PlanetWabu

Wednesday, October 20, 2004

Stem Cells

John Edwards, in a rally on October 11th, said:

"If we do the work that we can do in this country, the work that we will do when John Kerry is president, people like Christopher Reeve are going to walk, get up out of that wheelchair and walk again."

Wow. First Barbara Walters makes the implication that Christopher Reeve died because of Bush's decision about stem cells, and now Edwards says that spinal cord injuries will be healed when Kerry is President.

I think a little education on the realities of stem cells in is order.

Bush allowed federal funding on research for 60 stem-cell lines already in existence, but "created from embryos already destroyed."

What he didn't allow was the federal funding of research programs that create human embryos specifically for harvesting. Privately funded scientists already conduct this research. The issue isn't whether or not the research can take place; rather, the question is whether the researchers can come to the federal trough for funding.

Private funding has been pouring into adult stem-cell research. There have been very exciting reports coming out about the results of this morally non-controversial field. Scientists have experimented using human umbilical cord blood stem cells in mice and creating human blood vessels that might restore eyesight to patients with diabetes-related blindness. Some diabetes patients have been treated with pancreatic tissue from cadavers, and 80 percent have achieved insulin independence. Muscle tissue has been regenerated in mice with muscular dystrophy. Even spinal cords have been regenerated using gene therapy. All of this happened with adult stem cells. And all of this is ignored by the majority of the press and democratic talking heads.

Unlike adult stem-cells, embyonic stem cells can't be used in human studies for heath reasons. First, they cause tumors in animal studies. Secondly, they introduce a foreign tissue into the patient, frequently stimulating immune system rejection of the tissue.

These factors are reasons why the private sector has embraced adult stem-cell research and not embyonic stem cell research.

Here are just a few examples of the many recent exciting regenerative research successes using adult stem cells and other non-embryonic approaches:

*Brain function in five human patients with advanced Parkinson's disease was partially restored using a natural body chemical known as glial-derived neurotrophic factor (GDNF). One year after the infusion of GDNF, all patients had clinical improvement of motor function and in the ability to perform activities of daily living. Demonstrating the tremendous potential of this experimental therapy, three patients had their senses of taste and smell restored within a few weeks of starting therapy. "Phase II" human studies are now being contemplated that would include double blinding and use of placebo.

*In another Parkinson's case, a patient treated with his own brain stem cells appears to have experienced a substantial remission with no adverse side effects. Dennis Turner was expected by this time to require a wheelchair and extensive medication. Instead, he has substantially reduced his medication and rarely reports any noticeable symptoms of his Parkinson's. Human trials in this technique are due to begin soon.

*Bone marrow stem cells, blood stem cells, and immature thigh muscle cells have been used to grow new heart tissue in both animal subjects and human patients. Indeed, while it was once scientific dogma that damaged heart muscle could not regenerate, it now appears that cells taken from a patient's own body may be able to restore cardiac function. Human trials using adult stem cells have commenced in Europe and other nations. (The FDA is requiring American researchers to stick with animal studies for now to test the safety of the adult stem cell approach.)

*Harvard Medical School researchers reversed juvenile onset diabetes (type-1) in mice using "precursor cells" taken from spleens of healthy mice and injecting them into diabetic animals. The cells transformed into pancreatic islet cells. The technique will begin human trials as soon as sufficient funding is made available.

*In the United States and Canada, more than 250 human patients with type-1 diabetes were treated with pancreatic tissue (islet) transplantations taken from human cadavers. Eighty percent of those who completed the treatment protocol have achieved insulin independence for over a year. (Good results have been previously achieved with pancreas transplantation, but the new approach may be much safer than a whole organ transplant.)

*Blindness is one symptom of diabetes. Now, human umbilical cord blood stem cells have been injected into the eyes of mice and led to the growth of new human blood vessels. Researchers hope that the technique will eventually provide an efficacious treatment for diabetes-related blindness. Scientists also are experimenting with using cord blood stem cells to inhibit the growth of blood vessels in cancer, which could potentially lead to a viable treatment.

