Embryonic stem cells have the potential to revolutionize the treatment of incurable diseases, but they are highly controversial due to ethical issues. Induced pluripotent stem cells offer an alternative solution to this problem and require national research support.

How to cure incurable diseases in humans

How to cure incurable diseases in humans is a dream that has long been chased by many physicians and biologists. Diseases that are caused by internal factors in the body, such as cancer or genetic diseases, are more difficult to treat than those caused by other external infections. For example, leukemia is a disease caused by abnormal proliferation of white blood cells, and the only known treatment to date is to transplant bone marrow into the patient. However, this method faces the obstacle that it is very difficult to find a bone marrow donor that is suitable for the patient. However, with embryonic stem cell therapy, this step is eliminated entirely and immune rejection is not possible. This has revolutionized the treatment of incurable diseases for researchers. However, embryonic stem cell research is fraught with ethical issues, as embryos in the blastocyst stage must be destroyed to obtain embryonic stem cells. What is the answer to the question of whether embryonic stem cell research should be allowed?

Definition and characteristics of embryonic stem cells

Stem cells are cells that have the ability to differentiate into specific cells and tissues. Cells harvested from human embryos are called embryonic stem cells, which can differentiate into almost any cell and can be cultured into any cell depending on the input. When a fertilized egg, which is a combination of an egg and sperm, undergoes multiple cell divisions to become a blastocyst, it is ready to differentiate into an embryo. At this point, the cells inside the blastocyst have the ability to differentiate into cells of any tissue in the human body, and can be extracted to obtain pluripotent cells. These cells are self-renewing, meaning they can multiply in large numbers and can be transplanted into other people and other species without immune rejection. Embryonic stem cell therapy is a promising way to treat incurable and genetic diseases, as these cells can be used to replace damaged tissue or organs. In fact, in one case, an embryonic stem cell transplant restored sight to a blind patient with no side effects. Similarly, diseases such as leukemia and diabetes can be treated by injecting externally cultured cells. There seems to be no substitute for embryonic stem cells in terms of safety, functionality, and potential.

Ethical issues in embryonic stem cell research

Nevertheless, there are significant ethical issues with embryonic stem cell research. It’s important to clarify the issues that arise with embryonic stem cell research. First, there’s the issue of using embryos. Human embryonic stem cells are literally stem cells from embryos. An embryo is a fertilized egg up to eight weeks after fertilization by a sperm and egg. Embryonic stem cells are typically obtained from embryos that are about 4-5 days after fertilization. During this process, the early embryo is no longer able to differentiate and develop into a human being. The destruction of human life in the early embryonic state is unacceptable and poses a crucial bioethical issue for embryonic stem cell research. The embryos used for embryonic stem cells are either created through somatic cell cloning or are residual embryos left over from fertility treatments.
Proponents of using somatic cell cloning as a solution argue that cloned embryos are not life because they are not embryos created by fertilization of normal gametes. But is this argument convincing? In fact, in many cases, somatic cell cloned embryos have been created as life by allowing them to undergo the same developmental processes as normal embryos. The individual cloned in this way is Dolly the cloned sheep. Therefore, using somatic cell cloned embryos, let alone residual embryos, is also destroying embryos with human developmental processes and is not free from ethical issues.
It is also argued that it is difficult to view early embryos as human life. Defining when human life begins is a long-standing debate. Proponents of this argument say that early embryos should be distinguished in terms of dignity from later embryos, but this argument is not convincing. The fact that an early embryo does not have an established personhood identity and is less likely to develop into a fully-fledged person does not justify sacrificing it, because it contains all the biological information necessary for human life. A fertilized egg, fetus, and embryo are not separate entities, but a continuum of human life. Therefore, it is unjustifiable to characterize an early embryo as less human, and it deserves to be respected.

Concerns about human cloning

The second problem with this research is the concern about human cloning. The somatic cell cloning embryos mentioned earlier could be used to create cloned life. Following the success of the cloned sheep “Dolly,” reproductive cloning, which involves obtaining animals using somatic cell cloned embryos, is being experimented with on many animals and the success rate is increasing significantly. Cloned animals have been shown to die prematurely or suffer from a number of conditions. However, these problems are being addressed through repeated experiments, and at this point, cloning primates is known to be successful. While the use of human embryos for any purpose other than therapeutic cloning is prohibited, embryonic stem cell research is bound to contribute to the realization of human cloning. Human cloning involves not only the violation of human dignity, but also issues of personal identity, the commercialization of cloning, eugenic genetic manipulation, and other issues that will have a tremendous impact on society. Embryonic stem cell research runs too great a risk of going down this wrong path.

