Stem Cell Symposium for CMS Teachers
August 24, 07
Summary Notes
Hosted by Jerry Brown, Principal, School of Biotech at Olympic High.
Presenters:
Dr. Jean-Luc Mougeot
Dr. John Baker, Carolinas Health Care System (CHS)
Dr. Lance Stell –Ethics at Davidson College
David Carl- Chaplain (CHS)
Honorable James G. Martin –former Governor of N. Carolina
John Baker-Overview
Disclaimer: None of the sponsors are engaged in Human Embryonic Stem Cell Reseach
Tissue Engineering Applications-- Predictions:
Near Future/ Now—Re-implantation of patients own tissue
Ex: Dome of bladder rebuilt in bladder cancer
Breast re-implantation
20 years or more out—Replace neurons ie: ALS or Parkinson’s
Far future—create entire organ, such as a face for implatation
Jean-Luc Mougot—The Uses of Stem Cell Research
Totipotent
Pluripotent
Multipotent
Zygote and Morula
Trophoectoderm (blastodisc)
Gastrula (3 cell layers)
Differentiated Tissue
Totipotent- may become any cell type
Pluripotent – may become limited cell types
Multipotent—may become only specific tissue type
The greatest potential for research use at this time is in ADULT STEM CELLS.
Located in areas such as basal layer of mammary glands, bone marrow, and crypt of s. int.
Why? They are pluripotent (can form the 3 tissue layers), involve less ethical concerns, lower risk
of tumor formation, easier to culture and maintain.
Effective treatments used now: Cancer—bone marrow transplant- goes back many years.
Immune Deficiency—
Progress but not reliable treatments now:
Spinal cord injury, Lou Gehrig’s, Parkinson’s, Alzheimer’s
(Parkinson’s and Alzheimers research uses olfactory bulb stem cells)
Skin: Burns and Breast cancer
Bone regeneration
In order to do research with living cells, tissues or organisms, there are several review boards and
rigorous reporting on welfare of the material.
Some current concerns
Destruction of viable embryo, eugenics (creation of “perfect” humans), worldwide regulations,
profiting from embryonic stem cells (ESC).
Current challenges
Decreasing risk to embryo, danger to patient, differentiated cells do not always function,
More work in Adult Stem Cell (ASC) research is needed.
Lance Stell-Ethics
Ethics asks this question: “Can values based disagreements be resolved?”
It provides a framework for answering this question (but does not try to answer it.)
One way to view ethics related problems:
The Goal is to Decrease Discomfort and Suffering
Irreducible Values Pluralism—“Agree to Disagree”
The US is the living enactment of this Social Experiment.
Ethical Problem
Non-human animals
We base research on the assumption that animals shall bear the initial burden of
discovery. (See Nuremburg Code—1947 and Declaration of Helsinki)
This is not accepted by everyone.
Some questions that classes can ponder and discuss?
Who or what should bear the risks of discovery in medicine?
What regulations or protections are currently imposed?
If you disagree with using animals in research, are you willing to accept the products of
such research for your personal benefit? (Denying these products would severely limit the medications or
treatments that one could accept).
David Carl Chaplain, CHS
“I represent not the totipotent, pluripotent or multipotent but the omnipotent!”
He was on the Body Worlds advisory committee and that experience taught him that we are wonderfully
made.
Serves on several CHS review boards and backed up that all research is well reviewed, animals must be
well taken care of.
Governor James G. Martin
Princeton- Chemistry
2 terms as Governor
Tuba with Charlotte Symphony
In government, regulatory refers to what is prohibited. Funding determines what is encouraged.
In 1993, funding for ESC research was already authorized, but a ban was place on ability to create or
destroy new embryos.
Only about 16 cell lines were available in 2001 when existing cell line funding was passed.
So, states starting putting in $ for stem cell research.
Our forefather, James Madison, predicted such a situation when he said that the states would become
competitive laboratories.
N. Carolina is the 3rd largest Biotech Research State with satellites in Winston-Salem, Wilmington,
Charlotte, Greensboro, etc.
Cord blood is being stored by families that can afford, but this has limited potential in research as they are
multipotent.
Panel Discussion
Got into discussion of wealth related to healthcare, and made this notable comment:
“Wealthy people are subject to a type of exploitation that ordinary people are not. They may be able to
afford to take big risks and bet on a long shot.”
“Look at someone’s budget to see where they price their values”
Other remarks:
“Given what their problem is, people can have remarkable tunnel vision about the cure, but remain
remarkably ungenerous about the other advantages.”
My question: “Does anyone have any objection to presumed consent for organ and tissue donation, and
what is that objection?”
Well, Spain has it.
Trust issues, fear is an enormous factor here in the US.
Cultural issues.
Our big move is from presumption that you don’t want to donate to presumption that you want to
be asked. N. Carolina may make the indication of heart on license a final word on donation.
Issues of enhancement—making bigger, stronger, more beautiful. The only comment was that this is
nothing new.