Where Are We Going

Stem cell technology

BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7220.1308 (Published 13 November 1999) Cite this as: BMJ 1999;319:1308
  1. Paulo A Fontes, assistant professor of surgery (fontesp@msx.upmc.edu),
  2. Angus W Thomson, professor of surgery and molecular genetics and biochemistry
  1. Thomas E Starzl Transplantation Institute, Department of Surgery, University of Pittsburgh Medical Center, 4C Falk Clinic, Pittsburgh, PA 15213, USA
  1. Correspondence to: P Fontes

    Stem cell technology is a rapidly developing field that combines the efforts of cell biologists, geneticists, and clinicians and offers hope of effective treatment for a variety of malignant and non-malignant diseases. Stem cells are defined as totipotent progenitor cells capable of self renewal and multilineage differentiation.1 Stem cells survive well and show stable division in culture, making them ideal targets for in vitro manipulation. Although early research has focused on haematopoietic stem cells, stem cells have also been recognised in other sites. Research into solid tissue stem cells has not made the same progress as that on haematopoietic stem cells. This is due to the difficulty of reproducing the necessary and precise three dimensional arrangements and tight cell-cell and cell-extracellular matrix interactions that exist in solid organs. However, the ability of tissue stem cells to integrate into the tissue cytoarchitecture under the control of the host microenvironment and developmental cues, makes them ideal for cell replacement therapy. In this overview, we briefly discuss the current research and the clinical status of treatments based on haematopoietic and tissue stem cells.

    Summary points

    Stem cells are progenitor cells that are capable of self renewal and differentiation into many different cell lineages

    Stem cells have potential for treatment of many malignant and non-malignant diseases

    Peripheral blood stem cells are used routinely in autologous and allogeneic bone marrow transplantation

    Gene transfer into haematopoetic stem cells may allow treatment of genetic or acquired diseases

    Embryonic stem cells may eventually be grown in vitro to produce complex organs

    Neuronal stem cells are being used for neurone replacement in neurovegetative disorders such as Parkinson's and Huntingdon's diseases

    Haematopoietic stem cells

    Applications of cultured haematopoietic stem cells

    Haematopoietic stem cells are a somatic cell population with highly specific homing properties and are capable of self renewal and differentiation into multiple cell lineages.2 Human haematopoietic progenitor cells, …

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