By Rachel Zwick

Last Friday, I heard renowned stem-cell biologist Elaine Fuchs speak at the Pioneers in Science program hosted by the World Science Festival. Fuchs, who probably knows more about the genetic underpinnings of skin disorders than any other person on the planet, led an international group of high school students on a whirlwind tour of cell biology, regenerative medicine and her exhilarating life as a groundbreaking researcher. Students from New York City joined the talk in person, while classrooms from around the world tuned in via webcast to discuss the exciting challenges of mining stem cells for medical advances.

Students lobbed some tough questions. One participant wanted Dr. Fuchs’ take on the ethical implications of studying embryonic stem cells—cells from a fertilized egg that can give rise to any of the body’s 200 tissue types. Fuchs hit the question head on. “If you recognize that you can ultimately conduct research that could save lives,” she said, “it would be unethical to not do that.” Fuchs reemphasized the point throughout the program, saying that our rapidly increasing understanding of stem cells has the potential to radically reshape the face of medicine in the 21st century, and, ultimately, to save lives. 

Fuchs also touched on the other kind of stem cell—adult cells. No advance has been more hotly debated among stem-cell researchers in the last five years than induced pluripotent stem cells, or iPSCs. These are adult cells that have been ‘reprogrammed’ in the lab to revert back to their embryonic-like state.

Think of the process as a series of rewind buttons. Pressing ‘play’ directs iPSCs to specialize into a tissue of choice. The technique could let scientists replace mutated genes. When returned to the original donor, the cells would complete their last phases of specialization, only minus the faulty DNA. This therapeutic approach was first demonstrated in 2007 when researchers successfully replaced sickle-shaped blood cells in a mouse with normal cells, giving hope that the method could eventually lead to treatment strategies for the devastating disease sickle-cell anemia.

Alternatively, reprogrammed cells with genetic aberrations may be grown in the lab, where they can serve as a model of disease. Scientists used this method last month when they created a new disease model of cardiomyopathy. But techniques for harnessing iPSCs are still far from perfect, or appropriate for use in human therapy, and we still need a sharper understanding of embryonic stem cells to harness their full potential. As Fuchs pointed out, “the only way we can get there is by understanding what an embryonic stem cell looks like.”

Fuchs’ speciality at The Rockefeller University in Manhattan is adult skin stem cells. These special cells give rise to skin epidermis, hair follicles and sweat glands, and are remarkable for their ability to preserve throughout the entire adult life of an organism. Fuchs’ research has untangled the inner workings of these cells, shedding light on how they develop, repair skin wounds and self-renew. (Click here for a spectacular view of skin cells from labs around the country.) Her findings have implications for other types of stem cells, including blood, gut, lung, mammary glands, and fat cells—all cell types that have the potential to generate fully functional organs, making them major targets for regenerative medicine. “That’s what excites so many of us—the clinical setting is real” Fuchs said. “And it will continue to grow.”

Fuchs talked more than just stem cells. She also raised two profound and intricately connected aspects of scientific research: The uncertainty of exploring the unknown and the possibility of discovering the unexpected. “There’s no comfortable route for a scientist,” she told the students. “You want to learn to get comfortable with being uncomfortable.” Though most research studies are based on a specific question, few are answered in the linear way that scientists initially envision, and the implications of their work can be unexpected and far-reaching. Fuchs pointed out, for example, that the techniques developed to grow skin stem cells in the lab are now used to treat blindness. A small number of stem cells retrieved from an eye damaged by a chemical burn can be used to seed a population of functional corneal cells in the lab using techniques established for skin stem cells, and transplanted into patients to restore vision.

At the close of the formal question and answer session, Fuchs reminded the students in the room that they are the future of scientific and medical research. Clearly, the realistic but exciting picture of science she painted had captured their imaginations. The students, who were based everywhere from Brooklyn to Kabul, milled around Elaine Fuchs as if she were a rock star, hoping to keep the discussion going, and looking for advice in planning their own futures in science.