Multiple Sclerosis Research Paper
Extended Project Dissertation
To What Extent Is Regenerative Medicine The Most Effective Way Of Treating Multiple Sclerosis?
Candidate name: Joshua Carter
Candidate number: 7125
Centre number: 61425
Contents
Abstract- page 3
Introduction and research- page 4
Discussion- page 10
Conclusion- page 15
Bibliography- page 17
Abstract
Stem cells are going to be a major point of interest in a large part of modern day biology. They already dominate many of the headlines of newspapers nearly every day and this will only continue. With the continued research going on into this new, potential way of curing many diseases that 20 years ago we would never have thought could have been cured, can it do the same for the neurological …show more content…
condition, multiple sclerosis? And how effective is it in doing so? Many reports have come out of stem cells being effective in mice to cure the disease but with the many controversial points that come with the use of stem cells would alternative, existing methods be a better way of treating it? Are the immunosuppressant drugs of today more effective in treating the condition and are they a more realistic thing to be using? Also is it actually a good thing if we are finding new cures to all of these diseases? With the world’s population rapidly rising and resources running out to feed everybody and supply them all with energy, would it be better if we continued as we are and stopped ‘playing God’? These are the issues that I will be discussing in this essay.
Introduction and Research
What is multiple sclerosis? “An abnormal condition of a part, organ, or system of an organism resulting from various causes, such as infection, inflammation,environmental factors, or genetic defect, and characterized by an identifiable group of signs, symptoms, or both.” Is the definition of a disease in an online free dictionary[1] and they affect people’s lives in in many ways, nearly all of them being bad and detrimental to both society, families and the world. they can be passed on by direct transfer of bacteria, viruses and other germs. However they can be passed on by sex, either in the form of sexually transmitted diseases or by genetically passing down to offspring during fertilisation. A disease that is linked to being both hereditary and environmental is the neurodegenerative disease, Multiple Sclerosis.
Multiple Sclerosis is a disease that affects the nervous system of the body, specifically in the brain and spinal cord [2]. Every nerve cell in the body is surrounded by a protective layer known as the myelin sheath which enables electrical impulses that travel around the body to reach their destination hundreds of times quicker than it would without one. If a person has Multiple Scleroses, MS, then this myelin is broken down partly and therefore messages are not sent to the brain or spinal cord as efficiently. This results in a sufferer or MS to experience potential symptoms such as: loss of vision, in one eye usually, uncontrollable muscle spasms and muscle stiffness, difficulties in balance and co-ordination and people find they often suffer from tiredness and fatigue.
There are two main types of Multiple sclerosis that sufferers get. The first, relapsing remitting MS, occurs in approximately eight out of ten people that are diagnosed with MS are diagnosed with this form. Somebody with relapsing remitting multiple sclerosis will have periods without suffering any of the symptoms usually associated with the disease, then they will suffer periods where the symptoms are severe and the patient may become partially blind or be unable to move. However, this period will pass and the sufferer will go back to almost normal again without showing any signs or having the disease. This period may last weeks, months or even years and this is why diagnosing this type of MS is so hard to do because of how irregular it is it can be mistaken for a number of temporary conditions and people don’t report when they experience symptoms because they have “had them before and I was ok”. After 15 years of so, about half of people that have got relapsing remitting MS will go on to develop secondary progressive multiple sclerosis. This is much like the first form and people may still experience relapses but the symptoms will worsen over time and they may not fully recover from their relapse. Primary progressive MS is the least common type of sclerosis. This is where there are no periods of remission and symptoms just worsen over time with no break periods.
Treatments for multiple sclerosis:
Currently there is no cure for Multiple sclerosis but there are a number of treatments that can help [2]. Relapsing remitting multiple sclerosis can be treated with drugs called ‘disease modifying drugs’, these are not a cure for the disease but instead can reduce the severity of the symptoms in a sufferer and can reduce the number of relapses they have. However they are not suitable for all sufferers of Multiple Sclerosis. There are currently 10 licenced DMD’s (disease modifying drugs) [3] these are:
Aubagio (teriflunomide) – oral tablet taken once a day. Available if patient has had at least two relapses in the past two years.
Avonex (interferon beta-1a) – Injection available if patient has had two relapses in the past two years.
Betaferon (interferon beta-1b) – available if patient has had two relapses in the past two years, it is injected.
Copaxone (glatiramer acetate) – another injection available after two relapses in the same period of time.
Extavia (beta interferon-1b) – injection if patient has has 2 relapses in 2 years.
Gilenya (fingolimod) – available if patient is still experiences despite treatment with one of the beta interferons. It is an oral tablet taken once a day.
Lemtrada (alemtuzumab) – available for treating the active relapsing remitting form of multiple sclerosis. It is given to patient via a drip once a year.
Plegridy (peginterferon beta 1a) – injection for people living in Scotland for sufferers that have had 2 relapses in 2 years.
Rebif (beta interferon- 1a) – another injection available for patients suffering 2 relapses in the past 2 years.
Tecfidera (dimethyl fumarate) – used to treat active relapsing remitting MS. Approved by the NHS and became available in autum 2014. It is a oral tablet that should be taken twice a day.
Tysabri (natalizumab) – available if you have had 2 relapses in one year or if severity of relapses has increased once another DMD has been taken, given by drip monthly.
There are also a wide range of other treatments available to treat multiple sclerosis. Physiotherapy can be used to make day to day living with MS more bearable and steroids can be given to patients to speed up recovery times from relapses.
Causes of Multiple Sclerosis:
Multiple sclerosis is an autoimmune condition.
This means that the body’s defence against harmful diseases (the immune system) is affected in some way and that causes the immune system to change from attacking foreign viruses to attacking healthy body tissue- in multiple sclerosis this is the healthy Myelin that surrounds nerve cells in the body. The myelin is broken down by the body’s own immune system, nervous impulses are less efficient in travelling to the body’s Central Nervous System. As a result of this, in the places where the myelin on the myelin sheath has been thinned or destroyed, a hard region or scar is left in its place, often referred to as a sclerosis. Where there is multiple of these hardened scars on different places on the brain or spinal cord is where the autoimmune disease gets its name from- Multiple …show more content…
Sclerosis.
The causes of Multiple sclerosis are currently unknown; however scientists believe the main causes of the disease are a combination of genetic and environmental factors and are “putting the pieces of this complicated puzzle together” [4].
Genetic factors- genes are pieces of genetic information that code for the production of proteins, molecules that are essential for many of the bodies vital functions. Occasionally come genes may be faulty and produce defective proteins. This is the cause of many of the diseases we see today however this isn’t what is believed to occur in multiple sclerosis. It is thought that individuals that are affected by MS have slight variations, called polymorphins, which are healthy genes that fit badly when combined together in DNA and thus cause healthy cells around it to be altered, especially cells involved in the body’s immune system. This bad combination of genes is then passed down through the generations by normal mechanism of inheritance and therefore there is a strong link of multiple sclerosis being shared within families. There are a few genes that have been identified to make people more likely to get MS, in particular the HLA (also known as “major histocompatibility complex”, as containing the most MS susceptible gene. These proteins are found on the surface of all body cells. They act as a messenger to the immune system telling the body whether a cell is foreign or part of the body and whether it should be attacked or not. These proteins are usually healthy and therefore there must be another reason for them being altered to become defective. Scientists believe this is down to environmental factors.
