The University of Southampton

Author: Isabella Christodoulou

Endometrial Stem Cells – Putting an End to the Endoflare?

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Endometriosis is a painful, systemic condition where tissue such as the uterine lining grows outside the uterus, causing endoflares and infertility. It affects around 10% of individuals with uteruses of reproductive age, my mum being one of them. She was devastated thinking she’d never have a child but despite miscarriages and a tough pregnancy, I was born! After attending Dr. Nick Evans’ lectures on stem cells and TISSENG, I wondered if stem cell therapy could help treat endometriosis. Having witnessed first-hand the emotional and physical toll it takes, and given the lack of research on AFAB health, I decided to explore this possibility further.

Short video explaining endometriosis (closed captions available)

Endometrial Stem Cells

During my research, I came across endometrial stem cells (EnSCs), which can regenerate or repair endometrial tissue. Given that 3/4 of the endometrium sheds and regrows each month, this isn’t surprising. Studies suggest EnSCs may even help treat Alzheimer’s by differentiating into brain cells! In the context of endometriosis, they could potentially regenerate damaged tissue, reduce scarring, and improve fertility. I’m particularly intrigued by this idea since it could offer a long-term solution, unlike current treatments such as painkillers, hormonal therapy, hysterectomies and other surgeries that focus on managing symptoms and often come with significant side effects. Having seen my mum undergo various treatments without lasting relief, a permanent solution would be a game-changer for her and many others.

“When I got to hear about the endometrium and that three quarters of it sheds each month, and then it re-epithelializes and grows, I thought ‘there had to be stem cells in this tissue’”

Caroline Gargett, Biologist at Hudson Institute of Medical Research

Stem Cell Therapy Trials

The complexity of endometriosis itself poses a challenge to study since the behaviour of endometrial cells isn’t fully understood. However, recent studies show that stem cells, particularly EnSCs and iPSCs, offer promising solutions for regenerating tissue. These stem cells could promote natural healing, prevent symptom recurrence, and restore normal reproductive function. Several clinical trials are currently underway, and researchers are hopeful that these treatments could offer a long-term, safer alternative.

Ethical and Legal Considerations

While in theory this is all very exciting, important ethical and legal concerns must be considered. Some of the main concerns are:

  • Lack of informed donor consent
  • Potential for exploitation of vulnerable people seeking fertility treatments or low-income individuals to donate stem cells.
  • Public taboos surrounding menstrual health

For this reason, I believe it is crucial the research is conducted responsibly and follows legal and ethical guidelines. Donors must be fully informed of the experimental procedures which adhere to ethical principles like non-maleficence, beneficence and patient autonomy and privacy upheld. Regarding public perception, our bodies are capable of regenerating entire tissues and potentially treating many diseases. Why should that be stigmatised and overlooked? I strongly believe scientific advancement outweighs this concern.

As for legal framework, I noticed some laws hinder stem cell research. Funding is often restricted, approval processes can be slow and variations in laws internationally can limit collaboration and delay the global development of effective treatments.

Final Thoughts

EnSCs are a major breakthrough in regenerative medicine and present a promising future for treating endometriosis. While more clinical trials are needed to assess their effectiveness, the potential for a long-term solution is exciting. It is key that these trials adhere to ethical and legal guidelines, with continued dialogue between policymakers, scientists, and ethicists to ensure progress. Given that endometriosis is a chronically progressive condition with a 3-11 year delay in diagnosis, developing a biomarker for early diagnosis and treatment is crucial. In conclusion, I’m hopeful that EnSC regeneration will be the breakthrough people such as my mum have been waiting for.

References:
https://www.endometriosis-uk.org/endometriosis-facts-and-figures

https://www.the-scientist.com/an-endometrial-stem-cell-pioneer-72146

https://www.mdpi.com/2227-9059/11/1/39

https://pmc.ncbi.nlm.nih.gov/articles/PMC8849430

https://plan-international.org/news/2022/05/25/new-survey-shows-deep-rooted-taboos-around-periods

Paws to Consider: Ethics Within the Growing World of Animal Prosthetics

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Imagine a dragon regaining the ability to fly with a prosthetic tail. Now I’m not just talking about “Toothless” from the movie “How to train your dragon”, but this is a real emerging field in science where real animals in unfortunate situations get the chance to live a better life. As a pet owner myself, should something happen to my cats, I wouldn’t hesitate to provide them with the prostheses that they need to live comfortably again but is this really my choice to make? Are prosthetics for animals justifiable or are we just playing God?

Pivotal Events in Animal Prosthetics

Human prosthetics date back thousands of years but for animals, the idea emerged much more recently, evolving from rudimentary solutions to advanced personalised devices.

Timeline showing the evolution of animal prosthetics

High Profile Cases

“Winter”, a bottlenose dolphin who lost her tail after getting caught in a fishing net received a 3D-printed tail. She slowly regained mobility and could swim again at the Clearwater Marine aquarium (they even made a movie about her! Watch “Dolphin Tale” for her full story).

