Adult stem cell lies - everything old is new again

It's come time to lie about science again - this time about the reality of embryonic stem cell pluripotency - and some of the old lies are coming back out of the storage shed. For instance, Andrew Breitbart on Real Time last night, and in a video from (liar for Jesus) Tony Perkins of the Family Research Council, I've heard about how adult stem cells have cured or treated 72 diseases. Oh and embryonic stem cells, they've cured none. It's been a while since we've seen this adult stem cell nonsense.

I had to jog my memory for a minute, I knew this was a lie, but it had been so long since I heard it, that I really had to think about where I had heard it from. Oh yeah, this nonsense list that was famously cribbed by Ann Coulter from a right-to-life group.

To understand the problem with this list and why these citations don't say what they think they say, we have to learn a little bit about adult stem cells and a big scary word - transdifferentiation. Adult stem cells, which exist in many tissues throughout your body, have specific jobs to perform for the human body to continue to function. Hematopoietic (blood) stem cells make all the red blood cells, white blood cells, and platelets you need to as they are continuously lost or degenerating as part of their natural life span. Stem cells in your gut continuously replace the lining of your intestines as it wears down from the harsh process of breaking down food. There are stem cells that have been isolated from most tissues that function as a repair and maintenance pool of cells to keep our organs functional. Not all organs have a ready pool of stem cells, and most stem cell populations, with the notable exception of blood stem cells, are hard to harvest without risking injury to the host.

However, while these cells are great at doing their job, the issue with adult stem cell research is, can they do another stem cell's job? That is, instead of making just blood, could a hematopoietic stem cell make, say, an insulin secreting pancreatic cell? The answer, despite some initial promising results around 2001, is no. While hematopoietic stem cells may be able to make some other mesenchyme or connective tissue cells from the mesodermal germ layer, it doesn't appear that we can make such adult stem cells transdifferentiate - or make a type of cell from another embryonic germ layer. This ability is what is meant by totipotency. The ability to differentiate not just into one of the three major tissue types (mesoderm, ectoderm and endoderm), but all three of them.

So, what is up with this list then? They have 72 treatments using adult stem cells!

No they don't. This is a lie. They really only are describing one treatment in most of these list items. That is, hematopoietic stem cell replacement of marrow being used in the course of treatment of many diseases. The hematopoietic stem cells are not treating these illnesses, they're letting us use chemo, or irradiation, and then replenishing the patient's blood supply. In other words, they're doing what a good blood stem cell does, replace blood. They're not treating the disease at all.

Let's take a look at some of these references.

Here are the first twelve on the list:

BRAIN TUMORS--medulloblastoma and glioma
Dunkel, IJ; "High-dose chemotherapy with autologous stem cell rescue for malignant brain tumors";
Cancer Invest. 18, 492-493; 2000.

Right off the top of the list (you think they'd use a better one to start) we have an example of hematopoietic stem cells being used to replace bone marrow, not treat the disease! The stem cells are not doing anything for brain cancer, they're simply allowing high dose chemo-which injures the marrow- to be administered with subsequent auto-transplant of the patient's own blood stem cells to recover their blood and immune system

Abrey, LE et al.; "High dose chemotherapy with autologous stem cell rescue in adults with malignant primary brain tumors"; J. Neurooncol. 44, 147-153; Sept., 1999

See above. Blood stem cells being used as part of chemotherapy to replace blood, not treat the disease.

Finlay, JL; "The role of high-dose chemotherapy and stem cell rescue in the treatment of malignant brain
tumors: a reappraisal"; Pediatr. Transplant 3 Suppl. 1, 87-95; 1999

See above. Blood stem cells being used as part of chemotherapy to replace blood, not treat the disease.

RETINOBLASTOMA
Hertzberg H et al.; "Recurrent disseminated retinoblastoma in a 7-year-old girl treated successfully by high-dose chemotherapy and CD34-selected autologous peripheral blood stem cell transplantation"; Bone Marrow Transplant 27(6), 653-655; March 2001

See above. Blood stem cells being used as part of chemotherapy to replace blood, not treat the disease.

Dunkel IJ et al.; "Successful treatment of metastatic retinoblastoma"; Cancer 89, 2117-2121; Nov 15 2000

See above. Blood stem cells being used as part of chemotherapy to replace blood, not treat the disease.

OVARIAN CANCER
Stiff PJ et al.; "High-dose chemotherapy and autologous stem-cell transplantation for ovarian cancer: An autologous blood and marrow transplant registry report"; Ann. Intern. Med. 133, 504-515; Oct. 3, 2000

See above. Blood stem cells being used as part of chemotherapy to replace blood, not treat the disease.

Schilder, RJ and Shea, TC; "Multiple cycles of high-dose chemotherapy for ovarian cancer"; Semin. Oncol. 25, 349-355; June 1998

See above. Blood stem cells being used as part of chemotherapy to replace blood, not treat the disease.