One theory is that a virus that is usually lying dormant in the body may disturb the immune system and therefore cause the disease to develop. There is probably on one MS virus but actually a combination of a common virus such as measles that acts as a trigger for MS. This trigger activates white blood cells (lymphocytes) in the bloodstream, which enter the brain by making the brain’s defence mechanisms (i.e. the blood/brain barrier) vulnerable. Once inside the brain, these cells activate other elements of the immune system in such a way that they attack and destroy myelin. It is also thought that vitamin D, the vitamin we get from sunlight, is linked to the disease. There has been a correlation between people that receive low levels of vitamin D have a higher chance of developing MS. A number of studies have indicated that smoking is also linked to the development of Multiple Sclerosis. It is not clear why this happens however it has been theorised that chemicals in cigarettes may have some sort of effect on the immune system and may alter it. Smoking’s effect on the progression of multiple sclerosis is also being investigated as it could be the fact that smoking leads to the progression of the disease being quicker and it may cause relapses to be more often and more severe.
It is estimated that around 100,000 people in the uk are suffering with Multiple sclerosis at this present time, with 2.5 million cases of MS in the world. Every week in the United States there are 200 people diagnosed with MS so this is a disease that has worldwide influence and is a major problem worldwide however it is incurable, this needs to change. Although the disease is not fatal in itself, some complications that can arise from severe MS, such as pneumonia, can be. This means that in order to reduce the numbers of people and families suffering with this terrible disease we as a race need to find a new way of treating it. This might be achieved through regenerative medicine.
Regenerative medicine:
Regenerative medicine is the process by which scientists are able to restore normal bodily functions by repairing or replacing damaged or malfunctioning cells and tissues in cells[5] and although it is in its early stages of development, it is bringing huge advances in the field of medicine as it could provide the cure for many different diseases such as Multiple sclerosis, dementia, strokes, heart disease and many types of cancer.
For example, the guardian reported a recent trial on 18 people suffering with two different types of macular degeneration, the leading causes of blindness in adults and children in the world, Stargardt’s macular dystrophy and dry atrophic age-related macular degeneration[6]. The patients had embryonic stem cell therapy on their eyes and were cured of sight loss without any side effects. Whatever sources of potential bias the guardian may have, being a politically left leaning newspaper, the point still remains, stem cell therapy and regenerative medicine has and will continue to provide a big source of hope in the fight against many different deadly diseases. Regenerative medicine mainly comes in the form of stem cell treatment, allowing scientists to use undifferentiated cells and turn them into any cell in the body to serve any function. This is a huge breakthrough in science and medicine as it enables anything to be made, it solves the problem of organ storage or a lack of organ donors, as hearts and lungs can just be grown in a lab and
transplanted into the patient that requires them.
Stem cell Research:
In the early 1900s, European researchers discovered that various types of blood cells all came from a particular ‘stem cells’, however it was not until 1963 that the particular type of self-renewing cells was first described in mice bone marrow cells by Canadian researchers Ernest A McCulluch and James E Till [7]. Since that time there has been continued efforts to grow and differentiate adult animal and human stem cells in a lab. This was made a lot easier in the 1980s and 1990s where there was an introduction of techniques for targeting and altering genetic material and methods for growing human cells in the laboratory. These advances really opened the doors for human stem cell research. The breakthrough came in 1998 when James Thompson, from the university of Wisconsin in Madison, successfully removed embryonic cells from a fertility clinic and cultivated them in a lab, this launched stem cell research into the limelight. Since then there has been plenty of further research that suggests that these embryonic stem cells can specialise into any cell in the human body which, if mastered, could open up a whole new world of new medicine that could change millions of people’s lives. As stem cells were only brought into the public attention in 1998, the technology is still relatively new and still in its youth. There have been no clinical trials of stem cell treatments as of yet however; adult stem cells are already being used in treatments for over one hundred conditions including leukaemia, Hunter’s syndrome and heart disease.
So stem cells are the answer to all of humanities worry’s yes? Unfortunately that is not that case as this new technology does not come with many controversial parts with many people opposing to this potentially lifesaving new technology, the main point of controversy is the use of embryonic stem cells and the ethical considerations behind that.
In this document I will be discussing the main treatments of multiple sclerosis and relating it back to the question of ‘is Regenerative Medicine the most effective way of treating Multiple Sclerosis?’ so I will evaluating whether other methods of treating multiple sclerosis is more effective than stem cell research then I will be coming to a conclusion at the end of the essay.
Discussion
Effectiveness of Stem Cell Treatment:
The first issue to talk about is whether stem cells are an effective method of treating any disease and then to focus down on the specific disease we are looking at. There is no doubt that the discovery of these undifferentiated, unspecialised cells is a hugely promising unearthing, however are they a truly effective way of treatment? Do they actually do all the things that scientists promise they can do? And are they sustainable?
Firstly, let’s look at the plus sides of stem cells, what they can do that is beneficial to the body and what they can do to aid the recovery of a disease or illness. Diseases such as cancer or conditions such as birth defects are thought to occur because of problems in the differentiation process, an understanding of the development that happens in normal cells and stem cells will help scientists treat the developmental errors that can occur. This will help in two fields because we will know more about the development of cancers and birth defects as well as discovering more about how stem cells differentiate (to make or become different in the process of growth or development), and this will help us be able to use stem cells more effectively in turn at treating these problems, working in a positive feedback model.
The next advantage of stem cells, according to website ‘explore stem cells’ is that there is another potential application of cell based therapies [8]. This is when stem cells are used to grow specific cells and then are bound together using a mould to create a completely new organ or tissue. This is a huge advantage to stem cells as currently when a patient needs to new organ they get one transplanted from an organ donor. At this current time there is nowhere near the required amount of organ donors to supply the needs of people needing an organ transplant and with this new regenerative technique instead of waiting for a new organ to be donated, a new organ can be grown from scratch to fit into your body. This will dramatically reduce the amount of people dying whilst being on the waiting lists for an organ transplant. Stem cells can benefit those suffering from Parkinson’s disease, type 1 diabetes, arthritis, burn victims and people with cardiovascular diseases (the biggest killing disease in the UK- BBC) using this method of treatment.
