The scenario of human stem cell research in Malaysia related

ethical issues concerning its prospects in Malaysia

The prospects of stem cell research is still surprisingly new and totally off the radar in the
Malaysian scene despite being the epitome of advancement in molecular biology for quite a
long time in countries with more established technological advancement in particularly for
regenerative medication. Stem cell-based treatment shows its potential for cellular and tissue
replacement therapy for various inheritance-linked diseases as well as accident-acquired
injuries. Stem cell research came onto the scientific scene in the late 1998s upon reports that
researchers successfully isolated embryonic stem cells of human origins which contributes to
the unique properties of being unspecialized, which leads to the potential to form various
different cell types as well as being able of division and self-renewal, and even the ability to
form unspecialized cells that can differentiate into specialized cells such as muscle or neural
cells. The sources of stem cells includes the likes of embryonic, fetal, amniotic cells to name a
few. Such an examples are human made stem cells which meets the requirement of the being
pluripotent, so to speak which mainly originates from somatic cells that undergoes cellular
programming by sets of transcription factors for increased optimisim in clinical settings.
However, with the ongoing debate of scientific, ethical and moral issues there is not a definite
answer regarding the proven safety and implications.
Stem cells are differentiated into different categories based on their differential potentials.
Totipotent stem cells are found in every early embryos as they have the ability to form a
complete organism. Pluripotent stem cells exist in undifferentiated inner blastocyst cell masses
and can form any of the 200 different cell types existing in the body. Multipotent stem cells
originates from fetal cells, cord blood and adult stem cells having the ability to differentiate is

limited compared to pluripotent stem cells, but already are showing success in cell-based
therapies.
Embryonic stem (ES) cells

are isolated from the inner cell mass of blastocysts of

preimplantation-stage (7-10 days) embryos. These cells require specific signals to differentiate
to the desired cell type; if simply injected directly, they will differentiate into many different
types of cells, resulting in a tumor derived from this abnormal pluripotent cell development.
The directed differentiation of ES cells and avoidance of transplant rejection are just two of the
hurdles that ES cell researchers still face. Induced pluripotent stem cells (iPSCs) are somatic
cells that have been genetically reprogrammed to an embryonic stem celllike state by being
forced to express genes important for maintaining the defining properties of embryonic stem
cells. Although additional research is needed, iPSCs are already useful tools for drug
development and modeling of diseases, and scientists hope to use them in transplantation
medicine. In addition, tissues derived from iPSCs will be a nearly identical match to the cell
donor and thus probably avoid rejection by the immune system. By studying iPSCs and other
types of pluripotent stem cells, researchers may learn how to reprogram cells to repair
damaged tissues in the human body.
Adult stem cells - Many adult tissues contain stem cells that can be isolated. The use of adult
stem cells in research and therapy is less controversial than ES cells, because their production
does not require the destruction of an embryo. Additionally, when adult stem cells are obtained
from the intended recipient (an autograft) there is no risk of immune rejection. Adult stem cell
treatments have been successfully used for many years to treat leukemia and related bone/blood
cancers through bone marrow transplants. Fetal stem cells are taken from the germline tissues
that will make up the gonads of aborted fetuses. Umbilical cord stem cells are stem cells
similar to those found in bone marrow. Placenta derived stem cells are up to ten times as many
stem cells can be harvested from a placenta as from cord blood.

As mentioned above, the main application of stem cell research are cell-based therapies
which are aimed at replacing damaged or diseased cellular components with healthier, new cells.
When the stem cells are differentiated into specialized cell types, sources of cellular and tissue
replacement capabilities are possible in patients with burns, Alzheimers disease and spinal cord
injuries. Long-term gene expressions promised by gene therapy involving stem cells are vital for
genetic disorder treatments. Human developmental studies also applies the usage of embryonic
stem cells to further answer questions regarding the complex events occurring during the
development of humans as the main objective of this application is to determine how
undifferentiated stem cells transform into differentiated cells forming the related tissues and
organs along the way. In addition, scientists can also determine development of diseases that
occur during the process such as birth defects and this might lead to promising countermeasures
which can be adapted to correct the infants condition before birth. Current drug testing trials
also applies the usage of human stem cells for testing of toxicity and efficacy levels. For
example, novel medications are tested on differentiated cells generated from human pluripotent
cell lines of a wide range of cell types. Toxin screening is a sub-application of drug or chemical
testing which are potentially toxic to organism such as pesticides which are applied in the
environment. For example, liver-induced injury involves the usage of hepatocytes which are
stem-cell derived and is applied in the screening and detection of toxicity levels via screening
assays.
Unlike the applications of cloning which have and are continuing to draw negative responses
from not only the global audiences as well as Malaysia religious councils, stem cell research are
well received by the Malaysian government despite being new to the local scene. According to a
2009 speech conducted by the then Minister of Health, Dato Sri Liow Tiong Lai during a Stem
Cell Research And Therapy Seminar held at Hospital Ampang, he stressed the importance of
stem cell research which includes the potential in curing diseases such as strokes that result in

the loss or organ function and how the capabilities of stem cells can be harnessed to rectify the
matter. He also addressed the possible negative outlooks regarding stem cell research can be
deflected via using hematopoietic stem cells that originate from fully developed humans and not
deriving stem cells from fertilized embryos. As of such, difficult questions such as the morality
of destroying embryos or re-using aborted foetus embryos to improve human wellbeing can be
avoided as religious groups constantly stress that human life starts when an egg cell is fertilized
and in reflection, a human embryo is equivalent to a human being which are mainly addressed
towards the usage of embryonic stem cell research.
Despite the current controversies surrounding the stem cells research, Dato Liow has stated
that a set of ethical guidelines have to be followed in accordance to religious as well as morality
perspectives as he also reported that stem cell therapy in Malaysia is developing rather well
under supervision of the Ministry of Health and he also stated that local institutions such as
USM and UPM are welcomed with potential funding from the Ministry of Health or the
Ministry of Science, Technology and Innovation to further bring stem cell research to a higher
level of application and efficiency with possible collaboration from biomedical industries.
Before ending his speech, Dato Liow also stressed that the responsible practitioners as well
as researchers of stem cell and its products have to strictly follow guidelines for Good Clinical
Practice (GCP) during clinical trials by reporting all results and safety,quality and efficacy
standards as well as stem cell processing facilities strictly adhering to Good Laboratory
Practices (GLP) in the processing and handling procedures and will be examined by
representatives of the ministry frequently to ensure that every procedure is conducted in an
ethical manner.

Group members:
1) Tan Gaik Seng
2) Nadaraj Sivan
3) Tan Wei Shan
4) Lew Ming Xiang
5) Dinesh Arumugam
6) Lim Ren Ming
7) Michelle Tan Yan Tzie
8) Lee Wan Ning
9) Khaw Shin Yuan
10) Chong Hui Wen
11) Lim Hui Von
12) Liew Boon Yee
13) Vickneswaran Narayana Murthy