It feels like some time since I picked up one of the Very Short Introductions (VSI). This has, I think, been sat on my shelf for over a year now, as I plucked it off the shelf of one of my local bookshops with the simple thought, “I don’t really understand much about stem cells. I read about them in the news occasionally. Maybe I ought to plug a hole in my knowledge.”
A year from having bought it, that thought has barely changed. Any time the issue of stem cells appears on the news or is discussed in terms of ethics, I have felt myself at a loss through being under-informed. So how well did Jonathan Slacks’ book do in filling in this particular family of gaps in my understanding?
We begin with the basic question of ‘what is a stem cell?’ To answer this we get a crash course in terminology. It’s worth paying attention here as most of the book is written with fluent use of this. Though, as a mathematician, one might expect me to complain that biology is often the science of obfuscation by making up complicated words for relatively simple things! Thankfully, a useful glossary is provided at the back of the book. At times, one is forced to turn to this 2-3 times per sentence so that even though this is a short introduction at a little over 110 pages, one has read some parts several times over before the linguistic spaghetti is unravelled to render a paragraph comprehensible.
Slack defines a stem cell not by any inherent characteristic, but by the potential of what it does. He is also keen to stress that stem cells do not occur naturally in the body but are instead derived from cells that do occur naturally.
It is the natural step to look then in detail at the kind of stem cells most people have heard of, embryonic stem cells. Slack goes into some detail about basic cell biology and how embryonic stem cells are created and cultivated.
From here, he looks at the next class of stem cells, which he refers to as induced pluripotent stem cells (iPS cells). These are better known as adult stem cells though Slack expresses some disdain for the term. He gives a brief guide over how they are produced, though in so doing he throws around the names of various proteins and enzymes without much detail.
The question then is, what can be done with them? This is the realm where stem cells tend to make the news as though they were some kind of miracle cure. They’re not. Many treatments he describes as ‘aspirational’ which is another way of saying ‘unproven’. Nonetheless, stem cells can and do have their uses in some treatments. He picks up on the most widely known stem cell treatment, though it’s not often known as such, bone marrow transfers. Slack also outlines other uses, such as testing drugs on particular types of cells which can’t be tested in vivo (that is, in a living patient) but can be tested in vitro (in a petri dish). An example would be using stem cells to create cells that occur in the heart and then test to see if any new drugs cause an adverse reaction in the heart.
The book does have a couple of curious features, however. The first is that Slack tries to draw a distinction between scientists and clinicians. I think this is an idiosyncratic phraseology, whereby instead of meaning “scientists” I think he means to refer to “research scientists” since, of course, clinicians are just a subgroup of scientists. The other, which is perhaps more of a failing of the book, is its diminution of ethics. By all means, it gets mentioned, but for a more well-rounded account I think the matter could have been dealt with in a slightly less dismissive manner than Slack chooses here.
In spite of the linguistic befuddlement and the downplayed ethics, I think I did learn a lot from this. As I write this on the morning of the 9th of August, I noticed a stem cell related story in the news today. This book has enabled me to better understand such stories, which as to mean that it has achieved its aim of educating.