Stem cells also have the potential to reverse the effects of diseases. Stem cells are directed into differentiating into specific cell types, they can be fed into the body, providing a renewable resource of replacement cells for the patient. For example, people with heart disease can have stem cells differentiated into heart muscle cells to replace cells damaged by the disease, in Parkinson’s disease damaged brain cells can be reversed by replacing them with new healthy brain cells, reversing the effect of the disease. An even more exciting prospect is to address genetic defects that are present from birth by restoring function and health with the introduction of normal healthy cells that do not have these defects. Burn victims will, instead of suffering large amounts of pain from their injuries and instead of having to wait for donor tissues, they can have new healthy skin cells implanted onto the patient. Scientists are hoping to do this by growing skin cells in a lab from a very small piece of skin by triggering stem cells to differentiate outside the body so that large burn areas can be covered by a relatively small amount of initial skin cells.
The final major benefit to stem cells research is that is provides a huge role in the pharmaceutical industry and is involved heavily in drug development. Any new drugs that are being tested for human consumption can be tested on human stem cells before they are released for their safety. This could be the case with a new anti-tumour drug for example, and if the conditions that the drugs are tested in are in the correct conditions then the results could end up being very accurate and the drugs could be shown to be safe for human use and will help to treat people with life threatening diseases. The advantages of stem cells are well documented and for people with serious conditions could be a source of major hope that one day they could be the cure for them.
So it would seem as though stem cells are completely fine, effective and the answer to all of our prayers. This is not the case however, stem cell therapy is still a very controversial topic, and this is nearly all down the disadvantages that come about with stem cells. Firstly it is where stem cells are collected from. Many stem cells are collected from embryos to form embryonic stem cells; these are a very good type of stem cell to use as embryos are full of unspecialised cells as eventually these will turn into a new baby human being. However, if embryonic stem cells are used then effectively there is no chance that the embryo will develop into a new-born and an abortion will take place. For many people this raises the argument of at what point does an embryo become a human and therefore has the same rights as every other person? If that point comes about at fertilisation or during the embryonic stage then what occurs to extract stem cells out of these early life forms is effectively murder and therefore should not happen. Embryos are not the only place stem cells can be extracted from however, umbilical cords that are disposed of and bone marrow can be a plentiful source also however according to one source I found[9], religious groups Religious groups claim that because embryonic stem cell research requires the subsequent destruction of the embryos used, it is a form of abortion. They sustain that creating embryos for the sole purpose of commercial use, followed by their disposal is morally unacceptable, and strongly oppose the area of study while adult and cord stem cells are readily available instead.
Perhaps the biggest risk with this new area of research is the unknown. The introduction of stem cells into the body is permanent and this means there may be some long term side effects that we do not know about at the moment that might become clearer later along in the process. These are bad because we would not be able to reverse the effects of these side effects, A French study ten years ago found that recipients of genetically altered bone marrow transplants developed leukaemia years after their allegedly successful transplants had cured their severe combined immunodeficiency. Some research on rats in California found a way of successfully curing paralysis, however some small cysts appeared in the area near where the stem cells were injected. However harmless these were to rats, the effect of this to humans is still “questionable”. Other side effects that could be because of stem cell research include growth of strange objects such as teeth bones and hair on unusual areas, if this was done using embryonic stem cells these continue to grow throughout the patient’s life. Around 20% of rats injected with embryonic stem cells later die of some kind of cancerous tumour. This could be completely by chance but this high statistic is enough for large groups of people to doubt whether regenerative medicine is the right way to go in medicine.
Another major cause for concern in stem cells is that in some cases it is known for differentiated stem cells to be rejected by the host body. A report published in ‘nature’ in 2011[10] showed that when a specific type of stem cell, induced pluripotent stem cells (iPSCs), used to treat diseases, found that iPSCs could face rejection by the immune system, even when injected into the same person who donated the cells. This immune response could destroy the transplants, rendering them ineffective as treatments. Although a different report published in 2013 by ‘Nature’ seemed to show that these iPSCs were effective in being transferred in genetically identical mice and not triggering a strong immune response. This contrasting information shows just how unpredictable stem cell research is and that it may not be the best way to treat diseases.
In conclusion then I think that on balance using regenerative methods in treating diseases in general are a very effective way of doing things however it is not a completely safe and risj free process as in my opinion I still think that for it to be the best method stem cell therapy can be it still needs more research on the long term effects of the process, but from early indications it is looking promising barring a few studies.
However what about in our specific disease? How does a using stem cell therapy affect the multiple sclerosis disease? Is it as effective at treating it as the other conditions already mentioned? At present there are no treatments that specifically target the abnormal immune responses in MS. Current approaches, such as interferon, copaxone, or immune suppressants all act in a non‐specific manner blocking immune responses against the myelin sheath. While these approaches are useful for reducing the severity of disease, they do not repair the damage to nervous system tissue that has already occurred and therefore they cannot cure multiple sclerosis. However stem cells provide a different way of treating the disease. Instead of protecting the myelin sheath they allow it to be destroyed however it is replaced by stem cells that are externally differentiated in a lab before injected into the spinal cord or in the blood stream ready to be transferred to the brain. It is either this repair method used or, according to the MS society website, the nerve cell can be prevented from being damaged. This is called ‘neuroprotection’ and is an active area of research involving adult stem cells from the bone marrow called mesenchymal stem cells. These stem cells are taken from human umbilical cords [11] that are donated after normal healthy births so this avoids the debate over the controversial topic of where the stem cells are taken from. These stem cells are then screened for infectious diseases, with only about 1 in 10 umbilical cords passing screening tests. The advantages of this treatment are that anybody can be treated using these stem cells as they do not need to be matched with their genome, the stem cells are easily extracted and there is a large supply of them, and these HUCT mesenchymal stem cells are a lot more ‘robust’ then other types leading to a higher success rate.
So that type of stem cell treatment by the stem cell institute seems relatively effective in terms of protecting the myelin sheath from the autoimmune response brought about by MS. however this is not the only study I found that seems to show that Multiple sclerosis can be cured by regenerative medicine. “Scientists at The Scripps Research Institute (TSRI) have identified a set of compounds that may be used to treat multiple sclerosis (MS) in a new way. Unlike existing MS therapies that suppress the immune system, the compounds boost a population of progenitor cells that can in turn repair MS-damaged nerve fibers.”[12]. In this report, it is shown that a previous drug, benztropine, that was used to treat Parkinson’s disease, has been shown to increase numbers of oligodendrocyte (cells that make the myelin sheath and wrap it around the nerve fibre) in the nerve sharply, and thus increasing the amount of myelin produced. To do this scientists screen over 10,000 diverse compounds to see if any could potentially cause OPC cells to differentiate, and the already tested drug benztropine seemed to do that already.
However, not all studies show this trend however, a journal on PLOS one[13] shows that a new type of stem cell, neural stem cells (NSCs), “ does not have a major influence on the clinical course of rMOG-induced EAE. Improving the efficiency at which NSCs home to inflammatory sites may enhance their therapeutic potential in this model of CNS autoimmunity” Meaning that the new type of stem cell does not have any effect on the number of oligodendrocyte cells being produced to repair the myelin sheath, and thus showing that regenerative medicine isn’t always effective.
