Modern medicine has a tool that divided society into two opposing camps. This is a fetal therapy that uses material from embryos and stem cells. There are many myths and horror stories around this method. The media offer different points of view on methods of fetal therapy, and most of them are negative in moral terms. In the article we will try to understand the terms and consider the problems of this issue.
Stem cells - what is it?
The term "stem cells" was proposed by Russian-American scientist Alexander Maksimtsov in 1909. The concept was used in relation to the precursors of blood cells that are formed in the bone marrow of mammals during embryonic development. Only a hundred years have passed, and today modern medicine has learned to cultivate them, use them for transplantation, and reprogram them into ordinary somatic stem cells.
More than 220 types of cells are secreted in the human body, and all of them are derivatives of undifferentiated human stem cells. Their main properties:
- The ability to self-renew by asymmetric division, when two completely identical mother cells are formed from one stem cell without their differentiation.
- The presence of differentiating potential (potentiality), that is, the ability to share with the formation of specialized cells. In this case, two highly specialized ones are formed from one stem cell.
These cells, like all others, have their own age - short “infancy”, quickly ending “childhood”, rapid “youth” and long “maturity”.
Stem Cells: Infancy
In the initial sense, stem cells are embryonic germ cells. Recall where our body begins. A fertilized egg (zygote) begins to divide into blastomeres exponentially. At the stage of 32 blastomeres (morula), all cells are totipotent stem cells. What does it mean? That each of these cells can give rise to a new organism.
At the stage of 128 blastomeres (blastula), stem cells become pluripotent - they acquire a partial specialization and already give rise to germ layers, but retain the ability to become any cell in the body. However, they can be shared an unlimited number of times.
After the blastula stage, stem cells “mature” and can give rise only to strictly specialized cells. And it is precisely at the blastula stage that embryonic stem cells can be obtained, but the embryo itself can also be destroyed. Today, mainly human embryonic stem cells are obtained from embryos that have remained "superfluous" during in vitro fertilization.
Fetal cells - childhood and youth stem
Fetal stem cells (from the Latin “fetus” - fetus) are obtained from abortive material (6-21 weeks of pregnancy). These cells are already unipotent - they develop into a strictly defined type and cannot divide an unlimited number of times.
The earlier the term for the formation of the embryo on which these cells are obtained, the more plastic they are in terms of division and differentiation.
In the umbilical cord blood, which was collected during childbirth, there are quite “young” stem cells that can turn into blood cells, bones, the nervous system and others. In a small amount of umbilical cord blood there are very few of them, they multiply rapidly, and since they have not yet suffered viral attacks and the influence of negative environmental factors, they have not immunologically matured. That is why these cells are a promising area for transplantation. They are obtained from stem cell banks where frozen donor cord blood is stored.
Stem cell maturity
But even after birth, the human body has a small supply of this “plasticine,” which decreases with age. The body needs these cells in case of “breakdown”, fibroblasts are able to turn into a certain type of cells and replace damaged parts of organs and tissues. And besides, they stimulate the body's internal reserve for recovery.
They are found in bone marrow, adipose tissue, and other body structures. They are the authentic material for various transplants.
The specifics of therapy
Stem cells of any "age" can be used in the treatment of pathologies. But there is a specificity.
Therapy with embryonic stem cells, due to their totipotency, offers great promise. But they do not grow well in nutrient media, with each division they accumulate genetic errors, and during transplantation they develop randomly, often leading to the formation of teratomas (tumors from embryonic tissues). They are capable of degeneration into cancer cells and cause rejection reactions, like any other inclusion foreign to the body.
Fetal therapy is more predictable. After all, these cells can degenerate into a strictly defined type. But here there are many problems. Not to mention the ethical side of the issue, they also cause rejection and live very briefly. But, according to most scientists, this direction of development of techniques with stem cells is the most promising.
Successful Techniques
The first successful cord stem cell transplant was performed in 1987, when five-year-old Matthew Farrow was healed of a congenital blood disease (Fanconi anemia). Since then, more than 10 thousand patients have undergone such therapy. Its main drawback is the minimum (up to 100 ml) amount of blood that is extracted only once. The advantages of these methods include the possibility of freezing stem cells while preserving all their properties for a period of more than 20 years. And thanks to the presence of stem cell banks, it is possible to select donor blood.
Own stem cell therapy is far from new. This successful technique entered medicine in 1969 when a bone marrow transplant was performed for a patient with blood cancer by Dr. E. Thomas (Seattle, USA). Modern methods allow to defeat leukemia in 80% of children.
With an autologous transplant (with your own cells), there are no rejection reactions. With allogeneic (from the donor) transplantation, rejection reactions are possible. The possibilities of reproduction of these cells on nutrient media open up new horizons for medicine, which already today uses these methods for restoration of bones and joints, for tissue regeneration after burns.
Stem cell sources
Based on the foregoing, it is possible to divide all the sources of stem cells into groups, taking as a basis one of the signs.
If stem cells are taken from a donor, then they can be autologous (of their own body), allogeneic (donor is another person), xenograft (donor is a representative of another species).
If we take as a basis the place of stem cell sampling, then they can be taken from:
- Embryonic tissue.
- Fetal tissue.
- Bone marrow.
- Cord blood.
- Peripheral blood.
- Adipose tissue.
