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Obama Ends Stem Cell Research Ban – CBS News

October 27th, 2015 4:45 am

President Barack Obama said Monday he is allowing federal taxpayer dollars to fund significantly broader research on embryonic stem cells because "medical miracles do not happen simply by accident," and promised his administration would make up for the ground lost under his predecessor.

Fulfilling a campaign promise, Mr. Obama signed an executive order expected to set in motion increased research that supporters believe could uncover cures for serious ailments from diabetes to paralysis.

Mr. Obama's action, before a packed East Room audience, reverses former President George W. Bush's policy on stem cell research by undoing a 2001 directive that banned federal funding for research into stem lines created after that date.

Mr. Bush limited the use of taxpayer money to only the 21 stem cell lines that had been produced before his decision. He argued he was defending human life because days-old embryos - although typically from fertility clinics and already destined for destruction - are destroyed to create the stem cell lines.

The Obama order reverses that without addressing a separate legislative ban, which precludes any federal money paying for the development of stem cell lines. The legislation, however, does not prevent funds for research on those lines created without federal funding. (Read more about what this Executive Order will do -- and won't do.)

Researchers say the newer lines created with private money during the period of the Bush ban are healthier and better suited to creating treatment for diseases. Embryonic stem cells are master cells that can morph into any cell of the body. Scientists hope to harness them so they can create replacement tissues to treat a variety of diseases - such as new insulin-producing cells for diabetics, cells that could help those with Parkinson's disease or maybe even Alzheimer's, or new nerve connections to restore movement after spinal injury.

Mr. Obama called his decision a "difficult and delicate balance," an understatement of the intense emotions generated on both sides of the long, contentious debate. He said he came down on the side of the "majority of Americans" who support increased federal funding for the research, both because strict oversight would prevent problems and because of the great and lifesaving potential it holds.

CBS News polling on the topic shows that Americans do support medical research using embryonic stem cells. In 2007, the last time CBS News asked the question, sixty-five percent said they approved compared to twenty-five percent who disapproved. The number of those who approved had gone up steadily since the 2004 when fifty percent approved. (Read more about the polling.)

"Rather than furthering discovery, our government has forced what I believe is a false choice between sound science and moral values," Mr. Obama said. "In this case, I believe the two are not inconsistent. As a person of faith, I believe we are called to care for each other and work to ease human suffering. I believe we have been given the capacity and will to pursue this research and the humanity and conscience to do so responsibly." (Read all of Mr. Obama's remarks.)

Mr. Obama warned against overstating the eventual benefits of the research. But he said his administration "will vigorously support scientists who pursue this research," taking a slap at his predecessor in the process.

"I cannot guarantee that we will find the treatments and cures we seek. No president can promise that. But I can promise that we will seek them actively, responsibly, and with the urgency required to make up for lost ground."

It's a matter of competitive advantage globally as well, the president argued.

"When government fails to make these investments, opportunities are missed. Promising avenues go unexplored. Some of our best scientists leave for other countries that will sponsor their work. And those countries may surge ahead of ours in the advances that transform our lives," Mr. Obama said.

Early Show medical contributor Dr. Holly Phillips pointed out that such research was never banned or illegal. "The question that we're addressing today is what role, if any, federal funding should have" in this research.

"Many scientists for the last eight years have been complaining that they're spending more time trying to find funding for their research than actually doing their research. So for them this will really have a profound effect," Phillips said. "Certainly on an international level in medicine we're so excited about this research and the potential for healing that it has. So I think less red tape will have a profound effect."

Of the diseases or conditions that may be most affected by the end of the federal ban, Phillips said, "People are most excited about the neurological illnesses, things like Parkinson's and Alzheimer's. A group in California will start using embryonic stem cells in humans to hopefully cure spinal cell injuries for people who have been paralyzed from the waist down. We're also seeing some hope in treating diabetes, heart disease and even strokes. So really, millions of people could be affected by this research."

"We've got eight years of science to make up for," said Dr. Curt Civin, whose research allowed scientists to isolate stem cells and who now serves as the founding director of the University of Maryland School of Medicine's Center for Stem Cell Biology and Regenerative Medicine. "Now the silly restrictions are lifted."

Mr. Bush and his supporters said they were defending human life; days-old embryos - typically from fertility-clinic leftovers otherwise destined to be thrown away - are destroyed for the stem cells.

Family Research Council, which advocates for a "Judeo-Christian worldview" and warns against the reproductive cloning of a human being, opposes the use of embryonic stem cells, promoting instead adult stem cells as being superior.

Of Mr. Obama's new order, FRC's Dr. David Prentice told CBS' The Early Show, "In terms of scientific advances I don't think we are going to see anything for this. This is more of an ideological move."

House Republican Leader John Boehner said the president's repeal of the ban, "runs counter to President Obama's promise to be a president for all Americans. For a third time in his young presidency, the president has rolled back important protections for innocent life, further dividing our nation at a time when we need greater unity to tackle the challenges before us." (Read more about Republican reaction to the move.)

The president was insistent that his order would not open the door to human cloning.

"We will develop strict guidelines, which we will rigorously enforce, because we cannot ever tolerate misuse or abuse," Mr. Obama said. "And we will ensure that our government never opens the door to the use of cloning for human reproduction. It is dangerous, profoundly wrong, and has no place in our society, or any society."

Mr. Obama also issued a memo promising to restore "scientific integrity to government decision-making." That policy change was aimed more broadly than the stem cell debate, to reach into areas such as climate change as well.

"Promoting science isn't just about providing resources it is also about protecting free and open inquiry," Mr. Obama said. "It is about letting scientists like those here today do their jobs, free from manipulation or coercion, and listening to what they tell us, even when it's inconvenient especially when it's inconvenient. It is about ensuring that scientific data is never distorted or concealed to serve a political agenda and that we make scientific decisions based on facts, not ideology.

Mr. Obama said the presidential memorandum was the beginning of a process that would ensure that his administration: bases its decision "on the soundest science," appoints scientific advisers based on their credentials and experience, not their politics or ideology, and is "open and honest" about the science behind its decisions.

"We view what happened with stem cell research in the last administration is one manifestation of failure to think carefully about how federal support of science and the use of scientific advice occurs," said Harold Varmus, chairman of the White House's Council of Advisers on Science and Technology.

2009 CBS Interactive Inc. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. The Associated Press contributed to this report.

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Obama Ends Stem Cell Research Ban - CBS News

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Stem Cell Therapy Treats Kidney Disease or Kidney Failure …

October 27th, 2015 4:45 am

Stem Cell Therapy is one of the methods that have the potential to cure kidney diseases. As we know, the exact reasons of many kidney diseases are still unknown, let alone the cures for these diseases. Stem Cell Therapy is good news to many kidney disease patients. This article will give a brief introduction of this effective treatment.

In brief, Stem Cell Therapy is a kind of therapy that injects the stem cell into patients body to restore and rebuild the injured parts. Stem cell is basic cell of our body which can be found in umbilical cord or bone marrow and have the ability to mature into any type of tissue in our body. When the stem cells get into patients body, they will be attracted to the injured part. They differentiate into cells of the injured parts and replace the damaged cells. The purpose of treating disease can be reached. It is different from the traditional Chinese medicine and western medicine. The conventional way treat kidney disease is to suppress the overactive immunoreactions and reduce or alleviate inflammation and harmful substance to delay the progress of the disease. These treatments cant treat the disease completely.

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When these stem cells get into patients body, their kidneys will release cytokines to draw them to kidney. Then these stem calls will produce large quantity of daughter cells and these daughter cells will differentiate into all kinds of renal cells that are needed, such as renal tissues cells and renal blood vessel cells. If the microcirculation of kidney gets improved, the blood pressure of glomeruli will get lower. The relief of ischemia in kidney will contribute to the improvement of whole blood circulation. Simultaneously, the increase of EPO can alleviate the anemia condition of patients. Alone with enhancing of immunity, the excess immunoreactions will decrease, adjusting the immune system to work normally. The kidney lesion can be restored.

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This therapy can be widely used to treat many diseases and it can give patients complete treatments. Patients dont have to take many medicines or have an operation, so more and more kidney patients prefer to take this therapy for recovery.

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Since Stem Cell Therapy has the potential curative effects for kidney disease, many patients have asked whether it is available in India, Australia, USA, UK, Canada, etc. So far, Nephrologists in the hospital of China have applied the Stem Cell Therapy for years. They have rich experience in this therapy. If you are interested in this therapy, you can contact our online doctor. They will give you more detailed information.

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According to patients condition, the costs of Stem Cell Therapy are different. For example, some patients with little kidney function have to inject more stem cells than others, so their cost will be more. To learn the estimated total cost of Stem Cell Therapy for you, you can send your latest test report or illness description to kidney-symptoms@hotmail.com. Kidney experts here can tell you the treatment plan and cost in detail.

As for you own illness conditions, you can get some guidance related to diet, exercise, medicines or some natural remedies. The online consultation service is free. Please remember to leave your email address, or phone number so that we can contact you and help you! Please leave the patient's FULL name in case of a duplicate, and to make our doctor give timely response and help.

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Eye & Vision Problems – American Optometric Association

October 27th, 2015 4:42 am

The Importance of Nutrition

Researchers have linked eye-friendly nutrients such as lutein/zeaxanthin, vitamin C, vitamin E, and zinc to reducing the risk of certain eye diseases, including macular degeneration and cataract formation. For more information on the importance of good nutrition and eye health, please see the diet and nutrition section.

Acanthamoeba is one of the most ubiquitous organisms in the environment, but rarely causes infections. When infection does occur, however, it can be extremely serious and vision threatening. Recently, there have been multiple reports of increasing incidence of Acanthamoeba keratitis. Co-infection with a bacterial keratitis is common both in the contact lens case and on the cornea, complicating prevention, diagnosis and treatment.

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Lazy eye, or amblyopia, is the loss or lack of development of central vision in one eye that is unrelated to any eye health problem and is not correctable with lenses. It can result from a failure to use both eyes together. Lazy eye is often associated with crossed-eyes or a large difference in the degree of nearsightedness or farsightedness between the two eyes. It usually develops before age six and it does not affect side vision.

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Anterior uveitis is an inflammation of the middle layer of the eye, which includes the iris (colored part of the eye) and adjacent tissue, known as the ciliary body. If untreated, it can cause permanent damage and loss of vision from the development of glaucoma, cataract or retinal edema. It usually responds well to treatment; however, there may be a tendency for the condition to recur.

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Astigmatism is a vision condition that causes blurred vision due either to the irregular shape of the cornea, the clear front cover of the eye, or sometimes the curvature of the lens inside the eye.

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Blepharitis is an inflammation of the eyelids and eyelashes causing red, irritated, itchy eyelids and the formation of dandruff like scales on eyelashes.

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A cataract is a cloudy or opaque area in the normally clear lens of the eye. Depending upon its size and location, it can interfere with normal vision. Most cataracts develop in people over age 55, but they occasionally occur in infants and young children. Usually cataracts develop in both eyes, but one may be worse than the other.

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A chalazion is a slowly developing lump that forms due to blockage and swelling of an oil gland in the eyelid. It is more common in adults than children and occurs most frequently in persons 30 to 50 years of age.

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Color vision deficiency is the inability to distinguish certain shades of color or in more severe cases, see colors at all. The term "color blindness" is also used to describe this visual condition, but very few people are completely color blind.

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Conjunctivitis is an inflammation of the conjunctiva, the thin, transparent layer that lines the inner eyelid and covers the white part of the eye.

The three main types of conjunctivitis are infectious, allergic and chemical. The infectious type, commonly called "pink eye" is caused by a contagious virus or bacteria.

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Diabetes is a disease that interferes with the body's ability to use and store sugar and can cause many health problems. One, called diabetic retinopathy, can weaken and cause changes in the small blood vessels that nourish your eye's retina, the delicate, light sensitive lining of the back of the eye. These blood vessels may begin to leak, swell or develop brush-like branches.

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The tears your eyes produce are necessary for overall eye health and clear vision. Dry eye means that your eyes do not produce enough tears or that you produce tears which do not have the proper chemical composition.

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Eye coordination is the ability of both eyes to work together as a team. Each of your eyes sees a slightly different image and your brain, by a process called fusion, blends these two images into one three-dimensional picture. Good eye coordination keeps the eyes in proper alignment. Poor eye coordination results from a lack of adequate vision development or improperly developed eye muscle control.

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Glaucoma is an eye disease in which the internal pressure in your eyes increases enough to damage the nerve fibers in your optic nerve and cause vision loss. The increase in pressure happens when the passages that normally allow fluid in your eyes to drain become clogged or blocked. The reasons that the passages become blocked are not known.

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Farsightedness, or hyperopia, as it is medically termed, is a vision condition in which distant objects are usually seen clearly, but close ones do not come into proper focus. Farsightedness occurs if your eyeball is too short or the cornea has too little curvature, so light entering your eye is not focused correctly.

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Keratoconus is a vision disorder that occurs when the normally round cornea (the front part of the eye) becomes thin and irregular (cone) shaped. This abnormal shape prevents the light entering the eye from being focused correctly on the retina and causes distortion of vision.

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Macular degeneration is the leading cause of blindness in America. It results from changes to the macula, a portion of the retina that is responsible for clear, sharp vision and is located at the back of the eye.

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Nearsightedness, or myopia, as it is medically termed, is a vision condition in which near objects are seen clearly, but distant objects do not come into proper focus. Nearsightedness occurs if your eyeball is too long or the cornea has too much curvature, so the light entering your eye is not focused correctly.

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Nystagmus is a vision condition in which the eyes make repetitive, uncontrolled movements, often resulting in reduced vision. These involuntary eye movements can occur from side to side, up and down, or in a circular pattern. As a result, both eyes are unable to hold steady on objects being viewed. Nystagmus may be accompanied by unusual head positions and head nodding in an attempt to compensate for the condition.

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Ocular hypertension is an increase in the pressure in your eyes that is above the range considered normal with no detectable changes in vision or damage to the structure of your eyes. The term is used to distinguish people with elevated pressure from those with glaucoma, a serious eye disease that causes damage to the optic nerve and vision loss.

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Presbyopia is a vision condition in which the crystalline lens of your eye loses its flexibility, which makes it difficult for you to focus on close objects.

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Retinitis pigmentosa (RP) is a group of inherited diseases that damage the light-sensitive rods and cones located in the retina, the back part of our eyes. Rods, which provide side (peripheral) and night vision are affected more than the cones which provide color and clear central vision.

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Optometrists diagnose, refer, and comanage cancers that involve the eye area. The most common cancer involving the eye in young children is retinoblastoma. In the United States, this fast-growing cancer occurs in 1 in every 20,000 children, making it the tenth most common pediatric cancer.

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Spots (often called floaters) are small, semi-transparent or cloudy specks or particles within the vitreous, which is the clear, jelly-like fluid that fills the inside of your eyes. They appear as specks of various shapes and sizes, threadlike strands or cobwebs. Because they are within your eyes, they move as your eyes move and seem to dart away when you try to look at them directly.

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Strabismus occurs when one or both of your eyes turns in, out, up or down. Poor eye muscle control usually causes strabismus. This misalignment often first appears before age 21 months but may develop as late as age 6.

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20/20 vision is a term used to express normal visual acuity (the clarity or sharpness of vision) measured at a distance of 20 feet. If you have 20/20 vision, you can see clearly at 20 feet what should normally be seen at that distance. If you have 20/100 vision, it means that you must be as close as 20 feet to see what a person with normal vision can see at 100 feet.

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Eye & Vision Problems - American Optometric Association

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Driving eyesight rules – GOV.UK

October 27th, 2015 4:42 am

You must wear glasses or contact lenses every time you drive if you need them to meet the standards of vision for driving.

You must tell DVLA if youve got any problem with your eyesight that affects both of your eyes, or the remaining eye if you only have one eye.

This doesnt include being short or long sighted or colour blind. You also dont need to say if youve had surgery to correct short sightedness and can meet the eyesight standards.

Check if you need to tell DVLA about your eyesight problem by searching the A to Z of medical conditions that could affect your driving.