Egg harvesting issues

There are other problems with embryonic stem cell research. This research requires a very large number of eggs. The process of egg harvesting can be hazardous to women’s health, raises the issue of providing adequate information about egg donation, the issue of egg trafficking, and even the instrumentalization of women in biotechnology. In addition, there are many challenges to safely utilizing embryonic stem cells, including immune rejection, the potential for teratoma formation, and the induction of unstable differentiation.

Korea’s stance on embryonic stem cell research

In Korea, Prof. Hwang’s embryonic stem cell research was published in 2004, sparking a heated ethical debate centered on the Bioethics Society. The “Act on Bioethics and Safety,” enacted by the government in 2004, contains provisions related to embryonic stem cell research. It stipulates that “embryos shall not be created for purposes other than pregnancy” (Article 13) and allows research only for the following purposes: “residual embryos after the preservation period of embryos has elapsed, in vitro until the appearance of embryologically primordial glands, research for the development of infertility treatments and contraceptive technologies, research for the treatment of muscular dystrophy and other rare incurable diseases prescribed by the President, and other research prescribed by the President after deliberation by the National Bioethics Review Committee” (Article 17). In other words, it allows limited research using residual embryos and prohibits human cloning, but allows the use of somatic cell cloning embryos for the treatment of incurable diseases. South Korea is one of the few countries, including the United Kingdom, that allows residual embryo research. However, most industrialized countries, including the United States, Japan, Germany, and France, do not allow the creation of somatic cell cloned embryos due to ethical concerns, and severely restrict research that requires the destruction of embryos. The United Kingdom has enacted legislation to allow somatic cell cloning embryo research, but few studies have actually been allowed due to ethical controversy. As such, many developed countries do not legally allow embryonic stem cell research.

Alternatives to embryonic stem cells: induced pluripotent stem cells

As mentioned earlier, embryonic stem cells have unlimited potential research value. It’s a shame that ethical concerns prevent us from researching a technology with such irreplaceable potential. As a result, induced pluripotent stem cells (iPSCs) have been proposed as an alternative to embryonic stem cells. iPSCs are created by re-engineering factors characteristically expressed by embryonic stem cells into fully differentiated somatic cells. In 2006, Professor Yamanaka’s group in Japan succeeded in creating embryonic stem cell-like cells by introducing four genes, Oct4, Sox2, Klf4, and c-Myc, which play a key role in maintaining the pluripotency of embryonic stem cells, into mouse and human somatic cells. These cells grew at a rate similar to that of embryonic stem cells and expressed the pluripotency genes characteristic of embryonic stem cells, meaning that, like embryonic stem cells, they can develop into any tissue in the human body. For this work, Professor Shinya Yamanaka was awarded the Nobel Prize in Physiology or Medicine in 2012. iPSCs convert a patient’s own body cells into stem cells, so they have the same genes as the patient, eliminating the problem of immune rejection and allowing for mass production. Most importantly, induced pluripotent stem cells end the ethical problems of conventional embryonic stem cells, which can only be obtained by destroying embryos.

Clinical applications and prospects for induced pluripotent stem cells

Induced pluripotent stem cells represent a new paradigm as an alternative to embryonic stem cells, which inevitably raise many sensitive issues in clinical applications. Initially, to create these stem cells, genes were injected into somatic cells via viruses to modify them, which had the problem of causing cancer. However, over time, technologies have been developed that can solve this problem by inducing genes by other means other than viruses. In addition, many reverse differentiation techniques are being actively developed, such as excluding or replacing some of the four genes in inducing pluripotency to achieve the same result. Recently, there have also been some remarkable findings that have been published that have been able to reverse differentiate somatic cells into stem cells by simple stimulation without nuclear transplantation or genetic manipulation. As such, iPSCs have been a game-changer in stem cell research, and the focus of world research is now on them. However, it will still be some time before induced pluripotent stem cells are applied in cell therapy, as it is time-consuming to get them through the clinical process.

Conclusion: The importance of induced pluripotent stem cell research

In the past, there were clear arguments for and against embryonic stem cell research, but since the advent of induced pluripotent stem cells, these cells have become an alternative to embryonic stem cells. The development of iPSCs, which have gained worldwide attention, has virtually made the debate for and against embryonic stem cell research a moot point. Leaving aside embryonic stem cell research, which is not moving forward due to many obstacles, it seems to be the right way to focus on induced pluripotent stem cell research, which has taken over the mainstream of the world’s academic community. In addition, institutional arrangements, support, and attention will be needed at the national level to accelerate the realization of cell therapy using induced pluripotent stem cells and to secure national competitiveness in physiological medicine.