Cut a flat worm in two, the tail will grow a new head and
the head a new tail. Cut it right down
the middle, it will grow a mirror image. How does it know what to grow?
Flies can re-grow damaged tissues. Small fish can regenerate heart muscle. Why can’t humans?
In a developing infant, how do human embryonic stem cells
know to grow into heart, muscle, liver, neurological and other cell types at
the proper time and in the proper place?
These questions are at the center of science’s brave-new-world
of stem cell biology and were the topic of the recent 3rd Annual
Stem Cell Symposium. The science was
deep and detailed, and enormously enthralling. It was an intellectual playground of exciting ideas and fabulous potential.
The overriding lesson from the conference is that the
mechanism by which stem cells regulate how and when they replenish themselves vs
develop into different tissues is conserved in species as divergent as worms,
flies, fish and mammals. This is
fascinating for developmental biologists, but it also has a profound practical impact
for eventually using stem cells to treat human disease. Let me explain how.
A primer on stem cell
science
Consider for a moment what needs to be accomplished for an
immature stem cell to differentiate into, say a beating heart cell. First, there needs to be a stimulus that
initiates this program, telling the stem cell to specifically move along the
cardiac muscle developmental pathway. The
stem cell must then begin expressing heart cell genes while repressing the
expression of all other genes that could cause it to become liver, blood,
kidney and all other cell types. Quite a
tall order!
Once the stem cell develops into a mature beating heart cell,
it remains that type of cell. Mature
cells, like zebras, cannot change their stripes. We never see a heart cell become a skin cell
and vice versa. Cellular development is unidirectional
and this has been one of the central tenants of developmental biology.
Then along comes Scottish scientist, Ian Wilmut, who did an
experiment in the mid-1990s that no self-respecting developmental biologist
would attempt since we all “knew” that cell development only moved in one
direction.
What Wilmut did was to remove the nucleus from an egg cell
and replace it with the nucleus from a fully mature cell taken from a different
animal. Keep in mind that this donor
nucleus had already been directed to express only those genes of the tissue it
was taken from and to repress the expression of genes from all other
tissues.
Wilmut then transferred this engineered egg into the womb of
a pseudo-pregnant sheep, where the engineered egg should have died. Instead, a sheep was born that was a genetic
twin of the nucleus donor sheep and the world was introduced to the first
cloned animal, Dolly.
This is the type of research result that causes a scientific
paradigm shift. For the first time, we
realized that the genetic program of a fully developed adult cell, when placed
in the proper environment, can be reprogrammed to relinquish its adult cell
properties and return to its undifferentiated stem cell state, capable of
developing into a fully grown sheep.
Around the same time that Dolly was born, University of
Wisconsin-Madison scientist, Jamie Thomson, published his seminal studies
demonstrating the ability to grow monkey and human embryonic stem cells (or
ESCs). These, of course, are the immature
cells derived from five day old embryos that are able to develop into all
tissues of the adult body. The way that
ESCs are harvested kills these embryos making ESC research highly
controversial. It would be great to be
able to obtain such embryonic stem cells without having to destroy a functional
human embryo.
Fast forward ten years to the conference where Professor
Thomson gave an update on his recent report that he can reprogram adult cells
to become stem cells without having to transplant cell nuclei. Looking at recent research from different
labs, he noted that only a few regulatory genes are needed to maintain cells in
their nascent developmental stage. As
the research presented at the conference illustrated, these regulatory genes
work across different species, so this mechanism is highly conserved in biology.
Thomson used routine gene transfer technology to induce expression
of three different regulatory genes in the cells of mature fibroblasts and,
amazingly, the mature cells were re-programmed to become stem cells! What Wilmut was able to do by transferring a
cell nucleus to an enucleated egg can now be done in a petri dish and without
the egg cell.
At the conference, Thompson explained that these
“induced
pluripotent cells” or iPCs seem to behave exactly like ESCs. Think
about the implication of this observation: it means that mature cells
from an adult can
be re-programmed back to the stem cell state where they are able to
generate
anew, all tissues of the human body.
What next for stem
cells?
UW-Madison stem cell researcher, Clive Svendson, moderator
of the conference, believes that the next major advance will be the ability to
develop iPCs by simply changing the environment in which adult cells are grown in
the lab, which could be accomplished in about a year. This means that we would not have to insert
several genes into a cell’s DNA, which has significant risks and is not a trivial
procedure. Thus, it soon may be very
easy to take cells from your skin, put them into a defined tissue culture
environment and develop stem cells that contain your precise genetic
makeup. No embryos would be destroyed
and no clones would be created in the process, mitigating most of the ethical
concerns.
Svendson opined that this could lead to a big boost in the
tissue banking business as people store tissues when they are young for making
stem cells if they should need them later. This would be necessary because, as Thomson explained, chronologically
young cells are more efficient at being reprogrammed than cells from older
animals. One can envision that it could
become routine at birth to store placental tissue, the youngest tissue readily
available that is genetically identical to the newborn baby.
As exciting as the science was at the conference, there
remain some problems to deal with before these stem cells are used in the
clinic. First, as with ESCs, undifferentiated
iPCs form tumors called teratomas. Therefore,
we need to develop a fail-safe way to completely separate or incapacitate
contaminating stem cells from the functional tissues grown from them before we
put them into patients. According to an
article I posted here earlier, the FDA recently convened a meeting to grapple
with this problem in anticipation that clinical trials will begin in the near
future.
Next, even if we can use stem cells to regenerate damaged
tissues, we still need to continue research into the causes of degenerative
diseases because simply replacing the dying cells without dealing with what
causes them to die may only be a short term fix.
Potential ethical
issues may still arise
Finally, and potentially an explosive issue, there remains
an ethical question regarding iPCs that no one seems to have addressed. When a mature cell is reprogrammed, how far
back does it go? Do iPCs only have the
potential to develop into different body tissues, or can an iPC, if given the
chance, form an embryo? Of course, if
the iPC cells are more like fertilized eggs than stem cells, then all bets are
off--the ethical issues will arise again.
I asked both Svendson and Thompson about this and
both
admitted that this idea had not been tested. Svendson even owned up
that no one in the field wants to test it. They do not want to know the
answer because
it could be very inconvenient.
My prediction
Carl Gulbrandsen, Director of the Wisconsin Alumni
Foundation, shared with me that reading Thomson’s paper on reprogramming adult
cells to derive embryonic iPCs made him “tingle”. Mr. Gulbrandsen does not seem to be the tingly
type, but his response to Thomson’s results was not inappropriate—they are that
amazing and significant.
As a scientist, I have learned to be cautious about making predictions. However, I venture one prediction here that I
believe has a very good chance of being realized: Professor Jamie Thomson will, in the
not-to-distant future, be awarded the Nobel prize for his outstanding work that
has created a whole new field of stem cell biology and invigorated the practice
of regenerative medicine. While I am at
it, you can bet that he will share the prize with Ian Wilmut.
Any takers?
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This post was first published in-part by the Wisconsin Technology Network News
© 2008 Steven S. Clark, PhD. Disclaimer:
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