You could be prosecuted if you drive without meeting the standards of vision for driving.

You must be able to read (with glasses or contact lenses, if necessary) a car number plate made after 1 September 2001 from 20 metres.

You must also meet the minimum eyesight standard for driving by having a visual acuity of at least decimal 0.5 (6/12) measured on the Snellen scale (with glasses or contact lenses, if necessary) using both eyes together or, if you have sight in one eye only, in that eye.

You must also have an adequate field of vision - your optician can tell you about this and do a test.

You must have a visual acuity at least 0.8 (6/7.5) measured on the Snellen scale in your best eye and at least 0.1 (6/60) on the Snellen scale in the other eye.

You can reach this standard using glasses with a corrective power not more than (+) 8 dioptres, or with contact lenses. Theres no specific limit for the corrective power of contact lenses.

You must have a horizontal visual field of at least 160 degrees, the extension should be at least 70 degrees left and right and 30 degrees up and down. No defects should be present within a radius of the central 30 degrees.

You must tell DVLA if youve got any problem with your eyesight that affects either eye.

You may still be able to renew your lorry or bus licence if you cant meet these standards but held your licence before 1 January 1997.

At the start of your practical driving test you have to correctly read a number plate on a parked vehicle.

If you cant, youll fail your driving test and the test wont continue. DVLA will be told and your licence will be revoked.

When you reapply for your driving licence, DVLA will ask you to have an eyesight test with DVSA. This will be at a driving test centre. If youre successful, youll still have to pass the DVSA standard eyesight test at your next practical driving test.

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Driving eyesight rules - GOV.UK

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Reproductive Endocrinology | Fertility Specialists …

October 26th, 2015 12:46 pm

Ob/Gyn Specialists of the Palm Beaches, PA is pleased to announce an affiliation with Dr. Mick Abae and the opening of the brand new state of the art, full-service fertility treatment center located at the Wellington office.

Dr. Abae is a Board-Certified Reproductive Endocrinologist & Infertility Specialist and Medical Director at Fertility & Genetics. Dr. Abae has 20 years of experience in successfully helping couples with reproductive conditions through an individualized and comprehensive analysis of each patients unique fertility issue. By correctly diagnosing, and in some cases correcting, the underlying condition of infertility, he has helped thousands of couples achieve their dreams of having a family.

Dr. Abae will now be available to the patients of Ob/Gyn Specialists to provide compassionate and highly personalized reproductive care through a comprehensive fertility and genetics program offered jointly by the two entities. This affiliation will make reproductive services available to patients in the safe and familiar surroundings of Ob/Gyn Specialists office locations.

Dr. Abae and his team are now seeing new patients every Wednesday at both our Wellington and Palm Beach Gardens locations to serve our patients in both the eastern and western half of Palm Beach County. Our goal is to provide our patients with a full range of high quality, affordable assisted reproductive technologies such as IVF, ICSI, PGD, and Donor Egg IVF conveniently located at our existing office locations.

To schedule an appointment or inquire about fertility treatment options, contact Fertility & Genetics at 866-246-CARE. You can also visit http://www.fertilityandgenetics.com for further information about the services offered by our new integrated service.

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Genuine Stem Cell Breast Augmentation in Thailand Thai …

October 26th, 2015 12:47 am

Are you looking for a Non-Surgical & No-Implant or Natural Breast Enlargement? Thai Medical has the solution you are looking for. Cell Assisted Lipotransfer Or CAL are also known as the Stem Cell Breast Augmentation. Stemcell breast enlargement and Autologous Fat Grafting are very basic in nature. The treatment works its wonders by simply using your own enriched Adipose stem cells and tummy fat to create breast volume permanently! CAL Breast enlargement is most sophisticated modern technique ever created for creating natural breast tissue volume and shape.

The breasts are a big part of any womans body and self-image. Any chest defects or disfigurements can bea devastating experience for any woman. That is precisely why CAL or Cell Assisted Lipotransferwas originally invented.

The Cell Assisted Breast Augmentation technique was discovered in early 2006 by a Japanese Doctor named Kotaro Yoshimaru. The technique was developed and perfected as a result of Dr Kotaro and his clinicaltrials for survivors of women who were recovering from the horror of breast cancer via a single or double mastectomies (removal of breast tissue) that stopped the underlying breast cancer from spreading. If a womans self image and self-esteem could be simply restored through replacing what cancer took away prematurely, then it was sciences duty to help them in any way possible. Today, assisted fat grafting is used for both medical and cosmetic reasons to augment the breasts in a safe and natural way.

The revolutionary new CALbreast enlargement is nowavailable exclusively inBangkok for women looking for a non-surgical breastenhancement. CAL Breast is not available in Phuket and requires a minimum 1 week.

We are please to offer the ONLYGenuineStem Cell EnrichedFat Grafting Protocol in Thailand. The technique uses your very own (autologous) stem cell rich bodyfat. CAL is performed on an outpatient basis and takes between 3 and 6 hours from prep to discharge with only minimal aftercare required afterwards. The treatment can be done via local anesthesia but general is often used when doing multiple areas. Your bodies curves and silhouettes will be optimized without any synthetic materials such as saline or silicone in a simple 3-step process.

Stemcell Enriched Fat Grafting Surgery Overview

Step 1: Mini-Liposuction The fat and stem cells are first gently removed from the abdomen or thigh areas only using a proprietary method licensed from Dr Yoshimura in Japan. (The inventor of CAL). Ourtechnique uses a very precision based manual technique that require NO mechanical lipo devices such as vaser or Smart Lipo. The fat can be successfully and safely be removed usinggenuine micro-cannulas to avoid damaging or destroying the stem cells that occurs when using Vaser or other smartlaser liposuction ( smart lipocosts) methods.

Step 2: Stem Cell Enrichment & Processing-The carefully extracted adipose fat tissueand stem cells are then separated in a dedicated multi-million dollar closed-system stem cell lab in Bangkok. Unlike stem cell breast treatments in the US or Europe that do not expand/grow stem cells the treatment protocol our doctors in Bangkok use calls for proper expansion/growth of your stem cells in the lab before treatment to allow for the highest possible retention rates for the best overall results.

Step 3: Implantation into The Breasts The enriched stem cells are reintroduced strategically back into the breasts from multiple areas. The

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Genetics – B.S. – University of Georgia

October 26th, 2015 12:45 am

The Department of Genetics provides a supportive and unique environment for students to understand the full spectrum of molecular, evolutionary, and population genetics. Our major prepares students for careers in biomedical-related fields, as well as teaching, academic research, and the pharmaceutical and biotechnology industry. And, our students are competitive for admission to the top medical and professional schools and graduate programs in the country.

After taking introductory courses in genetics and evolutionary biology, majors may choose from a variety of upper level Genetics courses. Depending on the interests and career goals of a particular student, our majors can also satisfy requirements for major electives by taking upper level courses in other departments. In addition to lecture courses, majors can choose from several different laboratory courses, which focus on molecular genetics, evolutionary genetics, or genomics. The Department strongly encourages undergraduates to pursue independent research with one of our faculty. In addition to the high value placed on research by medical and graduate school admissions committees, an undergraduate research experience serves to consolidate all your Genetics training into a single keystone experience.

All details of the Genetics major are available at http://www.genetics.uga.edu/undergrad.html, and information about the department, including a list of faculty research interests, is available at http://www.genetics.uga.edu.

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Eye Exam – Sight and Eye Exam – Vision and Eye Health …

October 26th, 2015 12:44 am

Many people don't understand the importance of having an eye exam. You find time to visit your family doctor for an annual physical. You manage to take your children to their pre-appointed six-month dental hygiene visits. But are you or your family overdue for a trip to the eye doctor's office? Vision care is often neglected. In reality, how much could we actually accomplish in a day without the precious gift of sight? The eyes function as a window to our bodies. Dilated pupils can reveal the presence of undiagnosed problems throughout the body. Here are four great reasons to schedule a comprehensive eye examination.

Your prescription needs to be checked on a regular basis to make sure your visual acuity is the best it can be. Annoying headaches or general fatigue are often caused by slight over or under corrections of your prescription. In addition, if you spend more than two hours on a computer each day, you may develop a condition known as computer vision syndrome, or CVS. Symptoms of CVS include headaches, focusing difficulties, burning eyes, tired eyes, eyestrain, aching eyes, dry eyes, double vision, blurred vision, light sensitivity, and neck and shoulder pain. CVS is treated with eyeglasses made for computer users.

Many serious eye diseases often have no symptoms. Glaucoma is an eye disease that causes vision loss and is commonly known as the "sneak thief of sight." Conditions such as macular degeneration or cataracts develop so gradually that you may not even realize your vision has decreased. Diabetic retinopathy is a condition that may develop in diabetic patients. Early detection of these and other eye diseases is important for maintaining healthy vision.

Uncorrected vision problems in children often cause learning and reading difficulties or contribute to other medical problems such as dyslexia and ADD. Uncorrected vision in children can often cause amblyopia (lazy eye) or strabismus (eye turn) which can cause permanent vision loss if not treated early in life.

The primary reason for visiting your eye doctor should always be eye health, but there is nothing wrong with having a little fun. Eye doctors who offer eyewear strive to stock the latest fashions and quality eyewear. Lens-making technology continues to improve, as well as scratch-resistant and anti-reflective coatings. If you haven't updated your glasses in a while, you may be pleasantly surprised at the many options available to you today. Sunglasses have also become a fashion accessory...check out your optical for the latest trends and styles.

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WHO | Micronutrient deficiencies

October 26th, 2015 12:43 am

Vitamin A deficiency A few salient facts

Vitamin A deficiency (VAD) is the leading cause of preventable blindness in children and increases the risk of disease and death from severe infections. In pregnant women VAD causes night blindness and may increase the risk of maternal mortality.

Vitamin A deficiency is a public health problem in more than half of all countries, especially in Africa and South-East Asia, hitting hardest young children and pregnant women in low-income countries.

Crucial for maternal and child survival, supplying adequate vitamin A in high-risk areas can significantly reduce mortality. Conversely, its absence causes a needlessly high risk of disease and death.

WHOs goal is the worldwide elimination of vitamin A deficiency and its tragic consequences, including blindness, disease and premature death. To successfully combat VAD, short-term interventions and proper infant feeding must be backed up by long-term sustainable solutions. The arsenal of nutritional well-being weapons includes a combination of breastfeeding and vitamin A supplementation, coupled with enduring solutions, such as promotion of vitamin A-rich diets and food fortification.

WHO/NHD

The impact of this single supplementation on childhood mortality is as great or greater than that of any one vaccine and it costs only a couple of cents a dose.

The basis for lifelong health begins in childhood. Vitamin A is a crucial component. Since breast milk is a natural source of vitamin A, promoting breastfeeding is the best way to protect babies from VAD.

For deficient children, the periodic supply of high-dose vitamin A in swift, simple, low-cost, high-benefit interventions has also produced remarkable results, reducing mortality by 23% overall and by up to 50% for acute measles sufferers.

Planting these seeds between 6 months and 6 years of age can reduce overall child mortality by a quarter in areas with significant VAD. However, because breastfeeding is time-limited and the effect of vitamin A supplementation capsules lasts only 4-6 months, they are only initial steps towards ensuring better overall nutrition and not long-term solutions.

Cultivating the garden, both literally and figuratively, is the next phase necessary to achieve long-term results.

Food fortification takes over where supplementation leaves off. Food fortification, for example sugar in Guatemala, maintains vitamin A status, especially for high-risk groups and needy families.

For vulnerable rural families, for instance in Africa and South-East Asia, growing fruits and vegetables in home gardens complements dietary diversification and fortification and contributes to better lifelong health.

In 1998 WHO and its partners UNICEF, the Canadian International Development Agency, the United States Agency for International Development and the Micronutrient Initiative launched the Vitamin A Global Initiative. In addition, over the past few years, WHO, UNICEF and others have provided support to countries in delivering vitamin A supplements. Linked to sick-child visits and national poliomylitis immunization days, these supplements have averted an estimated 1.25 million deaths since 1998 in 40 countries.

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Cell Therapy Ltd

October 25th, 2015 6:41 pm

Founded in 2009 by Nobel prize winner Professor Sir Martin Evans and Ajan Reginald, former Global Head of Emerging Technologies at Roche, CTL develops life-saving and life altering regenerative medicines. CTLs team of scientists, physicians, and experienced management have discovered and developed a pipeline of world-class regenerative medicines.

Sir Martin Evans' unique expertise in discovering rare stem cells led to CTLs innovative drug discovery engine that can uniquely isolate very rare and potent tissue specific stem cells. This exceptional class of cells is then engineered into unique disease-specific cellular regenerative medicines. Each medicine is disease specific and forms part of CTLs world-class portfolio of four off the shelf blockbuster medicines all scheduled for launch before 2020.

The products in late stage clinical trials include Heartcel which regenerates the damaged heart of adults with coronary artery malformations and children with Kawasaki Disease and Bland White Garland Syndrome. In 2014, Heartcel reported unprecedented heart regeneration clinical trial results and is scheduled to launch in 2018 to treat ~400,000 patients worldwide. Myocardion is in Phase II/III trials and treats mild-moderate heart failure affecting 10 million patients worldwide. Tendoncel is the worlds first topical regenerative medicine, for early intervention of severe tendon injuries, and has completed Phase II trials. It is designed to treat the >1 million severe tendon injuries each year in the US and Europe. Skincel is for skin regeneration, and is due to complete Phase II trials in 2015. It is designed to address ulceration and wrinkles.

CTL combines world-class science and management expertise to bring life-saving regenerative medicines to market.

European Society of Gene and Cell Therapy Congress, 17-20 September 2015, Helsinki,Finland (ESGCT 2015)

4th International Conference and Exhibition on Cell & Gene Therapy, August 10-12, 2015, London (CGT 2015)

The International Society for Stem Cell Research Annual Meeting, 24th-27th June 2015, Stockholm, Sweden (ISSCR 2015)

British Society for Gene and Cell Therapy Annual Conference, 9th-11th June 2015, Strathclyde, Glasgow (BSGCT 2015)

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Genetic Anti-Aging and Health: Creating REAL Results by …

October 24th, 2015 3:45 pm

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Ethics of Stem Cell Research (Stanford Encyclopedia of …

October 24th, 2015 3:45 pm

The potential therapeutic benefits of HESC research provide strong grounds in favor of the research. If looked at from a strictly consequentialist perspective, it's almost certainly the case that the potential health benefits from the research outweigh the loss of embryos involved and whatever suffering results from that loss for persons who want to protect embryos. However, most of those who oppose the research argue that the constraints against killing innocent persons to promote social utility apply to human embryos. Thus, as long as we accept non-consequentialist constraints on killing persons, those supporting HESC research must respond to the claim that those constraints apply to human embryos.

In its most basic form, the central argument supporting the claim that it is unethical to destroy human embryos goes as follows: It is morally impermissible to intentionally kill innocent human beings; the human embryo is an innocent human being; therefore it is morally impermissible to intentionally kill the human embryo. It is worth noting that this argument, if sound, would not suffice to show that all or even most HESC research is impermissible, since most investigators engaged in HESC research do not participate in the derivation of HESCs but instead use cell lines that researchers who performed the derivation have made available. To show that researchers who use but do not derive HESCs participate in an immoral activity, one would further need to establish their complicity in the destruction of embryos. We will consider this issue in section 2. But for the moment, let us address the argument that it is unethical to destroy human embryos.

