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Remember stem cell politics during the 2004 presidential campaign?
VP candidate John Edwards told a crowd that embryonic stem cell research would allow people like Christopher Reeve "to walk, get up out of that wheelchair and walk again." In a speech at the Democratic convention, Ron Reagan Jr. predicted that cloning-based stem cell research would produce for each of us a "personal biological repair kit standing by at the hospital." Meanwhile, opponents of deriving stem cells from embryos lost no opportunity to proclaim equally miraculous powers for "adult" stem cells.
What a difference four years make.
The stem cell world has been reshaped, both in terms of the science and politics. There are no longer only two types of stem cells - adult stem cells that don't require embryos, and embryonic stem cells that have stirred all the controversy. Over the past year, researchers around the world have developed and refined the derivation and control of a third type of stem cells - "induced pluripotent stem cells" or "reprogrammed cells." These are produced from ordinary body cells, without using embryos or women's eggs. (The eggs are used in efforts - so far unsuccessful - to derive stem cells from cloned embryos. More about this in a subsequent post.)
The political changes have been as dramatic. Stem cells figured little in the 2008 campaign, with the exception of a Michigan ballot measure. Both presidential candidates supported embryonic stem cell research that use embryos created but not used for reproductive purposes, and President-elect Obama has made it clear that he will lift the Bush administration's restrictions on federal funding of it.
What's likely to happen after that?
The shift in policy will be valuable for both obvious and not-so-obvious reason. It will normalize the funding of stem cell research, putting it on a level playing field with other promising medical investigations and experiments. It will help move stem cell research away from its status as a hot-button partisan wedge issue. Hopefully, it will open discussion of stem cells to issues other than the status of human embryos.
A new chapter in the politics of stem cells will be good for science, and good for efforts to bring democratic accountability to the development of all genetic, reproductive and biomedical technologies. Here are some of the things we need:
- Researchers and research advocates (as well as bloggers and journalists) should take a sober look at the exaggeration and hype that have shaped the field over the past decade. They should re-commit themselves to responsible descriptions of their work's prospects, and refrain from exaggerating the likelihood and imminence of breakthroughs, treatments and cures.
- Democratic Congress members preparing stem cell legislation have indicated that their bills will include provisions for regulation and oversight of the research. Let's hope the structures and rules they propose are effective and transparent, and applicable to research whether it is publicly or privately funded.
- Lawmakers and research review boards need to pay special attention to safeguarding participants in clinical trials, whether of adult stem cells, embryonic stem cells or (further off) reprogrammed stem cells. Because stem cell researchers, like other biomedical scientists, are increasingly involved in commercial enterprises, conflicts between patient well-being and research advancement are not uncommon. Overheated expectations about stem cells further raise the stakes.
And one more thing: All of us should think carefully about the lessons of the stem cell wars for future decisions about human biotechnologies. I'm definitely not of the mind that we should take politics out of science - that's not possible, and winds up hiding rather than taming partisan motives, commercial prerogatives, and special interests.
The stem cell wars have provided a great example of how not to conduct the politics of science. Our job now is to work out what a democratic politics of human biotechnology would look like.
Any ideas?
Politics
Medicine & Health
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Posted by: Ray Mumme | November 29, 2008 3:33 PM
The Stem Cell Controversy
By Roger M. Nocera, M.D.
docrn@yahoo.com
The embryonic stem cell (ESC)-therapy debate centers on the ethical issues of destroying a potential human life of early stage human embryos, which has not really been a discussion of medical science but of faith, beliefs and religion. President Bush halted government funding of any new ESC-lines when he took office. President Obama will lift this ban early in his first term as president. If president Obama knew the medical and scientific truth about stem cell research he would not lift this ban. The correct resolution of the stem cell debate lies in the scientific medical discoveries that have occurred just after the Bush ban took effect, during which we have learned that adult stem cells (ASCs) are far more effective, much safer and cheaper to develop than ESCs. Despite what scientists have claimed, in fact, ESCs offer no advantages and many profound disadvantages compared to ASCs medically speaking. It's not even a close race. It?s what they call ? ?a no brainer?. Moreover, the cost of developing ESCs for therapy will be exponentially greater than the cost of using ASCs.
Only public education can save us now from the problems that will occur if we continue our present ESC approach to stem cell therapy development. Our health care cost crisis could be completely solved if we choose ASCs for therapy development, while it will worsen profoundly if we go the ESC route. President Obama, like most Americans is not aware of the scientific facts involved in the stem cell debate, in which there is much at stake for all of our children, our grandchildren, and us. Since Obama is clearly intelligent enough to understand the medical realities about stem cells we have to assume he, like most other Americans is getting inferior expert opinions on the subject. I fear we Americans are about to be bamboozled yet again, by experts, as in the case of the unregulated mortgage securities, which caused our current economic calamity.
