One salient point always to remember in medicine is that while we strive to help our patients we should avoid doing harm in any way. With stem cell treatment some risk or danger is unavoidable but certainly the risks should be as clearly defined as possible. Anyone currently offering stem cell treatment for financial reward without this knowledge will be considered to be acting unethically by the majority of the scientific and medical community.
So what could go wrong? First, the genetic manipulation of cells to create useful cells also throws into the mix the potential to induce neoplastic cancer cells. This is well known and described in laboratory controlled animal studies. It has also been observed in some individual patients from around the world who have been unfortunate after receiving what can best be described as a dirty slurry of stem cell material from unregulated unscrupulous clinics.
A second potential danger is a change in the immune system of recipient patients. This type of treatment runs a very real risk of altering our immunology for the worst. Furthermore, the cells used in the treatment have been created by genetic manipulation. The genetic stability of cell based treatments is of utmost importance. It would hardly be an advantage to cure one disease only to develop another potentially more fatal disorder.
If the opportunity arises to offer a cure for diabetes using this technology life long monitoring of patients will need to be built into the programme. This will need to be intensive and vigilant so as to study the benefits and the potential complications.
This brings us onto the internet and the dissemination of information to patients. It is understandable that if patients are constantly bombarded by newsflashes of possible cures not to be tempted to explore further. It is unnatural not to want the very latest in treatment. The problem with the widespread internet hard sell on this subject is that it appeals to a very clear personal need but it does not address safety in any satisfactory way. This area of medicine particularly has to demand the very highest standards of scientific rigor. The clinical results and risk-benefit assessments must be supported by peer reviewed evidence based research.