*Bone marrow stem cells have partially helped regenerate muscle tissue in mice with muscular dystrophy. Much more research is needed before final conclusions can be drawn and human studies commenced. But it now appears that adult stem cells may well provide future treatments for neuromuscular diseases.

*Severed spinal cords in rats were regenerated using gene therapy to prevent the growth of scar tissue that inhibits nerve regeneration. The rats recovered the ability to walk within weeks of receiving the treatments. The next step will be to try the technique with monkeys. If that succeeds, human trials would follow.

*In one case reported from Japan, an advanced pancreatic cancer patient injected with bone marrow stem cells experienced an 80 percent reduction in tumor size.

The list goes on and on. Adult stem cell and other experimental regenerative treatments are moving forward toward eventual clinical use at a breathtaking pace.

There have been enormous global investments made in the area of Adult Stem Cell (ASC) research. There have been practically no major investments on the Embryonic Stem Cell (ESC) research efforts on a global basis. There are an awful lot of smart people making investments in ASC because there are visibly huge payoffs. There are few in ESC because they don't see the benefits.
One of the reasons for the influx of monies and huge advances made by ASC researchers is because, since Bush's decision in 2001, Adult Stem Cells have been shown to be pluripotent, i.e. capable of becoming any other cell in the body. It was originally thought that only embryonic stem cells were pluripotent. In 2000-2001, pre-Bush's decision, it appeared as if ASC were not as flexible as ESC. In the subsequent years, that has been proven to be a false assumption. Regardless of what Michael J. Fox or Bill Clinton say, it sure looks like the smart money says that the future is in ASC, not ESC, research. Unless you think that all of the big global biotech companies and venture capitalists are now making their decisions based solely on a moral basis.

And speaking of moral issues, embryonic stem cell research has fairly significant moral implications. I think we all agree that there are serious moral issues associated with abortion. Given that, I think that part of the reason why the Federal government should stay out of funding Embyonic stem cell research is because it should avoid even tangentally endorsing abortion, especially without clear-cut evidence of benefit.

Also, to make it clear, the decision not to federally fund ESC research predates Bush. In fact, every appropriations bill before Congress for the funding of the NIH and DHHS contains the following language:

None of the funds made available in this Act may be used for—

(1) the creation of a human embryo or embryos for research purposes; or

(2) research in which a human embryo or embryos are destroyed, discarded, or knowingly subjected to risk of injury or death greater than that allowed for research on fetuses in utero under 45 CFR 46.204 and 46.207, and subsection 498(b) of the Public Health Service Act (42 U.S.C. 289g(b)).iii

(b) For purposes of this section, the term ‘human embryo or embryos’ includes any organism, not protected as a human subject under 45 CFR 46 as of the date of the enactment of the governing appropriations act, that is derived by fertilization, parthenogenesis, cloning, or any other means from one or more human gametes or human diploid cells

Note that this language does not prohibit the conduct of such research using private funding. Thus, it addresses itself not to what may or may not be lawfully done, but only to what may or may not be supported by taxpayer dollars. At the federal level, research that involves the destruction of embryos is neither prohibited nor supported and encouraged.

The two sides of the embryo research debate tend to differ sharply on the fundamental moral significance of the activity in question. One side believes that what is involved is morally abhorrent in the extreme, while the other believes embryo research is noble or even morally obligatory and worthy of praise and support. It would be very difficult for the government to find a middle ground between these two positions, since the two sides differ not only on what should or should not be done, but also on the moral premises from which the activity should be approached.

To this point, the federal government has pursued a policy whereby it does not explicitly prohibit embryo research but also does not officially condone it, encourage it, or support it with public funds (though state governments have often taken more active roles in both directions). To me, this seems to be a wise approach. I don't think that the federal budget is the place to take up the question of the moral status of human embryos.

The federal government also currently funds research on the existing viable lines. Until progress has been made with them, I am not sure why more money should be spent otherwise.

0 Comments:

Post a Comment

<< Home