A ‘KLOWN’ OF YOUR OWN?De Teague on ESCR (Embryonic Stem Cell Research)

May 17, 2015

• There is a controversy that arises from usage of stem cells for medicinal purposes. “Stem cells are a special form of human life: they are alive and contain human DNA. They have a unique feature in that they can be coaxed into developing into some or all of the 220 cell types found in the human body. Eventually, stem cells may be routinely used by doctors to generate new organs or new replacement body parts for people: They might become a new pancreas to cure a person with diabetes, or new nerve cells to cure a paralyzed person, etc” (“Stem Cell Research: All Points”). One of the most pro-active stem cells type - Embryonic - is a just fertilized embryo called a blastocyst, which consists of many undifferentiated stem cells surrounded by a covering. Embryonic stem cells are usually obtained by a destructive process that extracts the cells while killing the blastocyst itself. Many religious and social conservatives, who are also pro-life, believe that a pre-embryo from which embryonic stem cells are removed is an actual human person perhaps one with a soul. “To destroy an early human embryo in the course of carrying out stem cell research, on this view, is to destroy an individual human being like you or me, and such an act is profoundly morally wrong. This is the view that informs the stem cell research policy adopted by President Bush in 2001” (Cohen 62). Subsequent freezing of Federal funding of ESCR (Embryonic Stem Cell Research) lines - to only a few existing prior to adoption of such a policy - hampers the progress of medical field science and ability to advance research crucial to healthcare. Negative connotation, given to ESCR by religious cohorts, dwarfs the science and hinders progress.

• “Scientific investigators are growing human stem cells in cultures in the laboratory with several different goals in mind. Their first aim is to use stem cells as the basis of new therapies for those with serious diseases. A second major aim of stem cell researchers is to gain increased understanding of the processes of human development. A third goal of stem cell research,

• scientists point out, is to provide new ways to test drugs for efficacy, toxicity, and safety” (Cohen 24). Unravelling a fundamental secret of developmental biology is the main reason why those experiments take place. The mystery of how an extraordinarily complex human being can develop from a single fertilized egg has perplexed scientists and philosophers at least as far back in History as ancient Greece. Aristotle performed his own investigations, breaking open chick embryos at various stages, to see whether new structures emerged with time. They did. The debate was not settled in ancient Greece; it went on for centuries.

• On 5 July 1996, a new, noisy, and morally contentious being entered the world and transformed our experience of it. Dolly, the unsheepish sheep, was born in Roslin, a small town outside Edinburgh. Dolly remained a celebrity until her death of an epidemic lung infection on 14 February 2003. She was a first mammal cloned by nuclear transfer from a creature that had already lived and died. The nucleus of a single mammary cell from a 6 year old sheep was inserted into an egg cell which had been emptied of its own nucleus, but still contained a gel-like substance called cytoplasm. Factors in the cytoplasm are believed to be responsible for reprogramming the incoming nucleus, which is the essence of cloning by nuclear transfer. Cloning of Dolly was but the first of three extraordinary advances in human biological sciences that closed out the old millennium and rang in the new. (Despite its heavy load of pejorative metaphorical baggage, the word clone had a benign and rather innocuous beginning. Derived from Greek ‘klown’, it means twig. Taking cuttings of plants is cloning.) The second advance, the sequence of the human genome, was unveiled just as the new century began. The third major advance in biological science was the derivation of human embryonic stem (ES) cells. The main question risen by ES cells inquest is trying to perceive whether we were fully formed humans from the beginning or developed from the simple to complex? It is also helpful

• in trying to answer all those ethical and moral issues that compromise further research. Accepting the premise that a fertilized egg or zygote contains a complete blueprint of human being formation begs a question whether this master blueprint irretrievably lost (as our cells differentiate and specialize to perform their required functions), or does the entire plan survive in every body cell, with all unneeded instructions languishing in a dormant state? Dolly’s existence provided proof, since validated by cloning of other species, that in differentiated cells the entire body plan is suppressed but survives. ‘Klowning’ science isn’t only fascinating in its revelations about the nature of development, but has a life-saving potential. Genetically modified sheep, cows and goats are already producing proteins in their milk that could treat human diseases. There is also a huge gap between supply and demand of human transplant organs. Solution could be found in xenotranspalnts, organs from gene-modified pigs’, which are also not prone to immune rejection by human progeny. Not being able to continue these valuable experiments would be subject modern civilization to doom and gloom of healthcare uncertainty.

