Stem Cells Research and Therapy

I. Thesis Statement
Stem cell therapy raises many ethical questions, certain clinics carry out unapproved therapies, while at the same time it has great potential for treating many human diseases as well as bringing benefits such as improving the quality of life and physical condition of patients.
II. Ethical Concerns
A. Stem cell-based interventions

1. Stem cell trials are becoming increasingly mystifying due to the desire to promote stem cell-based interventions in clinics without adequate scientific support (Aboalola et al., 2022).
2. Unproven stem cell therapies are described as trials very often, although patients have to pay for the experimental treatment, which leads to the opening of a complex of economic, social, and ethical problems (Aboalola et al., 2022).
3. Therefore, it is necessary to improve the assessment of stem cell therapy to make a clear distinction between trials without preclinical safety, which can threaten the future of regenerative medicine, and trials that support scientific research (Aboalola et al., 2022).
   B. Prenatal Stem Cell therapy
4. Ethical considerations related to perinatal stem cell therapy and stem cell treatments cannot be assessed (Ekblad‐Nordberg et al., 2019).
5. The source of stem cells should be well controlled so that the material is obtained while respecting ethical principles towards donors.
6. Prenatal diagnosis should be reliable and accurate and communicated in such a way that parents can make a well-founded and informed decision about whether to consent to prenatal stem cell therapy or not (Ekblad‐Nordberg et al., 2019).
7. The availability of treatment before birth can influence the parent’s decision whether to continue or terminate the pregnancy, although the outcome of prenatal therapy is uncertain (Ekblad‐Nordberg et al., 2019).
8. Furthermore, in addition to the fetus being treated, the treatment can also affect the mother, which increases the need for a relevant ethical discussion (Ekblad‐Nordberg et al., 2019).
   III. Stem Cell Therapy Benefits
   A. Heart Diseases
9. Ischemic heart disease is the leading cause of death worldwide (Liu et al., 2021).
10. Stem cell transplantation has become a promising therapy for the treatment of ischemic heart disease.
11. Preclinical stem cell therapies are effective and with encouraging results, including reduction of myocardial cell death, prevention of myocardial cell death, improvement of cardiac function, promotion of angiogenesis, and inhibition of scar formation (Liu et al., 2021).
12. Research supports the safety of stem cell therapy for the treatment of chronic heart failure (Hoang et al., 2022).
13. Stem cell therapy in patients with chronic heart failure leads to improved cardiovascular outcomes as well as general physical health and quality of life (Hoang et al., 2022).
    B. Other Human Diseases
14. Stem cells obtained from the umbilical cord, adipose tissue, or bone marrow can be used to treat various human diseases such as lung dysfunctions, neurological disorders, endocrine diseases, metabolic diseases, skin burns, reproductive disorders, cardiovascular conditions that still cannot be treated (Hoang et al., 2022).
15. In addition, stem cell therapy can be used as a treatment for knee osteoarthritis (Kenihan et al., 2020).
16. There are no statistical data about the benefits of stem cell therapy in reviewed articles
    IV. Legislation
17. One of the main principles advocated by the International Society for Stem Cell Research (ISSCR), which should also be applied worldwide, is the availability and transparency of information to the general public (Aboalola et al., 2022).
18. Researchers should consistently report the results of preclinical studies regardless of whether they are inconclusive, negative, or positive (Aboalola et al., 2022).
19. Furthermore, there is an ongoing policy that encourages stem cell agencies and regulatory bodies around the world to enforce regulations against the use of unapproved stem cell treatments (Aboalola et al., 2022).
20. The ISSCR has developed a section on its website where the public can report unapproved stem cell treatments at disreputable clinics to counter the proliferation of clinics offering such treatments (Aboalola et al., 2022).
    V. Conclusion
    A. Conclusion
21. Stem cell therapies raise many ethical questions, both regarding the recipient and the donor.
22. Prenatal treatment with stem cells leads to raising ethical questions regarding not only the treatment of the fetus but also ethical questions related to the mother because the treatment can potentially affect the mother as well.
23. Stem cells can be used to treat and cure diseases for which it has not been possible to introduce a cure until now.
24. Stem cell therapy has great potential to be used for many human diseases such as cardiovascular diseases, brain injuries, skin burns, etc.
25. It is necessary to introduce strict regulations to prevent the implementation of unapproved stem cell treatments.
    B. Future Research
26. Further research should be focused on combinations of stem cells with new technologies such as tissue engineering and 3D printing of organs.
27. Furthermore, it is necessary to examine the potential of imaging that can guide stem cell transplantation and enable non-invasive or minimally invasive transplantation.

References
Aboalola, D., Badraiq, H., Alsiary, R., Zakri, S., Aboulola, N., Haneef, L., Malibari, D., Baadhaim, M., & Alsayegh, K. (2022). An Infodemic of Misinformation on Stem Cell Therapy Among the Population of Saudi Arabia: A Cross-Sectional Study. Frontiers in Medicine, 9. https://doi.org/10.3389/fmed.2022.789695
Ekblad‐Nordberg, Å., Walther‐Jallow, L., Westgren, M., & Götherström, C. (2019). Prenatal stem cell therapy for inherited diseases: Past, present, and future treatment strategies: Concise Review. STEM CELLS Translational Medicine. https://doi.org/10.1002/sctm.19-0107
Hoang, D. M., Pham, P. T., Bach, T. Q., Ngo, A. T. L., Nguyen, Q. T., Phan, T. T. K., Nguyen, G. H., Le, P. T. T., Hoang, V. T., Forsyth, N. R., Heke, M., & Nguyen, L. T. (2022). Stem cell-based therapy for human diseases. Signal Transduction and Targeted Therapy, 7(1), 1–41. https://doi.org/10.1038/s41392-022-01134-4
Kenihan, L., McTier, L., & Phillips, N. M. (2020). Patients’ expectations and experiences of stem cell therapy for the treatment of knee osteoarthritis. Health Expectations, 23(5), 1300–1309. https://doi.org/10.1111/hex.13113
Liu, C., Han, D., Liang, P., Li, Y., & Cao, F. (2021). The Current Dilemma and Breakthrough of Stem Cell Therapy in Ischemic Heart Disease. Frontiers in Cell and Developmental Biology, 9. https://doi.org/10.3389/fcell.2021.636136