Is it good that we are finding a way of treating Multiple Sclerosis?
Finding a way to cure MS might save millions of lives and improve the livelihoods of people around the world, and in my opinion that is a good thing and should come before anything else, however, some people believe that finding cures for life threatening diseases is not such a good thing at all and can have a negative effect on humanity. They believe that we are ‘playing god’ by finding cures to diseases such as multiple sclerosis and that this should be stopped. They have a point however because the world is running low on resources; oil, coal and natural gas, the three main contributors to producing the worlds electricity, are running in short supply, we as a planet are releasing more carbon dioxide and other greenhouse gasses into the atmosphere than ever before. Also finding enough food to go round and supplying everyone with clean, safe drinking water, these are many of the world’s main crises at the moment, and this is all mainly due to the rapidly rising population of the earth. The more people on the planet, the more people needing all of these resources and the more people releasing greenhouse gasses into the atmosphere, the more people wanting to develop to become more like the resource hungry western world. A rising population is most certainly not always a good thing and if we are saving lives by finding cures to diseases by using regenerative medicine then surely we are just adding to the already too many people of the world as it is, and that may worsen the situation even more. This is a controversial argument against modern medicine but still a valid one giving good points.
Conclusion
It would have been unwise to assume I had already found an answer to my research question before I started or even during my research due to the complex nature of all the medical problems and situation issues involved with coming to a conclusion but I will do it now. In order to answer this question I have to think about what it means for a treatment to be effective. I believe that for a treatment to be effective it has to be able to positively affect as many patients as possible to the best of its ability but still has to be sustainable and not cause any long term problems. The short answer to the question ‘to what extent is regenerative medicine the most effective method of treating multiple sclerosis’ is that we don’t know, yet. We cannot be 100 percent certain that what we are doing with stem cells is completely safe in the long run and that it won’t cause any long term side effects on patients. We also cannot guarantee that the stem cells will not be rejected by the body or if they will actually work or not. This is all because this is a relatively new technology that has not been fully tested on humans as of yet.
The alternatives are the medicines that are in place now, the interferon, copaxone, or immune suppressants are all known and tested to work, they have no known side effects and they are not any more controversial than any normal drug. However the problem with those drugs is that they only work up to a point. They are only designed to slow down the process of the damage of the nerve fibre and to reduce the impacts of a relapse, they do not, unlike stem cell treatment, enable MS sufferers to become better and reverse the treatment, effectively ‘curing’ them of the disease. This is why in my opinion, although hard to decide, I think that stem cells aren’t the most effective way of treating MS at the moment, I think traditional methods are, but carrying on the path of research that is going on at the moment, with a few breakthroughs I believe that regenerative medicine is the answer to the MS problem and will be by far the most effective way of treating multiple sclerosis and this is already starting to be shown with the tests on mice that are enabling things like paralysis and of course multiple sclerosis to be reversed. This will mean that hopefully in the near future many diseases will be able to be repaired or prevented and this, although may cause problems to humanity in terms of resources and population size, will be of huge significance saving countless lives.
This project has allowed me to explore a subject to a great depth that would otherwise have been impossible to achieve otherwise. This not only allowed me to explore a topic that I enjoy reading about, but a topic that will help me in my future studies. Research allows you to pursue your interests, to learn something new, to hone your problem-solving skills and to challenge yourself in new ways and this is, in my belief, of great importance of people of my generation to do so they can strive for success. I have learnt not only the concepts behind the science of multiple sclerosis and the treatments available for the disease, but also it has enabled me to read real scientific journals and research deeper into things of my interest, giving me a bigger understanding about the role and the world of science and biology.
Bibliography
[1] dictionary, t. f. (2015). disease. Retrieved from the free dicitonary: http://www.thefreedictionary.com/disease - free online dictionary, should be a reliable source with no bias. federation, M. i. (2015). causes of multiple sclerosis. Retrieved from MS international federation: http://www.msif.org/about-ms/causes/ - international organisation investigating stem cells, likely to be bias towards the use of stem cells as it is in their best interests. written by experts in their fields.
Ian Murnaghan BSc (hons), M. (2015, February ). Benefits of Stem Cells. Retrieved from Explore stem cells: http://www.explorestemcells.co.uk/benefitsofstemcells.html - credited author with high knowlage of subject. likely to be bias towards stem cell use, providing information about stem cells. medicine, c. o. (2015). stem cells and regenerative medicine . Retrieved from http://www.crm.ed.ac.uk/: http://www.crm.ed.ac.uk/stem-cells-and-regenerative-medicine/regenerative-medicine - providing basic information about stem cells, not likely to have much bias and are reliable as they are a charity providing information.
Natalie L. Payne, G. S.-G. (2012). Comparative Study on the Therapeutic Potential of Neurally Differentiated Stem Cells in a Mouse Model of Multiple Sclerosis. PLOS one, 14.- scientific journal showing the results from a experiment on stem cells. showing results so unlikely to be bias. experts written and has been peer reviewed.
Neil Rhiodan, P. (2012). Stem Cell Therapy multiple sclerosis. Retrieved from stem cell institute : https://www.cellmedicine.com/stem-cell-therapy-for-multiple-sclerosis-3/ - credited author liekly to be bias towards stem cells.
NHS. (2013, March 13). Multiple Sclerosis information. Retrieved from NHS choices : http://www.nhs.uk/conditions/Multiple-sclerosis/Pages/Introduction.aspx- NHS webpage written to inform, unlikely to be bias and is written by qualified scientists. profit, T. S.-n. (2013, October 9). New Strategy to Treat Multiple Sclerosis Shows Promise in Mice. Retrieved from the scripps research institute : http://www.scripps.edu/news/press/2013/20131009lairson.html - from a reaserch group telling of their latest findings. likely to be bias to their own discoveries however they are expertds in their field and it may have been peer reviewed.
Sample, I. (2014, October 15). Stem cell therapy success in treatment of sight loss from macular degeneration. Retrieved from http://www.theguardian.com/: - guardian article so potentual for political bias. http://www.theguardian.com/science/2014/oct/15/stem-cell-success-in-treating-macular-degeneration- another guardian artcile so more potentual for political bias.
Society, M. S. (2015). disease modifying drugs. Retrieved from MS Society: http://www.mssociety.org.uk/what-is-ms/treatments-and-therapies/licensed-disease-modifying-drugs - information on drugs to treat multiple sclerosis on a society dedicated to the disease. unlikely to be bias as it is just giving information. unknown. (2015). Risks and Disadvantages of Stem Cell Research. Retrieved from stem cell research: http://chem445stemcell.webs.com/risksanddisadvantages.htm- unknown author so potentual for bias and unkown the credibility of the source.
Young, E. (2013, January 9). Debate Over Stem Cell Effectiveness. Retrieved from The Scientist : http://www.the-scientist.com/?articles.view/articleNo/33902/title/Debate-Over-Stem-Cell-Effectiveness/ - article from scientific magazine. showing both sides of the argument however could be bias, author is an expert.