- Pancreas and prostate glands.
In ethical terms, which is completely unscientific and far-fetched, but sometimes becomes more significant than all other aspects, the material may be unclean (embryo or human fetus) or pure (all other stem cells). Although in this matter you can find pitfalls and suggest that all stem cells may have an ethically unclean origin.
Victory over the disease before birth
A separate area of fetal therapy is fetal surgery. This is EXIT technology, which means "partially inside, outside the uterus." These are operations on the fetus associated with the umbilical cord with the mother's body, which are performed after the 28th week of pregnancy.
Modern methods of fetal medicine are as follows:
- The drug method. In this case, drugs are injected directly into the umbilical cord. For example, corticosteroids help the fetus develop lungs if it is likely to be born prematurely. It is also used for fetal heart failure and prolonged pregnancy.
- Invasive methods. These are blood transfusions, and laser surgery, and intrauterine bypass surgery, and operations on the heart valves of the fetus.
Fetal surgery is looking for new techniques and, possibly, in the near future, operations and diseases will be a thing of the past.
Moral and ethical aspect
Fetal therapy is a transplantological manipulation. At the same time, it differs from conventional transplantology when organs of deceased people who have given this consent in life or donors who voluntarily agreed to this procedure are transplanted.
In this case, we are talking about the collection and use of fetal cells that have already formed in the womb. And so, in the later stages of pregnancy, cell therapy is preceded by killing. Indeed, for fetal medicine, it is important that the cells were taken from an absolutely healthy fetus, which means that an abortion is performed not at all for medical reasons.
The widespread practice of late abortions, when a child’s prenatal diagnosis reveals Down syndrome, poses a persistent contradiction to a woman. In addition, the diagnosis does not have a 100% guarantee of the accuracy of the result. According to some reports, out of 200 fetuses examined, at least 2, and this is 1%, turn out to be false positive. The appearance of professional “female incubators” who bear a baby for a fee until the time of premature birth, when he should not survive, only confirms the scale of negative opinions about the ethical side of fetal therapy.
At the same time, modern medicine allows you to save the life of a child born even at the 19th week. But the most optimal period of 20-22 weeks for fetal medicine gives rise to schemes for the delivery of abortive material by doctors. And this problem only adds fuel to the fire for the struggle of moral reactionaries and transplant biologists.
Any woman should know that invasive intervention during the period of fetal development in 0.5-3% leads to his death or pathologies. And only after carefully weighing all the risks, it is necessary to make such a difficult decision.
Fetal therapy in Russia
In the center of Moscow, on Oparina-4 street, there is a scientific center of obstetrics, gynecology and preriontology named after V.I. Kulakov. The stem cell cryogenic freezing center is located here. In the same building is the Laboratory of Clinical Immunology, which is headed by G. T. Sukhikh, academician and author of the patent on the use of embryonic and fetal stem cells.
About the center to them. Kulakova and G. Sukhikh laboratories there are many conflicting reviews. And all in Russia there are about 30 such institutions that work with fetal material.
One thing is for sure: with the development of this area, the statistics of late abortions (controlled abortion) in Russia have increased dramatically. Whether this is due to the fact that fetal cells are most promising for fetal medicine during pregnancy from 18 to 22 weeks can be argued. But abortion statistics have always existed. Isn’t it better to use this material for the benefit of people than to simply dispose of it?
Fetal medicine product
The cost of fetal therapy is impressive - one injection costs $ 500-2,000. This means of a wide spectrum of action - cures ailments, starting from Alzheimer's and Parkinson’s disease, defects of the nervous system, kidneys and other organs, ending with rejuvenation, revitalization, stopping aging, increasing mental abilities. This is one side of the coin. But there is another.
Fetal cells are used in cosmetology (injections of youth) and cosmetics (labeling Human or Fetal). Cosmetics using human embryo tissue are expensive and are made in the lines of French, Swiss, German manufacturers.
But that is not all. What drugs are made from embryos? Today, 5 to 10 types of vaccines are produced from this material - measles, mumps, rubella, herpes zoster, smallpox, hepatitis. There is evidence that the developed HIV vaccine is also based on work with abortive material.
One of PepsiCo's labs is developing modulators or flavor enhancers from fetal material.
The utilitarian use of abortive cells and tissues today is spreading for the treatment of humans, and the organs and tissues of an unborn child have the status of a “medicine”. In vitro fertilization and its result - multiple pregnancy - also become a source of embryonic stem cells.
To summarize
Modern stem cell therapy has long passed the stage of scientific experiments and has become a practice in many countries of the world. Fetal therapy opens up particular prospects in the treatment of atherosclerosis and joint pathologies, Parkinson's disease and multiple sclerosis. And these are far from all diseases that are not amenable to medical treatment, but are treatable by cell therapy methods . WHO statistics for 12 European countries confirms this - 16 operations using cell transplantation per million patients.
In addition, these methods have the prospect of improving the quality of life of people. This is a slowdown in the aging process, and an improvement in vitality, and an increase in potency.
According to Academician of RAMS and the author of patent RU (11) 2160112 (13) C1 “Method for the preparation of a cell transplant of fetal tissues” G. T. Sukhikh, fetal therapy is a promising area of modern medicine and the latest achievement in cell biology.
But each thinking person independently chooses how to relate to the problems of fetal medicine.