HeLa cells, Henrietta Lacks 1, 2
The story of Henrietta Lacks and the HeLa cells is of both great scientific and historical importance. A 2010 novel and a 2017 film starring Oprah Winfrey both tell the story of Henrietta Lacks from the perspective of writer Rebecca Skloot.
Lacks was an African American woman, born in Virginia in 1920. After losing her mother at a young age, Henrietta went to live with her grandfather on a tobacco farm.
They lived in a house that had formerly served as the family’s slave quarters. Henrietta had her first child at the age of 14, and would eventually become a mother of five.
The Lacks family later relocated to Maryland from Virginia, in search of a better life.
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Unfortunately, Henrietta was diagnosed with cervical cancer at the age of 30 and died within a year of her diagnosis. During her treatment at Johns Hopkins Hospital, doctors took two cervical samples without her consent.
To protect her identity, the samples were logged under the pseudonym Helen Lane and abbreviated as “HeLa” cells.
HeLa cells are remarkable because they continuously divide, allowing them to be used indefinitely in laboratory settings.
Prior to the discovery of these cells, regular cells typically lasted just a few days in a lab. The HeLa cells' ability to multiply offered scientists more time for their research. HeLa cells also allowed for experiments to have more reliability because of the novel ability to run tests on the same cells at different times and in different places.
HeLa cells became well known for their use in the research that led to the eradication of polio. After their use in the polio vaccine, HeLa cells started to be widely sought after by researchers.
They were eventually sent around the world in mass quantities. The immortal cell line has been used for medical and commercial research, generating billions of dollars.
The discovery of the cells and their ensuing usage revolutionized science.
HeLa cells were tested to learn the effects of zero gravity on the human body. They have also been used in many cases to test human sensitivity to various substances. Both Ebola and HIV treatments can accredit their development to HeLa cells.
There are thousands of patents involving the various utilizations of this immortal cell line. As fruitful as the cells have been, they are also known to be troublesome. HeLa cells have a tendency to produce so rapidly, they contaminate other cell cultures.
It is estimated that up to 20 percent of all cell cultures contain HeLa cells.
HeLa Cells, Source: NIH/flickr
HeLa Cell Line Controversy
Not only are unique characteristics of HeLa cells incredible, but so are the ethical developments that arose from their usage over time. Henrietta Lacks was a granddaughter of American slavery. She was born a descendent of both the master and the slaves of the former plantation that she grew up on.
She grew up a woman of modest means, and her descendants today mostly are working and middle-class people. This information makes her contribution, albeit non-consensual, to science remarkable. It also raises several questions about the ethics of the harvesting of her cells and the profit from their distribution.
At the time of her illness, informed consent was not legally enacted, so no laws were broken.
Despite the billions of dollars earned as a result of aggressive cancer that ended her life, none of the profit earned by companies using HeLa cells has been given to her family. Also, their genome was mapped and made easily available for public use.
Only recently did the National Institute of Health negotiate with the family to make their genetic information exclusively available to researchers.
Given the history of the United States and the abuses of African Americans in the country’s scientific legacy, HeLa cells are a sensitive issue despite the lack of protective practices at the time they were harvested.
Source: NIH/Wikimedia Commons
The sensitivity of race and research in the United States makes the life of Henrietta Lacks a testament to the need for the development of bioethics.
There are several reasons why the use of this woman’s cells provokes discussion regarding ethics in science. The primary ethical issue in regards to this case is the fact that the cells were harvested without consent.
This means that every entailing sale and experiment has also occurred without consent.
Informed consent is a concept that was developed well after Henrietta Lacks passed away.
It is a legally binding practice in science and medicine that requires the subject of research to be informed at their level of understanding regarding any research activities concerning their person before giving their explicit consent to the proposed activities.
The sale of HeLa cells also breaches unclear ethical territory. As mentioned previously, the Lacks family has not had a share in the profit garnered from the cells nor were they properly compensated for the book and film written about her life.
The lack of consent or family compensation is said, by some, to be reflective of racial inequality due to the power dynamics between researchers and her family.
Over time, the field of bioethics has led to policies that clearly delineate the rights of patients and medical field professionals.
However, these policies have done little to satisfy questions regarding HeLa cells due to the fact that the case predates the policies.
HeLa cells: Origin of this important cell line in life science research
If you work in Biology, you’ve most certainly heard of HeLa cells, as they have been around for over 60 years and are some of the most extensively used cell lines in Biomedical research. But where did these cell lines come from?