To What Extent Is Regenerative Medicine The Most Effective Way Of Treating Multiple Sclerosis?
Candidate name: Joshua Carter
Candidate number: 7125
Centre number: 61425
Contents
Abstract- page 3
Introduction and research- page 4
Discussion- page 10
Conclusion- page 15
Bibliography- page 17
Abstract
Stem cells are going to be a major point of interest in a large part of modern day biology. They already dominate many of the headlines of newspapers nearly every day and this will only continue. With the continued research going on into this new, potential way of curing many diseases that 20 years ago we would never have thought could have been cured, can it do the same for the neurological …show more content…
condition, multiple sclerosis? And how effective is it in doing so? Many reports have come out of stem cells being effective in mice to cure the disease but with the many controversial points that come with the use of stem cells would alternative, existing methods be a better way of treating it? Are the immunosuppressant drugs of today more effective in treating the condition and are they a more realistic thing to be using? Also is it actually a good thing if we are finding new cures to all of these diseases? With the world’s population rapidly rising and resources running out to feed everybody and supply them all with energy, would it be better if we continued as we are and stopped ‘playing God’? These are the issues that I will be discussing in this essay.
Introduction and Research
What is multiple sclerosis? “An abnormal condition of a part, organ, or system of an organism resulting from various causes, such as infection, inflammation,environmental factors, or genetic defect, and characterized by an identifiable group of signs, symptoms, or both.” Is the definition of a disease in an online free dictionary[1] and they affect people’s lives in in many ways, nearly all of them being bad and detrimental to both society, families and the world. they can be passed on by direct transfer of bacteria, viruses and other germs. However they can be passed on by sex, either in the form of sexually transmitted diseases or by genetically passing down to offspring during fertilisation. A disease that is linked to being both hereditary and environmental is the neurodegenerative disease, Multiple Sclerosis.
Multiple Sclerosis is a disease that affects the nervous system of the body, specifically in the brain and spinal cord [2]. Every nerve cell in the body is surrounded by a protective layer known as the myelin sheath which enables electrical impulses that travel around the body to reach their destination hundreds of times quicker than it would without one. If a person has Multiple Scleroses, MS, then this myelin is broken down partly and therefore messages are not sent to the brain or spinal cord as efficiently. This results in a sufferer or MS to experience potential symptoms such as: loss of vision, in one eye usually, uncontrollable muscle spasms and muscle stiffness, difficulties in balance and co-ordination and people find they often suffer from tiredness and fatigue.
There are two main types of Multiple sclerosis that sufferers get. The first, relapsing remitting MS, occurs in approximately eight out of ten people that are diagnosed with MS are diagnosed with this form. Somebody with relapsing remitting multiple sclerosis will have periods without suffering any of the symptoms usually associated with the disease, then they will suffer periods where the symptoms are severe and the patient may become partially blind or be unable to move. However, this period will pass and the sufferer will go back to almost normal again without showing any signs or having the disease. This period may last weeks, months or even years and this is why diagnosing this type of MS is so hard to do because of how irregular it is it can be mistaken for a number of temporary conditions and people don’t report when they experience symptoms because they have “had them before and I was ok”. After 15 years of so, about half of people that have got relapsing remitting MS will go on to develop secondary progressive multiple sclerosis. This is much like the first form and people may still experience relapses but the symptoms will worsen over time and they may not fully recover from their relapse. Primary progressive MS is the least common type of sclerosis. This is where there are no periods of remission and symptoms just worsen over time with no break periods.
Treatments for multiple sclerosis:
Currently there is no cure for Multiple sclerosis but there are a number of treatments that can help [2]. Relapsing remitting multiple sclerosis can be treated with drugs called ‘disease modifying drugs’, these are not a cure for the disease but instead can reduce the severity of the symptoms in a sufferer and can reduce the number of relapses they have. However they are not suitable for all sufferers of Multiple Sclerosis. There are currently 10 licenced DMD’s (disease modifying drugs) [3] these are:
Aubagio (teriflunomide) – oral tablet taken once a day. Available if patient has had at least two relapses in the past two years.
Avonex (interferon beta-1a) – Injection available if patient has had two relapses in the past two years.
Betaferon (interferon beta-1b) – available if patient has had two relapses in the past two years, it is injected.
Copaxone (glatiramer acetate) – another injection available after two relapses in the same period of time.
Extavia (beta interferon-1b) – injection if patient has has 2 relapses in 2 years.
Gilenya (fingolimod) – available if patient is still experiences despite treatment with one of the beta interferons. It is an oral tablet taken once a day.
Lemtrada (alemtuzumab) – available for treating the active relapsing remitting form of multiple sclerosis. It is given to patient via a drip once a year.
Plegridy (peginterferon beta 1a) – injection for people living in Scotland for sufferers that have had 2 relapses in 2 years.
Rebif (beta interferon- 1a) – another injection available for patients suffering 2 relapses in the past 2 years.
Tecfidera (dimethyl fumarate) – used to treat active relapsing remitting MS. Approved by the NHS and became available in autum 2014. It is a oral tablet that should be taken twice a day.
Tysabri (natalizumab) – available if you have had 2 relapses in one year or if severity of relapses has increased once another DMD has been taken, given by drip monthly.
There are also a wide range of other treatments available to treat multiple sclerosis. Physiotherapy can be used to make day to day living with MS more bearable and steroids can be given to patients to speed up recovery times from relapses.
Causes of Multiple Sclerosis:
Multiple sclerosis is an autoimmune condition.
This means that the body’s defence against harmful diseases (the immune system) is affected in some way and that causes the immune system to change from attacking foreign viruses to attacking healthy body tissue- in multiple sclerosis this is the healthy Myelin that surrounds nerve cells in the body. The myelin is broken down by the body’s own immune system, nervous impulses are less efficient in travelling to the body’s Central Nervous System. As a result of this, in the places where the myelin on the myelin sheath has been thinned or destroyed, a hard region or scar is left in its place, often referred to as a sclerosis. Where there is multiple of these hardened scars on different places on the brain or spinal cord is where the autoimmune disease gets its name from- Multiple …show more content…
Sclerosis.
The causes of Multiple sclerosis are currently unknown; however scientists believe the main causes of the disease are a combination of genetic and environmental factors and are “putting the pieces of this complicated puzzle together” [4].
Genetic factors- genes are pieces of genetic information that code for the production of proteins, molecules that are essential for many of the bodies vital functions. Occasionally come genes may be faulty and produce defective proteins. This is the cause of many of the diseases we see today however this isn’t what is believed to occur in multiple sclerosis. It is thought that individuals that are affected by MS have slight variations, called polymorphins, which are healthy genes that fit badly when combined together in DNA and thus cause healthy cells around it to be altered, especially cells involved in the body’s immune system. This bad combination of genes is then passed down through the generations by normal mechanism of inheritance and therefore there is a strong link of multiple sclerosis being shared within families. There are a few genes that have been identified to make people more likely to get MS, in particular the HLA (also known as “major histocompatibility complex”, as containing the most MS susceptible gene. These proteins are found on the surface of all body cells. They act as a messenger to the immune system telling the body whether a cell is foreign or part of the body and whether it should be attacked or not. These proteins are usually healthy and therefore there must be another reason for them being altered to become defective. Scientists believe this is down to environmental factors.
