Extended Project Dissertation Regenerative Medicine

With the continued research going on into this new, potential way of curing many diseases that 20 years go we would never have thought could have been cured, can it do the same for the neurological condition, multiple sclerosis? And how effective is it in doing so? Many reports have come out of stem cells being effective in mice to cure the disease but with the many controversial points that come with the use of stem cells would alternative, existing methods be a better way of treating it?

Are the instrumentation drugs of today more effective in treating the condition and are they a more realistic thing to be using? Also is it actually a good thing if we are finding new cures to all of these diseases? With he world’s population rapidly rising and resources running out to feed everybody and supply them all with energy, would it be better if we continued as we are and stopped ‘playing God? These are the issues that will be discussing in this essay.

Introduction and Research What is multiple sclerosis? An abnormal condition of a part, organ, or system of an organism resulting FRR mom various causes, such as infection, inflammation,environmental factors, or genetic defect, and characterized by an identifiable group of signs, symptoms, or both.

” Is the definition of a disease in an online free dictionary[l] and they effect people’s lives in in many ways, nearly all of them being bad and detrimental to both society, families and the world.

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They can be passed on by direct transfer of bacteria, viruses and other germs.

However they can be passed on by sex, either in the form of sexually transmitted diseases or by genetically passing down to offspring during fertilization. A disease that is linked to being both hereditary and environmental is the unrepresentative disease, Multiple Sclerosis. Multiple Sclerosis is a disease that affects the nervous system of the body, specifically in the brain and spinal cord Every river cell in the body is surrounded by a protective layer known as the myelin sheath which enables electrical impulses that travel around the body to reach their destination hundreds of times quicker than it would without one.

If a person has Multiple Scleroses, MS, then this myelin is broken down partly and therefore messages are not sent to the brain or spinal cord as efficiently. This results in a sufferer or MS to experience potential symptoms such as: loss of vision, in one eye usually, uncontrollable muscle spasms and muscle stiffness, difficulties in balance and co-ordination and people find they often suffer room tiredness and fatigue. There are two main types of Multiple sclerosis that sufferers get.

The first, relapsing remitting MS, occurs in approximately eight out of ten people that are diagnosed with MS are diagnosed with this form. Somebody with relapsing remitting multiple sclerosis will have periods without suffering any of the symptoms usually associated with the disease, then they will suffer periods where the symptoms are severe and the patient may become partially blind or be unable to move. However, this period will pass and the sufferer will go back to almost normal again without showing any signs or having the disease.

This period may last weeks, months or even years and this is why diagnosing this type of MS is so hard to do because of how irregular it is it can be mistaken for a number of temporary conditions and people don’t report when they experience symptoms because they have “had them before and was k”. After 15 years of so, about half of people that have got relapsing remitting MS will go on to develop secondary progressive multiple sclerosis. This is much like the first form and people may still experience relapses but the symptoms will worsen over time and they may not fully recover from their relapse.

Primary progressive MS is the least common type of sclerosis. This is where there are no periods of remission and symptoms just worsen over time with no break periods. Treatments for multiple sclerosis: Currently there is no cure for Multiple sclerosis but there are a number of treatments that can help Relapsing remitting multiple sclerosis can be treated with drugs called ‘disease modifying drugs’, these are not a cure for the disease but instead can reduce the severity of the symptoms in a sufferer and can reduce the number of relapses they have.

However they are not suitable for all sufferers of Multiple Sclerosis. There are currently 10 licensed Dam’s (disease modifying drugs) [3] these are: Bugaboo (trinitrotoluene) – oral tablet taken once a day. Available if patient has had at least two relapses in the past two years. Avenue (interferon beta-I a) -? Injection available if patient has had two relapses in the past two years. Beefeater (interferon beta-I b) – available if patient has had two relapses in the past years, it is injected. Capstone (glitterati acetate) -? another injection available after two relapses in the same period of time.

