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Many degenerative human diseases cause damage to cells that are not normally repaired or replaced, including
liver damage (as a result of hepatitis or substance abuse), heart attack,
Parkinson's disease, leukemia and diabetes. There is no fully effective
treatment for any of these diseases, but experimental studies in animals
and humans have suggested that these diseases might be treatable by
transplantation of healthy cells. The challenge for
biologists is to provide sufficient cells of the required type to make such
treatments practical. The cells should be immunologically matched
to the patient, have a normal life span, and be able to replace the
lost function after introduction into one or a small number of sites in the
body.
In principle, embryo stem cells could provide a source for all of the
different cell types and tissues needed. Cell lines might be obtained
from surplus embryos donated after successful IVF treatment, but they
would be immunologically different from most patients. The impact of
this difference might vary with different conditions. In the brain, where
immune rejection is less effective, it might be that no
immunosuppressive drugs would be required, or perhaps only a low
dose. When cells are transplanted to other sites, the patient would have
to choose between the disadvantages of the initial condition and a
lifetime of taking immunosuppressive drugs (and the resulting greater
vulnerability to infections and cancer).
Completely histocompatible cells could be obtained if stem cells were
derived from embryos produced by nuclear transfer from one of the
patient's own cells. Such "therapeutic cloning" would require large
numbers of oocytes for use as recipients. Oocytes might be obtained
(with permission) during surgery carried out for other reasons or
obtained from ovarian tissue matured in culture. There are, however,
immense practical limitations to these approaches, particularly if large
numbers of patients are to be treated.
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