JEDDAH, 29 October 2006 — Vaccination against disease is almost universally accepted as a positive step in health care. The recipient might not ever be exposed to the disease, but the preventative measures are in place — just in case. It is insurance in the future health of the recipient.
The next stage in preventative medicine and one which has arisen from controversy and has now moved out into the mainstream of preventative techniques is stem cell banking. Stem cells came into public prominence after the discovery that these basic building blocks of animal life could be harvested from embryos and used to grow organs and — just possibly — whole humans. Lost in the furious ethical debate was the fact that stem cells could also be retrieved from the blood contained in the umbilical cord — normally discarded at birth — of the new-born infant.
These cells can be frozen, stored and used possibly decades later to treat hundreds of diseases and conditions that medical science knows about now and perhaps can be used in ways that future medical research has not yet discovered.
Storing — banking — these potentially life-saving cells has developed into a well-regulated commercial procedure which young Saudi couples are turning to.
Khlood and Yasser are young Saudi professionals. Until the birth of their first child, Khlood was a brand manager in a large multinational company and Yasser is in the hospitality business with a number of restaurants. Their child, Yusef, now 30 months old, is fit and healthy. After his birth, Khlood heard about stem cell banking and its inbuilt benefits as an insurance against future diseases.
“I regretted not knowing about it during my first pregnancy,” Khlood continued. “The fact that there was a chance that my older child could also benefit from his brother’s stem cells highlighted the importance of this precaution, even though I hope my children will never need to use it.”
Most Saudi couples who decide on the procedure hear about it by word of mouth. There is little or no advertising and for many, the whole subject is surrounded in mystery. Khlood first heard of stem cell preservation from one of her friends during her second pregnancy. “She had undergone the procedure with a US company and I became interested in learning more about it so I did some online research and came across FutureHealth Technologies.”
FutureHealth Technologies, was the first private umbilical cord blood bank of its kind to be accredited by the Medicines Healthcare Products Regulatory Agency (MHRA), UK Department of Health, and licensed by the Human Tissue Authority (License 11058). The Human Tissue Authority (HTA) is now the Competent Authority in the UK under the new EU Tissues and Cells Directive and has the responsibility for licensing the storage of human tissues and cells, including haemopoietic stem cells.
Soon to be enacted laws in the EU will forbid the use of stem cells for a transplant or therapy from a bank not accredited by the MHRA. The HTA is now the Competent Authority in the UK under the new EU Tissues and Cells Directive, with responsibility for licensing the storage of human tissues and cells, including haemopoietic stem cells.
The arguments raging in the US about the ethics of using the stem cells of a fetus to grow body parts have tended to overshadow the other aspect of stem cell preservation. The “Frankenstein Factor” has cast a shadow over the simple but vitally important fact that there is more than one type of stem cell.
Originally, bone marrow transplants obtained blood stem cells (hematopoetic stem cells) from the bone marrow of a matched donor. Although in the US there are registers of donors, about half the patients who need the cells — to regenerate a faulty immune system for example — cannot find matching donors. The simplest stem cell — the totipotent cell — produces both pluripotent and haemopoietic stem cells. Pluripotent stem cells are those which can be extracted from embryos. Research shows that it is possible to use the fundamental, or pluripotent, stem cells from discarded human embryos to grow all kinds of human tissues. This is where the ethical minefield lies and the Frankenstein Factor originates. Umbilical cord blood contains hematopoetic — or blood stem cells — that are even more primitive than the blood stem cells found in bone marrow. Like bone marrow cells, they can also be transplanted to regenerate a patient’s immune system.
Haemopoietic should not be confused with pluripotent stem cells. Hematopoetic cells are blood stem cells which can be removed from the umbilical cord without harm to mother or baby and which can grow a complete immune system of blood cells. Public and private stem cell banks use only the cells found in the blood of the placenta of a new-born child. The use of those from a human embryo is illegal just about everywhere with the exception of some very closely regulated research institutions.
As of late 2000, medical research had established that small numbers of pluripotent stem cells could be harvested from bone marrow, umbilical cord blood, and placentas. That opens up the possibility that, under some circumstances, “blood” stem cells might be coaxed to grow into other types of tissue which would avoid many ethical issues.
“I hate to think anything will happen to my children,” said Khlood. “I am always conscious of them and want what’s best for them.” She said that should the children succumb to a condition treatable by stem cell therapy and she had not planned for such an eventuality, she could never forgive herself.
Khlood and Yasser found nothing in the principle or the procedure that conflicted with their religious or moral values and they are sure that they have done the right thing for their family. “When you think about the procedure, there is nothing in it that is controversial. They just take a sample of blood from the umbilical cord which cannot possibly harm the baby or the mother. It’s a very easy procedure and when the cells are stored, they can only be used by the family.”
Khlood noted that so far stem cells had been able to help cure more than 70 diseases. Developments in research announced daily in the media show the potential of stem cells to treat a variety of diseases including heart disease, Type 1 diabetes, Alzheimer’s disease, spinal cord injury and testicular cancer. The use of human stem cells in the treatment of disease is now established as a medical procedure. Private stem cell banking, where an individual can use his or her own tissue to treat disorders is established as a viable and increasingly common practice. One day it may be as common as immunization as a kind of medical insurance against disease.