Octavia (beta interferon-I b) – injection if patient has has 2 relapses in 2 years. Galilean (fondling) -? available if patient is still experiences despite treatment with one of the beta interferon. It is an oral tablet taken once a day. Elementary (lumberman) – available for treating the active relapsing remitting form of multiple sclerosis. It is given to patient via a drip once a year. Pleurisy (vociferation beta la) – injection for people living in Scotland for sufferers that have had 2 relapses in 2 years. Rebuff (beta interferon- 1 a) – another injection available for patients suffering 2 relapses in the past 2 years.

Deciders (timidity fumigate) – used to treat active elapsing remitting MS. Approved by the NASH and became available in autumn 2014. It is a oral tablet that should be taken twice a day. Disability (nutritional) – available if you have had 2 relapses in one year or if severity of relapses has increased once another DIM has been taken, given by drip monthly. There are also a wide range of other treatments available to treat multiple sclerosis. Physiotherapy can be used to make day to day living with MS more bearable and steroids can be given to patients to speed up recovery times from relapses.

Causes of Multiple Sclerosis: Multiple sclerosis is an autoimmune condition. This means that the body’s defense against harmful diseases (the immune system) is affected in some way and that causes the immune system to change from attacking foreign viruses to attacking healthy body tissue- in multiple sclerosis this is the healthy Myelin that surrounds nerve cells in the body. The myelin is broken down by the body’s own immune system, nervous impulses are less efficient in traveling to the body’s Central Nervous System.

As a result of this, in the places where the myelin on the myelin sheath has been thinned or destroyed, a hard region or scar is left in its place, often referred to as a sclerosis. Where there is multiple Of these hardened scars on different places On the brain or spinal cord is where the autoimmune disease gets its name from- Multiple Sclerosis. The causes of Multiple sclerosis are currently unknown; however scientists believe the main causes of the disease are a combination of genetic and environmental factors and are “putting the pieces of this complicated puzzle together” [4].

Genetic factors- genes are pieces of genetic information that code for the production of proteins, molecules that are essential for many of the bodies vital functions. Occasionally come genes may be faulty ND produce defective proteins. This is the cause of many of the diseases we see today however this isn’t what is believed to occur in multiple sclerosis. It is thought that individuals that are affected by MS have slight variations, called polymorphism, which are healthy genes that fit badly when combined together in DNA and thus cause healthy cells around it to be altered, especially cells involved in the body’s immune system.

This bad combination of genes is then passed down through the generations by normal mechanism of inheritance and therefore there is a strong link of multiple sclerosis being hared within families. There are a few genes that have been identified to make people more likely to get MS, in particular the HAL (also known as “major historiography’s complex”, as containing the most MS susceptible gene. These proteins are found on the surface of all body cells. They act as a messenger to the immune system telling the body whether a cell is foreign or part of the body and whether it should be attacked or not.

These proteins are usually healthy and therefore there must be another reason for them being altered to become defective. Scientists believe this is down to environmental actors. One theory is that a virus that is usually lying dormant in the body may disturb the immune system and therefore cause the disease to develop. There is probably on one MS virus but actually a combination of a common virus such as measles that acts as a trigger for MS. This trigger activates white blood cells (lymphocytes) in the bloodstream, which enter the brain by making the brain’s defense mechanisms (I. . The blood/brain barrier) vulnerable. Once inside the brain, these cells activate other elements of the immune system in such a way that they attack and destroy myelin. It is also Hough that vitamin D, the vitamin we get from sunlight, is linked to the disease. There has been a correlation between people that receive low levels of vitamin D have a higher chance of developing MS. A number of studies have indicated that smoking is also linked to the development of Multiple Sclerosis.

It is not clear why this happens however it has been theorized that chemicals in cigarettes may have some sort of effect on the immune system and may alter it. Smoking effect on the progression of multiple sclerosis is also being investigated as it could be the fact that smoking leads to the regression of the disease being quicker and it may cause relapses to be more often and more severe. It is estimated that around 100,000 people in the UK are suffering with Multiple sclerosis at this present time, with 2. Million Cases Of MS in the world. Every week in the United States there are 200 people diagnosed with MS so this is a disease that has worldwide influence and is a major problem worldwide however it is incurable, this needs to change. Although the disease is not fatal in itself, some complications that can arise from severe MS, such as pneumonia, can be. This means that in order to reduce the numbers of people and families offering with this terrible disease we as a race need to find a new way of treating it.

