The future of stem-cell science will not be defined by dramatic breakthroughs alone. It will depend on less visible work: improving safety, reducing costs, standardising manufacturing and strengthening regulatory framework, write Ali S Arbab and Abdullah A Dewan
STEM cells occupy a unique and increasingly central place in modern medicine. Frequently described as the body’s ‘master cells’, they are defined by two extraordinary properties: self-renewal, the ability to divide repeatedly without losing identity, and potency, the capacity to develop into specialised cells such as blood, nerve, heart or muscle. These qualities have reshaped how scientists investigate disease, test drugs and imagine regenerative therapy. Yet stem-cell science now sits at a dangerous crossroads. Genuine clinical breakthroughs coexist with inflated claims, commercial exploitation and regulatory gaps that blur the line between medicine and false hope. Understanding where real progress ends and myth begins has become a matter of public health, not scientific curiosity.
At their core, stem cells are not a single entity but a spectrum. Embryonic stem cells, derived from early-stage embryos, are pluripotent and capable of forming nearly any tissue in the body. Their scientific value is immense, but their use remains ethically contested, with societies adopting sharply different regulatory positions. Adult, or somatic, stem cells are far more familiar to clinical medicine. Found in tissues such as bone marrow and skin, they are more limited in what they can become, yet they underpin one of the most successful therapies in modern healthcare: bone-marrow transplantation. For decades, haematopoietic stem-cell transplants have rebuilt immune systems in patients with leukaemia and other blood disorders, long before ‘stem cells’ became a fashionable phrase.
The most transformative advance, however, arrived with induced pluripotent stem cells, or iPSCs. This discovery demonstrated that ordinary adult cells could be genetically reprogrammed back into a pluripotent state. It overturned the idea that cellular identity is fixed and opened a new era of personalised medicine. Because iPSCs can be created from a patient’s own cells, they largely avoid the ethical concerns surrounding embryos and reduce the risk of immune rejection. More importantly, they allow diseases to be studied with unprecedented precision. A patient’s skin or blood cell can be converted into heart cells, neurons or liver tissue carrying the exact genetic defect responsible for their illness. Disease is no longer inferred; it is observed directly.
This shift has quietly transformed medical research. Rare genetic disorders that were once poorly understood can now be modelled outside the human body. Inherited heart-rhythm diseases can be studied using lab-grown beating heart cells. Neurodegenerative conditions such as Parkinson’s disease can be examined by observing how patient-derived neurons fail over time. These models provide a testing ground for drugs without exposing patients to experimental risks and without relying solely on animal models that often fail to predict human outcomes.
The most striking clinical expression of this science has emerged through the convergence of stem-cell biology and gene editing. In 2023, the approval of gene-editing therapies for sickle-cell disease marked a historic milestone. These treatments involve extracting a patient’s own blood-forming stem cells, precisely editing their DNA, and reinfusing them after intensive conditioning. For many patients, the result has been freedom from lifelong transfusions and debilitating pain crises. The procedure is arduous and extraordinarily expensive, but it demonstrates something fundamental: stem cells can serve as vehicles to correct disease at its genetic root, rather than merely managing symptoms.
Elsewhere, progress has been slower and more cautious. Early trials using stem-cell injections for heart failure produced modest results, reminding researchers that biological complexity resists simple solutions. Newer approaches, such as implanting cardiac tissue patches derived from iPSCs after heart attacks, are still experimental. In ophthalmology, stem-cell-derived retinal cells have shown promise in slowing or reversing certain forms of blindness. In neurology, efforts are underway to replace dopamine-producing neurons lost in Parkinson’s disease, though long-term safety remains under close scrutiny.
Parallel to these efforts is the rise of organoids — three-dimensional, miniaturised versions of human organs grown in the laboratory. These structures mimic aspects of real organs, allowing scientists to observe disease progression in ‘slow motion’. Combined with organ-on-a-chip technology, which simulates blood flow and mechanical forces, they offer a powerful alternative to animal testing and a step toward genuinely personalised treatment strategies.
Yet the very sophistication of these advances has created fertile ground for abuse. In countries where regulation struggles to keep pace with scientific development, including Bangladesh, unlicensed clinics openly market ‘stem-cell cures’ for conditions ranging from autism to spinal injury. These interventions are often unsupported by credible evidence and are promoted using the language of legitimate science. Patients, desperate and hopeful, are charged vast sums for procedures that can result in infection, disability or permanent harm. This is not merely misinformation; it is medical exploitation.
The central biological risk is well known: stem cells proliferate. If their growth is not tightly controlled, they can form tumours or behave unpredictably. This is why legitimate therapies undergo years of testing under strict regulatory oversight. Bypassing these safeguards does not accelerate progress; it endangers lives. The persistence of predatory stem-cell markets reflects regulatory failure as much as scientific complexity.
Beyond safety lies a deeper ethical dilemma. As medicine enters an era of gene-edited cures and personalised cell therapies, cost threatens to become the most exclusionary barrier of all. Treatments priced in the millions raise uncomfortable questions about who benefits from scientific progress. Without deliberate policy intervention, stem-cell medicine risks reinforcing global health inequalities rather than alleviating them.
There is also a growing ethical grey zone at the frontier of research. Advances in creating embryo-like models for studying early development challenge traditional definitions of life and moral status. These developments demand sustained dialogue between scientists, ethicists, policymakers and the public, rather than quiet decisions made behind laboratory doors.
The future of stem-cell science will not be defined by dramatic breakthroughs alone. It will depend on less visible work: improving safety, reducing costs, standardising manufacturing and strengthening regulatory frameworks. The technology has already proven that it can repair, regenerate and, in some cases, cure. The more difficult task now is ensuring that these capabilities are deployed responsibly.
Stem cells have changed how we understand the human body — not as a machine destined to wear out, but as a system capable of renewal under the right conditions. That promise is real, but it is fragile. Only by maintaining disciplined scepticism, resisting commercial hype and insisting on ethical accountability can society ensure that stem-cell science fulfils its medical potential rather than becoming another cautionary tale of overreach disguised as hope.
Dr Abdullah A Dewan, former physicist and nuclear engineer at BAEC, is a professor emeritus of economics at Eastern Michigan University, USA. Dr Ali S Arbab is a professor and stem cell researcher at Medical College of Georgia, USA.
