Promise of stem cells extends to dermatology

No area of science is so deeply interwoven with ethical concerns as stem cells, but no single area of biomedicine holds greater promise for improving human health, said Ponciano Cruz Jr., M.D., during the plenary session at Academy '06.

"We stand at the rim of a cascade that will provide us new knowledge and the promise of prolonged and improved life. Just as the discoveries of microbes, cells and DNA have revolutionized science and provided us great benefits, there is no doubt that stem cells can also offer such contributions," says Dr. Cruz, professor and vice chairman of dermatology, University of Texas Southwestern Medical Center, Dallas.

The promise of stem cells lies in multiple areas. Their use may be expected to provide insights into disease pathogenesis, but they also have great implications for therapy as they might be employed to replenish or replace cells and tissue that have been destroyed by disease. In addition, stem cells may be envisioned as powerful laboratory tools to aid in research aimed at identifying new therapies.

Discussing stem cell research in dermatology, Dr. Cruz explained that two types of keratinocyte stem cells have been identified that are present in the interfollicular basal cells and in the follicular bulge. Those stem cells have been shown to have independent functions and each has been identified to have several cell surface markers.Dr. Cruz also told attendees that stem cells have emerged as a potential target in cancer treatment based on a new paradigm that stem cells in cancer drive tumor growth.

"In other words, not all cancer cells are equal, and instead of aiming to debulk the tumor, targeting stem cells may be the more logical approach in treating malignancies," Dr. Cruz says.

Stem cells also hold great promise in developing new treatments for scarring alopecias, recognizing that in inflammatory cutaneous diseases associated with permanent hair loss, the lymphocytes are directed at the superficial follicle, including the bulge.

"If the bulge is the source of hair replenishment, it would make sense that immune cells attacking that region would result in scarring alopecia," Dr. Cruz explains.

However, looking to the future, Dr. Cruz raises the fear that progress in this important area of research may be hampered. "It has been said that life can only be understood backward, although living life can only be done forward. Many of us are concerned that we are controlled by those who are certain about their understanding of life going forward, but who live life backward," he says.