This might be achieved through regenerative medicine. Regenerative medicine: Regenerative medicine is the process by which scientists are able to restore normal bodily functions by repairing or replacing damaged or malfunctioning cells and tissues in cells[5] and although it is in its early stages of development, it is bringing huge advances in the field of medicine as it could provide the cure for many different diseases such as Multiple sclerosis, dementia, strokes, heart disease and many types of cancer.

For example, the guardian reported a recent trial on 18 people suffering with two different types of muscular degeneration, the leading causes of blindness in adults and children in the world, Stardust’s muscular dystrophy and dry atrophic age- related muscular degeneration[6]. The patients had embryonic stem cell therapy on their eyes and were cured of sight loss without any side effects.

Whatever sources of potential bias the guardian may have, being a politically left leaning newspaper, the point still remains, stem cell therapy and regenerative medicine has and will continue to provide a big source of hope n the fight against many different deadly diseases. Regenerative medicine mainly comes in the form Of stem cell treatment, allowing scientists to use undifferentiated cells and turn them into any cell in the body to serve any function.

This is a huge breakthrough in science and medicine as it enables anything to be made, it solves the problem of organ storage or a lack of organ donors, as hearts and lungs can just be grown in a lab and transplanted into the patient that requires them. Stem cell Research: In the early 1 sass, European researchers discovered that various types of load cells all came from a particular ‘stem cells’, however it was not until 1 963 that the particular type of self-renewing cells was first described in mice bone marrow cells by Canadian researchers Ernest A McCullough and James E Till [7].

Since that time there has been continued efforts to grow and differentiate adult animal and human stem cells in a lab. This was made a lot easier in the 1 sass and sass where there was an introduction of techniques for targeting and altering genetic material and methods for growing human cells in the laboratory. These advances really opened the doors for human tem cell research. The breakthrough came in 1998 when James Thompson, from the university of Wisconsin in Madison, successfully removed embryonic cells from a fertility clinic and cultivated them in a lab, this launched stem cell research into the limelight.

Since then there has been plenty of further research that suggests that these embryonic stem cells can specialist into any cell in the human body which, if mastered, could open up a whole new world of new medicine that could change millions of people’s lives. As stem cells were only brought into the public attention in 1 998, the technology is still elatedly new and still in its youth. There have been no clinical trials of stem cell treatments as of yet however; adult stem cells are already being used in treatments for over one hundred conditions including leukemia, Hunter’s syndrome and heart disease.

So stem cells are the answer to all of humanities work’s yes? Unfortunately that is not that case as this new technology does not come with many controversial parts with many people opposing to this potentially lifesaving new technology, the main point of controversy is the use Of embryonic stem cells and the ethical considerations behind that. In this document I will be discussing the main treatments of multiple sclerosis and relating it back to the question of ‘is Regenerative Medicine the most effective way of treating Multiple Sclerosis? O I will evaluating whether other methods of treating multiple sclerosis is more effective than stem cell research then I will be coming to a conclusion at the end of the essay. Discussion Effectiveness of Stem Cell Treatment: The first issue to talk about is whether stem cells are an effective method of treating any disease and then to focus down on the specific disease we are looking at. There is no doubt that the discovery of these undifferentiated, unspecified cells is a hugely promising unearthing, however are they a truly effective way of treatment?

Do they actually do all the things that scientists promise they can do? And are they sustainable? Firstly, lets look at the plus sides of stem cells, what they can do that is beneficial to the body and what they can do to aid the recovery of a disease or illness. Diseases such as cancer or conditions such as birth defects are thought to occur because of problems in the differentiation process, an understanding of the development that appends in normal cells and stem cells will help scientists treat the developmental errors that can occur.

This will help in two fields because we will know more about the development of cancers and birth defects as well as discovering more about how stem cells differentiate (to make or become different in the process of growth or development), and this will help us be able to use stem cells more effectively in turn at treating these problems, working in a positive feedback model. The next advantage of stem cells, according to website ‘explore stem cells’ is that there is another potential application of cell based therapies [8].

