The Stem Cell Divide

AORN Journal, Sept, 2007 by Helen Beckwith

The Stem Cell Divide Michael Bellomo 2006, 272 pages $24.95 hardcover

The author summarizes the purpose of this book in the subtitle: "The Facts, the Fiction, and the Fear Driving the Greatest Scientific, Political, and Religious Debate of Our Time." Only after defining stem cells; how they are obtained; and the moral, religious, scientific, and political challenges researchers must face can one begin to understand the implications of and laws pertaining to this science, which are not always black and white.

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Stem cells are isolated from embryonic tissue seven to nine days after fertilization using extremely technical methods. These cell clusters have no clearly defined purpose. When they are placed in Petri dishes in a guarded medium, they can be grown into specific cells, such as muscle, bone, or skin cells. The central, controversial question is "Do these cells represent life, or are they just a collection of cells?"

Worldwide, cloning is very controversial, and the legislation regarding cloning and stem cell research varies from country to country. Great Britain and the United States have the strictest guidelines on human cloning. Germany, as a result of the Nazi experiments, must import embryonic tissue for research. Spain, Belgium, and Denmark use surplus embryos created by in vitro fertilization procedures. In South Africa, India, China, and other Asian countries, stem cell programs are controlled by the government and are the most liberal.

According to the author, venture capitalists have been reluctant to embrace stem cell initiatives because of the issues and uncertainties involved, the significant investments required, and the lengthy wait for possible returns. The author cites the poor stock market performance of stem cell stocks from 1993 to the present to underline the problems.

The book covers some of the science involved in stem cell research, which is far from perfected. After stem cells have been grown in Petri dishes for many generations, a process that takes one to two years, they often can become rampant. When this occurs, the stem cells produce an ugly lump of tissue known as a teratoma in which cells have developed into such disparate types as hair, teeth, and nerve tissue. The reason the cells develop this way has not been determined.

The author also discusses some of the scientific breakthroughs in stem cell research as well as some of the more notorious failures. For example, Hwang Woo Suk, DVM, PhD, a leading South Korean scientist and researcher, became a national celebrity when he managed to clone an Afghan hound. Dr Hwang and his team of researchers worked daily for three years and collected 1,095 eggs from 122 dogs before their work successfully resulted in a pair of cloned puppies. One of the cloned puppies died within a month, resulting in an overall success rate of two-tenths of 1%; however, no research group in the world has been able to replicate his work. Subsequent claims by Dr Hwang of success in working with human embryos initially made him an international hero, and it was even suggested that he be awarded the Nobel Prize. Much of his research, however, was later discredited by his fellow researchers as fabricated, and other accusations of improper procedures surfaced as well.

To date, no embryonic stem cells have been used in humans, but there is growing interest in the potential of using adult stem cells. Adult stem cells collected from a person's own bone marrow (ie, hematopoietic stem cells); preserved; and then reinjected into the same person have shown promise in the treatment of a long list of blood disorders, including many leukemias, other inherited blood disorders, and plasma cell disorders. Adult stem cells also can be used to build muscle strength, a technique that is not detectible by testing and that could raise problems in the field of professional athletics.

This book is informative, unbiased, and readable. Research and use of this science, with all the complex issues involved, is highly controversial. The book is relevant to the present day, and the information it contains could be useful to nurses, the medical community, and the general public.

This book is available from AMACOM, 1601 Broadway, New York, NY 10019.

HELEN BECKWITH

RN, CNOR

STAFF NURSE

VAIL VALLEY MEDICAL CENTER

VAIL, CO