A premise of the argument against killing embryos is that human embryos are human beings. The issue of when a human being begins to exist is, however, a contested one. The standard view of those who oppose HESC research is that a human being begins to exist with the emergence of the one-cell zygote at fertilization. At this stage, human embryos are said to be whole living member[s] of the species homo sapiens [which] possess the epigenetic primordia for self-directed growth into adulthood, with their determinateness and identity fully intact (George & Gomez-Lobo 2002, 258). This view is sometimes challenged on the grounds that monozygotic twinning is possible until around days 1415 of an embryo's development (Smith & Brogaard 2003). An individual who is an identical twin cannot be numerically identical to the one-cell zygote, since both twins bear the same relationship to the zygote, and numerical identity must satisfy transitivity. That is, if the zygote, A, divides into two genetically identical cell groups that give rise to identical twins B and C, B and C cannot be the same individual as A because they are not numerically identical with each other. This shows that not all persons can correctly assert that they began their life as a zygote. However, it does not follow that the zygote is not a human being, or that it has not individuated. This would follow only if one held that a condition of an entity's status as an individual human being is that it be impossible for it to cease to exist by dividing into two or more entities. But this seems implausible. Consider cases in which we imagine adult humans undergoing fission (for example, along the lines of Parfit's thought experiments, where each half of the brain is implanted into a different body) (Parfit 1984). The prospect of our going out of existence through fission does not pose a threat to our current status as distinct human persons. Likewise, one might argue, the fact that a zygote may divide does not create problems for the view that the zygote is a distinct human being.

There are, however, other grounds on which some have sought to reject that the early human embryo is a human being. According to one view, the cells that comprise the early embryo are a bundle of homogeneous cells that exist in the same membrane but do not form a human organism because the cells do not function in a coordinated way to regulate and preserve a single life (Smith & Brogaard 2003, McMahan 2002). While each of the cells is alive, they only become parts of a human organism when there is substantial cell differentiation and coordination, which occurs around day-16 after fertilization. Thus, on this account, disaggregating the cells of the 5-day embryo to derive HESCs does not entail the destruction of a human being.

This account is subject to dispute on empirical grounds. That there is some intercellular coordination in the zygote is revealed by the fact that the development of the early embryo requires that some cells become part of the trophoblast while others become part of the inner cell mass. Without some coordination between the cells, there would be nothing to prevent all cells from differentiating in the same direction (Damschen, Gomez-Lobo and Schonecker 2006). The question remains, though, whether this degree of cellular interaction is sufficient to render the early human embryo a human being. Just how much intercellular coordination must exist for a group of cells to constitute a human organism cannot be resolved by scientific facts about the embryo, but is instead an open metaphysical question (McMahan 2007a).

Suppose that the 5-day human embryo is a human being. On the standard argument against HESC research, membership in the species Homo sapiens confers on the embryo a right not to be killed. This view is grounded in the assumption that human beings have the same moral status (at least with respect to possessing this right) at all stages of their lives.

Some accept that the human embryo is a human being but argue that the human embryo does not have the moral status requisite for a right to life. There is reason to think that species membership is not the property that determines a being's moral status. We have all been presented with the relevant thought experiments, courtesy of Disney, Orwell, Kafka, and countless science fiction works. The results seem clear: we regard mice, pigs, insects, aliens, and so on, as having the moral status of persons in those possible worlds in which they exhibit the psychological and cognitive traits that we normally associate with mature human beings. This suggests that it is some higher-order mental capacity (or capacities) that grounds the right to life. While there is no consensus about the capacities that are necessary for the right to life, some of the capacities that have been proposed include reasoning, self-awareness, and agency (Kuhse & Singer 1992, Tooley 1983, Warren 1973).

The main difficulty for those who appeal to such mental capacities as the touchstone for the right to life is that early human infants lack these capacities, and do so to a greater degree than many of the nonhuman animals that most deem it acceptable to kill (Marquis 2002). This presents a challenge for those who hold that the non-consequentialist constraints on killing human children and adults apply to early human infants. Some reject that these constraints apply to infants, and allow that there may be circumstances where it is permissible to sacrifice infants for the greater good (McMahan 2007b). Others argue that, while infants do not have the intrinsic properties that ground a right to life, we should nonetheless treat them as if they have a right to life in order to promote love and concern towards them, as these attitudes have good consequences for the persons they will become (Benn 1973, Strong 1997).

Some claim that we can reconcile the ascription of a right to life to all humans with the view that higher order mental capacities ground the right to life by distinguishing between two senses of mental capacities: immediately exercisable capacities and basic natural capacities. (George and Gomez-Lobo 2002, 260). According to this view, an individual's immediately exercisable capacity for higher mental functions is the actualization of natural capacities for higher mental functions that exist at the embryonic stage of life. Human embryos have a rational nature, but that nature is not fully realized until individuals are able to exercise their capacity to reason. The difference between these types of capacity is said to be a difference between degrees of development along a continuum. There is merely a quantitative difference between the mental capacities of embryos, fetuses, infants, children, and adults (as well as among infants, children, and adults). And this difference, so the argument runs, cannot justify treating some of these individuals with moral respect while denying it to others.

Given that a human embryo cannot reason at all, the claim that it has a rational nature has struck some as tantamount to asserting that it has the potential to become an individual that can engage in reasoning (Sagan & Singer 2007). But an entity's having this potential does not logically entail that it has the same status as beings that have realized some or all of their potential (Feinberg 1986). Moreover, with the advent of cloning technologies, the range of entities that we can now identify as potential persons arguably creates problems for those who place great moral weight on the embryo's potential. A single somatic cell or HESC can in principle (though not yet in practice) develop into a mature human being under the right conditionsthat is, where the cell's nucleus is transferred into an enucleated egg, the new egg is electrically stimulated to create an embryo, and the embryo is transferred to a woman's uterus and brought to term. If the basis for protecting embryos is that they have the potential to become reasoning beings, then, some argue, we have reason to ascribe a high moral status to the trillions of cells that share this potential and to assist as many of these cells as we reasonably can to realize their potential (Sagan & Singer 2007, Savulescu 1999). Because this is a stance that we can expect nearly everyone to reject, it's not clear that opponents of HESC research can effectively ground their position in the human embryo's potential.

One response to this line of argument has been to claim that embryos possess a kind of potential that somatic cells and HESCs lack. An embryo has potential in the sense of having an active disposition and intrinsic power to develop into a mature human being (Lee & George 2006). An embryo can mature on its own in the absence of interference with its development. A somatic cell, on the other hand, does not have the inherent capacity or disposition to grow into a mature human being. However, some question whether this distinction is viable, especially in the HESC research context. While it is true that somatic cells can realize their potential only with the assistance of outside interventions, an embryo's development also requires that numerous conditions external to it are satisfied. In the case of embryos that are naturally conceived, they must implant, receive nourishment, and avoid exposure to dangerous substances in utero. In the case of spare embryos created through in vitro fertilizationwhich are presently the source of HESCs for researchthe embryos must be thawed and transferred to a willing woman's uterus. Given the role that external factorsincluding technological interventionsplay in an embryo's realizing its potential, one can question whether there is a morally relevant distinction between an embryo's and somatic cell's potential and thus raise doubts about potentiality as a foundation for the right to life (Devolder & Harris 2007).

Some grant that human embryos lack the properties essential to a right to life, but hold that they possess an intrinsic value that calls for a measure of respect and places at least some moral constraints on their use: The life of a single human organism commands respect and protection no matter in what form or shape, because of the complex creative investment it represents and because of our wonder at the divine or evolutionary processes that produce new lives from old ones. (Dworkin l992, 84). There are, however, divergent views about the level of respect embryos command and what limits exist on their use. Some opponents of HESC research hold that the treatment of human embryos as mere research tools always fails to manifest proper respect for them. Other opponents take a less absolutist view. Some, for example, deem embryos less valuable than more mature human beings but argue that the benefits of HESC research are too speculative to warrant the destruction of embryos, and that the benefits might, in any case, be achieved through the use of noncontroversial sources of stem cells (e.g., adult stem cells) (Holm 2003).

Many, if not most, who support the use of human embryos for HESC research would likely agree with opponents of the research that there are some circumstances where the use of human embryos would display a lack of appropriate respect for human life, for example, were they to be offered for consumption to contestants in a reality TV competition or destroyed for the production of cosmetics. But proponents of the research hold that the value of human embryos is not great enough to constrain the pursuit of research that may yield significant therapeutic benefits. Supporters of the research also frequently question whether most opponents of the research are consistent in their ascription of a high value to human embryos, as opponents generally display little concern about the fact that many embryos created for fertility treatment are discarded.

When spare embryos exist after fertility treatment, the individuals for whom the embryos were created typically have the option of storing for them for future reproductive use, donating them to other infertile couples, donating them to research, or discarding them. Some argue that as long as the decision to donate embryos for research is made after the decision to discard them, it is morally permissible to use them in HESC research even if we assume that they have the moral status of persons. The claim takes two different forms. One is that it is morally permissible to kill an individual who is about to be killed by someone else where killing that individual will help others (Curzer, H. 2004). The other is that researchers who derive HESCs from embryos that were slated for destruction do not cause their death. Instead, the decision to discard the embryos causes their death; research just causes the manner of their death (Green 2002).

Both versions of the argument presume that the decision to discard spare embryos prior to the decision to donate them to research entails that donated embryos are doomed to destruction when researchers receive them. There are two arguments one might marshal against this presumption. First, one who wants to donate embryos to research might first elect to discard them only because doing so is a precondition for donating them. There could be cases in which one who chooses the discard option would have donated the embryos to other couples were the research donation option not available. The fact that a decision to discard embryos is made prior to the decision to donate the embryos thus does not establish that the embryos were doomed to destruction before the decision to donate them to research was made. Second, a researcher who receives embryos could choose to rescue them, whether by continuing to store them or by donating them to infertile couples. While this would violate the law, the fact that it is within a researcher's power to prevent the destruction of the embryos he or she receives poses problems for the claim that the decision to discard the embryos dooms them or causes their destruction.

Assume for the sake of argument that it is morally impermissible to destroy human embryos. It does not follow that all research with HESCs is impermissible, as it is sometimes permissible to benefit from moral wrongs. For example, there is nothing objectionable about transplant surgeons and patients benefiting from the organs of murder and drunken driving victims (Robertson 1988). If there are conditions under which a researcher may use HESCs without being complicit in the destruction of embryos, then those who oppose the destruction of embryos could support research with HESCs under certain circumstances.

Researchers using HESCs are clearly implicated in the destruction of embryos where they derive the cells themselves or enlist others to derive the cells. However, most investigators who conduct research with HESCs obtain them from an existing pool of cell lines and play no role in their derivation. One view is that we cannot assign causal or moral responsibility to investigators for the destruction of embryos from which the HESCs they use are derived where their research plans had no effect on whether the original immoral derivation occurred. (Robertson 1999). This view requires qualification. There may be cases in which HESCs are derived for the express purpose of making them widely available to HESC investigators. In such instances, it may be that no individual researcher's plans motivated the derivation of the cells. Nonetheless, one might argue that investigators who use these cells are complicit in the destruction of the embryos from which the cells were derived because they are participants in a research enterprise that creates a demand for HESCs. For these investigators to avoid the charge of complicity in the destruction of embryos, it must be the case that the researchers who derived the HESCs would have performed the derivation in the absence of external demand for the cells (Siegel 2004).

The issue about complicity goes beyond the question of an HESC researcher's role in the destruction of the particular human embryo(s) from which the cells he or she uses are derived. There is a further concern that research with existing HESCs will result in the future destruction of embryos: [I]f this research leads to possible treatments, private investment in such efforts will increase greatly and the demand for many thousands of cell lines with different genetic profiles will be difficult to resist. (U.S. Conference of Catholic Bishops 2001). This objection faces two difficulties. First, it appears to be too sweeping: research with adult stem cells and non-human animal stem cells, as well as general research in genetics, embryology, and cell biology could be implicated, since all of this research might advance our understanding of HESCs and result in increased demand for them. Yet, no one, including those who oppose HESC research, argues that we should not support these areas of research. Second, the claim about future demand for HESCs is speculative. Indeed, current HESC research could ultimately reduce or eliminate demand for the cells by providing insights into cell biology that enable the use of alternative sources of cells (Siegel 2004).

While it might thus be possible for a researcher to use HESCs without being morally responsible for the destruction of human embryos, that does not end the inquiry into complicity. Some argue that agents can be complicit in wrongful acts for which they are not morally responsible. One such form of complicity arises from an association with wrongdoing that symbolizes acquiescence in the wrongdoing (Burtchaell 1989). The failure to take appropriate measures to distance oneself from moral wrongs may give rise to metaphysical guilt, which produces a moral taint and for which shame is the appropriate response (May 1992). The following question thus arises: Assuming it is morally wrongful to destroy human embryos, are HESC researchers who are not morally responsible for the destruction of embryos complicit in the sense of symbolically aligning themselves with a wrongful act?

One response is that a researcher who benefits from the destruction of embryos need not sanction the act any more than the transplant surgeon who uses the organs of a murder or drunken driving victim sanctions the homicidal act (Curzer 2004). But this response is unlikely to be satisfactory to opponents of HESC research. There is arguably an important difference between the transplant case and HESC research insofar as the moral wrong associated with the latter (a) systematically devalues a particular class of human beings and (b) is largely socially accepted and legally permitted. Opponents of HESC research might suggest that the HESC research case is more analogous to the following kind of case: Imagine a society in which the practice of killing members of a particular racial or ethnic group is legally permitted and generally accepted. Suppose that biological materials obtained from these individuals subsequent to their deaths are made available for research uses. Could researchers use these materials while appropriately distancing themselves from the wrongful practice? Arguably, they could not. There is a heightened need to protest moral wrongs where those wrongs are socially and legally accepted. Attempts to benefit from the moral wrong in these circumstances may be incompatible with mounting a proper protest (Siegel 2003).

But even if we assume that HESC researchers cannot avoid the taint of metaphysical guilt, it is not clear that researchers who bear no moral responsibility for the destruction of embryos are morally obligated not to use HESCs. One might argue that there is a prima facie duty to avoid moral taint, but that this duty may be overridden for the sake of a noble cause.

Most HESCs are derived from embryos that were created for infertility treatment but that were in excess of what the infertile individual(s) ultimately needed to achieve a pregnancy. The HESCs derived from these leftover embryos offer investigators a powerful tool for understanding the mechanisms controlling cell differentiation. However, there are scientific and therapeutic reasons not to rely entirely on leftover embryos. From a research standpoint, creating embryos through cloning technologies with cells that are known to have particular genetic mutations would allow researchers to study the underpinnings of genetic diseases in vitro. From a therapeutic standpoint, the HESCs obtained from leftover IVF embryos are not genetically diverse enough to address the problem of immune rejection by recipients of stem cell transplants. (Induced pluripotent stem cells may ultimately prove sufficient for these research and therapeutic ends, since the cells can (a) be selected for specific genetic mutations and (b) provide an exact genetic match for stem cell recipients.) At present, the best way to address the therapeutic problem is through the creation of a public stem cell bank that represents a genetically diverse pool of stem cell lines (Faden et al. 2003, Lott & Savulescu 2007). This kind of stem cell bank would require the creation of embryos from gamete donors who share the same HLA-types (i.e., similar versions of the genes that mediate immune recognition and rejection).

Each of these enterprises has its own set of ethical issues. In the case of research cloning, some raise concerns, for example, that the perfection of cloning techniques for research purposes will enable the pursuit of reproductive cloning, and that efforts to obtain the thousands of eggs required for the production of cloned embryos will result in the exploitation of women who provide the eggs (President's Council on Bioethics 2002, Norsigian 2005). With respect to stem cell banks, it is not practically possible to create a bank of HESCs that will provide a close immunological match for all recipients. This gives rise to the challenge of determining who will have biological access to stem cell therapies. We might construct the bank so that it provides matches for the greatest number of people in the population, gives everyone an equal chance of finding a match, or ensures that all ancestral/ethnic groups are fairly represented in the bank (Faden et al. 2003, Bok, Schill, & Faden 2004, Greene 2006).

There are, however, more general challenges to the creation of embryos for research and therapeutic purposes. Some argue that the creation of embryos for non-reproductive ends is morally problematic, regardless of whether they are created through cloning or in vitro fertilization. There are two related arguments that have been advanced to morally distinguish the creation of embryos for reproductive purposes from the creation of embryos for research and therapeutic purposes. First, each embryo created for procreative purposes is originally viewed as a potential child in the sense that each is a candidate for implantation and development into a mature human. In contrast, embryos created for research or therapies are viewed as mere tools from the outset (Annas, Caplan & Elias 1996, President's Council on Bioethics 2002). Second, while embryos created for research and therapy are produced with the intent to destroy them, the destruction of embryos created for reproduction is a foreseeable but unintended consequence of their creation (FitzPatrick 2003).

