Plan your child’s future – because you never know when sci-fi becomes true

In the second of five articles short-listed for the ICR's Mel Greaves Science Writing Prize 2015, Marcia Costa delves into the science and ethics behind many of science fiction's greatest stem-cell inventions.

Stem cell research has long been controversial – not only among the scientific community, but also with the general public. From science fiction to reality, how close are we to unveiling all the potential of stem cells in medical research, particularly in cancer?

Why is stem cell research so important?

For those who do not know what stem cells are, imagine yourself as a child when you believe you can become a singer, a painter or a scientist. Eventually, you realise you are tone deaf or colour blind and the only skills you have left are analytical judgement, curiosity, perseverance and a need for self-sacrifice – then you stick with your third option. The same for stem cells: these are an undifferentiated type of cell in multicellular organisms that can specialise in different types of tissues, for example, a blood or a brain cell. This definition gives you a clue to the important role these cells can have in medical research: they open a wide range of possibilities in regenerative medicine, in diseases such as Alzheimer’s, Parkinson’s and cancer.

Stem cell research is one of the greatest science-fiction hits. From The Island in 1980, to Jurassic Park and Gattaca in the 90s, stem cells are a recurrent theme for writers, since they allow them to ‘justifiably’ create the most unbelievable creatures. We are indeed using stem cells in research, but instead of creating ‘Frankensteins’, biomedical scientists are exploring the idea of obtaining types of cells or tissue which could improve patients’ quality of life and even save their lives. Stem cells are also MARVELous! From Schizoid Man to Freak, and Stem Cell which is actually a character from one of the MARVEL comics, the idea is to create the most powerful superhero (or villain…), without having to rely on extra-terrestrial powers, poisonous spiders or a very wealthy family.

I am a great fantasy fan but also a scientist-to-be, so let’s get to the facts.

Ethics and religion: when does life start?

Stem cells are broadly divided into embryonic and adult, depending on if they are collected from an embryo or from already differentiated tissue (in most cases, bone marrow). Can you spot the problem?

There are major ethical concerns about the use of embryos, for any type of research. Embryos can be seen as a person or a potential one. If you agree with this argument, you should also agree that they should be protected as such, and that embryonic stem cell research should not be performed. However, another opinion about this matter is that embryos are not yet a person, since an embryo not implanted in the uterus does not possess the psychological, emotional or physical properties that define us as human beings. In order to balance both points of view, a 14-day after fertilisation threshold has been defined as the time limit for using embryos for research. This threshold was based on the fact that before the 14th day post-fertilisation embryos do not have a central nervous system and after this time point they cannot split to form twins.

Religious points of view also vary greatly. For example, the Catholic, Orthodox and Protestant churches claim that the embryo does have a human status, hence embryonic research should not be permitted. Interestingly, Judaism and Islam argue that embryos do not have a full human status before the 40th day and they actually agree with some embryonic research.

You might ask: if it is so arguable to use embryonic stem cells, why not just use adult stem cells? Well, adult stem cells are less versatile since they are collected from an already differentiated tissue. Also, embryonic stem cells are ‘younger’, which means they are less likely to have abnormalities.

So the real question you should ask yourself is: how do I feel about an embryo? Here, I cannot tell you what is right or wrong. It’s mostly a personal conception.

Where are we technologically?

There are various ongoing preclinical studies and clinical trials using stem cell technology in several areas of medicine. One of the most promising applications, however, is in cell-based therapies, since stem cells could be a renewable source for replacing damaged cells and tissue, helping patients with muscular degeneration, spinal cord injury or heart disease, for example.

Nevertheless, in clinical practice, the biggest loser is cancer, particularly leukaemia (bone marrow and blood), lymphoma (lymph nodes) and myeloma (white blood cells). These types of cancer are spread through the body, which means patients receive aggressive treatments, such as high chemotherapy doses or whole-body radiotherapy. These treatments are effective, but they also destroy the bone marrow, where stem cells are present and develop into essential blood cells. Through bone marrow transplants, it is possible to replace the lost stem cells, actually saving lives.

So, would you like to review your concept of an embryo now?

What can you do?

Cancer patients often need bone marrow transplants and, in two thirds of the cases, family members won’t be compatible. If you are healthy, over 18, weigh more than 50kg and have a body mass index less than 40, you can become a donor! If you are thinking about it, but are unsure of the procedure, contact your GP or visit the NHS website. If you are expecting a baby, then you should know that you can have its umbilical cord or placenta’s blood collected. These are two great sources of stem cells, and can be donated to the NHS cord blood bank for use by anyone who needs them.

I think it is important to be informed, consider your options and then act in accordance to what you think is morally correct. Please decide for yourself. And if, like me, you love sci-fi and superhero movies, then this is a great year for you!