Changing lives: a vision of the future

What are stem cells? Stem cells are cells that are at an early stage of development and have the ability to turn into almost any other type of cell in the body. There are embryonic stem cells, which are derived from embryos, and adult stem cells, which can be found in some adult tissue, for example bone marrow.

By developing these cells, scientists hope they can produce a form of repair kit for the human body and reverse the effects of chronic diseases that doctors cannot cure today.

As yet, none of the potential treatments described here is ready for use in patients.

However, Sir Graeme Catto, chairman of the Scottish Stem Cell Network, says Scotland is at the "leading edge" in the stem cell research field and the country should be ready to invest should a breakthrough occur.

LIVER
Scientists at Edinburgh University have generated human liver cells from embryonic stem cells. It is ultimately hoped they could be used to treat patients with liver disease and spare patients a potentially fatal wait for a liver transplant. Liver disease is the fifth most common cause of death in the UK and its incidence is rising.

However, while researchers are investigating how such generated liver cells could be used in treatment, there is another field where they could revolutionise medicine sooner.

Pure liver cells grown in a laboratory could be used to test drugs for potentially harmful side-effects before they are trialled in patients. Problems in the liver serve as a warning sign when a substance is toxic. Currently livers left by donors which are not good enough quality for transplant are used to test new drugs, but supply of these is obviously restricted.

An unlimited stash of liver cells could improve the way new drugs for treating the liver and other organs are tested.

BONE
Radical new ways of mending bones and cartilage using a patient's own stem cells are also being explored.

This line of work could have a major impact on treating conditions such as osteoarthritis (sometimes known as wear and tear arthritis) as well as accident victims whose bones have shattered.

At Edinburgh University scientists are looking to culture bone-forming cells by taking stem cells from the patient's own bone marrow or even from their blood.

They hope to be able to place these in the affected area and use a special mesh, coated with a drug, to protect them and stimulate their growth into the bone or cartilage needed to repair the damage.

Earlier this year the team involved were awarded £1.4m to develop the technique and at the time said they planned to begin testing in hospitals within two years.

Staff at Aberdeen University are also looking to mend joints using adult stem cells. Researchers there have been successful in isolating adult stem cells from joint membranes in patients as old as 101. Already they have managed to grow these cells into tissue in the laboratory and in animal models. They want to be able to implant tissue or inject the cells into patients, and are also investigating whether drugs could be given to people with joint problems to stimulate the stem cells already present to solve the problem themselves. Their immediate hope is that treatments could prevent people with lesions in their joints from developing osteoarthritis. These patients are often young sports enthusiasts.

BLOOD
Patients needing bone marrow transplants or blood transfusions could eventually be treated with blood stem cells grown in a laboratory. Edinburgh University scientists were able to multiply blood stem cells taken from mice 150 times in the lab. They ultimately hope human blood cells for transplant could be produced the same way and used to treat patients with cancers such as leukaemia and lymphoma, genetic blood diseases and patients who have lost a lot of blood through injury. This could reduce pressure on blood donor supplies.

At the same time staff at Glasgow University are attempting to generate blood by using embryonic stem cells to make red blood cells. If they succeed in creating large quantities it could also help preserve donor blood reserves. They hope to start early clinical tests within the next five years.

HEART
Clinicians and researchers at Glasgow University are working to make heart muscle and blood vessel cells for repairing the circulation system. The cells are being developed from embryonic stem cells and then assessed to see how well they function. For example, does the cultured heart muscle tissue beat as efficiently as that which works automatically from birth?

NERVES
Treatment to reverse the effects of the neurological condition multiple sclerosis are being explored at the MS research centre set up using a donation from Harry Potter author JK Rowling. In MS myelin, the sheath that protects nerve fibres, becomes damaged causing the transfer of messages from the brain to be disrupted.

At the moment doctors can offer patients little to reverse the growing damage so most sufferers become increasingly debilitated.

Earlier this year Professor Charles ffrench-Constant, director of the Edinburgh-based centre, said he wanted to find a way to make the body rebuild damaged myelin using stem cells.

Apparently there are a surprisingly high number of stem cells in the brain and his centre hopes to recruit them to repair the myelin.

In April he told The Herald he envisaged patients receiving drugs to activate the process in 10 to 15 years.

DIABETES
Using stem cells to help patients with diabetes produce insulin is an area of research being explored around the world. In Aberdeen, scientists are currently trying to understand which stem cells give rise to insulin-producing cells in the pancreas. By knowing this, they hope to throw light on how diabetes can be tackled using stem cell technology.

CANCER
There is a relatively new theory that cancers themselves grow out of a specific population of cancer stem cells. If these could be identified, there is hope doctors could stop cancers from even developing in the first place.

A team at Dundee University are investigating the possibility that some forms of colon cancer develop from malfunctioning stem cells in the gut. Studying gut stem cells in normal and cancerous conditions may tell us how the disease might be treated.