Here are the facts.
The human egg and sperm fuse into one cell called a zygote, which produces the first batch of ESCs. These ESCs produce cells in a cascade of cellular development until in the end all 220 adult cell types are produced. Included in these 220 adult cells are adult stem cells (ASCs) that we have recently discovered heal the human body from cradle to grave. Scientists have learned that biochemicals called cytokines are the triggers to these cellular changes in the developing embryo. So by soaking ESCs in different cytokine-soup recipes in just the right sequences they will be able, theoretically, to get ESCs to produce any cell type needed.
Currently we have profound unresolved problems with ESCs. We know that ESCs: produce cancers, don?t heal diseased tissues very well and are rejected by the immune system of any patient they are injected into unless large doses of dangerous immune-suppressive drugs are also given. ESC-scientists are hoping that if they can soak their ESCs in just the right types and sequences of cytokine soup recipes, imitating nature all the way, they will end up someday with a stem cell that will heal injured tissues, not cause tumors, and not be rejected by the patient?s immune system before healing can occur. This research to create such a wonderful stem cell from ESCs by the sequenced cytokine soup method is going to eventually work, no doubt. However, it is going to cost huge amounts of money. This cost will eventually be passed on to consumers, as are all medical development costs. There are already many earned intellectual properties and patents relating to the types and kinds of cytokine soup recipes and procedures involved in these ESC transformations. There will be many more. Each one adds to the cost of production.
Now here?s the rub. All this research on ESCs is entirely unnecessary. When ESC scientists finish this research they will have made exactly precisely what we already have, allogeneic ASCs, except these new ASCs that are made from ESCs will cost a fortune. These allogeneic ASCs that we already have: don?t cause tumors, heal diseases better than any ESC, and have the ability to heal before immune rejection takes place, and are obtained at one day of age, so that they are as youthful and robust as any ESC. These stem cells that we already have actually come from ESCs via the natural cascade of cytokine exposure that occurs in the normal developing fetus and are taken from the umbilical cord blood and/or the placenta after the birthing of a normal healthy baby without doing any harm to the infant whatsoever. Yet, we are going to study nature to see which cytokines it uses to make ASCs so we can make them ourselves in the laboratory at far greater cost. Brilliant. Something tells me there are financial rather than medical and scientific considerations at play here. We are going to pay through the nose for intellectual property and patent fees to make something we already exactly have. Since ASCs are used for therapy very much as they exist already in nature, most patents are unnecessary. Moreover, by using the cytokine soak method we can multiply and grow these allogeneic ASCs from thousands into trillions of cells, cheaply making enough stem cells to treat everyone in the world who needs them very inexpensively. This is great news for consumers who desperately need a break from the ever-spiraling cost of medical healthcare. Obama has the health care cost crisis solution right under his nose, but is being denied ability to see it because of dreadfully bad expert advice that is probably financially motivated. He is going to be upset when he finds out, and he will find out eventually, that he has been duped by personal-agenda motivated ?medical authorities?.
The latest ESC scheme has sidestepped the ethical argument by creating an ESC from a normal skin cell instead of an embryo. This man-made ESC will never be a viable treatment option because of cost. In order to make these ESCs, which still have all the tumor and immunity problems of normal ESCs, a highly trained cell biologist must meticulously take the nucleus out of a skin cell and place it into an egg cell, by hand, under extreme microscopic conditions for each and every patient to be treated. Since this is such a highly skilled, labor-intensive process the costs of production will never decrease to an affordable level.
In conclusion, the right-to-life folks have been saying, in effect, that even though ASCs are not as powerful as ESCs, we should choose them nonetheless because it is more ethical to do so. Well, the right-to-life folks are very wrong about that. ASCs are not an inferior substitute for ESCs. Allogeneic ASCs are superior in every way imaginable to ESCs medically. ESC-therapy research should stop, not because it is immoral, but because it is profoundly inferior and flawed in comparison to ASCs medically.
Posted by: Roger Nocera, M.D. | November 30, 2008 12:06 PM
If your claims that embryonic stem cell research results in the taking of a human life and is unnecessary because adult stem cell research is better were true, they would be excellent arguments. No sane person would support taking a person's life to save another or using a therapy that doesn't work. I ought to know I have Parkinson's disease. But they are false.
ESCR or blastocyst stem cell research involves microscopic undifferentiated cells created in a petri dish, not a tissue, fetus, or baby ripped from a womb.
There are no cures for Parkinson's disease and other deadly maladies - I would know if there were.
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