• “Scientists see the possibilities of disease curing stem cells as two fold. One of the goals of stem cell research is to determine how undifferentiated cells become differentiated. Figuring out how this transformation occurs is essential to discovering cures for some of the most serious medical conditions, like cancer and birth defects, since these illnesses are due to abnormal cell division” (“The Science behind Stem Cell Research”). “In culture, rapidly proliferating adult stem cells may be transformed into cancerous cells. More broadly, there is uncertainty about just what the scientific and therapeutic potential of adult stem cells might be. There are huge gaps between growing a set of adult stem cells in culture, controlling their differentiation into specific cell types (such as heart or nerve cells), injecting such cells into patients in order to treat disease, and ensuring that uncontrolled development of cancerous tumors does not occur.

• If such stem cells are to be of therapeutic use, it will be necessary to learn how to isolate them, grow them in culture, and differentiate them into normal new cell types. Perhaps the most serious problem associated with the therapeutic use of embryonic stem cells in humans is that, if they are transferred to patients, these cells might grow into unwanted tissue or cancerous tumors. Another significant problem, that those attempting to use embryonic stem cells for therapeutic purposes have to confront, is that of immune rejection” (Cohen 19, 24). This evokes urgency for much needed full-scale ESCR, as cancerous ‘rogue’ cells rapidly becoming the plague of the XXI century, which, surely, couldn’t be meant as God’s creation of Man in its likeness. Some advances in ESCR breed optimism, but consistency of it is still much to be desired. Chronicles buzz: “Australian researchers at the Monash Institute of Medical Research in Melbourne have grown a human prostate from embryonic stem cells, allowing scientists to monitor the progression of the gland from normal to a diseased state, according to a study in Nature Methods (2006; 3:179-81). Developed in 12 weeks to a tissue equivalent to that of a young man, the gland expresses hormones and PSA, enabling researchers to observe the factors contributing to development of BPH and the subsequent transition to prostate cancer and to explore preventive strategies for these disease states” (“Embryonic Stem Cells Used to Grow Human Prostate”). “Recent seemingly unorthodox collaboration between the Vatican and NeoStem is an example of the type of interaction between religion, science, medicine, bioethics, economics and philosophy that could pave the way for an interdisciplinary approach to stem cell research. This unusual collaboration made headlines last year when the Vatican donated $1 million to NeoStem’s Stem for Life foundation, the objective of which was to develop ‘ethical stem cell research’. Although the worlds of science and religion do not necessarily oppose each other, the Vatican has not been seen as an unbiased partner with regard to its support for science, for example, the Vatican

• condemned Galileo Galilei as a heretic for his theories on the universe” (Meissner-Roloff, Pepper 1). One of the pitfalls of such seemingly laudable collaboration between ‘Church and Science’ is that the motives of it are probably less altruistic that claimed. “NeoStem has interests in adult cellular regenerative therapy, both in harvesting and storing adult cell units as well as in manufacturing adult stem cell (ASC) therapeutics, while also searching for the cultural impact of their own work, which is very unusual”, as “many companies will look at the profit and only at the profit. There might be more to gain for NeoStem in the collaboration from a commercial perspective than the Vatican cares to admit. However, the collaboration was showcased under principles of morality and ethics, and although NeoStem will almost certainly benefit commercially, the focus was nonetheless on how to make stem cell therapies more ethical by focusing on ASCs rather than embryonic stem cells (ESCs)” (Meissner-Roloff, Pepper 1).

• Rome holds firm against ESCR and its Vatican website echoes that “while it is convinced of the need to support and promote scientific research for the benefit of humanity, extracting ES cells from living human embryos raises ethical questions of the highest order.” To the Catholic, life begins at conception and IVF (In Vitro Fertilization) and ESCR “involve the destruction of human beings and are morally illicit or sin”. The general consensus among rabbis is that ESCR is an important step for science. Essay from a Jewish Action magazine comments that adherents of Judaism are required, in a sense, “to play God” - a “concept of emulating God is implicit in the mandate to heal and provide effective medical relief wherever possible.” “Normative Jewish law sanctions - nay, encourages - medical intervention to correct both congenital and acquired defects, and makes no distinction between stem and somatic (body) cell tissues. However, Jewish law forbids one to tamper with, or attempt to improve, creation.

