The University of Southampton

Author: Chahil Makwana

WILL STEM CELL POTENTIALLY SURPASS OUR POV ON ETHICS

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Over the past few weeks I’ve had the privilege to learn about the various topics and categories of what we know as engineering and topics. From our lectures, 2 topics had especially stood out to me, and these were stem cells, and Bioethics. And they went surprisingly hand in hand.

What are stem cells?

Stem cells utilise the ability of differentiation to the max by possessing the gift of differentiating into any of the cells in our body, asymmetrically or symmetrically. Just from this you can see they have the potential to make many strides in modern medicine, in fact there have already been papers regarding their use in surgeries already. 

An example of stem cells potential in surgeries can be their use in deep tissue repair following burns to the face.

A paper from Ncbi states: current treatments with skin replacement aren’t capable of generating fully functional skin, and mentions “ administration of growth factors has occurred, it comes with many consequences- in summary : “ using stem cells in treating burns is justified here, as stem cells are able to secrete these growth factors in a sustained manner”(Kareem NA, et al (2021))  Allowing me to believe they’re a more beneficial alternative to current components in surgery. 

My own research on other articles concerning stem cells, left me with a lasting impression on how they can revolutionise modern medicine in the future. HOWEVER, I was reminded of our ethics and law lectures, and while stem cells are viewed in such an amazing light, they can easily be abused and researched with the wrong intent. 

Jeremy Bentham. (1748-1842) the one who created the Theory of consequentialism

After reading multiple articles I noticed that the intent of research always originates from the researchers own moral compass. Which correlates to the theory on consequentialism, it defines the right action in terms  of promotion of good consequences, concerned with maximising the good outcome.

Ensuring the benefit of humanity isn’t perceived as exploring our potential evolutionary consequences. 

FROM A RELIGIOUS POV 

Christianity- found in a paper published by the University of Notre Dame 

“Clearly, the church favours ethically acceptable stem cell research” however later states “we must respect life at all times especially when your goal is to save lives”. Telling me that, we want to respect life as much as possible so in the future, when research has developed further, we don’t overshadow our morals as human beings by exploring humanities limits through human subjects. 

Islamic perspective: an article on Georgetown explains that “ they’ve prohibited using embryonic stem cells which have the potential to develop into a life in research as it entails their destruction during the process of procurement”. 

Explaining that if using stem cells in the lab involves developing a life form to be used for experimentation, it cannot be condoned as morally right because in the later stages of development is when they believe this life form is endowed with a soul. 

WHAT DOES ALL THIS MEAN FOR US IN THE FUTURE

In my opinion Stem cells will help solve various problems in medicine in the future, these include the issue of waiting for donors for a transplant, or an alternative to animal experimentation. I believe that those conducting research using stem cells only view it as a means to benefit us without compromising our moral compasses as human beings. 

CONCLUSION 

To conclude, the use of stem cell research provide an essential role both now and in the future for counteracting various problems in the medical field, ranging from unforeseen diseases yet to sprout, to limbs lost during accidents causing trauma. However this only applies if they’re used for the specific benefit they have in mind, and there is a thin line between using stem cells as a means for improving our quality of life, and using stem cells to explore the capabilities of us as humans.

Restoring My Old Self- Is tissue Engineering Really the Key?

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From beginning this module, I was exposed to various different topics all under the field of engineering replacement body parts ranging from ethics in research to orthopaedics. However I was surprised to find myself knowing nothing about tissue engineering until the lecture we had on it had taken place. Which was what had inspired me to do some research on the topic.

WHAT IS TISSUE ENGINEERING

Falling under the field of regenerative medicine, tissue engineering bares the goal: to assemble functional constructs that restore, maintain, or improve damaged tissues or whole organs.

It could potentially be used in surgeries in which necrosis (premature cell death in tissues) occurs. It has very considerable potential, for which scaffolds from human tissue are thrown away because of necrosis, and in combination with a patients own cells, could make synthesized organs that won’t be rejected by the immune system.

Because tissues are groups of cells grouped together, its obvious there would be certain cells needed so that tissue engineering can be brought about, the types are:

  • Adult/fetal cells
  • Adult/fetal stem cells
  • Pluripotent stem cells

And these cell sources can be divided based on their origin:

  • Allogenic cells- from a human donor
  • Autogenic cells- the donor and recipient are the same
  • Syngenic cells- from an identical twin
  • Xenogenic cells- from an animal
Allogenic cells
– Adult cells- currently have greatest clinical use
– Using fibroblasts which come from banks (of human donors)
– Available commercially Have a high growth potential		Autogenic cells
– Involved biopsy of cartilage (examination of sample cells from a patient to determine presence/extent of disease)
– From which chondrocytes are isolated and cultured, then implanted (with a biomaterial) back into a damaged joint to form a functional cartilage
– But its controversial and has mixed results
Syngenic cells
Aren’t used commercially		Xenogenic cells
– Aren’t used commercially at all
– Hybrid embryos are allowed to be created
Table summarizing the 4 origins of cell sources

TISSUE ENGINEERING IN PRACTICE

 A science paper published on the National Institute of health mentions: “currently, tissue engineering plays a relatively small role in patient treatment. Supplement bladders, small arteries, skin grafts, cartilage, and even a small trachea have been implanted into patients, but the procedures are still experimental and very costly. “

This means, they have been successful in implanting small tissues into patients, however it comes at a price. On the other hand, more larger organ replacements like the heart and lungs, although have been successfully synthesized in the lab, have yet to be successful in replacing the organ in a patient. But steady progress has been made.  