One response to the first argument has been to suggest that we could, under certain conditions, view all research embryos as potential children in the relevant sense. If all research embryos were included in a lottery in which some of them were donated to individuals for reproductive purposes, all research embryos would have a chance at developing into mature humans (Devander 2005). Since those who oppose creating embryos for research would likely maintain their opposition in the research embryo lottery case, it is arguably irrelevant whether embryos are viewed as potential children when they are created. Of course, research embryos in the lottery case would be viewed as both potential children and potential research tools. But this is also true in the case of embryos created for reproductive purposes where patients are open to donating spare embryos to research.

As to the second argument, the distinction between intending and merely foreseeing harms is one to which many people attach moral significance, and it is central to the Doctrine of Double Effect. But even if one holds that this is a morally significant distinction, it is not clear that it is felicitous to characterize the destruction of spare embryos as an unintended but foreseeable side-effect of creating embryos for fertility treatment. Fertility clinics do not merely foresee that some embryos will be destroyed, as they choose to offer patients the option of discarding embryos and carry out the disposal of embryos when patients request it. Patients who elect that their embryos be discarded also do not merely foresee the embryos' destruction; their election of that option manifests their intention that the embryos be destroyed. There is thus reason to doubt that there is a moral distinction between creating embryos for research and creating them for reproductive purposes, at least given current fertility clinic practices.

Recent scientific work suggests it is possible to derive gametes from human pluripotent stem cells. Researchers have generated sperm and eggs from mouse ESCs and iPSCs and have used these stem cell-derived gametes to produce offspring (Hayashi 2011; Hayashi 2012). While it may take several years before researchers succeed in deriving gametes from human stem cells, the research holds much promise for basic science and clinical application. For example, the research could provide important insights into the fundamental processes of gamete biology, assist in the understanding of genetic disorders, and provide otherwise infertile individuals a means of creating genetically related children. The ability to derive gametes from human stem cells could also reduce or eliminate the need for egg donors and thus help overcome concerns about exploitation of donors and the risks involved in egg retrieval. Nonetheless, the research gives rise to some controversial issues related to embryos, genetics, and assisted reproductive technologies (D. Mathews et al. 2009).

One issue arises from the fact that some research on stem cell-derived gametes requires the creation of embryos, regardless of whether one is using ESCs or iPSCs. To establish that a particular technique for deriving human gametes from stem cells produces functional sperm and eggs, it is necessary to demonstrate that the cells can produce an embryo. This entails the creation of embryos through in vitro fertilization. Since it would not be safe to implant embryos created during the early stages of the research, the likely disposition of the embryos is that they would be destroyed. In such instances, the research would implicate all of the moral issues surrounding the creation and destruction of embryos for research. However, the creation of embryos for research in this situation would not necessitate the destruction of the embryos, as it does when embryos are created to derive stem cell lines. One could in principle store them indefinitely rather than destroy them. This would still leave one subject to the objection that life is being created for instrumental purposes. But the force of the objection is questionable since it is not clear that this instrumental use is any more objectionable than the routine and widely accepted practice of creating excess IVF embryos in the reproductive context to increase the probability of generating a sufficient number of viable ones to produce a pregnancy.

Further issues emerge with the prospect of being able to produce large quantities of eggs from stem cells. As the capacity to identify disease and non-disease related alleles through preimplantation genetic diagnosis (PGD) expands, the ability to create large numbers of embryos would substantially increase the chances of finding an embryo that possesses most or all of the traits one wishes to select. This would be beneficial in preventing the birth of children with genetic diseases. But matters would become morally contentious if it were possible to select for non-disease characteristics, such as sexual orientation, height, superior intelligence, memory, and musical ability. One common argument against using PGD in this way is that it could devalue the lives of those who do not exhibit the chosen characteristics. Another concern is that employing PGD to select for non-disease traits would fail to acknowledge the giftedness of life by treating children as objects of our design or products of our will or instruments of our ambition rather accepting them as they are given to us (Sandel 2004, 56). There is additionally a concern about advances in genetics heightening inequalities where certain traits confer social and economic advantages and only the well-off have the resources to access the technology (Buchanan 1995). Of course, one can question whether the selection of non-disease traits would in fact lead to devaluing other characteristics, whether it would alter the nature of parental love, or whether it is distinct enough from currently permitted methods of gaining social and economic advantage to justify regulating the practice. Nonetheless, the capacity to produce human stem cell-derived gametes would make these issues more pressing.

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Ethical Issues and Risk Assessment in Biotechnology

October 24th, 2015 3:45 pm

Bioindustry: A Description of California's Bioindustry and Summary of the Public Issues Affecting Its Development By Gus A. Koehler, PhD. Return to table of contents There is a rich public debate about how the potential risks associated with biotechnology methods and bioindustry products should be assessed and about whether and how bioethics should influence public policy. A general structure for guiding public policy discourse is emerging but is not fully developed. Groups perceive risks differently depending on their culture, scientific background, perception of government, and other factors. Expert opinion supports a range of positions. 194 Deeply and honestly held but often conflicting beliefs and values about nature, animals, and the community good animate the debate. The result is that biotechnology issues are often highly contentious and debated on both scientific and ethical grounds. Two contemporary examples are:

Biotechnology's risks are sometimes purely conjectural. Without research and clinical trials, risks cannot be fully assessed. Yet conjectural and ethical issues are important because biotechnology affects not only human practices and economic sectors, but also medical practices and the relationship between humanity, animals and the environment. In Paul Thompson's view,

Public Policy Debate

There are many complex and emotionally charged ethical issues that the development of biotechnology poses for the first time or reframes. This paper can only touch on some of them. Federal and state governments are attempting to grapple with these issues and create a framework to deal with them.

Three Federal panels addressed bioethical issues prior to 1983:

These federal panels had a major impact on bioethical debate and risk assessment. For example, the President's Commission:

Except for the National Institutes of Health-Department of Energy Working Group on Ethical, Legal, and Social Implications of the Human Genome Project, bioethical issues have been analyzed since 1983 on an ad hoc basis by temporary panels leading to delayed discussions, restricted scope, and inconsistent policy positions between panels. Congressional attempts to create a new national commission in 1990 to examine bioethical issues were unsuccessful, primarily due to a highly contentious debate over fetal research.

Bioethics examines broad issues such as animal rights and welfare, human testing, and the potential effects of genetically engineered species on other species and the environment. Risk assessments analyze the relative risks posed by possible toxic, pathogenic, and ecological effects of biotechnology and bioindustry. There are three broad analytical approaches to risk assessment:

States and the federal government generally focus on the second approach, the characteristics and environmental risks of the altered organism, and not on the processes used to produce it or on possible natural rights. This "organism-in the environment" approach to risk assessment involves evaluation of any of the following: 199

The science of developing transgenic animals is just beginning. Critics contend that it raises both animal physiological (possible loss of function or generation of deformities) or psychological problems (unacceptable levels of stress or loss of function) and associated ethical issues. A 1989 statement, "Consultation on Respect for Life and the Environment," signed by the National Council of Churches, the Foundation on Economic Trends, and the Center for the Respect of Life and the Environment, called for a moratorium on transgenic animal research. The statement asserted that such technology "portends fundamental changes in the public's perception of, and attitude towards animals, which would be regarded as human creations, inventions, and commodities, rather than God's creation and subjects of nature." 200 For example, during their development transgenic swine had many serious problems:

Should we understand animal well-being to include an animal's entitlement to certain key traits that it would be unethical to select against or to seriously weaken? 202 Should transgenic animal research and use be restricted to certain species? 203 How are each of these questions to be reconciled with potential improvements in human health that could result from such research?

In contrast, the U.S. Department of Agriculture, the Biotechnology Industry Organization, and the American Medical Association argue that the creation of altered animals is medically and economically beneficial for humans and should continue.

Is the legal status of a transgenic animal that is owned by its creating company different from a domesticated animal? How do existing animal welfare statutes (humane treatment) apply to such animals? Each of these issues are magnified by the emerging ability to mass-produce large numbers of bioengineered animals such as genetically identical sheep and cattle that could become a primary source of fiber and food.

The deliberate manipulation of the gene line to achieve desirable human characteristics by altering sperm genes or to inserting genes from other species into human sex cells also has serious ethical implications. For example, is it ethical to make inheritable changes in the human genome affecting the characteristics of individuals that would be born with it? Who has the right to make a genetic therapy decision involving a fetus, children, or other? Should such guidelines extend to fetuses not brought to term for experimental purposes? 204 Some of these issues may be addressed in guidelines being developed by the National Institutes of Health.

In May 1995, a large coalition of religious leaders--Catholic bishops, Protestant and Jewish leaders and groups of Muslims, Hindus and Buddhists--announced its opposition to patents on human and animal life. The coalition did not oppose genetic engineering or biotechnology, but rather patenting human genes or organisms. It contends that such patents violate the sanctity of human life and reduce the "blueprint of evolution" to a marketable commodity. The group argues that life is a gift from God that should be cherished and nurtured. To reduce life to a commodity is to turn it into a product that can be owned and manipulated for profit alone, according to the group. 205

A second broad coalition of U.S. and international indigenous peoples, consumer, environmental, and other non-government groups issued the "Blue Mountain Declaration" in June 1995, declaring, in part,

This group also strongly opposes federal funding for the Human Genome Diversity Project. In particular, it is concerned about gathering samples of human genetic material from indigenous communities around the world. Related issues include ownership of cell lines, informed consent before providing the sample, patenting of genetic sequences, and who should benefit from the sale of related products.

Counter arguments are presented in the patenting (p. 38), human biological materials ownership (p. 41), and human and animal related products (p. 3-1) portions of this paper. These issues are currently under consideration by the courts and various professional organizations. Generally, the trend appears to be in the direction of allowing private ownership of laboratory-created organisms and the continued collection of human genetic material, on the grounds that the results are beneficial to humanity.

Organ transplants and the availability of embryological tissue for research are important and difficult issues for modern medicine. Many lives are prolonged or saved every year through organ transplants. The National Organ Transplantation Act prohibits the sale of human tissue and organs for transplantation. This prohibition does not apply to non-transplantation purposes, including the sale of organs and other parts, such as embryological tissue, for research. 207

Fetal organs and tissue are believed by some researchers to be essential to research that might lead to alleviation of Parkinson's disease, diabetes, and other serious illnesses.

The federal government banned federally funded human embryology research for 15 years, (1979 to 1994), although some research continued with private funding. President Clinton has ordered that no federal funds be spent on embryos created for research. 208 However, the order did not specifically forbid support for research on human embryos.

The National Institutes of Health convened an ad hoc Human Embryo Research Panel to examine the issue of embryo research. In 1994, the panel found that such research could make substantial contributions and agreed that pre-implantation embryos should receive serious moral consideration but not to the same degree as infants and children. The panel restricted its attention to research on pre-implantation embryos, or multi-cell clusters that are less than 14 days old and that are without a definite nerve system. The panel recommended an advisory process similar to that being followed for gene therapy, and contended that federal funding would help to establish consistent public review of the research. 209

Researchers obtain fetal tissue from hospitals and clinics. Some clinics have developed an informed consent form for patients giving permission to use fetal tissue from an aborted fetus for research or organ transplant. However, one author contends that, "there has been virtually no effective policing of fetal organ harvesting by the federal government or any state agency," and that such appears unlikely. 210

Animal to Human Organ Transplants

The area of organ transplants from animals to humans is developing so rapidly that the National Academy of Science's Institute of Medicine has created a committee to examine the practice. 211 Issues that the Institute will examine include, "How to protect the rights of the first 'pioneer' patients? How to prevent the introduction of dangerous animal pathogens into the human population? And will the public find the idea of transplanting animal organs into humans acceptable?" 212

The FDA has also expressed concerns about animal-to-human transplants. Transplants might allow dangerous pathogens in animals to enter humans. Researchers plan to screen tissues for known viruses and to monitor recipients for infectious disease. However, screening for known viruses may not be adequate to apprehend new pathogens. The FDA wants stricter safeguards that could include improved tests for pathogens, protocols to quarantine patients, and the creation of colonies of "clean" animals. 213

Bioethics and Human Diagnostics

Testing for genetic defects is generally considered to be helpful and to increase possible treatment options. The issue becomes much more complex when genetic information has implications for reproductive choice or portends an unhealthy future for a currently healthy person (for example, having a mastectomy to prevent the potential future occurrence of a genetically-based cancer). Related issues include: disclosure of a genetic defect; availability and affordability of genetic counseling and health insurance; and employee screening. Screening for genetic diseases is controlled by the National Genetic Diseases Act, which provides for research, screening, counseling, and professional education for people with Tay-Sachs disease, Cystic Fibrosis, Huntington's disease, and a number of other conditions in which genetic mutations may be involved.

The use of genetic testing in the workplace can involve genetic screening or genetic monitoring. Screening involves a one-time test to detect a pre-existing trait in a worker or job applicant. Genetic monitoring involves multiple tests of a worker over time to determine if an occupational exposure has induced a genetic change. In 1989 five percent of the Fortune 500 companies surveyed either were using or had used employee genetic monitoring. [214] Genetic monitoring is reliable at the population level, not the individual employee level. There are three principal issues: [215]

The implementation of genetic testing can affect job applicants and workers, employers, and society differently. The impact varies according to whether the test performed is for genetic monitoring for chromosomal damage due to workplace conditions, genetic screening for susceptibilities to occupational illness, or genetic screening for inherited conditions or traits unrelated to the workplace but that could affect health insurance costs. Employees may wish to be genetically tested to track their health status but be concerned that the information could be used to remove them from the workplace, to deny insurance or keep them from being hired. On the other hand, employers contend that they need such information for hiring purposes and may wish to use genetic screening tests, establish conditions for employee participation, and implement consequences. Such employer practices are consistent with existing pre-employment medical testing practices. The Office of Technology Assessment (OTA), after a review of the issues involved, found:

Federal legislation (including the Occupational Safety and Health Act, the Rehabilitation Act of 1973, Title VI of the Civil Rights Act of 1964, the National Labor Relations Act, and the Americans with Disabilities Act) provides some protections against genetic testing and screening abuses, particularly against unilateral employer imposition of genetic monitoring and screening, discrimination, and breaches in confidentiality. States have also been active in this area, adopting legislation concerning genetic screening and employment. [217]

The ability to test for possible inherited tendencies such as high blood pressure and other heart-related diseases, diabetes, and cancer has important implications for access to health insurance. Health insurance could become too expensive for some people. In the 1970s some people were denied insurance, charged higher premiums, or denied jobs because they tested positive as carriers of sickle cell anemia (a genetic condition inherited by some African Americans). 218 More recent studies have documented cases of genetic descrimination against healthy persons with a gene that predisposes them or their children to an illness. "In a recent survey of people with a known genetic condition in the family, 22% indicated that they had been refused health insurance coverage because of their genetic status, whether they were sick or not." 219

Genetic information is already requested on health insurance applications. According to a 1992 OTA survey:

Thirteen states have passed genetic testing laws. 221 Most of the laws are narrowly drawn and attempt to prevent discrimination such as denial of insurance or employment because of a genetically identified disease. For example, an Ohio law prohibits insurers from requiring potential clients to submit to genetic tests as a condition of coverage. 222 Recent state actions regarding genetic testing include: 223

In a related decision, "...the U.S. Equal Employment Opportunity Commission has concluded that healthy people carrying abnormal genes are protected against employment discrimination by the Americans with Disabilities Act." 224 The decision seems to limit the use of genetic screening. California Department of Fair Employment and Housing regulations protect employees who have an increased likelihood of developing a physical handicap, but it is not clear whether this rule applies to genetic monitoring.

