Adult stem cells are very powerful and important, but it is basically now an established fact that pluripotent stem cells will have important, unique applications in the clinic. Adult stem cells are not a panacea and we need pluripotent stem cells too.
But what is the most promising type of pluripotent stem cell?
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A couple words about the possible challenges with each type.
“Traditional” human embryonic stem cells (hESCs) have important potential, but with today’s technology they (or cellular products made from them) have to be used in an allogeneic manner clinically speaking. This means they are a non-self transplant and immunosuppression may be needed to some degree.
hESC made by SCNT (therapeutic cloning) would be similar to hESCs made in the traditional way, except they could in principle be made as a personal therapy for each patient. Thus, they could be used as an autologous transplant. The big hitch is of course that at least so far no one has published a successful way to make normal hESC by SCNT.
iPS cells have big potential, but there are still some concerns about them such as a few mutations they might each possess and epigenetic glitches. While there is some debate as to whether these imperfections exist and even if they do whether they have any functional meaning, conventional wisdom in the field today is that they are of some concern.
I believe that there is also still a gap in the iPS cell field as well in terms of data on how iPS cell-related products behave in vivo in the context of clinically relevant transplantation.
Adult pluripotent stem cells of various kinds pop up on the radar screen now and then. But most stem cell scientists today either do not believe that such cells really exist or that they only can be found under extraordinarily rare circumstances.