for therapeutic cloning.

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Q#5: Cloning stem cells from people with a genetic disorder would allow researchers:

A. To prevent these people from passing the disease causing genes to their children.

B. To treat these people with their own cells.

C. To find and work with the DNA that causes the disease.

D. To create disease-free embryos.

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The Australian embryologist and stem cell biologist Alan Trounson, a pioneer of in vitro fertilization, believes that

“Studying disease with stem cells is incredibly important for research. We need to develop embryonic cell lines from patients who've got muscular dystrophy, Alzheimer's disease, and cystic fibrosis. That way we can develop drugs that actually block the disease from occurring.”

Excerpted from ‘Stem Cell Now' by Christopher Thomas Scott.

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CQ#6: What advantage is there to cloning someone’s stem cells rather than culturing already established stem cells?

A. Cloned cells divide more rapidly.

B. Cloning would not involve embryos.

C. Cloned cells would be disease-free.

D. Rejection issues with transplants could be avoided.

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Brad stood up and faced Sam. “Maybe great medical treatments can be developed, but at what cost? Those are human beings we’re talking about, not just ‘clumps of cells.’ I don’t understand, Sam. You have always had pro-life beliefs like me. Those are our babies that you’re talking about destroying!”

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“But we’re not going to use those embryos to create children, Brad. You’ve said yourself you don’t want any more children. What are you going to do? Leave them frozen forever?” cried Sam.

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“I don’t know. I hadn’t thought about it much until you brought this up. Maybe we can donate them to another infertile couple. Can we do that? Besides, they said in the show that at this point in time the government won’t fund any new research that destroys embryos to make cell lines.”

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“The only embryonic stem cell lines that can be used in federally funded research were already created before the government banned their use, so you probably couldn’t donate our embryos to science anyway. And what about adult stem cells? Or umbilical cord stem cells?” continued Brad. “Why can’t researchers use those? Why use embryos in the first place?”

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Blastocyst

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A New Category of Stem Cell

• In November 2007, scientists reported they were able to reprogram skin cells to become pluripotent stem cells.

“Induced Pluripotent Stem Cell Lines Derived from Human Somatic Cells,” by Junying Yu, Maxim A. Vodyanik, Kim Smuga-Otto, Jessica Antosiewicz-Bourget, Jennifer L. Frane, Shulan Tian, Jeff Nie, Gudrun A. Jonsdottir, Victor Ruotti, Ron Stewart, Igor I. Slukvin, and James A. Thomson (21 December 2007) Science 318 (5858): 1917.

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CQ#7: If you were President, which type(s) of stem cell research would you support?

A. Embryonic stem cell research only

B. Adult stem cell research only

C. Umbilical stem cell research only

D. B and C

E. A, B, and C

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“All I know is that I want to do the right thing. If we aren’t able to donate our embryos and we’re not going to use them to have more children, what should we do with them?” Sam said softly.

“I don’t know,” sighed Brad.

They both looked away from each other and out at the windswept landscape outside.

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CQ#8: If you were Samantha or Brad, what would you want to do?

A. Donate the embryos for research

B. Leave the embryos frozen indefinitely

C. Put the embryos up for adoption

D. Destroy the embryos

Slide CreditsSlide 1—Images A and B.

Description: Embryonic Stem Cells. (A) shows hESCs. (B) shows neurons derived from hESCs.

Source: Follow the Money – The Politics of Embryonic Stem Cell Research. Russo E, PLoS Biology Vol. 3/7/2005, e234 http://dx.doi.org/10.1371/journal.pbio.0030234

Author: Nissim Benvenisty

Clearance: PLoS--This image was published in a Public Library of Science journal. Their website states that the content of all PLoS journals is published under the Creative Commons Attribution 2.5 license.

 

Slide 3—

Description: Icicles.

Source: Flickr.com, http://www.flickr.com/photos/59089068@N00/3254479

Author: ms.Tea / tracy ducasse

Clearance: This file is licensed under the Creative Commons Attribution 2.0 Generic license.

Slide 4—

Description: Twins.

Source: Wikimedia Commons, http://commons.wikimedia.org/wiki/File:Retos-twins.jpg

Author: Reto Stauffer, www.hopp-schwiiz.ch

Clearance: This file is licensed under the Creative Commons Attribution-Share Alike 2.0 Germany license.

Slide 5—

Description: In-vitro fertilisation (IVF) process.

Source: © fotomontage - Fotolia.com

Link: http://us.fotolia.com/id/17428575

Clearance: Licensed.

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Slide Credits cont.Slide 7—

Description: Illustration of embryonic development.

Source: © Guniita | Dreamstime.com.

Link: http://www.dreamstime.com/royalty-free-stock-photos-cell-development-image19080278

Clearance: Licensed.

Slide 16—

Description: Embryonic stem cells.

Source: Wikimedia Commons, http://commons.wikimedia.org/wiki/File:Stem_cells_diagram.png

Author: Wikipedia contributor Mike Jones.

Clearance: This file is licensed under the Creative Commons Attribution-Share Alike 2.5 Generic license.

Slide 17—

Description: The Promise of Stem cell Research

Source: Downloads and Media Resources. In Stem Cell Information [World Wide Web site]. Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services, 2008 [cited Friday, February 27, 2009] Available at <http://stemcells.nih.gov/info/media/defaultpage>

Clearance: United States Government Agency.

Slide 34 —

Description: Blastocyst.

Source: Wikimedia Commons, http://commons.wikimedia.org/wiki/File:Blastocyst_English.svg

Clearance: This file is licensed under the Creative Commons Attribution ShareAlike 3.0 License.