MERKEL CELL CARCINOMA
Waldmann V et al.; "Transient complete remission of metastasized merkel cell carcinoma by high-dose polychemotherapy and autologous peripheral blood stem cell transplantation"; Br. J. Dermatol. 143,
837-839; Oct 2000

See above. Blood stem cells being used as part of chemotherapy to replace blood, not treat the disease.

TESTICULAR CANCER
Bhatia S et al.; "High-dose chemotherapy as initial salvage chemotherapy in patients with relapsed testicular cancer"; J. Clin. Oncol. 18, 3346-3351; Oct. 19, 2000

See above. Blood stem cells being used as part of chemotherapy to replace blood, not treat the disease.

LYMPHOMA
Tabata M et al.; "Peripheral blood stem cell transplantation in patients over 65 years old with malignant lymphoma--possibility of early completion of chemotherapy and improvement of performance status"; Intern Med 40, 471-474; June 2001

See above. Blood stem cells being used as part of chemotherapy to replace blood, not treat the disease.

Josting, A; "Treatment of Primary Progressive Hodgkin's and Aggressive Non-Hodgkin's Lymphoma: Is There a Chance for Cure?"; J Clin Oncol 18, 332-339; 2000

See above. Blood stem cells being used as part of chemotherapy to replace blood, not treat the disease.

Koizumi M et al.; "Successful treatment of intravascular malignant lymphomatosis with high-dose chemotherapy and autologous peripheral blood stem cell transplantation"; Bone Marrow Transplant 27, 1101-1103; May 2001

See above. Blood stem cells being used as part of chemotherapy to replace blood, not treat the disease.

This list is a lie. They are describing one treatment with adult stem cells in these twelve instances, and the rest of the list is more or less the same thing. Yes, it is true, since the 1950s we've been using adult stem cell therapy. We've been doing bone marrow transplantation (which is really just stem cell transplant - nowadays we just mobilize the marrow stem cells into the peripheral blood and harvest them there). However, it is dishonest to use every instance that bone marrow is transplanted as part of treatment of a disease to say that "adult stem cells treat 72 diseases". No! Chemo is treating 72 diseases. Bone marrow transplant is treating one disease in all twelve of these instances - post-chemotherapy bone marrow suppression. Adult stem cells are doing their one thing - differentiating into their destined progeny. They are not transdifferentiating into many different cell types, with the exception of cord blood which does show some promise in this respect.

Further I'm familiar with many of these papers, and many of these papers do not represent treatments that are routinely used. Don't get me wrong, they're wonderful papers, but many of these treatments have not panned out, like injecting hematopoietic stem cells or other adult stem cells into the heart. This not being widely implemented because we haven't been able to show a great benefit, and the little benefit that has been observed has not been from transdifferentiation of the cells into cardiac cells (some cells may fuse to existing myocytes and the injected cells are usually only transiently present), but some effect of cytokines the cells release in the infarct area. Some of the treatments tried on this list are more risky or harmful than the disease, as bone marrow transplant is not without significant risks and potential for harm to the recipient. They are therapies of last resort. Some of them I know have been totally abandoned.

So, of the few on the list that aren't just repetition of bone marrow transplant, you have experimental therapies which are just that, experimental. None that I see are actually implemented outside of experimental protocols. To sum up, the true state of the field is that with the exception of hematopoietic stem cell transplant to replace bone marrow, adult stem cells are no farther along in application to human disease than ES cells are - they are in a purely experimental stage.

Embryonic stem cells are so promising because they don't just make one type of cell or cells from one of the three tissue layers. By definition, they can make every type of cell in the body. For example, here is an embryoid body made of mouse ES cells I filmed in my lab, with a focus of beating cardiac cells.

This is functional cardiac tissue generated from completely undifferentiated, and infinitely expandable cell line. That is the power of ES cells. Not just one stem cell job but all of them.

Now, I agree with some of these jokers that they may have one point to argue for their position. As I've said as well, iPSC will likely supplant embryonic stem cell therapy as it is a very promising technology that is less difficult, less expensive, and solves the immune rejection problem. However, it's still a technology in its infancy. We don't know if iPSC are truly ES cell like, or will be in every instance. We don't know yet if we can make them without oncogenic transformation. We don't know if they'll serve the same way ES cells will for basic science research study because of the possibility of fundamental differences in genetic or epigenetic regulation of the cells.

We just don't know. So, while iPSC have promise, and I believe will probably, probably, replace ES cells in the long run, it's simply too early to tell for sure. We should pursue all avenues, and that includes ES cells, especially considering the objection is based on religious dogma about ensoulment, rather than a legitimate ethical concern.

But I'm still left disgusted with these people. Why is it not enough to argue this stuff on the merits? Why do they have to lie, and lie, and lie, about science? Why isn't the truth part of their moral code, in addition to preserving life?

