Research using human embryonic stem (ES) cell lines is urgently required in Ireland to help understand why certain diseases occur and to help in the discovery of new treatment for patients with chronic debilitating diseases.
Enormous advances in health care have been made during the previous 30 years, especially in the areas of cardiovascular and cancer diseases. Subsequently, we have witnessed rapid extensions of life span to approximately 80 years for women and 78 years for men.
On the flip side, epidemic occurrences in diabetes and neurodegenerative disorders have emerged and their exponential rise has huge implications for quality of life in patients and their families, as well as for society in terms of socioeconomic burden.
There are many drugs in clinical trials at present, however, health care systems and drug companies around the world are devoid of novel agents that reverse prevalent disorders like Alzheimer’s disease, Parkinson’s disease and Multiple Sclerosis.
Fundamentally, this is because we still do not fully understand the molecular and molecular mechanisms that underlie these widely prevalent diseases.
It is only through increasing our knowledge of how neurons in the brain develop and respond to environmental challenges will we be begin to prevent and reverse such devastating conditions in patients.
Embryonic stem cells have enormous potential as we use them to help understand how biochemical mechanisms control neurodegeneration and how damage in the brain may be prevented and reversed.
Of course, there are serious ethics to consider when doing such research and many countries have developed an ethics-infrastructure to deal with the associated issues.
However, at present, there is no constitutional legislation in Ireland that deals with scientists or medics using human ES cells for research purposes. Such legislation is urgently required.
The main issue surrounding research with human ES cells is that the process of extracting these cells from an early-stage embryo or blastocyst results in loss of viability of the blastocyst. Advocates against such research argue that science tells us life begins at conception and that destruction of a 2 week-old blastocyst is wanton termination of life.
Science, of course, does not state that human life begins at conception. It states simply, that when single egg and sperm cells fuse together, new genetic material is created. No more, no less.
The new DNA has the potential to control development of the fused cell into a blastocyst, embryo and human, however, this process will not happen unless the embryo implants in the womb.
The Supreme Court of Ireland recognised this fact last December and effectively ruled that embryos created outside the person during in vitro fertilisation (IVF
) are not humans and are not protected under the Irish constitution.
Therefore, it follows that researchers who wish to use IVF-generated embryos, that have been discarded following successful IVF treatment, for generation of human ES cells should be allowed do so.
An argument often presented against using human ES cells for research is that adult stem cells are better and research has shown that a limited number of diseases can be effectively treated with such cells.
It is wonderful, after years of research, that some blood born leukaemia diseases, can be treated using adult stem cells, however, the majority of current scientific opinion is that ES cells have much more research and therapeutic potential than adult stem cells.
Many scientists, myself included, would prefer to avoid working with human ES cells due to the ethical confrontations that exist. But when it comes down to a choice between not destroying a tiny mass of approximately 200 cells or helping a fully grown human with chronic disease, I choose the latter.
A 2 week old embryo that is left under liquid nitrogen storage is not the same as a 7 year old girl with leukaemia nor a 32 year old woman with multiple sclerosis nor a 55 year old man with Parkinson’s disease.
All of these patients deserve as much help as possible from society and ES cells that are known scientifically to have a much better potential than adult stem cells are a possible means to achieve this goal.
Important knowledge of cellular mechanisms involved in human diseases has been discovered using ES cells. This research is also directly responsible for the exciting new discovery that human skin cells can be reprogrammed to become very similar to embryonic stem cells.
These cells are called induced pluripotent stem (iPS) cells and a massive worldwide focus on their use in drug screening and potential use in transplantation therapies has begun. This development is proceeding in tandem with human ES cell research.
It remains to be seen if stem cell research can cure the above diseases however the successes that have already been achieved suggest that this kind of research should be pursued.
It is vital that Ireland is part of this development and that Irish patients reap the full benefit of such research.
Dr Davey is a Senior Lecturer in the Institute of Neuroscience.