From another point of view:

A different means in which tissue engineering can provide a useful solution in is plastic surgery:

  • another paper published by the National Institute of Health mentions:

“As a group, reconstructive surgeons are facing more challenging composite defects than ever before coupled with internet and media savvy patients with increasing expectation.”

 And goes on to say:

“Among these approaches, the most attractive concept is tissue engineering.”

 Indicating in order to overcome the increasing expectations of patient’s expectations, and the number of potential patients in the future, by using the concept of tissue engineering. They can meet these demands, and “restore both form and function” to the area in which surgery takes place.

CONCLUSION

To conclude, tissue engineering has brought about potential solutions to various issues in both the medical and cosmetic field. Ranging from lack of potential donors in both of these fields (which means they won’t have to standby and wait for donors in transplant surgeries), to overcoming the severely high demand to of potential patients in the future expecting full restorations in reconstructive surgeries. Meaning, tissue engineering could become a key in which modern medicine can be revolutionized.

Getting back on your feet- I Mean Literally

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As comparison to now and a few decades ago, the field of bioengineering has come a long way, especially in the field of prostheses. Throughout our engineering lectures thus far, what particularly struck me was the week in which we had covered prostheses and limbs in our lectures. This was because they have such a huge number of applications in which can be used to help people return to living a normal life (at least as best as they can).

As someone who is passionate about the field of sports medicine, what triggered me to do further research into what prostheses were like in earlier ages- like the 90s in comparison to the ones now, specifically ones specialised for athletes.

  • The picture on the left is what prosthetics had looked like during the mid-90s. Earlier prosthetics were often made of wood, leather and metal that limited movement.
  • The image in the middle displays what prosthetics look like now. It shows that advances in material and design have enabled prosthetic limbs we use now to be more functional and comfortable. Making use of lightweight yet very durable materials like carbon fibre and thermoplastics.
  • The image on the right is what a specialized prosthetic for athletes looks like now, they make use of a device with a curved blade, which provides a good balance between flexibility and strength to withstand high- impact activities like sprinting and jumping.

From these design and material advances, more endeavors have been made to aid people in somewhat returning to a normal life (as well as attempts to make less expensive alternatives for those who can’t afford certain prosthetic’s), and furthermore provide less fortunate people an opportunity to at least recover from trauma.

A research study, taken by the University of Southampton, published in the journal of Global health. Talks about how they’re helping countries like Cambodia plan future prosthetics and orthotics.

It mentions: “thanks to a grant from Global challenges Research Fund, the University’s People Powered Prosthetic group and Exceed Worldwide, a Non-governmental Organisation (NGO) which trains specialist staff and provides P&O services- like supplying prosthetic limbs, braces, wheelchairs and community support- were able to access and, for the first time, analyse routinely collected data from existing electric patient records in an aggregated and anonymous way”

This indicates that by determining patterns in the cause of injury and disease from which amputations are required. Together with cross referencing data from the data from current patients, applications of prosthetics can be made specifically for these people, which can provide opportunities to return to work and sustain both themselves and their family.

CASE STUDY- AN ATHLETES POV

From another perspective- of someone with congenital (birth) defects- more specifically an athlete would be Richard Whitehead (a Paralympic gold medalist in London 2012, and silver medalist in Tokyo 2020). He was born with a congenital condition with which had left him with a ‘double through knee amputation’ meaning he was born without the bottom half of his legs.

Even with this condition, he went on to set a world record for athletes with double amputation (which took place at the 2010 Chicago marathon). Unfortunately, he was unable to compete in the marathon at London 2012 as there was no category for leg amputees, and was refused permission by the IPC to compete against upper limb amputees.

Because of this he turned to sprinting to compete at the 2012 Paralympics. Here was where he obtained gold in the 200m T42 Athletics event, setting a world record time of 24.38 seconds. And later on in 2013 was appointed the first ever patron of Sacroma UK, a bone and soft tissue cancer charity.

CONCLUSION

From just the past few decades (as mentioned before) technological advances, aiding both design and material advances have allowed us to consistently come up with new and innovative ways to get people back on their feet both figuratively and literally. And its yet to show and slowing down in its rate of improvement.

Overall, from cases such as Richard Whitehead, who had taken his condition as something that will not stop him from reaching his dream. As well as other cases like the people from the research study who were provided with a means to recover from traumatic events like natural disasters. It’s clear to see that prosthetics have become an integral part in the lives of these people. And taking these examples, as starting points for more research, more persistent endeavours can be made from which, more ingenious solutions can be introduced and applied to treatment for potential patients in the future.