One theory is that a virus that is usually lying dormant in the body may disturb the immune system and therefore cause the disease to develop. There is probably on one MS virus but actually a combination of a common virus such as measles that acts as a trigger for MS. This trigger activates white blood cells (lymphocytes) in the bloodstream, which enter the brain by making the brain’s defence mechanisms (i.e. the blood/brain barrier) vulnerable. Once inside the brain, these cells activate other elements of the immune system in such a way that they attack and destroy myelin. It is also thought that vitamin D, the vitamin we get from sunlight, is linked to the disease. There has been a correlation between people that receive low levels of vitamin D have a higher chance of developing MS. A number of studies have indicated that smoking is also linked to the development of Multiple Sclerosis. It is not clear why this happens however it has been theorised that chemicals in cigarettes may have some sort of effect on the immune system and may alter it. Smoking’s effect on the progression of multiple sclerosis is also being investigated as it could be the fact that smoking leads to the progression of the disease being quicker and it may cause relapses to be more often and more severe.
It is estimated that around 100,000 people in the uk are suffering with Multiple sclerosis at this present time, with 2.5 million cases of MS in the world. Every week in the United States there are 200 people diagnosed with MS so this is a disease that has worldwide influence and is a major problem worldwide however it is incurable, this needs to change. Although the disease is not fatal in itself, some complications that can arise from severe MS, such as pneumonia, can be. This means that in order to reduce the numbers of people and families suffering with this terrible disease we as a race need to find a new way of treating it. This might be achieved through regenerative medicine.
Regenerative medicine:
Regenerative medicine is the process by which scientists are able to restore normal bodily functions by repairing or replacing damaged or malfunctioning cells and tissues in cells[5] and although it is in its early stages of development, it is bringing huge advances in the field of medicine as it could provide the cure for many different diseases such as Multiple sclerosis, dementia, strokes, heart disease and many types of cancer.
For example, the guardian reported a recent trial on 18 people suffering with two different types of macular degeneration, the leading causes of blindness in adults and children in the world, Stargardt’s macular dystrophy and dry atrophic age-related macular degeneration[6]. The patients had embryonic stem cell therapy on their eyes and were cured of sight loss without any side effects. Whatever sources of potential bias the guardian may have, being a politically left leaning newspaper, the point still remains, stem cell therapy and regenerative medicine has and will continue to provide a big source of hope in the fight against many different deadly diseases. Regenerative medicine mainly comes in the form of stem cell treatment, allowing scientists to use undifferentiated cells and turn them into any cell in the body to serve any function. This is a huge breakthrough in science and medicine as it enables anything to be made, it solves the problem of organ storage or a lack of organ donors, as hearts and lungs can just be grown in a lab and
transplanted into the patient that requires them.
Stem cell Research:
In the early 1900s, European researchers discovered that various types of blood cells all came from a particular ‘stem cells’, however it was not until 1963 that the particular type of self-renewing cells was first described in mice bone marrow cells by Canadian researchers Ernest A McCulluch and James E Till [7]. Since that time there has been continued efforts to grow and differentiate adult animal and human stem cells in a lab. This was made a lot easier in the 1980s and 1990s where there was an introduction of techniques for targeting and altering genetic material and methods for growing human cells in the laboratory. These advances really opened the doors for human stem cell research. The breakthrough came in 1998 when James Thompson, from the university of Wisconsin in Madison, successfully removed embryonic cells from a fertility clinic and cultivated them in a lab, this launched stem cell research into the limelight. Since then there has been plenty of further research that suggests that these embryonic stem cells can specialise into any cell in the human body which, if mastered, could open up a whole new world of new medicine that could change millions of people’s lives. As stem cells were only brought into the public attention in 1998, the technology is still relatively new and still in its youth. There have been no clinical trials of stem cell treatments as of yet however; adult stem cells are already being used in treatments for over one hundred conditions including leukaemia, Hunter’s syndrome and heart disease.
So stem cells are the answer to all of humanities worry’s yes? Unfortunately that is not that case as this new technology does not come with many controversial parts with many people opposing to this potentially lifesaving new technology, the main point of controversy is the use of embryonic stem cells and the ethical considerations behind that.
In this document I will be discussing the main treatments of multiple sclerosis and relating it back to the question of ‘is Regenerative Medicine the most effective way of treating Multiple Sclerosis?’ so I will evaluating whether other methods of treating multiple sclerosis is more effective than stem cell research then I will be coming to a conclusion at the end of the essay.
Discussion
Effectiveness of Stem Cell Treatment:
The first issue to talk about is whether stem cells are an effective method of treating any disease and then to focus down on the specific disease we are looking at. There is no doubt that the discovery of these undifferentiated, unspecialised cells is a hugely promising unearthing, however are they a truly effective way of treatment? Do they actually do all the things that scientists promise they can do? And are they sustainable?
Firstly, let’s look at the plus sides of stem cells, what they can do that is beneficial to the body and what they can do to aid the recovery of a disease or illness. Diseases such as cancer or conditions such as birth defects are thought to occur because of problems in the differentiation process, an understanding of the development that happens in normal cells and stem cells will help scientists treat the developmental errors that can occur. This will help in two fields because we will know more about the development of cancers and birth defects as well as discovering more about how stem cells differentiate (to make or become different in the process of growth or development), and this will help us be able to use stem cells more effectively in turn at treating these problems, working in a positive feedback model.
The next advantage of stem cells, according to website ‘explore stem cells’ is that there is another potential application of cell based therapies [8]. This is when stem cells are used to grow specific cells and then are bound together using a mould to create a completely new organ or tissue. This is a huge advantage to stem cells as currently when a patient needs to new organ they get one transplanted from an organ donor. At this current time there is nowhere near the required amount of organ donors to supply the needs of people needing an organ transplant and with this new regenerative technique instead of waiting for a new organ to be donated, a new organ can be grown from scratch to fit into your body. This will dramatically reduce the amount of people dying whilst being on the waiting lists for an organ transplant. Stem cells can benefit those suffering from Parkinson’s disease, type 1 diabetes, arthritis, burn victims and people with cardiovascular diseases (the biggest killing disease in the UK- BBC) using this method of treatment.
