Chapter 8: CARDIOVASCULAR TISSUE MODIFICATION BY GENETIC APPROACHES STEM CELL BIOLOGY
Recently, pluripotent human stem cells have been discovered or derived from human embryos.92 These stem cells have the potential to differentiate into any kind of cell and thus may be used to treat or cure many diseases, including heart disease, diabetes, Parkinson's disease, Alzheimer's disease, and others.93 There are two types of stem cells: embryonic and adult stem cells. Embryonic stem (ES) cells have not become differentiated and hence are pluripotent. Adult stem cells have undergone differentiation, and their potential to regenerate damaged tissue is limited. There is controversy surrounding stem cell research with regard to funding for the derivation of human embryonic stem cells and for research on ES cells once derived.
The following scenario could be envisioned. ES cells are derived by culturing a several-day-old human embryo or blastocyst. The trophoblast will form the placenta, while the inner cell mass will form the embryo. The inner cell mass is isolated. This tissue contains ES cells that have the potential to differentiate into any kind of tissue. The ES cells are cultured in media to grow colonies of cells. Special factors can be applied to encourage differentiation. Subpopulations of cells can be separated, i.e., bone marrow cells, cardiac myocytes, neurons, etc. The differentiated cells are then engineered to be an immunologic match with the patient and then can be administered. For example, ES cells that have differentiated into cardiac myocytes can be injected into a patient having sustained a myocardial infarction or heart failure.
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