Bone marrow derived stem cells can give rise to heart muscle cells. This plasticity concept – the ability of bone marrow cell to transdifferentiate into heart muscle cell – is supported by experimental and clinical data. Another possibility is to replace the missing function by causing transdifferentiation of existing cells. Transdifferentiation means converting one sort of cell, e.g. fibroblast, into another, e.g. muscle cell. There is real hope that we may be able to control this unique phenomenon to produce many heart cells to create a new heart muscle based on cells harvested from the patient himself.
These plasticity concepts have challenged the traditional dogma of tissue specific stem cell differentiation in adults and have raised hot debate. Many scientists have suggested alternative interpretations for plasticity research findings. Furthermore, recently, the debate regarding bone marrow and other adult stem cell plasticity has moved into the political and public zone. Opponents of human embryonic stem cell research see the plasticity of adult cells as a means of avoiding the use of human blastocysts (embryos a few days old) that is required to obtain pluripotent embryonic stem cells.
Despite the plasticity controversy and our limited understanding of stem cell plasticity, we hope that if we can control this process we may be able to use adult cells to produce new heart tissue for transplant and heart repair. J Leor (TEl Hashomer, IL)
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