• Many Jewish rabbis cite the Talmudic tradition that life begins after 40 days of gestation (which ‘non-surprisingly’ is also echoed by Islam), before then it is ‘mere water’ and of lesser human status” (“Who is Right about Stem Cell Research?”). Therefore, using frozen embryos from IVF is acceptable and nearly obligatory, given the mandate to “play God.” Additionally, some rabbis believe embryos developed in a lab setting cannot develop into a fetus, and are therefore not alive. Dalai Lama gave his thoughts on when an embryo becomes sentient from the Buddhist point of view. According to the Abhidharma texts, “consciousness enters the embryo through the meeting of the regenerative substances of the father and mother, and at that point it becomes a sentient being.” From the classical Buddhist standpoint, it has become a sentient being and extermination of that would be morally equivalent, almost, to killing a human being. However, Dalai Lama admitted that knowing when an embryo becomes conscious is problematic: “A fetus, which is becoming a human, is already a sentient being. But a fertilized egg may actually bifurcate into 8, 16, 32, 64 cells and become an embryo, and yet be naturally aborted and never become a human being. This is why … for the formation of life, for something to actually become a human, something more is needed than simply a fertilized egg.” These religious views collide, clash and seem to present dissenting opinions, with no ‘Final Authority’ on the issue. In fact, they rather do disservice, with each new idea, opinion and theological interpretation fueling the confusion. Examining various religious viewpoints does not clear up the issue. “Man has dominion over the animal kingdom” (Gen. 1:26). “His creative output proves this. While the human brain is only slightly more complex than any animal, each person has an additional element that sets him apart from the beasts of the earth—the human spirit” (I Cor. 2:11; Job 32:8). “When God imparts His Spirit into a human mind, God’s Spirit combines with the human spirit, and the person becomes a spirit being in embryo. This fertilization of Spirit and mind is immediate—there is no lag or grey area during which the person is not on his way to being born a child of God.

• One must have God’s Spirit to be a son of God” (Rom. 8:9, 14) the Biblical accounts state. But, while discussion of the moral status of the embryo is usually phrased as an enquiry into just when life begins, that is not question at all. We should more properly be asking when an embryo becomes morally significant. According to United Kingdom’s Human Fertilization and Embryology Act of 1990 - legislation that regulates embryo research and assisted reproduction with donated gametes and its Committee’s report “A Question of Life” that was published 2 years after the Dolly’s birth, an early embryo could not be considered a person; thus the moral duties we owe to the persons simply do not apply. Research should be allowed but only until the embryo reaches the 14th day of development and the primitive streak appears. At this point, the body plan of the embryo begins to be laid down. One consequence of this is the induction of the nervous system.

• “Just as the stem of a plant gives rise to other structures, stem cells give rise to all the other cells in the body”. The very existence of Dolly, cloned from somatic cell of narrow destiny and function, proved that, developmentally speaking, cloning renders the nucleus of donor cells young again. Is that possible that ES cells, that “differentiate and mature into the specialized cells that make up all of the body’s tissues and organs and give rise to each and every one of the body’s 10 trillion cells”, are a ‘fountain of youth’? Adult (somatic) stem cells play a different role, as they increase in number and replenish themselves through cell division. Unlike germ cells – eggs and sperm – they are programmed to die after they divide a specified number of times. “All adult organs contain a small number of stem cells that reside in a special protected region or niche.” Since “most cells in a tissue or organ have a limited life span, stem cells function as a reserve of cells that can be moved out of their niche, begin dividing, and differentiate into specialized organ cells to replace dying or injured cells.

