D-I-Y Therapy

STEM cell therapy might be the most glamorous treatment technique of the day, but it8217;s also the most controversial. A small-time Delhi clinic recently exemplified the dangers by claiming to have used the therapy to treat 100 people8212;including high-profile politico Ajit Jogi8212;but carefully overlooked the fact that the government is yet to clear such treatment.

What are stem cells?
Simply put, these are unspecialised cells that have the unique capacity to renew themselves through cell division. They are present at various sites in the human body. Recent research suggests human stem cells can develop into many different kinds of cells, like the blood-pumping cells of the heart or the insulin-secreting cells of the pancreas. It follows that they are key to major healthcare advances, since new cells could potentially replace damaged cells anywhere in the body.

How many kinds are there?
Depending on their source and function, scientists distinguish between adult stem cells, cord blood stem cells, foetal stem cells and embryonic stem cells. Each comes with its own baggage.

ADULT STEM CELLS
Derived from adult cells like bone marrow or blood cells, they have been used in medicine for more than a decade. Recently, doctors at AIIMS, New Delhi, derived stem cells from blood as well. Stem cells in adult tissue are often multipotent and can produce many but not all types of cells.

Ethical issues According to the Indian Council of Medical Research ICMR, there are no ethical issues with the use of adult stem cells. However, all centres offering the treatment need to be registered with the government. 8216;8216;Inter-nationally, autologous adult stem cells don8217;t evoke ethical concerns,8217;8217; says Dr Aarti Vij of the AIIMS Stem Cell facility.

CORD BLOOD STEM CELLS
Obtained from umbilical cord blood, they have worked successfully in reconstituting bone marrow in children and also in blood cancers. Obviously, the cord blood has to be stored shortly after birth for the benefits. At present, only the Reliance Life Sciences lab in Mumbai offers the banking facility; AIIMS has plans to launch its own bank soon.

Ethical issues First, ICMR wants scientists to ensure there is no threat to the newborn. 8216;8216;The mother8217;s consent is essential before cord blood is collected,8217;8217; says Dr Vij. Also, all new parents need to be informed of the risk of not storing the cord blood.

FOETAL STEM CELLS

Culled from aborted foetuses, these cells are multipotent and can develop into many kinds of tissues once injected into a human body. They can be multiplied and maintained in labs.

Ethical issues Since abortion is not illegal in India, these stem cells do not raise as many issues here as abroad. However, the government wants to make sure pregnancies aren8217;t aborted to obtain stem cells. At this point, foetal stem cells can only be used for research; the ICMR does not allow their use for treatment.

EMBRYONIC STEM CELLS
Potentially the most vital and already the most controversial. Obtained from a new embryo within five to seven days of conception, these cells have the potential to develop into any kind of human tissue once injected in a like area. Hypothetically, they can treat Parkinson8217;s disease, Alzheimer8217;s, leukaemia, multiple sclerosis, spinal cord injuries, burns, cancers8212;anything that originates in tissue damage.

Ethical issues 8216;8216;Scientists say these cells are expected to provide an unlimited supply of tissues and organs for transplantation. But a lot of basic research is necessary before this step is reached,8217;8217; says Dr Vij. Also, abortion is an issue. The ICMR has barred treatment with these stem cells; no pregnancy can be aborted for research either.

So there are lots of grey areas. What are the dangers?
Not every doctor is capable of culling stem cells and treating conditions with them. While the ICMR and AIIMS are approaching the subject with caution, many clinics may claim to have used stem cell therapy for miracle cures in hopeless cases.