Stem cells also have the potential to reverse the effects of diseases. Stem cells are directed into differentiating into specific cell types, they can be fed into the body, providing a renewable resource of replacement cells for the patient. For example, people with heart disease can have stem cells differentiated into heart muscle cells to replace cells damaged by the disease, in Parkinson’s disease damaged brain cells can be reversed by replacing them with new healthy brain cells, reversing the effect of the disease. An even more exciting prospect is to address genetic defects that are present from birth by restoring function and health with the introduction of normal healthy cells that do not have these defects. Burn victims will, instead of suffering large amounts of pain from their injuries and instead of having to wait for donor tissues, they can have new healthy skin cells implanted onto the patient. Scientists are hoping to do this by growing skin cells in a lab from a very small piece of skin by triggering stem cells to differentiate outside the body so that large burn areas can be covered by a relatively small amount of initial skin cells.
The final major benefit to stem cells research is that is provides a huge role in the pharmaceutical industry and is involved heavily in drug development. Any new drugs that are being tested for human consumption can be tested on human stem cells before they are released for their safety. This could be the case with a new anti-tumour drug for example, and if the conditions that the drugs are tested in are in the correct conditions then the results could end up being very accurate and the drugs could be shown to be safe for human use and will help to treat people with life threatening diseases. The advantages of stem cells are well documented and for people with serious conditions could be a source of major hope that one day they could be the cure for them.
So it would seem as though stem cells are completely fine, effective and the answer to all of our prayers. This is not the case however, stem cell therapy is still a very controversial topic, and this is nearly all down the disadvantages that come about with stem cells. Firstly it is where stem cells are collected from. Many stem cells are collected from embryos to form embryonic stem cells; these are a very good type of stem cell to use as embryos are full of unspecialised cells as eventually these will turn into a new baby human being. However, if embryonic stem cells are used then effectively there is no chance that the embryo will develop into a new-born and an abortion will take place. For many people this raises the argument of at what point does an embryo become a human and therefore has the same rights as every other person? If that point comes about at fertilisation or during the embryonic stage then what occurs to extract stem cells out of these early life forms is effectively murder and therefore should not happen. Embryos are not the only place stem cells can be extracted from however, umbilical cords that are disposed of and bone marrow can be a plentiful source also however according to one source I found[9], religious groups Religious groups claim that because embryonic stem cell research requires the subsequent destruction of the embryos used, it is a form of abortion. They sustain that creating embryos for the sole purpose of commercial use, followed by their disposal is morally unacceptable, and strongly oppose the area of study while adult and cord stem cells are readily available instead.
Perhaps the biggest risk with this new area of research is the unknown. The introduction of stem cells into the body is permanent and this means there may be some long term side effects that we do not know about at the moment that might become clearer later along in the process. These are bad because we would not be able to reverse the effects of these side effects, A French study ten years ago found that recipients of genetically altered bone marrow transplants developed leukaemia years after their allegedly successful transplants had cured their severe combined immunodeficiency. Some research on rats in California found a way of successfully curing paralysis, however some small cysts appeared in the area near where the stem cells were injected. However harmless these were to rats, the effect of this to humans is still “questionable”. Other side effects that could be because of stem cell research include growth of strange objects such as teeth bones and hair on unusual areas, if this was done using embryonic stem cells these continue to grow throughout the patient’s life. Around 20% of rats injected with embryonic stem cells later die of some kind of cancerous tumour. This could be completely by chance but this high statistic is enough for large groups of people to doubt whether regenerative medicine is the right way to go in medicine.
Another major cause for concern in stem cells is that in some cases it is known for differentiated stem cells to be rejected by the host body. A report published in ‘nature’ in 2011[10] showed that when a specific type of stem cell, induced pluripotent stem cells (iPSCs), used to treat diseases, found that iPSCs could face rejection by the immune system, even when injected into the same person who donated the cells. This immune response could destroy the transplants, rendering them ineffective as treatments. Although a different report published in 2013 by ‘Nature’ seemed to show that these iPSCs were effective in being transferred in genetically identical mice and not triggering a strong immune response. This contrasting information shows just how unpredictable stem cell research is and that it may not be the best way to treat diseases.
In conclusion then I think that on balance using regenerative methods in treating diseases in general are a very effective way of doing things however it is not a completely safe and risj free process as in my opinion I still think that for it to be the best method stem cell therapy can be it still needs more research on the long term effects of the process, but from early indications it is looking promising barring a few studies.
However what about in our specific disease? How does a using stem cell therapy affect the multiple sclerosis disease? Is it as effective at treating it as the other conditions already mentioned? At present there are no treatments that specifically target the abnormal immune responses in MS. Current approaches, such as interferon, copaxone, or immune suppressants all act in a non‐specific manner blocking immune responses against the myelin sheath. While these approaches are useful for reducing the severity of disease, they do not repair the damage to nervous system tissue that has already occurred and therefore they cannot cure multiple sclerosis. However stem cells provide a different way of treating the disease. Instead of protecting the myelin sheath they allow it to be destroyed however it is replaced by stem cells that are externally differentiated in a lab before injected into the spinal cord or in the blood stream ready to be transferred to the brain. It is either this repair method used or, according to the MS society website, the nerve cell can be prevented from being damaged. This is called ‘neuroprotection’ and is an active area of research involving adult stem cells from the bone marrow called mesenchymal stem cells. These stem cells are taken from human umbilical cords [11] that are donated after normal healthy births so this avoids the debate over the controversial topic of where the stem cells are taken from. These stem cells are then screened for infectious diseases, with only about 1 in 10 umbilical cords passing screening tests. The advantages of this treatment are that anybody can be treated using these stem cells as they do not need to be matched with their genome, the stem cells are easily extracted and there is a large supply of them, and these HUCT mesenchymal stem cells are a lot more ‘robust’ then other types leading to a higher success rate.
So that type of stem cell treatment by the stem cell institute seems relatively effective in terms of protecting the myelin sheath from the autoimmune response brought about by MS. however this is not the only study I found that seems to show that Multiple sclerosis can be cured by regenerative medicine. “Scientists at The Scripps Research Institute (TSRI) have identified a set of compounds that may be used to treat multiple sclerosis (MS) in a new way. Unlike existing MS therapies that suppress the immune system, the compounds boost a population of progenitor cells that can in turn repair MS-damaged nerve fibers.”[12]. In this report, it is shown that a previous drug, benztropine, that was used to treat Parkinson’s disease, has been shown to increase numbers of oligodendrocyte (cells that make the myelin sheath and wrap it around the nerve fibre) in the nerve sharply, and thus increasing the amount of myelin produced. To do this scientists screen over 10,000 diverse compounds to see if any could potentially cause OPC cells to differentiate, and the already tested drug benztropine seemed to do that already.
However, not all studies show this trend however, a journal on PLOS one[13] shows that a new type of stem cell, neural stem cells (NSCs), “ does not have a major influence on the clinical course of rMOG-induced EAE. Improving the efficiency at which NSCs home to inflammatory sites may enhance their therapeutic potential in this model of CNS autoimmunity” Meaning that the new type of stem cell does not have any effect on the number of oligodendrocyte cells being produced to repair the myelin sheath, and thus showing that regenerative medicine isn’t always effective.
Is it good that we are finding a way of treating Multiple Sclerosis?