This is when stem cells are used to grow specific cells and then are bound together using a mould to create a completely new organ or tissue. This is a huge advantage to stem cells as currently when a patient needs to new organ they get one transplanted from an organ donor. At this current time there is nowhere near the required amount of organ donors to supply the needs of people needing an organ transplant and with this new regenerative technique instead of waiting for a new organ to be donated, a new organ can be grown from scratch to fit into your body.

This will dramatically reduce the amount of people dying whilst being on the waiting lists for an organ transplant. Stem cells can benefit those suffering from Parkinson disease, type 1 diabetes, arthritis, burn victims and people with cardiovascular diseases (the biggest killing disease in the UK- BBC) using this method of treatment. Stem cells also have the potential to reverse the effects of diseases. Stem cells are directed into differentiating into specific cell types, they can be fed into the body, providing a renewable resource of replacement cells for the patient.

For example, people with heart ease can have stem cells differentiated into heart muscle cells to replace cells damaged by the disease, in Parkinson disease damaged brain cells can be reversed by replacing them with new healthy brain cells, reversing the effect of the disease. An even more exciting prospect is to address genetic defects that are present from birth by restoring function and health with the introduction of normal healthy cells that do not have these defects.

Burn victims will, instead of suffering large amounts of pain from their injuries and instead of having to wait for donor tissues, they can have new healthy skin ells implanted onto the patient. Scientists are hoping to do this by growing skin cells in a lab from a very small piece of skin by triggering stem cells to differentiate outside the body so that large burn areas can be covered by a relatively small amount of initial skin cells. The final major benefit to stem cells research is that is provides a huge role in the pharmaceutical industry and is involved heavily in drug development.

Any new drugs that are being tested for human consumption can be tested on human stem cells before they are released for their safety. This could be the case with a new anti- amour drug for example, and if the conditions that the drugs are tested in are in the correct conditions then the results could end up being very accurate and the drugs could be shown to be safe for human use and will help to treat people with life threatening diseases. The advantages of stem cells are well documented and for people with serious conditions could be a source Of major hope that one day they could be the cure for them. O it would seem as though stem cells are completely fine, effective and the answer to all of our prayers. This is not the case however, stem cell therapy is till a very controversial topic, and this is nearly all down the disadvantages that come about with stem cells. Firstly it is where stem cells are collected from. Many stem cells are collected from embryos to form embryonic stem cells; these are a very good type of stem cell to use as embryos are full of unspecified cells as eventually these will turn into a new baby human being.

However, if embryonic stem cells are used then effectively there is no chance that the embryo will develop into a new-born and an abortion will take place. For many people this raises the argument of at what point does an embryo come a human and therefore has the same rights as every other person? If that point comes about at fertilization or during the embryonic stage then what occurs to extract stem cells out of these early life forms is effectively murder and therefore should not happen.

Embryos are not the only place stem cells can be extracted from however, umbilical cords that are disposed of and bone marrow can be a plentiful source also however according to one source found[9], religious groups Religious groups claim that because embryonic stem cell research requires the subsequent destruction of the embryos used, it is a form of abortion. They sustain that creating embryos for the sole purpose of commercial use, followed by their disposal is morally unacceptable, and strongly oppose the area of study while adult and cord stem cells are readily available instead.

Perhaps the biggest risk with this new area of research is the unknown. The introduction of stem cells into the body is permanent and this means there may be some long term side effects that we do not know about at the moment that might become clearer later along in the process. These are bad because we would not be able to reverse the effects of these side effects, A French study ten years ago found that spiniest of genetically altered bone marrow transplants developed leukemia years after their allegedly successful transplants had cured their severe combined immunodeficiency.

Some research on rats in California found a way of successfully curing paralysis, however some small cysts appeared in the area near where the stem cells were injected. However harmless these were to rats, the effect of this to humans is still “questionable”. Other side effects that could be because of stem cell research include growth of strange objects such as teeth bones and hair on unusual areas, if this was done using embryonic stem cells these continue to grow wrought the patient’s life. Around 20% of rats injected with embryonic stem cells later die of some kind of cancerous tumor.

