Henrietta Lacks had an ordinary background. Her mother died after giving birth to a 10th child when she was four. This prompted her father to distribute her and her siblings among their relatives. She ended up with her maternal grandfather and worked as a tobacco farmer at an early age like most of her family members living in Virginia. Her adult life was no different. She married David Lacks in 1941, moved to the African-American community of Turner Station, and raised five children. She might had an ordinary life but circumstances made her one of the most significant women in history and the field of medicine.
How Henrietta Lacks Contributed to Medicine and Became One of the Most Prominent Names in History: The Importance of the Immortal HeLa Cell Lines and Discourses About Ethics in Medicine
The seemingly ordinary life of Henrietta Lacks took a turn when she visited Johns Hopkins Hospital in Baltimore on 29 January 1951. She was suffering from vaginal bleeding and felt that there was a “knot” in her womb. Johns Hopkins was the only hospital in her area that treated African-American patients. Her gynecologist, Howard W. Jones, took a biopsy of a mass found on her cervix for laboratory testing. She was later diagnosed with malignant epidermoid carcinoma of the cervix or cervical cancer. Take note that physicians discovered in 1970 that she specifically had adenocarcinoma of the cervix.
Lacks underwent several sessions of radium treatment via radium tube inserts. This was an inpatient procedure and it was the best medical treatment available at the time for her condition. A sample of her cancer cells retrieved from her initial biopsy and another two samples of healthy cells and cancer cells taken without her consent during her treatments were sent to physician and cancer and virus researcher George Otto Gey.
Take note that Gey had been collecting cells from cervical cancer patients at the Johns Hopkins Hospital as part of his ongoing research undertakings. The problem with collected cell samples during then was their short lifespan which last for only a few days at most. This was not enough to perform varied tests on the same sample and made relevant research challenging. However, upon encountering and handling the samples from Lacks, Gey discovered that the cancer cells could be divided multiple times without dying. Each cell even doubled every 20 to 24 hours. This allowed more in-depth biomedical studies.
Lacks succumbed to cancer on 8 August 1951 at the age of 31. Mary Kubicek, the laboratory assistant of Gey, was instructed to take further samples while the deceased body was in the autopsy facility of Johns Hopkins Hospital. Gey was able to start a cell line from the samples collected from Lacks. The reproduced cells became known as HeLa cells. The characteristics of these cells made them the first immortal cell line.
Medical Discoveries and Advances From the HeLa Cell Line
The immortal HeLa cell line is the main legacy of Henrietta Lacks. The ability to reproduce these cells indefinitely in laboratory conditions has advanced various areas of biomedical research and resulted in different important discoveries and breakthroughs in medicine and human biology. In fact, due to high demand and because they have become an invaluable resource, these cells were put into mass production and mailed to researchers.
American virologist and polio vaccine inventor Jonas Salk was one of the most prominent scientists who based his breakthrough around HeLa cells. His research required large amounts of human cells that can be infected by the poliovirus and used to test formulations. HeLa cells were ideal for this purpose. Salk eventually came up with the first polio vaccine in 1955 using the HeLa cell line. The vaccine was instrumental in eradicating polio.
The first anti-cancer vaccines were also developed due to HeLa cells. German virologist Harald zur Hausen found in the 1980s that the cells from the original biopsy of Lacks contained the human papillomavirus or HPV-18. The virus was later linked to cervical cancer. This finding paved the way for the development of HVP vaccines to prevent cervical cancer and earned Harald zur Hausen a Nobel Prize in Physiology in 2008.
Several discoveries in genetics emerged through research involving the immortal HeLa cell line. A lab mistake in 1953 enabled researchers to see and count each chromosome clearly in HeLa cells. Prior convention put the number to 24 pairs. Indonesian-born American cytogeneticist Joe Hin Tjio and Swedish geneticist Albert Levan used the cells and revealed that there are 23 pairs of chromosomes or a total of 46 in each human cell.
Henry Harris and John Watkins created the first ever human-mouse hybrid cell line in 1965 by fusing HeLa cells with mouse embryo cells. The hybrid cell line allowed the use of proteins as markers to assign genes to specific chromosomes. This became central to the Human Genome Project. HeLa cells became instrumental in mapping the human genome. This provided insights into the genetic basis of human health and disease.
The cells have been used in various areas of medicine and specific fields of biomedical research around the world. These include cancer research, infectious disease and virology, immunology, drug research and development, medical diagnostics, and gene editing, among others. The entire immortal HeLa cell line contributed to the improvement of cell culture practices that range from quality control to shipment and contamination prevention.
Emerging Ethics and Legal Standards of Informed Consent
It is important to reiterate the fact that the immortal HeLa cell line was obtained and created under unethical circumstances. The contribution of Henrietta Lacks has transpired beyond discoveries and breakthroughs in medicine. Her story eventually brought forth questions, criticisms, and standards as regards the proper and ethical collection of samples from patients and the use of human tissues for research and commercial gains.
The case of Lacks has been described as one of the best examples of the lack of informed consent in the 20th century. Samples from patients were collected without the knowledge of patients and without explaining to them what their cells or tissues will be used for. The issue was aggravated further by the fact that Johns Hopkins Hospital and other hospitals providing free or subsidized patient care used uninformed patients as research subjects.
It is also worth mentioning that the family of Lacks was out of the loop. They had no access to her medical records and were not entitled to have a role in determining what to do with HeLa cells and who would receive these cells. The immortal cell line was also commercialized. The family of Lacks did not receive financial benefits. The situation was exacerbated by the fact that the family members continued to live with limited access to healthcare.
Take note that the Supreme Court of California ruled in the 1990 case Moore v. Regents of the University of California that the discarded tissues and cells of a person are not his or her property and can be commercialized. HeLa cells have generated billions of dollars in revenue for researchers, non-profit institutions, and biomedical companies that have used them for scientific or medical purposes and even commercial purposes.
Lacks eventually influenced the establishment of the Common Rule in 1991. It provided an ethical framework for biomedical and behavioral research involving human subjects. The framework rule enforces informed consent, promotes the privacy of patients, and obliges doctors to inform patients and secure from them expressed consent for plans that involve using whatever medical records or patient details in research.
Furthermore, in 2021, the estate of Henrietta Lacks sued biotech company Thermo Fisher Scientific for an alleged unauthorized sale of product lines involving HeLa cells. The company settled the suit with the family of Lacks in August 2023 with undisclosed terms. The case and its outcome are believed to open doors to other legal actions. There are around 100 companies that have used and profited from commercializing the immortal HeLa cell line.