In January 1995, a new California law took effect prohibiting health insurers from discriminating against an applicant by increasing rates because of genetic traits when the person has no symptoms of any disease or disorder. Insurance companies are also prohibited from requesting or providing genetic information without prior authorization. Chaptered legislation introduced by Senator Johnston in the 1995 session (SB 1020) extends this provision by prohibiting insurance companies from requiring a higher rate or charge or offering or providing different terms, conditions, or benefits on the basis of a person's genetic characteristics. SB 970 (Johnston, 1995) would expand the definition of medical condition under the Department of Fair Employment and Housing to include discrimination against people who have an increased likelihood of developing a physical handicap due to genetic problems.

Federal law limits state protection against insurance coverage genetic discrimination. Self-funded insurance plans are exempted from state law by the federal Employee Retirement Income Security Act. Nationally, about one-third of the non-elderly insured are covered by such plans. In addition, most state laws prohibit discrimination based on genetic tests carried out in a laboratory. However these laws often do not extend that protection to use of genetic information gathered by other methods that trace genetic inheritance or to disclosure of a request to have a genetic test. 225

Recently, the National Action Plan on Breast Cancer and the Working Group on Ethical, Legal, and Social Implications of the Human Genome Project developed a set of recommendations and definitions for state policy makers to protect against genetic discrimination. 226

Genetic counseling services are important to individuals and families for understanding the results of genetic tests. These services also face serious ethical dilemmas. For example, a parent may refuse to share a diagnosis of an inherited tendency for colon cancer with the family, including the children. To honor the patient's request might harm the rest of the family. 227

In 1993, a panel of the National Academy of Sciences concluded that federal oversight of gene testing needs to be improved. 228 The Health Care Financing Administration and the Food and Drug Administration are both responsible for ensuring the quality of testing in commercial laboratories. Currently the Health Care Financing Administration has no specific standards for laboratories that analyze DNA, and inspectors are not trained to evaluate the appropriate execution of DNA tests. The Food and Drug Administration requires that manufacturers obtain approval before marketing laboratory test kits and that laboratories offering experimental genetic tests be cleared and approved by the FDA. 229s

The field testing and release of genetically engineered plants and crops remains controversial but is widespread. Small-scale field tests of genetically-engineered crops have been under way in the U.S. for almost six years. Regulatory standards have been developed, and crops approved for testing and release. Since 1987, the U.S. Department of Agriculture has approved more than 860 applications and notifications to field-test transgenic crops. 230 More than 1,025 field tests of genetically modified plants were conducted in 32 countries between 1986 and 1993. Thirty-eight different plant species with nearly 200 different engineered properties have been tested in the field to date. By the year 2000, there may be as many as 400 different, economically important genetically modified plants under field evaluation. 231

As noted above, the USDA has recently expedited approvals for field-test permits. In 1995, the EPA approved the first pesticidal transgenic plants (corn, potato, and cotton plants) for "limited" commercialization. Approval for full scale production is expected by 1996. 232

The U.S. National Academy of Sciences concluded in 1987, "There is no evidence of the existence of unique hazards either in the use of RDNA techniques or in the movement of genes between unrelated organisms." 233 The U.S. National Research Council agreed: "No conceptual distinction exists between genetic modification of plants and microorganisms by classical methods or by molecular techniques that modify DNA and transfer genes," whether in the laboratory, in the field, or in large-scale environmental introductions. 234

The EPA,

Nevertheless, there is still considerable public disagreement over the implications of introducing genetically-engineered species into the environment for testing or commercial purposes. Critics have been successful at obtaining court injunctions to stop the release of biological materials into the environment. Some scientists and ecologists claim that unlike risk assessment for synthetic chemicals, "there is no commensurate methodology for assessing the risks of released organisms." 236 However, the overall likelihood of harm could rise as the number and variety of crop releases increase. If a problem occurs it could be high-risk with long-term unexpected consequences. Among the possibilities:

There is preliminary evidence that seems to support some of these concerns. Some exchanges of genetic information between plants in the field may occur by way of bacteria 237 or viruses:

Other scientists believe that the problem may not be significant, as "the potential benefits of engineered resistance genes far outweigh the vanishingly small risk of creating new and harmful viruses." 239

In some cases, a permit must be obtained from the USDA to begin limited field testing. The review often includes assessment of whether the product meets federal environmental-assessment standards and the environmental requirements of the Plant Pest Act. The EPA has developed guidelines for evaluating modified microorganisms under the Toxic Substances Control Act and for small-scale field testing of plants that produce pesticides under the Federal Insecticide, Fungicide, and Rodenticide Act. 240 These processes are considered by the respective agencies and industry to be more than adequate for evaluating new organisms, detecting any viral recombination that might create new, potentially high-risk viruses, 241 and for field testing pesticide producing plants.

Regulatory decisions on field testing seriously affect research agendas. For example, after the Environmental Protection Agency refused Monsanto's request to field test a new genetically engineered bacterium to improve plant resistance to frost, the company dismantled its entire research program on microbial biocontrol agents. (Monsanto remains very involved in other biotechnology research areas.) 242

Some ecologists remain concerned about the need for additional information beyond that required by the USDA and EPA on a species' ability to survive, proliferate, and disperse in nature, and about the potential for genetic exchange of materials between species. 243 One analysis concludes,

Jack Dekker and Gary Comstock, of Iowa State University, propose that ethical and technical criteria be developed and included in the regulatory process to address the issue:

Existing field experiments have not resolved the debate. There are conflicting studies with differing answers. These findings show just how complex and unresolved the issue is. For example, one research effort found that transgenic sugar beets could transfer genes to weed relatives. Other evidence indicates that viral RNA or DNA inserted in a plant to make it virus-resistant may combine with genetic material from an invading virus to form new, more virulent strains. But, recent work on the transgenic squash has "found no evidence that wild squash have bred with transgenic plants to form virus-resistant wild squash." 246 Despite concerns expressed by some observers, scientists consider it highly unlikely that the squash's wild relatives could obtain genetically engineered benefits from commercial relatives or that "novel recombinant viruses could crop up from [squashes] infected by wild viruses." 247 It might take a number of unlikely conditions occurring in the environment before new or damaging recombinant viruses could spread. 248 A more recent Danish study found that a commercial crop called oil seed rape containing a herbicide resistant gene can cross-fertilize with a weed called Brassica Campetris. Both plants are from the same mustard family. 249 The bioengineered gene is present in the crossbreeds and is passed on to subsequent generations.

Large scale plantings of transgenic crops might resolve some of these questions:

According to a report in Science, "Chinese scientists have recently launched massive field trials of transgenic tobacco, tomatoes, and rice on thousands of hectares." 251 Scientists in developing countries who are faced with food production problems may take more risks than others, the report notes. 252

Recent research also raises questions about the adequacy of models used to predict the dispersion of genetically engineered plants into the environment.

The possible accidental release of potentially damaging organisms into the environment extends to other organisms as well. For example, efforts by Australian scientists to restrict a deadly virus (used in experiments against wildly proliferating European rabbits) to an off coast island failed. "Officials foresaw little possibility of the virus's escaping from the island, but escape it did." 254

There are inherent conflicts involved in how biotechnology develops as an industry and the way ethical questions and public policy positions are discussed and adopted. Key factors include, for example:

The conflict between the ethical issues that emerge as research proceeds and discoveries are made, and the time and other pressures to immediately move products to the market place create public policy issues that cannot be easily resolved for a number of complex and interacting reasons:

Potential health, economic, and business benefits are huge. The potential human and financial rewards that could emerge from curing serious diseases, increasing the food supply, and substantially extending and improving the quality of human life are very large. It is this possibility that drives researchers, investors, and potential benefactors.

Biotechnology/bioethical issues are not simple. The underlying science is complex, as are the resulting issues. Bioethics is a new field that is developing right along with biotechnology.

It is difficult to know which biotechnology-induced changes in an organism or production technology might result in large scale social or economic changes. The often new relationship of the discovery to the greater environment, human health, marketplace, and to future generations is unknown. The law of unintended consequences is a major concern.

Measurements of the socio-economic and market effects of a new technology are hard to make. Methods for measuring expected human, ecological, industrial, and financial risks, short and long term costs/benefits, and other relevant factors are just being developed. It may be particularly difficult to estimate the long terms costs of biotechnology innovations, given their often unpredictable effects.

There is pressure to achieve immediate short term economic gains that might have essentially unknowable long-term effects. For example, patenting corn, rice, potatoes and wheat and the accompanying farming and marketing methods might reorder the entire agricultural industry and rural life.

Issues are set within conflicting time horizons and value systems. Research and marketing time horizons are relatively short, emphasizing immediate financial pay-off and scientific prestige. In contrast, bioethics and public policy questions often involve a long-term time horizon (generations of people), whole systems (ecological or industry), and the quality of individual and community life.

The definition of what "safe" means and how to evaluate an acceptable level of risk is still evolving. For example, how should manufacturers label bioengineered products and other products that may use genes inserted from plants to which people might be allergic? The large scale availability of genetic testing and its implications for the workplace and for inherited health problems are issues that are just now being addressed.

There is strong competitive pressure to go forward with new and potentially risky technology in a global market. European, Asian and other nations are fiercely competing with each other to develop and dominate a segment of the biotechnology industry, if not the industry itself. As noted, China (page 61), has already embarked on a series of field tests that would probably not be approved in the West.

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Kidney transplantation – Wikipedia, the free encyclopedia

October 24th, 2015 3:44 pm

Kidney transplantation or renal transplantation is the organ transplant of a kidney into a patient with end-stage renal disease. Kidney transplantation is typically classified as deceased-donor (formerly known as cadaveric) or living-donor transplantation depending on the source of the donor organ. Living-donor renal transplants are further characterized as genetically related (living-related) or non-related (living-unrelated) transplants, depending on whether a biological relationship exists between the donor and recipient. Exchanges and chains are a novel approach to expand the living donor pool.

One of the earliest mentions about the real possibility of a kidney transplant was by American medical researcher Simon Flexner, who declared in a reading of his paper on Tendencies in Pathology in the University of Chicago in 1907 that it would be possible in the then-future for diseased human organs substitution for healthy ones by surgery including arteries, stomach, kidneys and heart.[1]

In 1933 surgeon Yuri Voronoy from Kherson in the Soviet Union attempted the first human kidney transplant, using a kidney removed 6 hours earlier from the deceased donor to be reimplanted into the thigh. He measured kidney function using a connection between the kidney and the skin. His first patient died 2 days later as the graft was incompatible with the recipient's blood group and was rejected.[2]

It was not until June 17, 1950, when a successful transplant could be performed on Ruth Tucker, a 44-year-old woman with polycystic kidney disease, at Little Company of Mary Hospital in Evergreen Park, Illinois. Although the donated kidney was rejected ten months later because no immunosuppressive therapy was available at the timethe development of effective antirejection drugs was years awaythe intervening time gave Tucker's remaining kidney time to recover and she lived another five years.[3]

The first kidney transplants between living patients were undertaken in 1952 at the Necker hospital in Paris by Jean Hamburger although the kidney failed after 3 weeks of good function [4] and later in 1954 in Boston. The Boston transplantation, performed on December 23, 1954, at Brigham Hospital was performed by Joseph Murray, J. Hartwell Harrison, John P. Merrill and others. The procedure was done between identical twins Ronald and Richard Herrick to eliminate any problems of an immune reaction. For this and later work, Dr. Murray received the Nobel Prize for Medicine in 1990. The recipient, Richard Herrick, died eight years after the transplantation.[5]

The first kidney transplantation in the United Kingdom did not occur until 1960, when Michael Woodruff performed one between identical twins in Edinburgh.[6] Until the routine use of medications to prevent and treat acute rejection, introduced in 1964, deceased donor transplantation was not performed. The kidney was the easiest organ to transplant: tissue typing was simple, the organ was relatively easy to remove and implant, live donors could be used without difficulty, and in the event of failure, kidney dialysis was available from the 1940s. Tissue typing was essential to the success: early attempts in the 1950s on sufferers from Bright's disease had been very unsuccessful.

The major barrier to organ transplantation between genetically non-identical patients lay in the recipient's immune system, which would treat a transplanted kidney as a "non-self" and immediately or chronically reject it. Thus, having medications to suppress the immune system was essential. However, suppressing an individual's immune system places that individual at greater risk of infection and cancer (particularly skin cancer and lymphoma), in addition to the side effects of the medications.

The basis for most immunosuppressive regimens is prednisolone, a corticosteroid. Prednisolone suppresses the immune system, but its long-term use at high doses causes a multitude of side effects, including glucose intolerance and diabetes, weight gain, osteoporosis, muscle weakness, hypercholesterolemia, and cataract formation. Prednisolone alone is usually inadequate to prevent rejection of a transplanted kidney. Thus other, non-steroid immunosuppressive agents are needed, which also allow lower doses of prednisolone.

The indication for kidney transplantation is end-stage renal disease (ESRD), regardless of the primary cause. This is defined as a glomerular filtration rate <15ml/min/1.73 sq.m. Common diseases leading to ESRD include malignant hypertension, infections, diabetes mellitus, and focal segmental glomerulosclerosis; genetic causes include polycystic kidney disease, a number of inborn errors of metabolism, and autoimmune conditions such as lupus. Diabetes is the most common cause of kidney transplantation, accounting for approximately 25% of those in the US. The majority of renal transplant recipients are on dialysis (peritoneal dialysis or hemofiltration) at the time of transplantation. However, individuals with chronic renal failure who have a living donor available may undergo pre-emptive transplantation before dialysis is needed.

Contraindications include both cardiac and pulmonary insufficiency, as well as hepatic disease. Concurrent tobacco use and morbid obesity are also among the indicators putting a patient at a higher risk for surgical complications.

Kidney transplant requirements vary from program to program and country to country. Many programs place limits on age (e.g. the person must be under a certain age to enter the waiting list) and require that one must be in good health (aside from the kidney disease). Significant cardiovascular disease, incurable terminal infectious diseases and cancer are often transplant exclusion criteria. In addition, candidates are typically screened to determine if they will be compliant with their medications, which is essential for survival of the transplant. People with mental illness and/or significant on-going substance abuse issues may be excluded.

HIV was at one point considered to be a complete contraindication to transplantation. There was fear that immunosuppressing someone with a depleted immune system would result in the progression of the disease. However, some research seem to suggest that immunosuppressive drugs and antiretrovirals may work synergistically to help both HIV viral loads/CD4 cell counts and prevent active rejection.

Since medication to prevent rejection is so effective, donors do not need to be similar to their recipient. Most donated kidneys come from deceased donors; however, the utilization of living donors in the United States is on the rise. In 2006, 47% of donated kidneys were from living donors.[7] This varies by country: for example, only 3% of kidneys transplanted during 2006 in Spain came from living donors.[8]

Approximately one in three donations in the US, UK, and Israel is now from a live donor.[9][10][11] Potential donors are carefully evaluated on medical and psychological grounds. This ensures that the donor is fit for surgery and has no disease which brings undue risk or likelihood of a poor outcome for either the donor or recipient. The psychological assessment is to ensure the donor gives informed consent and is not coerced. In countries where paying for organs is illegal, the authorities may also seek to ensure that a donation has not resulted from a financial transaction.