Henrietta Lacks (1920-1951)
In 1951, Henrietta Lacks came into John Hopkins Hospital in Baltimore, worried about a lump in her abdomen, where she was diagnosed and treated for cervical cancer (adenocarcinoma of the cervix, a particularly aggressive type of cancer). She eventually died of her cancer later that year, without knowing what her cells would help accomplish.
The surgeon treating Henrietta’s adenocarcinoma had been collecting cancerous tissue samples from patients for research lead by Dr. George Gey, Director of the Tissue Culture Laboratory at John Hopkins. His objective was to cure cancer by creating an immortalized cell line for research, in order to develop therapies and medicines.
For years, Dr. Gey and his wife Margaret (a trained surgical nurse) had been trying to cultivate human cells in vitro. All their previous attempts at growing human cells in a laboratory lead to the death of the cell cultures within a few generations. That is, until Henrietta’s tumour sample: HeLa, named after the two first letters of Henrietta and Lacks.
What’s different about HeLa cells?
There are 3 major differences between normal cells and HeLa cells:
Henrietta Lacks is best known as the source of cells that form the HeLa line, used extensively in medical research since the 1950s.
Henrietta Lacks was born in 1920 in Roanoke, Virginia. Lacks died of cervical cancer in 1951.
Cells taken from her body without her knowledge were used to form the HeLa cell line, which has been used extensively in medical research since that time.
Lacks's case has sparked legal and ethical debates over the rights of an individual to his or her genetic material and tissue.
Henrietta Lacks was born Loretta Pleasant on August 1, 1920, in Roanoke, Virginia. At some point, she changed her name to Henrietta.
After the death of her mother in 1924, Henrietta was sent to live with her grandfather in a log cabin that had been the slave quarters of a white ancestor's plantation. Henrietta Lacks shared a room with her first cousin, David “Day” Lacks.
In 1935, the cousins had a son they called Lawrence. Henrietta was 14. The couple had a daughter, Elsie, in 1939, and married in 1941.
Henrietta and David moved to Maryland at the urging of another cousin, Fred Garret. There, they had three more children: David Jr., Deborah and Joseph. They placed their daughter Elsie, who was developmentally disabled, in the Hospital for the Negro Insane.
On January 29, 1951, Lacks went to Johns Hopkins Hospital to diagnose abnormal pain and bleeding in her abdomen. Physician Howard Jones quickly diagnosed her with cervical cancer.
During her subsequent radiation treatments, doctors removed two cervical samples from Lacks without her knowledge. She died at Johns Hopkins on October 4, 1951, at the age of 31.
HeLa cells (1951)
She was poor, black and terminally ill with cervical cancer. Henrietta Lacks was a 31-year-old mother of five when she died in 1951, but her name and memory live on in the form of a remarkable lineage of continually dividing cells that have achieved, to all intents and purposes, “immortality”. Her cancer cells have continued to live well beyond her death in labs around the world, replicating so prolifically that laid end-to-end they could be wrapped around the earth three times.
When Henrietta attended a cancer clinic at Johns Hopkins in Baltimore in January 1951, the only hospital in the area to treat African Americans, little did she realise that she would achieve a kind of immortality herself.
Her surgeon, Howard Jones, took a tissue biopsy of her cancerous womb without her knowledge or consent, which was passed to George Otto Gey, a physician and cancer researcher in the same Baltimore hospital who was astonished by the ability of the cells to replicate in laboratory culture.
Normally, cancer cells would divide a few times and die off before any decent studies could be done with them.
But Henrietta’s just kept on dividing and dividing, just so long as they were fed the right mix of nutrients for them to grow.
Henrietta’s cancer cells became the first human “cell line” to be established in culture and Gey named them after the first two letters of her name – HeLa (pronounced “hee-la”).
Hela cells have since become the most widely used human cell line in biological research and were critical for many biomedical breakthroughs of the past half century.
Jonas Salk, for instance, used them in 1954 to develop the polio vaccine and in the 1980s Aids researchers used them to identify and isolate the human immunodeficiency virus (HIV) while in recent years HeLa cells were critical for the “omics” revolution, from genomics to transcriptomics and proteomics.
Some 70,000 studies have been published involving the use of HeLa cells and they are in widespread use throughout the field of immunology.
At least two Nobel Prizes have been awarded recently for research involving HeLa cells, one on the link between human papilloma virus and cervical cancer (2008 by Harald zur Hausen), which was shared with the discoverers of HIV (Luc Montagnier and Francoise Barre-Sinoussi), and the other into the part played by the telomerase enzyme in preventing chromosome degradation (2009 by Elizabeth Blackburn, Carol Greider and Jack Szostak).