Finding a way to cure MS might save millions of lives and improve the livelihoods of people around the world, and in my opinion that is a good thing and should come before anything else, however, some people believe that finding cures for life threatening diseases is not such a good thing at all and can have a negative effect on humanity. They believe that we are ‘playing god’ by finding cures to diseases such as multiple sclerosis and that this should be stopped. They have a point however because the world is running low on resources; oil, coal and natural gas, the three main contributors to producing the worlds electricity, are running in short supply, we as a planet are releasing more carbon dioxide and other greenhouse gasses into the atmosphere than ever before. Also finding enough food to go round and supplying everyone with clean, safe drinking water, these are many of the world’s main crises at the moment, and this is all mainly due to the rapidly rising population of the earth. The more people on the planet, the more people needing all of these resources and the more people releasing greenhouse gasses into the atmosphere, the more people wanting to develop to become more like the resource hungry western world. A rising population is most certainly not always a good thing and if we are saving lives by finding cures to diseases by using regenerative medicine then surely we are just adding to the already too many people of the world as it is, and that may worsen the situation even more. This is a controversial argument against modern medicine but still a valid one giving good points.
Conclusion
It would have been unwise to assume I had already found an answer to my research question before I started or even during my research due to the complex nature of all the medical problems and situation issues involved with coming to a conclusion but I will do it now. In order to answer this question I have to think about what it means for a treatment to be effective. I believe that for a treatment to be effective it has to be able to positively affect as many patients as possible to the best of its ability but still has to be sustainable and not cause any long term problems. The short answer to the question ‘to what extent is regenerative medicine the most effective method of treating multiple sclerosis’ is that we don’t know, yet. We cannot be 100 percent certain that what we are doing with stem cells is completely safe in the long run and that it won’t cause any long term side effects on patients. We also cannot guarantee that the stem cells will not be rejected by the body or if they will actually work or not. This is all because this is a relatively new technology that has not been fully tested on humans as of yet.
The alternatives are the medicines that are in place now, the interferon, copaxone, or immune suppressants are all known and tested to work, they have no known side effects and they are not any more controversial than any normal drug. However the problem with those drugs is that they only work up to a point. They are only designed to slow down the process of the damage of the nerve fibre and to reduce the impacts of a relapse, they do not, unlike stem cell treatment, enable MS sufferers to become better and reverse the treatment, effectively ‘curing’ them of the disease. This is why in my opinion, although hard to decide, I think that stem cells aren’t the most effective way of treating MS at the moment, I think traditional methods are, but carrying on the path of research that is going on at the moment, with a few breakthroughs I believe that regenerative medicine is the answer to the MS problem and will be by far the most effective way of treating multiple sclerosis and this is already starting to be shown with the tests on mice that are enabling things like paralysis and of course multiple sclerosis to be reversed. This will mean that hopefully in the near future many diseases will be able to be repaired or prevented and this, although may cause problems to humanity in terms of resources and population size, will be of huge significance saving countless lives.
This project has allowed me to explore a subject to a great depth that would otherwise have been impossible to achieve otherwise. This not only allowed me to explore a topic that I enjoy reading about, but a topic that will help me in my future studies. Research allows you to pursue your interests, to learn something new, to hone your problem-solving skills and to challenge yourself in new ways and this is, in my belief, of great importance of people of my generation to do so they can strive for success. I have learnt not only the concepts behind the science of multiple sclerosis and the treatments available for the disease, but also it has enabled me to read real scientific journals and research deeper into things of my interest, giving me a bigger understanding about the role and the world of science and biology.
Bibliography
[1] dictionary, t. f. (2015). disease. Retrieved from the free dicitonary: http://www.thefreedictionary.com/disease - free online dictionary, should be a reliable source with no bias. federation, M. i. (2015). causes of multiple sclerosis. Retrieved from MS international federation: http://www.msif.org/about-ms/causes/ - international organisation investigating stem cells, likely to be bias towards the use of stem cells as it is in their best interests. written by experts in their fields.
Ian Murnaghan BSc (hons), M. (2015, February ). Benefits of Stem Cells. Retrieved from Explore stem cells: http://www.explorestemcells.co.uk/benefitsofstemcells.html - credited author with high knowlage of subject. likely to be bias towards stem cell use, providing information about stem cells. medicine, c. o. (2015). stem cells and regenerative medicine . Retrieved from http://www.crm.ed.ac.uk/: http://www.crm.ed.ac.uk/stem-cells-and-regenerative-medicine/regenerative-medicine - providing basic information about stem cells, not likely to have much bias and are reliable as they are a charity providing information.
Natalie L. Payne, G. S.-G. (2012). Comparative Study on the Therapeutic Potential of Neurally Differentiated Stem Cells in a Mouse Model of Multiple Sclerosis. PLOS one, 14.- scientific journal showing the results from a experiment on stem cells. showing results so unlikely to be bias. experts written and has been peer reviewed.
Neil Rhiodan, P. (2012). Stem Cell Therapy multiple sclerosis. Retrieved from stem cell institute : https://www.cellmedicine.com/stem-cell-therapy-for-multiple-sclerosis-3/ - credited author liekly to be bias towards stem cells.
NHS. (2013, March 13). Multiple Sclerosis information. Retrieved from NHS choices : http://www.nhs.uk/conditions/Multiple-sclerosis/Pages/Introduction.aspx- NHS webpage written to inform, unlikely to be bias and is written by qualified scientists. profit, T. S.-n. (2013, October 9). New Strategy to Treat Multiple Sclerosis Shows Promise in Mice. Retrieved from the scripps research institute : http://www.scripps.edu/news/press/2013/20131009lairson.html - from a reaserch group telling of their latest findings. likely to be bias to their own discoveries however they are expertds in their field and it may have been peer reviewed.
Sample, I. (2014, October 15). Stem cell therapy success in treatment of sight loss from macular degeneration. Retrieved from http://www.theguardian.com/: - guardian article so potentual for political bias. http://www.theguardian.com/science/2014/oct/15/stem-cell-success-in-treating-macular-degeneration- another guardian artcile so more potentual for political bias.
Society, M. S. (2015). disease modifying drugs. Retrieved from MS Society: http://www.mssociety.org.uk/what-is-ms/treatments-and-therapies/licensed-disease-modifying-drugs - information on drugs to treat multiple sclerosis on a society dedicated to the disease. unlikely to be bias as it is just giving information. unknown. (2015). Risks and Disadvantages of Stem Cell Research. Retrieved from stem cell research: http://chem445stemcell.webs.com/risksanddisadvantages.htm- unknown author so potentual for bias and unkown the credibility of the source.
Young, E. (2013, January 9). Debate Over Stem Cell Effectiveness. Retrieved from The Scientist : http://www.the-scientist.com/?articles.view/articleNo/33902/title/Debate-Over-Stem-Cell-Effectiveness/ - article from scientific magazine. showing both sides of the argument however could be bias, author is an expert.