The relationship the donor has to the recipient has evolved over the years. In the 1950s, the first successful living donor transplants were between identical twins. In the 1960s1970s, live donors were genetically related to the recipient. However, during the 1980s1990s, the donor pool was expanded further to emotionally related individuals (spouses, friends). Now the elasticity of the donor relationship has been stretched to include acquaintances and even strangers ("altruistic donors"). In 2009, Minneapolis transplant recipient Chris Strouth received a kidney from a donor who connected with him on Twitter, which is believed to be the first such transplant arranged entirely through social networking.[12][13]

The acceptance of altruistic donors has enabled chains of transplants to form. Kidney chains are initiated when an altruistic donor donates a kidney to a patient who has a willing but incompatible donor. This incompatible donor then "pays it forward" and passes on the generosity to another recipient who also had a willing but incompatible donor. Michael Rees from the University of Toledo developed the concept of open-ended chains.[14] This was a variation of a concept developed at Johns Hopkins University.[15] On July 30, 2008, an altruistic donor kidney was shipped via commercial airline from Cornell to the University of California, Los Angeles, thus triggering a chain of transplants.[16] The shipment of living donor kidneys, computer-matching software algorithms, and cooperation between transplant centers has enabled long-elaborate chains to be formed.[17]

In carefully screened kidney donors, survival and the risk of end-stage renal disease appear to be similar to those in the general population.[18] However, women who have donated a kidney have a higher risk of gestational hypertension and preeclampsia than matched nondonors with similar indicators of baseline health.[19] Traditionally, the donor procedure has been through a single incision of 47 inches (1018cm), but live donation is being increasingly performed by laparoscopic surgery. This reduces pain and accelerates recovery for the donor. Operative time and complications decreased significantly after a surgeon performed 150 cases. Live donor kidney grafts have higher long-term success rates than those from deceased donors.[20] Since the increase in the use of laparoscopic surgery, the number of live donors has increased. Any advance which leads to a decrease in pain and scarring and swifter recovery has the potential to boost donor numbers. In January 2009, the first all-robotic kidney transplant was performed at Saint Barnabas Medical Center through a two-inch incision. In the following six months, the same team performed eight more robotic-assisted transplants.[21]

In 2004 the FDA approved the Cedars-Sinai High Dose IVIG therapy which reduces the need for the living donor to be the same blood type (ABO compatible) or even a tissue match.[22][23] The therapy reduced the incidence of the recipient's immune system rejecting the donated kidney in highly sensitized patients.[23]

In 2009 at the Johns Hopkins Medical Center, a healthy kidney was removed through the donor's vagina. Vaginal donations promise to speed recovery and reduce scarring.[24] The first donor was chosen as she had previously had a hysterectomy.[25] The extraction was performed using natural orifice transluminal endoscopic surgery, where an endoscope is inserted through an orifice, then through an internal incision, so that there is no external scar. The recent advance of single port laparoscopy requiring only one entry point at the navel is another advance with potential for more frequent use.

In the developing world some people sell their organs illegally. Such people are often in grave poverty[26] or are exploited by salespersons. The people who travel to make use of these kidneys are often known as "transplant tourists." This practice is opposed by a variety of human rights groups, including Organs Watch, a group established by medical anthropologists, which was instrumental in exposing illegal international organ selling rings. These patients may have increased complications owing to poor infection control and lower medical and surgical standards. One surgeon has said that organ trade could be legalized in the UK to prevent such tourism, but this is not seen by the National Kidney Research Fund as the answer to a deficit in donors.[27]

In the illegal black market the donors may not get sufficient after-operation care,[28] the price of a kidney may be above $160,000,[29] middlemen take most of the money, the operation is more dangerous to both the donor and receiver, and the buyer often gets hepatitis or HIV.[30] In legal markets of Iran the price of a kidney is $2,000 to $4,000.[30][31]

An article by Gary Becker and Julio Elias on "Introducing Incentives in the market for Live and Cadaveric Organ Donations"[32] said that a free market could help solve the problem of a scarcity in organ transplants. Their economic modeling was able to estimate the price tag for human kidneys ($15,000) and human livers ($32,000).

Now monetary compensation for organ donors is being legalized in Australia and Singapore too. Kidney disease organizations in both countries have expressed their support.[33][34]

Deceased donors can be divided in two groups:

Although brain-dead (or "beating heart") donors are considered dead, the donor's heart continues to pump and maintain the circulation. This makes it possible for surgeons to start operating while the organs are still being perfused (supplied blood). During the operation, the aorta will be cannulated, after which the donor's blood will be replaced by an ice-cold storage solution, such as UW (Viaspan), HTK, or Perfadex. Depending on which organs are transplanted, more than one solution may be used simultaneously. Due to the temperature of the solution, and since large amounts of cold NaCl-solution are poured over the organs for a rapid cooling, the heart will stop pumping.

"Donation after Cardiac Death" donors are patients who do not meet the brain-dead criteria but, due to the unlikely chance of recovery, have elected via a living will or through family to have support withdrawn. In this procedure, treatment is discontinued (mechanical ventilation is shut off). After a time of death has been pronounced, the patient is rushed to the operating room where the organs are recovered. Storage solution is flushed through the organs. Since the blood is no longer being circulated, coagulation must be prevented with large amounts of anti-coagulation agents such as heparin. Several ethical and procedural guidelines must be followed; most importantly, the organ recovery team should not participate in the patient's care in any manner until after death has been declared.

In general, the donor and recipient should be ABO blood group and crossmatch (HLA antigen) compatible. If a potential living donor is incompatible with their recipient, the donor could be exchange for a compatible kidney. Kidney exchange, also known as "kidney paired donation" or "chains" had recently gained popularity over the past few years.

In an effort to reduce the risk of rejection during incompatible transplantation, ABO-incompatible and densensitization protocols utilizing intravenous immunoglobulin (IVIG) have been developed, with the aim to reduce ABO and HLA antibodies that the recipient may have to the donor.

In the 1980s, experimental protocols were developed for ABO-incompatible transplants using increased immunosuppression and plasmapheresis. Through the 1990s these techniques were improved and an important study of long-term outcomes in Japan was published ([1]). Now, a number of programs around the world are routinely performing ABO-incompatible transplants.[35]

The level of sensitization to donor HLA antigens is determined by performing a panel reactive antibody test on the potential recipient. In the United States, up to 17% of all deceased donor kidney transplants have no HLA mismatch. However, HLA matching is a relatively minor predictor of transplant outcomes. In fact, living non-related donors are now almost as common as living (genetically)-related donors.

In most cases the barely functioning existing kidneys are not removed, as this has been shown to increase the rates of surgical morbidities. Therefore, the kidney is usually placed in a location different from the original kidney, often in the iliac fossa, so it is often necessary to use a different blood supply:

There is disagreement in surgical textbooks regarding which side of the recipients pelvis to use in receiving the transplant. Campbell's Urology (2002) recommends placing the donor kidney in the recipients contralateral side (i.e. a left sided kidney would be transplanted in the recipient's right side) to ensure the renal pelvis and ureter are anterior in the event that future surgeries are required. In an instance where there is doubt over whether there is enough space in the recipients pelvis for the donor's kidney the textbook recommends using the right side because the right side has a wider choice of arteries and veins for reconstruction. Smith's Urology (2004) states that either side of the recipient's pelvis is acceptable, however the right vessels are more horizontal with respect to each other and therefore easier to use in the anastomoses. It is unclear what is meant by the words more horizontal. Glen's Urological Surgery (2004) recommends putting the kidney in the contralateral side in all circumstances. No reason is explicitly put forth; however, one can assume the rationale is similar to that of Campbell'sto ensure that the renal pelvis and ureter are most anterior in the event that future surgical correction becomes necessary.

Occasionally, the kidney is transplanted together with the pancreas. University of Minnesota surgeons Richard Lillehei and William Kelly perform the first successful simultaneous pancreas-kidney transplant in the world in 1966.[36] This is done in patients with diabetes mellitus type 1, in whom the diabetes is due to destruction of the beta cells of the pancreas and in whom the diabetes has caused renal failure (diabetic nephropathy). This is almost always a deceased donor transplant. Only a few living donor (partial) pancreas transplants have been done. For individuals with diabetes and renal failure, the advantages of earlier transplant from a living donor (if available) are far superior to the risks of continued dialysis until a combined kidney and pancreas are available from a deceased donor.[citation needed] A patient can either receive a living kidney followed by a donor pancreas at a later date (PAK, or pancreas-after-kidney) or a combined kidney-pancreas from a donor (SKP, simultaneous kidney-pancreas).

Transplanting just the islet cells from the pancreas is still in the experimental stage, but shows promise. This involves taking a deceased donor pancreas, breaking it down, and extracting the islet cells that make insulin. The cells are then injected through a catheter into the recipient and they generally lodge in the liver. The recipient still needs to take immunosuppressants to avoid rejection, but no surgery is required. Most people need two or three such injections, and many are not completely insulin-free.

The transplant surgery takes about three hours.[37] The donor kidney will be placed in the lower abdomen and its blood vessels connected to arteries and veins in the recipient's body. When this is complete, blood will be allowed to flow through the kidney again. The final step is connecting the ureter from the donor kidney to the bladder. In most cases, the kidney will soon start producing urine.

Depending on its quality, the new kidney usually begins functioning immediately. Living donor kidneys normally require 35 days to reach normal functioning levels, while cadaveric donations stretch that interval to 715 days. Hospital stay is typically for 47 days. If complications arise, additional medications (diuretics) may be administered to help the kidney produce urine.

Immunosuppressant drugs are used to suppress the immune system from rejecting the donor kidney. These medicines must be taken for the rest of the recipient's life. The most common medication regimen today is a mixture of tacrolimus, mycophenolate, and prednisone. Some recipients may instead take ciclosporin, sirolimus, or azathioprine. Ciclosporin, considered a breakthrough immunosuppressive when first discovered in the 1980s, ironically causes nephrotoxicity and can result in iatrogenic damage to the newly transplanted kidney. Blood levels must be monitored closely and if the recipient seems to have declining renal function or proteinuria, a biopsy may be necessary to determine whether this is due to rejection [38][39] or ciclosporin intoxication .

Kidney transplant recipients are discouraged from consuming grapefruit, pomegranate and green tea products. These food products are known to interact with the transplant medications, specifically tacrolimus, cyclosporin and sirolimus; the blood levels of these drugs may be increased, potentially leading to an overdose.[40]

Acute rejection occurs in 1025% of people after transplant during the first 60 days.[citation needed] Rejection does not necessarily mean loss of the organ, but it may necessitate additional treatment and medication adjustments.[41]

Problems after a transplant may include: Post operative complication, bleeding, infection, vascular thrombosis and urinary complications

A patient's age and health condition before transplantation affect the risk of complications. Different transplant centers have different success at managing complications and therefore, complication rates are different from center to center.

The average lifetime for a donated kidney is ten to fifteen years. When a transplant fails, a patient may opt for a second transplant, and may have to return to dialysis for some intermediary time.

Infections due to the immunosuppressant drugs used in people with kidney transplants most commonly occur in mucocutaneous areas (41%), the urinary tract (17%) and the respiratory tract (14%).[43] The most common infective agents are bacterial (46%), viral (41%), fungal (13%), and protozoan (1%).[43] Of the viral illnesses, the most common agents are human cytomegalovirus (31.5%), herpes simplex (23.4%), and herpes zoster (23.4%).[43] Infection is the cause of death in about one third of people with renal transplants, and pneumonias account for 50% of the patient deaths from infection.[43]

Kidney transplantation is a life-extending procedure.[44] The typical patient will live 10 to 15 years longer with a kidney transplant than if kept on dialysis.[45] The increase in longevity is greater for younger patients, but even 75-year-old recipients (the oldest group for which there is data) gain an average four more years of life. People generally have more energy, a less restricted diet, and fewer complications with a kidney transplant than if they stay on conventional dialysis.

Some studies seem to suggest that the longer a patient is on dialysis before the transplant, the less time the kidney will last. It is not clear why this occurs, but it underscores the need for rapid referral to a transplant program. Ideally, a kidney transplant should be preemptive, i.e., take place before the patient begins dialysis. The reason why kidneys fail over time after transplantation has been elucidated in recent years. Apart from recurrence of the original kidney disease, also rejection (mainly antibody-mediated rejection) and progressive scarring (multifactorial) play a decisive role.[46] Avoiding rejection by strict medication adherence is of utmost importance to avoid failure of the kidney transplant.

At least four professional athletes have made a comeback to their sport after receiving a transplant: New Zealand rugby union player Jonah Lomu, German-Croatian Soccer Player Ivan Klasni, and NBA basketballers Sean Elliott and Alonzo Mourning.[citation needed]

In addition to nationality, transplantation rates differ based on race, sex, and income. A study done with patients beginning long-term dialysis showed that the sociodemographic barriers to renal transplantation present themselves even before patients are on the transplant list.[53] For example, different groups express definite interest and complete pretransplant workup at different rates. Previous efforts to create fair transplantation policies had focused on patients currently on the transplantation waiting list.

Transplant recipients must take immunosuppressive anti-rejection drugs for as long as the transplanted kidney functions. For the routine immunosuppressives Prograf, Cellcept, and prednisone, these drugs cost US$1,500 per month. In 1999 the United States Congress passed a law that restricts Medicare from paying for more than three years for these drugs, unless the patient is otherwise Medicare-eligible. Transplant programs may not transplant a patient unless the patient has a reasonable plan to pay for medication after the Medicare expires; however, patients are almost never turned down for financial reasons alone. Half of end-stage renal disease patients only have Medicare coverage.

In March 2009 a bill was introduced in the U.S. Senate, 565 and in the House, H.R. 1458 that will extend Medicare coverage of the drugs for as long as the patient has a functioning transplant. This means that patients who have lost their jobs and insurance will not also lose their kidney and be forced back on dialysis. Dialysis is currently using up $17 billion yearly of Medicare funds and total care of these patients amounts to over 10% of the entire Medicare budget.

The United Network for Organ Sharing, which oversees the organ transplants in the United States, allows transplant candidates to register at two or more transplant centers, a practice known as "multiple listing."[54] The practice has been shown to be effective in mitigating the dramatic geographic disparity in the waiting time for organ transplants,[55] particularly for patients residing in high-demand regions such as Boston.[56] The practice of multiple-listing has also been endorsed by medical practitioners.[57][58]

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Gene therapy – PBS

October 24th, 2015 3:44 pm

A treatment for Cystic Fibrosis. A cure for AIDS. The end of cancer. That's what the newspapers promised us in the early 1990's. Gene therapy was the answer to what ailed us. Scientists had at last learned how to insert healthy genes into unhealthy people. And those healthy genes would either replace the bad genes causing diseases like CF, sickle-cell anemia and hemophilia or stimulate the body's own immune system to rid itself of HIV and some forms of cancer. A decade later, none of these treatments have come to fruition and research into gene therapy has become politically unpopular, making clinical trials hard to approve and research dollars hard to come by. But some researchers who are taking a different approach to gene therapy could be on the road to more success than ever before. - - - - - - - - - - - -

Early Promise

Almost as soon as Watson and Crick unwound the double helix in the 1950's, researchers began considering the possibility- and ethics- of gene therapy. The goals were lofty- to fix inherited genetic diseases such as Cystic Fibrosis and hemophilia forever.

Gene therapists planned to isolate the relevant gene in question, prepare good copies of that gene, then deliver them to patients' cells. The hope was that the treated cells would give rise to new generations of healthy cells for the rest of the patient's life. The concept was elegant, but would require decades of research to locate the genes that cause illnesses.

By 1990, it was working in the lab. By inserting healthy genes into cells from CF patients, scientists were able to transmogrify the sick cells as if by magic into healthy cells.

That same year, four-year-old Ashanti DeSilva became the first person in history to receive gene therapy. Dr. W. French Anderson of the National Heart, Lung and Blood Institute and Dr. Michael Blaese and Dr. Kenneth Culver, both of the National Cancer Institute, performed the historic and controversial experiment.

DeSilva suffered from a rare immune disorder known as ADA deficiency that made her vulnerable to even the mildest infections. A single genetic defect- like a typo in a novel- left DeSilva unable to produce an important enzyme. Without that enzyme, DeSilva was likely to die a premature death.

Anderson, Blaese and Culver drew the girl's blood and treated her defective white blood cells with the gene she lacked. The altered cells were then injected back into the girl, where- the scientists hoped- they would produce the enzyme she needed as well as produce future generations of normal cells.

Though the treatment proved safe, its efficacy is still in question. The treated cells did produce the enzyme, but failed to give rise to healthy new cells. DeSilva, who is today relatively healthy, still receives periodic gene therapy to maintain the necessary levels of the enzyme in her blood. She also takes doses of the enzyme itself, in the form of a drug called PEG-ADA, which makes it difficult to tell how well the gene therapy would have worked alone.