As for Henrietta’s extended family, they were kept in the dark about what happened to their ancestor’s unwitting bequest to medical science until relatively recently, a shocking oversight that led in the US to a change in the ethical ground-rules covering the taking and use of hospital biopsies without informed consent. The story of Lack’s life and afterlife can be better understood “The immortal life of Henrietta Lacks”, a novel written by Rebecca Skloot.
Why is Henrietta Lacks Important?
Henrietta Lacks was a poor African-American raised on a tobacco farm in Virginia. After she died in 1951, medical researchers collected her cells. They named these cells HeLa cells.
These cells changed the course of medical research. In fact, some people argue that most of the world’s population has benefited from research using HeLa cells.
Visit almost any cell culture lab and you will find millions, if not billions, of frozen HeLa cells.
Cells being prepared in a tissue culture lab (Source: elkor via iStockphotos).
In biomedical research, HeLa cells are as important as lab rats and petri dishes. Lacks’ chromosomes and proteins have been studied in so much detail that scientists know their every quirk. But until recently, very few people knew of or acknowledged the contributions of Henrietta Lacks.
Did you know?
Today, there are trillions more HeLa cells growing in laboratories than there ever were in Henrietta Lacks' body!
How do HeLa cells work in biomedical research?
Scientists were studying human cells long before they started using HeLa cells. However, they had a lot of trouble keeping individual cell lines alive.
A cell line refers to all the generations of cells produced from a specific culture of cells. Working with a single cell line allowed researchers to verify their results and build on previous research.
But when all the cells in a line died, they had to start over with a new one.
Lacks’ cells were different. They provided researchers with the first immortal human cell line ever grown in a laboratory. Researchers originally took HeLa cells from an aggressive cervical cancer tumour. These cells never stopped reproducing. When given a constant supply of nutrients, they produced a new generation of cells in less than 24 hours.
The immortal cells of Henrietta Lacks (2016) by Robin Bulleri, TED Ed (4:26 min.).
HeLa cells grew so rapidly and so well that research could now be done much faster than before. As soon as scientists recognized their potential, HeLa cells went into mass production. They were produced at the world’s first cell factory. From there, they were made available to labs around the world.
Henrietta Lacks, HeLa Cells, and Cell Culture Contamination
Henrietta Lacks died in 1951 of an aggressive adenocarcinoma of the cervix. A tissue biopsy obtained for diagnostic evaluation yielded additional tissue for Dr George O. Gey's tissue culture laboratory at Johns Hopkins (Baltimore, Maryland).
The cancer cells, now called HeLa cells, grew rapidly in cell culture and became the first human cell line. HeLa cells were used by researchers around the world. However, 20 years after Henrietta Lacks' death, mounting evidence suggested that HeLa cells contaminated and overgrew other cell lines.
Cultures, supposedly of tissues such as breast cancer or mouse, proved to be HeLa cells. We describe the history behind the development of HeLa cells, including the first published description of Ms Lacks' autopsy, and the cell culture contamination that resulted.
The debate over cell culture contamination began in the 1970s and was not harmonious. Ultimately, the problem was not resolved and it continues today. Finally, we discuss the philosophical implications of the immortal HeLa cell line.
On February 1, 1951, a 30-year-old woman named Henrietta Lacks presented to the Johns Hopkins Gynecology Clinic in Baltimore, Maryland, for symptoms of spotting between her menstrual periods. Her last menstrual period had been on January 4, 1951.
1 Although the results of her general examination were unremarkable, examination of the cervix revealed a raised, smooth, glistening, and purple lesion less than 2.54 cm (1 inch) in size.2 The lesion was confined to the cervix and appeared different from other carcinomas of the cervix seen by the treating physician.
It was later noted in the autopsy report3 by Ella Oppenheimer, MD, that “1 year before death the patient delivered a normal infant and 6 weeks later her cervix was said to be normal. Three months later she presented herself to the clinic with a 2–3 cm cervical tumor.” Results of tests for sexually transmitted diseases were negative and a biopsy of the cervix was performed.
Four pieces of tissue from the biopsy were sent to the pathology department and “epidermoid carcinoma, cervix uteri, spinal cell type” was diagnosed with definite invasion of the stroma (Figure 1).1
During the next several months, the patient received 4800 mg-h of radium and 11 500 R (roentgen) of deep x-ray.3 Treatment failed to prevent spread of the cancer, however, and it extended relatively rapidly to both parametria. On August 8, 1951, she developed severe abdominal pain and was admitted to The Johns Hopkins Hospital (Baltimore, Maryland).