• But unlike embryonic stem cells, which have the potential to morph into any cell type, adult stem cells ordinarily develop only into the same cells as their parent organs”(“Stem Cells and the Prostate I”). Within each of our cells, the physical structure that carries the genetic material or DNA is called chromosome. At the end of each chromosome is a bit of DNA that does not code for proteins. These ends are called telomeres. Each time somatic cell divides, telomere shortens. Cell division continues as long as enough of the telomere tip remains to keep the coding portion of the chromosome from fraying. The ESCR controversy about the length of telomeres in cloned species and reversing an aging clock – at least at the cellular level - rages on. Nonetheless, “scientists have high hopes for ES cells therapeutic potentials, because they are relatively easy to maintain in tissue culture for prolonged periods and because they have the theoretical ability to differentiate into any cell in the body. Researchers hope they will one day be able to stimulate embryonic stem cells to differentiate into healthy nerve cells that could be transplanted into patients to replace nerve cells damaged by Parkinson’s disease, strokes, or spinal cord injuries. Similarly, they hope to treat diabetes with pancreas cells, heart attacks with healthy heart muscle cells, and so forth.” “Although embryonic stem cells hold great promise, actual treatments are a long way off. Current technology relies on obtaining these cells from early embryos that have been produced for IVF but are not needed by patients and would be discarded if not used for research. Adult blood stem cells have been used for some bone marrow transplants in leukemia patients for over 30 years. Until very recently, however, therapeutic adult stem cell research has been thwarted by the difficulty of obtaining these cells and in coaxing them to regain the embryonic stem cells’ ability to differentiate into many types of tissue cells. Scientists are making progress in both areas, but practical treatments are still over the horizon” (“Stem Cells and the Prostate II”). Also, who pays and who controls research is an important factor.

• "If you can establish sufficient funding through the private sector, that's fine, but that's not as easy as it used to be in medicine, in general”, thus, there is an apprehension whether “research will progress as quickly and the funding would … be as great, if the government isn't involved. It would slow the potential benefits down, as to when the results would become available" (Nash 28). Therefore, without ‘spiritual leaders’ working in unison with ‘metaphysical ones’, it’s a big ask to broaden our horizons, breach gaps and harness the mystery of our creation rather sooner than later so that to find cures against so many terrifying and debilitating diseases. There are all too few eureka moments in science. It’s built on careful, painstaking and laborious insights of others. Thus, Newton’s resounding observation that scientists stand on the shoulders of their predecessors rings undeniably true! ESCR shall carry on - ‘no strings attached’!

• Works Cited: • Cohen, Cynthia B. Renewing the Stuff of Life: Stem Cells, Ethics, and Public Policy. Oxford: Oxford University Press,

2007. E-Book Collection (EBSCOhost). Web. 21 May 2015• "Embryonic Stem Cells Used To Grow Human Prostate." Urology Times 34.4 (2006): 6. Health Source - Consumer Edition.

Web. 28 May 2015.• Meissner-Roloff, Madelein, and Michael S. Pepper. "Stem Cell Research Engenders Interdisciplinary Collaboration In

Science, Ethics And Religion." South African Journal of Science 108.5/6 (2012): 1-2. Academic Search Premier. Web. 17 May 2015.

• Nash, Karen. "Urologists Express Mixed Feelings over Stem Cell Research." Urology Times 33.12 (2005): 26-28. Health Source - Consumer Edition. Web. 28 May 2015.

• “Stem Cells and Diseases.” The National Institute of Health. http://stemcells.nih.gov/info/health.asp. Web. 16 Apr. 2015.• “Stem Cells and the Prostate I” Harvard Health Newsletters N0110b• http://www.harvardhealthcontent.com/Newsletters/69,N0110b. Web 17 May 2015• "Stem Cells and the Prostate II" Harvard Men's Health Watch 14.6 (2010): 5-7.  Health Source-Consumer Edition. Web.

28 May 2015.• “Stem Cell Research: All Points” Religious Tolerance • http://www.religioustolerance.org/res_stem.htm. Web 17 May 2015.• “The Science behind Stem Cell Research” Rights to Research and the Stem Cell Debate• www.macalester.edu/academics/environmentalstudies/students/projects/stemcellwebsite/science.html. Web. 17

May 2015.• “Who is Right about Stem Cell Research?” The Real Truth • http://realtruth.org/articles/090504-005-analysis.html. Web. 17 Apr 2015