"It was a very logical approach," says Dr. Jeffrey Isner, Chief of Vascular Medicine and Cardiovascular Research at St. Elizabeth's Medical Center in Boston as well as Professor of Medicine at Tufts University School of Medicine. "But in most cases the strategy failed, because the vectors we have today are not ready for prime time." - - - - - - - - - - - - 4 pages: | 1 | 2 | 3 | 4 |

Photo: Dr. W. French Anderson

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Breast Augmentation with Autologous Fat and Stem Cells …

October 24th, 2015 3:43 pm

At a Glance

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Breast augmentation with stem cell-enriched autologous fat (cell-assisted lipotransfer (CAL)), enables breast augmentation to be carried out without using silicone or other artificial fillers, without the use of scalpels or general anesthesia, leaving no scars and with no negative effects on the natural breast function.

This procedure is suitable for women who always wanted to have larger breasts and also for those whose original breast volume has decreased, e.g., by breastfeeding or weight loss. Augmentation of around one half up to two cup sizes is usually possible with one intervention.

After an in-depth advice and medical consultation, you can schedule an appointment for surgery at a date of your choice.

Breast augmentation is carried out on an outpatient basis using local anesthesia in our specially-equipped operating rooms. The procedure takes approx. 3 to 4 hours.

We use liposuction to harvest the autologous fat required for obtaining stem cells and the actual breast augmentation. Liposculpture is a special form of liposuction, whereby we extract fat from the bodys fat depots by suction. This method is done by hand and is gentle on the tissue. We never use suction machines or scalpels.

Thin microcannulas with a diameter of 1.0 to 2.5 millimeters are used for liposuction or alternatively, conventional regular cannulas with a diameter of 3.0 millimeters upwards. Experience has shown that microcannulas have to be used on very slim women to harvest sufficient fat.

A part of your autologous fat is used to obtain your own bodys stem cells, which is processed with the remaining body fat in clean room conditions, and injected into your breasts.

Using this stem cell-enriched fat, a considerably longer-lasting result can be achieved than with other methods of autologous fat transfer. In the long term, normally a large part of the volume introduced is retained, which is why one intervention usually suffices.

Aftercare is relatively straightforward: You must wear a bandage overnight and wear compression garments afterwards. If regular cannulas were used, you need to wear the compression garments for 6 to 8 weeks; if liposuction was carried out with microcannulas, usually they have to be worn for 1 week. A sports bra should be worn for approx. 4 weeks.

You usually should be able to go back to work 1 to 2 days after having breast augmentation with stem cell-enriched autologous fat. It is important that you do not lift anything heavy during the first few weeks after surgery. Wear comfortable loose clothing over the compression garments to cover up your little secret.

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The type of sport and your individual healing process determine when you will be able to begin sports again. We will monitor your health during the healing process and give you recommendations tailored to your needs.

The positive results of breast augmentation with autologous stem cells can be seen by their natural appearance and youthful firmness. Since the additional volume consists exclusively of your bodys own material, the augmented breast feels absolutely real and looks natural in any posture, whether you are at rest or moving. Additionally, the local rejuvenating effect of the stem cells often gives the breasts a younger, firmer and more toned appearance.

Breast augmentation of approx. one half up to two cup sizes can be achieved with one intervention. Augmentations of around one cup size are typical. The punctures on the breast made by injection needles almost always heal with scars invisible to the naked eye, just as when blood samples are taken.

After breast augmentation with stem cell-enriched autologous fat, normally a large part of the new breast volume is retained for years. Refreshments are therefore mostly unnecessary.

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Diabetes and Endocrinology | Diabetes Center St Louis …

October 24th, 2015 12:45 pm

Barnes-Jewish & Washington University Diabetes Center The Washington University Diabetes Center at Barnes-Jewish Hospital is designed to offer an easier way to a better life. The Diabetes Center is an American Diabetes Association nationally recognized quality education program.

The comprehensive Diabetes Center is unique in the region, offering the latest in treatment and technology for patients with diabetes. This treatment includes convenient access to essential services including:

Patients have access to leading-edge treatment for even the most complicated cases. With a comprehensive, one-stop location for diabetes care, patients are better able to manage their symptoms from diabetes, and possibly avoid potential complications from uncontrolled blood sugar levels.

Through the Diabetes Center, patients with diabetes throughout the Midwest can access the latest advancements in diabetes treatment and a comprehensive range of services in one convenient setting. The Diabetes Center's focus is on making treatment fit your life so your diabetes is easier for you to manage.

With the multi-specialty team of the Diabetes Center working together, patients enjoy an improved quality and depth of diabetes-related medical treatment. The Diabetes Center, located on the 13th floor of the Center for Advanced Medicine at Barnes-Jewish Hospital, serves as a meaningful resource for patients, their families and their referring physicians. In partnership with referring physicians, the Diabetes Center team of specialists help patients manage complex cases or complications to those newly diagnosed.

The well-planned, comfortable Diabetes Center includes private and group education rooms, as well as a foot care area with a specially designed chair for exams and treatment. We have even designed wider doorways and larger exam tables to ensure your comfort. Our team takes the time to thoroughly evaluate you and provide the individual attention you deserve.

As you know, diabetes is a complex disease. It is progressive and can affect every part of your body in some way. At the Diabetes Center, you'll benefit from physicians and staff who specialize in diabetes and understand its many facets. The Center will make it easier to manage your disease.

The Diabetes Center enables specialists to work closely together sharing information and collaborating so all your medical and medication needs are addressed. The bottom line is you receive more effective diabetes management.

The Diabetes Center's team includes top-ranked endocrinologists (diabetes specialists) and disease-related specialists, including:

In addition, the team includes diabetes nurse practitioners, certified diabetes nurse educators, registered dietitians and a certified foot nurse. Our medical assistants are all trained to provide a high level of support to our diabetes patients. The team works closely with you and your primary care physician to create an individualized treatment plan. Ultimately, the team is committed to empower you to control your diabetes.

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Texas Gov. Rick Perry Received Experimental Stem Cell …

October 23rd, 2015 7:50 pm

Texas Gov. Rick Perry, a potential presidential candidate, underwent spinal fusion surgery in early July that included an injection of his own stem cells, a therapy that is unapproved by the FDA and costs tens of thousands of dollars.

While the Texas governor supports adult stem cell research, he is an opponent of embryonic stem cell research, a position held by the social conservative base.

As first reported by the Texas Tribune, Perry's surgery included "the innovative use of his own adult stem cells" and any cost not covered by health insurance was paid for by Perry, according to his spokesman Mark Miner.

The stem cell treatment was the doctor's first attempt at the surgery ever, and the lab responsible for culturing Perry's stem cells is a branch of a South Korean company that has become known for commercialized dog cloning, "regenerative" beauty products, and accusations of conducting "stem cell tourism."

According to the Texas Tribune, Dr. Stanley Jones, a Houston orthopedic surgeon and personal friend of Perry, removed two teaspoons of fatty tissue from the governor's hip and placed it in a culture, waiting several weeks before the stem cells expanded. Jones later injected the stem cells into the governor's spine and into his blood stream to help speed up the healing process.

On the day of his surgery, Perry tweeted, "Little procedure went as advertised. Blessed to be married to the world's best nurse. Thanks for all the prayers!!"

Perry has been a strong proponent of adult stem cell research, even urging the Texas Medical Board to consider enhancing the state's position on adult stem cell research. In his 2009 State of the State address, Perry called for greater investment in the adult stem cell industry.

"Let's get Texas in on the ground floor and invest in adult stem cell research, the one area of that field that is actually proven to expedite cures," Perry said. "Expertise in this emerging and increasingly promising field will not only bring healing to the suffering and create jobs for Texans, it will also establish an appropriate firewall protecting the unborn from exploitation."

However, Perry opposes any form of embryonic stem cell research, a position that resonates with the social conservatives in the GOP. Perry's 2010 gubernatorial campaign website touts his support for banning embryonic stem cell research, a position held by a majority of the social conservative base.

"Gov. Perry supports a ban on human cloning and has vowed to veto any legislation that provides state dollars for embryonic stem cell research," the website reads. "He has been a strong advocate of utilizing adult stem cells in their place. Adult stem cell research can provide much-needed solutions for Texans suffering from various tissue and organ disorders while protecting the unborn from exploitation. They are also proven more effective in research than embryonic stem cells."

The Family Research Council, which opposes embryonic stem cell research, said Perry's use of adult stem cell therapy will reinforce the success of adult stem cells and will show embryonic stem cell therapy is not needed.

"We're actually very pleased that Gov. Perry would make public the fact that he used his own adult stem cells as part of this surgery to assist the healing process," Dr. David Prentice, senior fellow for life sciences at the Family Research Council, told ABC News. "People see that you don't need or want embryonic stem cells. You want, instead, those cells that work. Adult stem cells are ethical, but they're successful and they're working for thousands of patients right now, including, apparently, Gov. Perry."

But the Genetics Policy Institute, a public interest organization that supports all forms of stem cell research, warned that Perry should use his experimental therapy as an educational moment about consumer fraud in the stem cell field.

"As a public figure that availed himself of an experimental treatment, it behooves him to release to the public enough details about it to know that the treatment was legitimate," Bernard Siegel, executive director of the Genetics Policy Institute, told ABC News. "He needs to be aware of the consumer fraud that's out there and people who are desperate patients being lured to clinics, many of them abroad, that are selling snake oil and using the label stem cell to bring people in."

Last week, a federal judge threw out a lawsuit challenging the use of federal funding for embryonic stem cell research.

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Cancer stem cell – Wikipedia, the free encyclopedia

October 23rd, 2015 7:49 pm

Cancer stem cells (CSCs) are cancer cells (found within tumors or hematological cancers) that possess characteristics associated with normal stem cells, specifically the ability to give rise to all cell types found in a particular cancer sample. CSCs are therefore tumorigenic (tumor-forming), perhaps in contrast to other non-tumorigenic cancer cells. CSCs may generate tumors through the stem cell processes of self-renewal and differentiation into multiple cell types. Such cells are hypothesized to persist in tumors as a distinct population and cause relapse and metastasis by giving rise to new tumors. Therefore, development of specific therapies targeted at CSCs holds hope for improvement of survival and quality of life of cancer patients, especially for patients with metastatic disease.

Existing cancer treatments have mostly been developed based on animal models, where therapies able to promote tumor shrinkage were deemed effective. However, animals do not provide a complete model of human disease. In particular, in mice, whose life spans do not exceed two years, tumor relapse is difficult to study.

The efficacy of cancer treatments is, in the initial stages of testing, often measured by the ablation fraction of tumor mass (fractional kill). As CSCs form a small proportion of the tumor, this may not necessarily select for drugs that act specifically on the stem cells. The theory suggests that conventional chemotherapies kill differentiated or differentiating cells, which form the bulk of the tumor but do not generate new cells. A population of CSCs, which gave rise to it, could remain untouched and cause relapse.

Cancer stem cells were first identified by John Dick in acute myeloid leukemia in the late 1990s. Since the early 2000s they have been an intense focus of cancer research[1]

In different tumor subtypes, cells within the tumor population exhibit functional heterogeneity, and tumors are formed from cells with various proliferative and differentiate capacities.[2] This functional tumour heterogeneity among cancer cells has led to the creation of at least two models, which have been put forward to account for heterogeneity and differences in tumor-regenerative capacity: the cancer stem cell (CSC) and clonal evolution models[3]

The cancer stem cell model refers to a subset of tumor cells that have the ability to self-renew and are able to generate the diverse tumor cells.[3] These cells have been termed cancer stem cells to reflect their stem-like properties. One implication of the CSC model and the existence of CSCs is that the tumor population is hierarchically arranged with CSCs lying at the apex of the hierarchy[4] (Fig. 3).

The clonal evolution model postulates that mutant tumor cells with a growth advantage are selected and expanded. Cells in the dominant population have a similar potential for initiating tumor growth[5] (Fig. 4).

[6] These two models are not mutually exclusive, as CSCs themselves undergo clonal evolution. Thus, the secondary more dominant CSCs may emerge, if a mutation confers more aggressive properties[7] (Fig. 5).

The existence of CSCs is a subject of debate within medical research, because many studies have not been successful in discovering the similarities and differences between normal tissue stem cells and cancer (stem) cells.[8] Cancer cells must be capable of continuous proliferation and self-renewal in order to retain the many mutations required for carcinogenesis, and to sustain the growth of a tumor since differentiated cells (constrained by the Hayflick Limit[9]) cannot divide indefinitely. However, it is debated whether such cells represent a minority. If most cells of the tumor are endowed with stem cell properties, there is no incentive to focus on a specific subpopulation. There is also debate on the cell of origin of CSCs - whether they originate from normal stem cells that have lost the ability to regulate proliferation, or from more differentiated population of progenitor cells that have acquired abilities to self-renew (which is related to the issue of stem cell plasticity).

The first conclusive evidence for CSCs was published in 1997 in Nature Medicine. Bonnet and Dick[10] isolated a subpopulation of leukaemic cells that expressed a specific surface marker CD34, but lacked the CD38 marker. The authors established that the CD34+/CD38 subpopulation is capable of initiating tumors in NOD/SCID mice that are histologically similar to the donor. The first evidence of a solid tumor cancer stem-like cell followed in 2002 with the discovery of a clonogenic, sphere-forming cell isolated and characterized from human brain gliomas [Human cortical glial tumors contain neural stem-like cells expressing astroglial and neuronal markers in vitro.[11]

In cancer research experiments, tumor cells are sometimes injected into an experimental animal to establish a tumor. Disease progression is then followed in time and novel drugs can be tested for their ability to inhibit it. However, efficient tumor formation requires thousands or tens of thousands of cells to be introduced. Classically, this has been explained by poor methodology (i.e. the tumor cells lose their viability during transfer) or the critical importance of the microenvironment, the particular biochemical surroundings of the injected cells. Supporters of the CSC paradigm argue that only a small fraction of the injected cells, the CSCs, have the potential to generate a tumor. In human acute myeloid leukemia the frequency of these cells is less than 1 in 10,000.[10]

Further evidence comes from histology, the study of the tissue structure of tumors. Many tumors are very heterogeneous and contain multiple cell types native to the host organ. Heterogeneity is commonly retained by tumor metastases. This implies that the cell that produced them had the capacity to generate multiple cell types. In other words, it possessed multidifferentiative potential, a classical hallmark of stem cells.[10]

The existence of leukaemic stem cells prompted further research into other types of cancer. CSCs have recently been identified in several solid tumors, including cancers of the:

Once the pathways to cancer are hypothesized, it is possible to develop predictive mathematical biology models,[29] e.g., based on the cell compartment method. For instance, the growths of the abnormal cells from their normal counterparts can be denoted with specific mutation probabilities. Such a model has been employed to predict that repeated insult to mature cells increases the formation of abnormal progeny, and hence the risk of cancer.[30] Considerable work needs to be done, however, before the clinical efficacy of such models[31] is established.

The origin of cancer stem cells is still an area of ongoing research. Several camps have formed within the scientific community regarding the issue, and it is possible that several answers are correct, depending on the tumor type and the phenotype the tumor presents. One important distinction that will often be raised is that the cell of origin for a tumor can not be demonstrated using the cancer stem cell as a model. This is because cancer stem cells are isolated from end-stage tumors. Therefore, describing a cancer stem cell as a cell of origin is often an inaccurate claim, even though a cancer stem cell is capable of initiating new tumor formation.

With that caveat mentioned, various theories define the origin of cancer stem cells. In brief, CSC can be generated as: mutants in developing stem or progenitor cells, mutants in adult stem cells or adult progenitor cells, or mutant differentiated cells that acquire stem-like attributes. These theories often do focus on a tumor's cell of origin and as such must be approached with skepticism.