Her pain became progressively more severe and intractable. Because of failure to void urine, ureteral catheterization was unsuccessfully attempted several times and the serum level of nonprotein nitrogen rose to from 120 to 150 mg/dL (reference range, 25-50 mg/dL). Diathermy therapy was tried without positive effect.
Henrietta Lacks died at 12:15 am on October 4, 1951.3
Ms Lacks' autopsy was performed at 10:30 am on the same day as her death. Examination of the body revealed a “well-developed, thin, colored female [with] deeply pigmented skin over the lower abdomen such as seen after x-ray treatment.
” 3 The peritoneal cavity contained a small amount of yellowish fluid and approximately 1 L of fluid was found in the pleural cavity, but the pericardium was devoid of fluid. The lungs were noted to have bibasilar lobar pneumonia with cheesy material in the bronchi. The mucosa of the bronchi was blood stained.
The cranial cavity and neck organs were not examined because permission was not granted.
Small, white, and firm nodules were observed throughout both the thoracic and abdominal cavities, including the surfaces of the peritoneum, the entire length of the intestines, and the surface of the liver.
Furthermore, both the pleural surface and the superior surface of the diaphragm (right side more than the left side) were covered with nodules, as were the lung, liver parenchyma, and the pericardium.
The nodules varied slightly in size, measuring from 8 mm in diameter on the peritoneal surface to 1 cm in the lung parenchyma. However, the largest mesenteric lymph node infiltrated with tumor was 6 cm in length. Small tumor nodules, 3 mm in diameter, were seen in each adrenal gland.
At the apex of the right ventricle, a tumor nodule approximately 1 cm in diameter protruded into the lumen. Relatively little necrosis was seen in any of the nodules.
A large subcapsular hematoma was present at the superior pole of the right kidney and a tumor nodule had grown into the capsule. Bilaterally, the ureters, calyces, and pelves were markedly dilated, consistent with severe hydronephrosis.
The left ureter was involved in a mass of tumor just inside the brim of the pelvis, while a tumor mass near the posterior wall of the bladder entangled the right ureter. The bladder itself was adherent to the anterior abdominal wall.
Many small nodules were seen on the bladder mucosa, and the external surface was nearly a solid mass of tumor.
The right ureter was dilated within 4 cm of the bladder, where the dilatation ceased abruptly. At this level, the circumference of the ureter was 14 mm; distally, the right ureter had been left intact and a probe passed with some difficulty down to the bladder.
The probe could not be passed through the left ureter to the bladder, although both ureteral openings appeared patent from within the bladder. Closer examination revealed that the left ureter was dilated to the bladder wall, at which point a mass of tumor on the external surface caused the obstruction.
The bladder was partially surrounded by nodular masses of tumor that penetrated the bladder wall, particularly in the trigone area. The bladder was not especially dilated. Tumor was seen infiltrating the wall of the vagina and friable masses of tumor replaced the cervix.
The uterus was approximately normal in size and covered with tumor nodules, while the fallopian tubes and ovaries were obliterated by clusters of tumor nodules. A mass of tumor surrounded the iliac veins, and the area of the right iliac vein appeared to have tumor entering its lumen. Focal uremic diphtheritic colitis was also noted.
Henrietta Lacks' cervical biopsy supplied tissue to the pathology department for clinical evaluation and to the Tissue Culture Laboratory in the Department of Surgery at The Johns Hopkins Hospital for research purposes.
In 1951, George Gey, MD, was director of the laboratory and had already spent many years at Johns Hopkins as a student and faculty member. Prominent scientists at Johns Hopkins, such as Ross Harrison, MD, PhD, and Warren Lewis, MD, made important contributions to the history of tissue culture.
4,5 Dr Gey and his wife and chief collaborator, Margaret Gey, RN, continued in this tradition and began working on tissue culture in association with Dr Lewis in 1922.
Dr Gey's work grew to encompass in vitro investigations related to endocrinology, cancer, and virology in addition to intracellular and membrane cytology.4 However, his greatest scientific contribution was due to Henrietta Lacks.
While Henrietta Lacks was treated at Johns Hopkins, Dr Gey was attempting to fulfill ambitious goals for the Tissue Culture Laboratory, that is, “the isolation and maintenance of normal and malignant or otherwise diseased tissues as temporary or stable organoids or as derived cell strains.