YouTube video of Winter getting fitted with her new tail

Other notable cases:

Mr. Stubbs the Alligator

  • First reptile to receive a prosthetic limb
  • Lost his tail after being illegally transported
  • Was fitted with a 3D-printed prosthetic one

Naki’o the Dog

  • Rescued from a frozen puddle as a puppy
  • Lost his paws and part of his tail due to frostbite
  • Was fitted with 4 prosthetic limbs (first dog to have 4 prosthetic limbs!)

Motala the Elephant

  • Lost her leg by stepping on a landmine
  • Received a prosthetic leg

A Deep Dive into Ethics

All these cases are inspiring, however the question of whether we should be altering an animal’s body remains an ethical dilemma. While I believe for the most part that prosthetics can help improve an animal’s life, some ethical issues are raised:

  • It’s not entirely clear if animals truly benefit from prosthetics long-term or if their suffering is simply prolonged.
  • Often, the need for animal prosthetics may be driven more by the human desire to “fix” things rather than the animal’s genuine needs.
  • In many cases, animals are given prosthetics for cosmetic reasons, to meet human expectations.
  • Animals can’t voice their opinions, so the decision lies in the hands of veterinarians, caretakers and pet owners.

Legal Boundaries of Animal Prosthetics

While there are general veterinary medical guidelines ensuring the safety and well-being of animals undergoing procedures, legal frameworks related to prosthetics are still developing.

  • There are no universal laws that protect animals from unnecessary prosthetic procedures.
  • The cost of the prosthetics can be substantial.
  • Insurance often doesn’t cover the procedures, as they are not always classified as medical necessities.
  • Pet owners are left to bear the financial burden.

A New Era of Compassion

In the past century, society’s perception of disabled animals has drastically shifted. Injured/disabled animals were often euthanised, due to few chances of recovery. Now, thanks to animal advocacy groups, the public has become more sympathetic toward animals with disabilities, many seeing prosthetics as a viable way to provide their furry companions with fuller, happier lives. Rehabilitation has also proven that animals with prosthetics can not only survive but thrive in their environment.

Final Thoughts

Some scepticism still exists about whether animals truly need prosthetics, or if they are merely a human desire. Ultimately, I firmly believe that the decision to fit an animal with a prosthetic should be made in the best interests of the animal and should involve careful consideration of the animal’s needs and physical and emotional state by professionals.

References:

https://watermark.silverchair.com/vcae013.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAA0wwggNIBgkqhkiG9w0BBwagggM5MIIDNQIBADCCAy4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMw1-KMyh7YV1719YwAgEQgIIC_0E3oGMRiztUg7f_5QozdIzViH-p3cpz-bvJ7MltSYSC-KZMLgNCpA2yk22KM_XzoSHQCKVLCNqi1LsvCpJkWvixmdqaUTDa3VX_ZEUZUsafL_ID-M0cVdnu_fLMaI_3OBA8N2xmffUY9VisZUvZ2JSZAt3L9CyYXKLPibd-7EgWWaLMo8hvPHqXFhGEENxRaAC-jtRT_TFQ6q4WQeshnLZ-q-ez5Sa92tphkoxJYN2OUduzCzL08oAKaxhihUPPT28dYImGl7SaQwOuVwVteZChAAtWwzdrZgj7m0–WXcpNWKotCEdG6SsZwT3x1S1fAAohrqD5dPG8NCatV3Mc3XMwi7hRYvml7BAW3kogSvEc9ko2sEmXxOI10Rt-CaHzZXsDPziQ8NsxcGu6SfZ4bZm-ddEaASLPsYd0X6GtI6VSDLMJT5gVF11N2tCynj1sdQ5B3Ok7ly-hpx-rqFY6nehTd8TP_eR6ZDhTW1DRL70Z1z2imMSdjmkdAa1tNYqUGLtWvOdMMby-6i6dx9lphDSBzeNkAtDqyPYpJp1s7IQwdi3GV3vnjxjXBlu9KGCbi64XwfOgkGHqG2r0v9SCNkt5tk08W5wh324OqYyJpnjK9etqdR9cLOjyo9DjK5Dl_fs4McupWDe4S3ggs3q2lopuyjkdTt_YNUhkLQVetxzxfODG1f9S89WQnPsgRadv0kEp0_lYIDINM2XOL5oP-R9eh_sykEVpH30JstS7oG1LU7AxzvEGmNXvqOB8n6M2bd195c4ECUoRpeqyf4PyKiG_Eat2uhKWy0kEAe15KiyZiT7ko-LMgCxHZIOngClcknw9DdcAsNkQvXk-ItVxQPPvwPQZhBeENmhVLnwLSmYlImGj3AkmrI3z7QceCMZEyEoumdYoYbfnflEzJTwmw76l65h6SVF6nIhw3RP6Rsa29jMkXhn8sFL7YCp0wqSXzAgw423ivNYQ78tSVZGYgu1b696qriXupmZOAxBnCsousweU-qebbEAgL1K1cto

https://www.cmaquarium.org/animals/dolphins/winter

https://www.mentalfloss.com/article/55866/11-animals-amazing-prosthetics

https://www.rcvs.org.uk/setting-standards/advice-and-guidance/code-of-professional-conduct-for-veterinary-surgeons/supporting-guidance/miscellaneous

https://en.wikipedia.org/wiki/List_of_animal_rights_groups