Some researchers favor the theory that the cancer stem cell is generated by a mutation in stem cell niche populations during development. The logical progression claims that these developing stem populations are mutated and then expand such that the mutation is shared by many of the descendants of the mutated stem cell. These daughter stem cells are then much closer to becoming tumors, and since there are many of them there is more chance of a mutation that can cause cancer.[32]

Another theory associates adult stem cells with the formation of tumors. This is most often associated with tissues with a high rate of cell turnover (such as the skin or gut). In these tissues, it has long been expected that stem cells are responsible for tumor formation. This is a consequence of the frequent cell divisions of these stem cells (compared to most adult stem cells) in conjunction with the extremely long lifespan of adult stem cells. This combination creates the ideal set of circumstances for mutations to accumulate; accumulation of mutations is the primary factor that drives cancer initiation. In spite of the logical backing of the theory, only recently has any evidence appeared showing association represents an actual phenomenon. It is important to bear in mind that due to the heterogeneous nature of evidence it is possible that any individual cancer could come from an alternative origin. Recent evidence supports the idea that cancer stem cells, and cancer, arise from normal stem cells.[33][34]

A third possibility often raised is the potential de-differentiation of mutated cells such that these cells acquire stem cell like characteristics. This is often used as a potential alternative to any specific cell of origin, as it suggests that any cell might become a cancer stem cell.

Another related concept is the concept of tumor hierarchy. This concept claims that a tumor is a heterogeneous population of mutant cells, all of which share some mutations but vary in specific phenotype. In this model, the tumor is made up of several types of stem cells, one optimal to the specific environment and several less successful lines. These secondary lines can become more successful in some environments, allowing the tumor to adapt to its environment, including adaptation to tumor treatment. If this situation is accurate, it has severe repercussions on cancer stem cell specific treatment regime.[35] Within a tumor hierarchy model, it would be extremely difficult to pinpoint the cancer stem cell's origin.

CSC, now reported in most human tumors, are commonly identified and enriched using strategies for identifying normal stem cells that are similar across various studies.[36] The procedures include fluorescence-activated cell sorting (FACS), with antibodies directed at cell-surface markers, and functional approaches including SP analysis (side population assay) or Aldefluor assay.[37] The CSC-enriched population purified by these approaches is then implanted, at various cell doses, in immune-deficient mice to assess its tumor development capacity. This in vivo assay is called limiting dilution assay. The tumor cell subsets that can initiate tumor development at low cell numbers are further tested for self-renewal capacity in serial tumor studies.[38]

CSC can also be identified by efflux of incorporated Hoechst dyes via multidrug resistance (MDR) and ATP-binding cassette (ABC) Transporters.[37]

Another approach which has also been used for identification of cell subsets enriched with CSCs in vitro is sphere-forming assays. Many normal stem cells such as hematopoietics or stem cells from tissues are capable, under special culture conditions, to form three-dimensional spheres, which can differentiate into multiple cell types. As with normal stem cells, the CSCs isolated from brain or prostate tumors also have the ability to form anchorage-independent spheres.[39]

Data over recent years have indicated the existence of CSCs in various solid tumors. For isolating CSCs from solid and hematological tumors, markers specific for normal stem cells of the same organ are commonly used. Nevertheless, a number of cell surface markers have proved useful for isolation of subsets enriched for CSC including CD133 (also known as PROM1), CD44, CD24, EpCAM (epithelial cell adhesion molecule, also known as epithelial specific antigen, ESA), THY1, ATP-binding cassette B5 (ABCB5).,[40] and CD200.

CD133 (prominin 1) is a five-transmembrane domain glycoprotein expressed on CD34+ stem and progenitor cells, in endothelial precursors and fetal neural stem cells. It has been detected using its glycosylated epitope known as AC133.

EpCAM (epithelial cell adhesion molecule, ESA, TROP1) is hemophilic Ca2+-independent cell adhesion molecule expressed on the basolateral surface of most Epithelial cells.

CD90 (THY1) is a glycosylphosphatidylinositol glycoprotein anchored in the plasma membrane and involved in signal transduction. It may also mediate adhesion between thymocytes and thymic stroma.

CD44 (PGP1) is an adhesion molecule that has pleiotropic roles in cell signaling, migration and homing. It has multiple isoforms, including CD44H, which exhibits high affinity for hyaluronate, and CD44V which has metastatic properties.

CD24 (HSA) is a glycosylated glycosylphosphatidylinositol-anchored adhesion molecule, which has co-stimulatory role in B and T cells.

CD200 (OX-2) is a type 1 membrane glycoprotein, which delivers an inhibitory signal to immune cells including T cells, NK cells and macrophages.

ALDH is a ubiquitous aldehyde dehydrogenase family of enzymes, which catalyzes the oxidation of aromatic aldehydes to carboxyl acids. For instance, it has role in conversion of retinol to retinoic acid, which is essential for survival.[41][42]

The first solid malignancy from which CSCs were isolated and identified was breast cancer. Therefore, these CSCs are the most intensely studied. Breast CSCs have been enriched in CD44+CD24/low,[40] SP,[43]ALDH+ subpopulations.[44][45] However, recent evidence indicates that breast CSCs are very phenotypically diverse, and there is evidence that not only CSC marker expression in breast cancer cells is heterogeneous but also there exist many subsets of breast CSC.[46] Last studies provide further support to this point. Both CD44+CD24 and CD44+CD24+ cell populations are tumor initiating cells; however, CSC are most highly enriched using the marker profile CD44+CD49fhiCD133/2hi.[47]

CSCs have been reported in many brain tumors. Stem-like tumor cells have been identified using cell surface markers including CD133,[48]SSEA-1 (stage-specific embryonic antigen-1),[49]EGFR[50] and CD44.[51] However, there is uncertainty about the use of CD133 for identification of brain tumor stem-like cells because tumorigenic cells are found in both CD133+ and CD133 cells in some gliomas, and some CD133+ brain tumor cells may not possess tumor-initiating capacity.[50]

Similarly, CSCs have also been reported in human colon cancer.[52] For their identification, cell surface markers such as CD133,[52] CD44[53] and ABCB5,[54] or functional analysis including clonal analysis [55] or Aldefluor assay were used.[56] Using CD133 as a positive marker for colon CSCs has generated conflicting results. Nevertheless, recent studies indicated that the AC133 epitope, but not the CD133 protein, is specifically expressed in colon CSCs and its expression is lost upon differentiation.[57] In addition, using CD44+ colon cancer cells and additional sub-fractionation of CD44+EpCAM+ cell population with CD166 enhance the success of tumor engraftments.[53]

Multiple CSCs have been reported in prostate,[58]lung and many other organs, including liver, pancreas, kidney or ovary.[41][59] In prostate cancer, the tumor-initiating cells have been identified in CD44+[60] cell subset as CD44+21+,[61] TRA-1-60+CD151+CD166+[62] or ALDH+[63] cell populations. Putative markers for lung CSCs have been reported, including CD133+,[64] ALDH+,[65] CD44+[66] and oncofetal protein 5T4+.[67]

Metastasis is the major cause of tumor lethality in patients. However, not every cell in the tumor has the ability to metastasize. This potential depends on factors that determine growth, angiogenesis, invasion and other basic processes of tumor cells. In the many epithelial tumors, the epithelial-mesenchymal transition (EMT) is considered as a crucial events in the metastatic process.[68] EMT and the reverse transition from mesenchymal to an epithelial phenotype (MET) are involved in embryonic development, which involves disruption of epithelial cell homeostasis and the acquisition of a migratory mesenchymal phenotype.[69] The EMT appears to be controlled by canonical pathways such as WNT and transforming growth factor pathway.[70] The important feature of EMT is the loss of membrane E-cadherin in adherens junctions, where the -catenin may play a significant role. Translocation of -catenin from adherens junctions to the nucleus may lead to a loss of E-cadherin, and subsequently to EMT. There is evidence that nuclear -catenin can directly transcriptionally activate EMT-associated target genes, such as the E-cadherin gene repressor SLUG (also known as SNAI2).[71]

Recent data have supported the concept, that tumor cells undergoing an EMT could be precursors for metastatic cancer cells, or even metastatic CSCs.[72] In the invasive edge of pancreatic carcinoma a subset of CD133+CXCR4+ (receptor for CXCL12 chemokine also known as a SDF1 ligand) cells has been defined. These cells exhibited significantly stronger migratory activity than their counterpart CD133+CXCR4 cells, but both cell subsets showed similar tumor development capacity.[73] Moreover, inhibition of the CXCR4 receptor led to the reduced metastatic potential without altering tumorigenic capacity.[74]

On the other hand, in the breast cancer CD44+CD24/low cells are detectable in metastatic pleural effusions.[40] By contrast, an increased number of CD24+ cells have been identified in distant metastases in patients with breast cancer.[75] Although, there are only few data on mechanisms mediating metastasis in breast cancer, it is possible that CD44+CD24/low cells initially metastasize and in the new site they change their phenotype and undergo limited differentiation.[76] These findings led to new dynamic two-phase expression pattern concept based on the existence of two forms of cancer stem cells - stationary cancer stem cells (SCS) and mobile cancer stem cells (MCS). SCS are embedded in tissue and persist in differentiated areas throughout all tumor progression. The term MCS describes cells that are located at the tumor-host interface. There is an evidence that these cells are derived from SCS through the acquisition of transient EMT [77] (Fig. 7)

The existence of CSCs has several implications in terms of future cancer treatment and therapies. These include disease identification, selective drug targets, prevention of metastasis, and development of new intervention strategies.

Normal somatic stem cells are naturally resistant to chemotherapeutic agents. They produce various pumps (such as MDR[citation needed]) that pump out drugs and DNA repair proteins and they also have a slow rate of cell turnover (chemotherapeutic agents naturally target rapidly replicating cells)[citation needed]. CSCs that develop from normal stem cells may also produce these proteins, which could increase their resistance towards chemotherapeutic agents. The surviving CSCs then repopulate the tumor, causing a relapse.[78] By selectively targeting CSCs, it would be possible to treat patients with aggressive, non-resectable tumors, as well as preventing patients from metastasizing and relapsing.[78] The hypothesis suggests that upon CSC elimination, cancer could regress due to differentiation and/or cell death[citation needed]. What fraction of tumor cells are CSCs and therefore need to be eliminated is not clear yet.[79]

A number of studies have investigated the possibility of identifying specific markers that may distinguish CSCs from the bulk of the tumor (as well as from normal stem cells).[13] Proteomic and genomic signatures of tumors are also being investigated.[80][citation needed]. In 2009, scientists identified one compound, Salinomycin, that selectively reduces the proportion of breast CSCs in mice by more than 100-fold relative to Paclitaxel, a commonly used chemotherapeutic agent.[81] Some types of cancer cells can survive treatment with salinomycin through autophagy,[82] whereby cells use acidic organelles like lysosomes, to degrade and recycle certain types of proteins. The use of autophagy inhibitors can enable killing of cancer stem cells that survive by autophagy.[83]

The cell surface receptor interleukin-3 receptor-alpha (CD123) was shown to be overexpressed on CD34+CD38- leukemic stem cells (LSCs) in acute myelogenous leukemia (AML) but not on normal CD34+CD38- bone marrow cells.[84] Jin et al., then demonstrated that treating AML-engrafted NOD/SCID mice with a CD123-specific monoclonal antibody impaired LSCs homing to the bone marrow and reduced overall AML cell repopulation including the proportion of LSCs in secondary mouse recipients.[85]

The design of new drugs for the treatment of CSCs will likely require an understanding of the cellular mechanisms that regulate cell proliferation. The first advances in this area were made with hematopoietic stem cells (HSCs) and their transformed counterparts in leukemia, the disease for which the origin of CSCs is best understood. It is now becoming increasingly clear that stem cells of many organs share the same cellular pathways as leukemia-derived HSCs.

Additionally, a normal stem cell may be transformed into a cancer stem cell through disregulation of the proliferation and differentiation pathways controlling it or by inducing oncoprotein activity.

The Polycomb group transcriptional repressor Bmi-1 was discovered as a common oncogene activated in lymphoma[86] and later shown to specifically regulate HSCs.[87] The role of Bmi-1 has also been illustrated in neural stem cells.[88] The pathway appears to be active in CSCs of pediatric brain tumors.[89]

The Notch pathway has been known to developmental biologists for decades. Its role in control of stem cell proliferation has now been demonstrated for several cell types including hematopoietic, neural and mammary[90] stem cells. Components of the Notch pathway have been proposed to act as oncogenes in mammary[91] and other tumors.

A particular branch of the Notch signaling pathway that involves the transcription factor Hes3 has been shown to regulate a number of cultured cells with cancer stem cell characteristics obtained from glioblastoma patients.[92]

These developmental pathways are also strongly implicated as stem cell regulators.[93] Both Sonic hedgehog (SHH) and Wnt pathways are commonly hyperactivated in tumors and are required to sustain tumor growth. However, the Gli transcription factors that are regulated by SHH take their name from gliomas, where they are commonly expressed at high levels. A degree of crosstalk exists between the two pathways and their activation commonly goes hand-in-hand.[94] This is a trend rather than a rule. For instance, in colon cancer hedgehog signalling appears to antagonise Wnt.[95]

Sonic hedgehog blockers are available, such as cyclopamine. There is also a new water-soluble cyclopamine that may be more effective in cancer treatment. There is also DMAPT, a water-soluble derivative of parthenolide (induces oxidative stress, inhibits NF-B signaling[96]) for AML (leukemia), and possibly myeloma and prostate cancer. A clinical trial of DMAPT is to start in England in late 2007 or 2008[citation needed]. Finally, the enzyme telomerase may qualify as a study subject in CSC physiology.[97] GRN163L (Imetelstat) was recently started in trials to target myeloma stem cells. If it is possible to eliminate the cancer stem cell, then a potential cure may be achieved if there are no more CSCs to repopulate a cancer.

The monolayer of CSCs grown as spheroids showed better growth rate than the MDA-MB 231 cells, which shows the efficacy of 3D spheroid format of growing CSCs. CD44 show increased expression in spheroids compared to 2D culture of MDA-MB 231. ALDH1 a key marker of breast stem cells was highly expressed in BCSCs and MDA-MB 231 grown in 3D, while being absent in CSCs and MDA-MB 231 cells grown in 2D.

The CSCs grown as spheroids showed better growth rate, which showed the efficacy of 3D spheroid format for CSCs culture. Since the association between BCSCs prevalence and clinical outcome and the evidence presented in this study support key roles of CSCs in breast cancer metastasis and drug resistance, it has been proposed that new therapies must target these cells[98]

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Department of Microbiology and Molecular Genetics at the …

October 23rd, 2015 7:47 pm

Whether you're seeking a B.S. or a Ph.D. in Microbiology or Molecular Genetics, you'll find our department has broad research strengths ranging from molecular, structural, and computational biology to cellular and pathogenic microbiology. You will have access to a rich course curriculum and research laboratories where experienced and supportive faculty will guide your research and help you sharpen your scientific communication skills.

Our research addresses fundamental questions in eukaryotic and prokaryotic cell and molecular biology, using the methods of microbiology, genetics, biochemistry, bioinformatics, and structural biology. This work bears directly on crucial health-related problems such as cancer, AIDS, and infectious disease. Outstanding institutional core facilities provide access to the latest research technologies. The highly collaborative culture of the department is fostered by cross-departmental meetings and journal clubs on a variety of interdisciplinary topics, including DNA repair, parasitology and microbial pathogenesis, and by cross-college consortia such as the Vermont Center for Immunobiology and Infectious Disease. Learn More

The collaborative and interdisciplinary nature of our research programs means that a prospective graduate student is offered a wide choice of research opportunities. While all of our students take the same core curriculum, in their second year they choose to specialize in one of four advanced concentration areas. Our alumni have gone on to become university professors, journal editors and senior scientists and executives in the biotechnology industry. UVM is located in Burlington VT, consistently ranked one of the best places to live in the USA. Learn more

Unique opportunities await students majoring in Microbiology or Molecular Genetics at UVM. Our program is small, which permits our faculty to give each student the individual attention necessary to help them succeed. Our lecture and cutting-edge laboratory courses are challenging and provide each student with a strong foundation and the confidence to work at the bench. The flexibility of our curriculum is such that students can get credit for summer internships or for performing research in one of the many labs at UVM. Small classes foster long lasting camaraderie among our students: MMG'ers are quick to support each other, suggest study tips or point out where to find the best pizza. A student in MMG is never a face in the crowd; our students receive one-on-one mentoring and more often than not end up achieving more than they thought they could. Learn more

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