Stem cells are cells that divide by mitosis to form either  
    How the choice is made is still unknown. However, several genes    have been found whose activity prevents a daughter cell from    differentiating.  
        The only totipotent cells are the fertilized egg and        the first 4 or so cells produced by its cleavage (as shown by        the ability of mammals to produce identical twins,        triplets, etc.).      
        In mammals, the expression totipotent stem cells is        a misnomer  totipotent cells cannot make more of        themselves.      
        Three types of pluripotent stem cells occur naturally:      
        All three of these types of pluripotent stem cells      
        In mice and rats, embryonic stem cells can also:      
        Using genetic manipulation in the laboratory, pluripotent        stem cells can now be generated from differentiated cells.        These induced pluripotent stem cells (iPSCs) are        described below.      
        Multipotent stem cells are found in adult animals; perhaps        most organs in the body (e.g., brain, liver, lungs) contain        them where they can replace dead or damaged cells. These        adult stem cells may also be the cells that  when        one accumulates sufficient mutations  produce a clone of        cancer cells.      
    Examples:  
    While progress has been slow, some procedures already show    promise.  
    Using multipotent "adult" stem cells.  
    One way to avoid the problem of rejection is to use stem cells    that are genetically identical to the host.  
    This is already possible in the rare situations when the    patient has healthy stem cells in an undamaged part of the body    (like the stem cells being used to replace damaged corneas).  
    In this technique,  
    Using this procedure it possible to not only grow blastocysts    but even have these go on to develop into adult animals     cloning  with a nuclear genome identical to that of the    donor of the nucleus. The first successful cloning by SCNT was    with amphibians [View    procedure]. Later, mammals such as sheep (Dolly), cows, mice and    others were successfully cloned. And in the 11 November 2007    issue of Science, researchers in Oregon reported success    with steps 14 in rhesus monkeys (primates like us).  
    Their procedure:  
    This should reassure people who view with alarm the report in    May 2013 by the same workers that they have finally succeeded    in producing embryonic stem cells (ESCs) using SCNT from    differentiated human tissue. The workers assure us that they    will not attempt to implant these blastocysts in a surrogate    mother to produce a cloned human. And their failure with    monkeys suggests that they would fail even if they did try.  
    While cloning humans still seems impossible, patient-specific    ESCs  
    Whether they will be more efficient and more useful than    induced pluripotent stem cells [below]    remains to be seen.  
        Sperm and eggs each contain certain genes that carry an        "imprint" identifying them later in the fertilized egg as        being derived from the father or mother respectively.      
        Creating an egg with a nucleus taken from an adult cell may        not allow a proper pattern of imprinting to be established.      
        When the diploid adult nucleus is inserted into the        enucleated egg (at least those of sheep and mice), the new        nucleus becomes "reprogrammed". What reprogramming actually        means still must be learned, but perhaps it involves the        proper methylation and        demethylation of imprinted genes. For example, the        inactive X        chromosome in adult female cells must be reactivated in        the egg, and this actually seems to happen.      
        In primates (in contrast to sheep, cattle, and mice), the        process of removing the resident nucleus causes molecules        associated with the centrosome to be lost as        well. Although injecting a donor nucleus allows mitosis to        begin, spindle formation may be disrupted, and the        resulting cells fail to get the correct complement of        chromosomes (aneuploidy).      
        In other words, mutations that might be well-tolerated in a        single somatic cell of the adult (used to provide the        nucleus) might well turn out to be quite harmful when they        become replicated in a clone of cells injected later into        the patient.      
        The goal of this procedure (which is often called        therapeutic cloning even though no new individual is        produced) is to culture a blastocyst that can serve as a        source of ES cells.      
        And in fact, Dolly and other animals are now routinely        cloned this way. Link to a        description.      
        The spectre of this is so abhorrent to many that they would        like to see the procedure banned despite its promise for        helping humans.      
        In fact, many are so strongly opposed to using human        blastocysts  even when produced by nuclear transfer  that        they would like to limit stem cell research to adult stem cells (even though these are        only multipotent).      
    A promising alternative to the use of embryonic stem cells in    human therapy are recently-developed methods of genetically    reprogramming the nuclei of differentiated adult cells    so that they regain the pluripotency of embryonic stem (ES)    cells.  
    In June 2007, three laboratories reported that introducing    extra copies of only 4 genes into adult mouse skin cells    (fibroblasts) enables them to regain the properties of ES    cells. When these cells, named induced pluripotent stem    cells (iPSCs for short), were placed in mouse blastocysts,    they participated in building all the tissues of the chimeric mice that resulted. (When    placed in tetraploid    (4n) blastocysts  unable by themselves to develop    normally  embryos were formed that thus were clones of the    skin cell donor.) The four genes: c-Myc, Sox2,    Oct3/4, Klf4.  
    Reprogramming works in humans, too! Using the same four genes,    the Yamanaka lab in Japan reported on 20 November 2007, that    they now had reprogrammed human skin cells to become induced    pluripotent stem cells (iPSCs). And the Thomson lab in    Wisconsin accomplished the same thing using SOX2,    OCT4, NANOG, and LIN28.  
    These achievements open the possibility of  
        Therapy with iPSCs has already been demonstrated in mice.        Three examples:      
        The result: all the signs of sickle-cell disease (e.g.,        anemia) in the treated animals showed marked improvement.      
        The result: the implanted buds developed a blood supply and        the mice began to secrete human albumin, human alpha-1-antitrypsin,        and to to detoxify injected chemicals just as human livers        do.      
    Let us hope that what works in mice can someday be developed    into a safe therapy that will work in humans. (In the case of        Type 1 diabetes mellitus, however, even patient-derived    beta cells will    still be at risk of the same autoimmune rejection that caused    the disease in the first place.)  
    Despite these successes, iPSCs may not be able to completely    replace the need for embryonic stem cells and may even be    dangerous to use in human therapy. Several groups have found    that human iPSCs contain mutations as well as epigenetic patterns (e.g.,    methylation of their DNA) that are not found in embryonic stem    cells. Some of the mutations are also commonly found in cancer    cells.   
    Applied to humans, none of the above procedures would involve    the destruction of a potential human life.  
Excerpt from:
Stem Cells - RCN