” 6 Toward this purpose, Dr Gey and his colleagues collected tissue from surgical procedures throughout the hospital.7 Approximately 30 specimens of cervical cancer had been sent to the laboratory of Dr Gey by the time Ms Lacks presented to the gynecology clinic.
2 An investigator in the laboratory, Mary Kubicek (Figure 2), placed cells obtained from the biopsy specimen of Henrietta Lacks into culture by using the roller-tube technique; the cells grew robustly, contrary to the results with previous specimens, becoming the first human cancer cell line immortalized in tissue culture.
The cells were named “HeLa” after the initial 2 letters of Henrietta Lacks' first and last names. She would not be credited as the originator of the cell line for many years, and HeLa cells were misinterpreted as originating with “Harriet Lane” or “Helen Lane” for years.7,8
Previous efforts to grow either normal cervical epithelium or cervical carcinoma in culture proved elusive9; however, efforts to grow cells from the aggressive adenocarcinoma of the cervix that had affected Henrietta Lacks were successful.
Twenty years later, reexamination of the histopathology slides from Ms Lacks' surgical biopsy and autopsy led to a revision of the initial diagnosis, with the finding that the patient had a very aggressive adenocarcinoma of the cervix.
9 The cervical carcinoma was clearly very malignant and the patient had a rapid clinical deterioration. Although the concept of rapidly progressive cervical carcinoma has been questioned,10 this case history would suggest otherwise.
Recently, HeLa cells have been shown to contain human papillomavirus (HPV) 18 DNA11 and HPV18-positive HeLa cells have been linked to changes in microRNA expression.
12 Since HPV18 has been associated with very aggressive adenocarcinomas, this finding may explain why Dr Gey was surprised by the prolific growth of HeLa cells in culture. Routine Papanicolaou smear screening may not detect rapidly progressive cervical carcinomas; the new HPV vaccine holds the promise of preventing these tumors.
Gey and colleagues13 published data with HeLa cells in 1952, reporting the “evaluation in vitro of the growth potential of normal, early intra-epithelial, and invasive carcinoma from a series of cases of cervical carcinoma.
” Only 1 strain of cervical carcinoma cells was established in “continuous roller-tube cultures for almost a year,” which grew in a medium of chicken plasma, bovine embryo extract, and human placental cord serum: HeLa.
13 Dr Gey's roller-tube technique for tissue culture was another significant scientific contribution and was used by John Enders, PhD, and colleagues in their work cultivating poliomyelitis virus in nonnervous system tissue.
4 Perhaps less well known in the history of poliomyelitis research is that Dr Gey successfully propagated poliomyelitis viruses in HeLa cell culture.14
George Gey was generous with requests for HeLa cells.
Since HeLa cells were a robust, immortal cell line, easily propagated over generations in culture, Dr Gey supplied samples to scientists in the United States and internationally who were interested in studying the first established human cancer cell line.
HeLa cells proliferated in cultures around the world and, as the years passed, evidence accumulated that HeLa cells had contaminated other cell lines. Interspecies cross-contamination with HeLa, easier to detect than intraspecies contamination, was described in the early 1960s.15,16
Henrietta Lacks’ ‘Immortal’ Cells
Medical researchers use laboratory-grown human cells to learn the intricacies of how cells work and test theories about the causes and treatment of diseases.
The cell lines they need are “immortal”—they can grow indefinitely, be frozen for decades, divided into different batches and shared among scientists.
In 1951, a scientist at Johns Hopkins Hospital in Baltimore, Maryland, created the first immortal human cell line with a tissue sample taken from a young black woman with cervical cancer.
Those cells, called HeLa cells, quickly became invaluable to medical research—though their donor remained a mystery for decades. In her new book, The Immortal Life of Henrietta Lacks, journalist Rebecca Skloot tracks down the story of the source of the amazing HeLa cells, Henrietta Lacks, and documents the cell line's impact on both modern medicine and the Lacks family.
Who was Henrietta Lacks?
She was a black tobacco farmer from southern Virginia who got cervical cancer when she was 30. A doctor at Johns Hopkins took a piece of her tumor without telling her and sent it down the hall to scientists there who had been trying to grow tissues in culture for decades without success. No one knows why, but her cells never died.
Why are her cells so important?
Henrietta’s cells were the first immortal human cells ever grown in culture. They were essential to developing the polio vaccine. They went up in the first space missions to see what would happen to cells in zero gravity. Many scientific landmarks since then have used her cells, including cloning, gene mapping and in vitro fertilization.
There has been a lot of confusion over the years about the source of HeLa cells. Why?