This could be completely by chance but this high statistic is enough for large groups of people to doubt whether regenerative medicine is the right way to go in medicine. Another major cause for concern in stem cells is that in some cases it is known for differentiated stem cells to be rejected by the host body. A report published in ‘nature’ in 2011 showed that when a specific type Of stem cell, induced plenteous stem cells (epics), used to treat diseases, found hat epics could face rejection by the immune system, even when injected into the same person who donated the cells.

This immune response could destroy the transplants, rendering them ineffective as treatments. Although a different report published in 201 3 by ‘Nature’ seemed to show that these epics were effective in being transferred in genetically identical mice and not triggering a strong immune response. This contrasting information shows just how unpredictable stem cell research is and that it may not be the best way to treat diseases.

In conclusion then think that on balance using generative methods in treating diseases in general are a very effective way Of doing things however it is not a completely safe and iris free process as in my opinion still think that for it to be the best method stem cell therapy can be it still needs more research on the long term effects of the process, but from early indications it is looking promising barring a few studies. However what about in our specific disease? How does a using stem cell therapy affect the multiple sclerosis disease?

Is it as effective at treating it as the other conditions already mentioned? At present there are no treatments that pacifically target the abnormal immune responses in MS. Current approaches, such as interferon, capstone, or immune suppressants all act in a non-specific manner blocking immune responses against the myelin sheath. While these approaches are useful for reducing the severity of disease, they do not repair the damage to nervous system tissue that has already occurred and therefore they cannot cure multiple sclerosis.

However stem cells provide a different way Of treating the disease. Instead Of protecting the myelin sheath they allow it to be destroyed however it is replaced by stem cells that re externally differentiated in a lab before injected into the spinal cord or in the blood stream ready to be transferred to the brain. It is either this repair method used or, according to the MS society website, the nerve cell can be prevented from being damaged.

This is called ‘imperfection’ and is an active area of research involving adult stem cells from the bone marrow called mechanical stem cells. These stem cells are taken from human umbilical cords [1 1] that are donated after normal healthy births so this avoids the debate over the controversial topic of where the stem cells are oaken from. These stem cells are then screened for infectious diseases, with only about 1 in 10 umbilical cords passing screening tests.

The advantages of this treatment are that anybody can be treated using these stem cells as they do not need to be matched with their genome, the stem cells are easily extracted and there is a large supply of them, and these HI-?CIT mechanical stem cells are a lot more ‘robust’ then other types leading to a higher success rate. So that type of stem cell treatment by the stem cell institute seems relatively effective in terms of protecting the myelin sheath from the autoimmune response brought about by MS. However this is not the only study I found that seems to show that Multiple sclerosis can be cured by regenerative medicine. Scientists at The Scripps Research Institute (TSR) have identified a set of compounds that may be used to treat multiple sclerosis (MS) in a new way. Unlike existing MS therapies that suppress the immune system, the compounds boost a population of progenitor cells that can in turn repair MS-damaged nerve fibers. “[1 2]. In this report, it is shown that a previous drug penetration, that was used to treat Parkinson disease, as been shown to increase numbers of electioneered (cells that make the myelin sheath and wrap it around the nerve fiber) in the nerve sharply, and thus increasing the amount of myelin produced.

To do this scientists screen over 1 0,000 diverse compounds to see if any could potentially cause OPS cells to differentiate, and the already tested drug penetration seemed to do that already. However, not all studies show this trend however, a journal on PLOPS one[1 3] shows that a new type of stem cell, neural stem cells (NCSC), ” does not have a major influence on the clinical course of room-induced EYE.

Improving the efficiency at which NCSC home to inflammatory sites may enhance their therapeutic potential in this model of CONS autoimmunity” Meaning that the new type of stem cell does not have any effect on the number of electioneered cells being produced to repair the myelin sheath, and thus showing that regenerative medicine isn’t always effective.