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Nice debunking as usual, Mark. I've been seeing that "list of cures" popping up again on message boards (from the usual subliterate Freeptrash), and while I knew enough about the list to rebut it, linking here will save more time. :)

I've been keeping track of the Washington Post's Opinion pages over this, and I'm completely unsurprised to see that they're continuing their tradition of airing a whole range of far-right viewpoints, from "outraged" to "droolingly apoplectic" over Obama's decision to lift the restrictions.

I counted six right-wing anti-Obama-stem-cell pieces this week. Not just from the usual suspects (Krauthammer, Gerson), but also three commissioned pieces from theocrats and self-appointed bioethicists, none with any scientific credentials of course.

On the other hand, there was one, brief, tepid anonymous op-ed in favor of Obama's decision. No sign yet of any pieces from someone at the NIH who might have been involved with the talks with Obama, or is involved in developing their ethics policies, or from anyone like Elizabeth Blackburn.

Anyway, the "intellectual" righties blabbering in these columns have been eschewing easily-debunked crap like that bogus list, but they have all, nearly to a man, implied that Obama went with the "most extreme" option by leaving the ethics guidelines to be developed at the NIH. Because scientists cannot be trusted (even the ones at the NIH who have developed and stuck by some of the most stringent and ethical animal and human-subject research guidelines in the world), because, like, some scientists do bad stuff.

Krauthammer, the latecomer, felt the need to go even further and trotted out the Nazi comparisons. Charming. Apart from the obvious Godwinning, the one nugget of truth there -- that scientists are humans too -- ignores the obvious reality that any class of humans, viewed broadly enough, has blood on its hands and you can therefore turn that whole argument around on politicians, priests, lawyers, and whoever else you think should be really making the decision. What matters is whether there are safeguards and buffers in place already, and as I said before, the NIH already has a concerned, thoughtful, and above all, knowledgeable apparatus in place.

(Plus, you know, I'm not about to tolerate moral judgments from one of the bloodthirstiest cheerleaders for the pointless and murderous Iraq invasion.)

Long post short, it really is clearly all about the far-right wanting to retain a political veto over science. If ethics ever entered into their minds, they would be pushing just as hard against abortion and IVF clinics.

By minimalist (not verified) on 14 Mar 2009 #permalink

minimalist - Does the WaPo editorial page not inform you that the hyperchristians and their Republican allies are pushing quite hard against abortion clinics?!?

That's how they got into the embryo- fixation in the first place...

By Pierce R. Butler (not verified) on 14 Mar 2009 #permalink

MarkH,

I agree with you on this one. The promise of adult stem cell research is irrelevant, and exaggerated by these folks, to the issue of embryonic stem cell research.

If they are honest about their motivations I have some respect for their arguments, although I completely disagree with their premise, that an undifferentiated clump of cells is a human being.

It is at least consistent with their belief in a "soul". They should be allowed to present their ethical objections so long as they do so honestly, which would show that their objections have no basis in science.

Overstating the case for adult stem cell therapies just shows that they will twist what little science they understand to defend their (poorly) hidden theological agenda.

They seem to be bending the "Thou shall not lie" rule to achieve the "Thou shall not kill" objective. Maybe lying for Jesus is OK.

They christofascists dont argue their case on the merits because they have no merit, that's why they have to lie. The basis of their argument is that they would rather consign real, living people to suffer from some thing like diabetes than allow science to go forward on a small clump of cells that will be destroyed anyways.

You embryonikarians find it awfully easy to tackle what you call christofacts, but how about this feminist (since 1972) jew? One who has actually been responsible for hundreds of successful stem cell therapies, and whose only agenda is to bring modern medicine to the worst medical system in the developed world. I have, over the past five year helped bring a better quality of life to more human beings than EVERY EMBRYONIC SCIENTIST IN THE WORLD COMBINED.

First, when Dr. Prentice came out with his paper, you complained and changed the rules. You said scientific papers are meaningless unless the FDA approves a clinical trial. Which means if a doctor in India cures fifty people, writes a paper, and doesn't happen to have a quarter billion dollars, IT DOESN'T COUNT!

Second, you then complained, "Where are the cures?"

So I started an organization to answer your question. I found the 8 best stem cell treatment centers in the world, and started directing people to them.

THEN you said that they are "Snake Oil." If you can handle the truth, go to donmargolis.com and read what REAL PATIENTS (or their parents) have to say about adult stem cells.

So much for the science which is helping patients by the thousands. Now on to the science of Illusion---the viability of embryonic stem cells.

You can refute people downgrading embryonics in your closed world simply by calling them religious nuts, but try this on for size, point by point---and realize, gentlemen, that I have a world-class embryonic scientist behind statements 1, 2, & 3 and dozens of news articles about 4 & 5:

Reason one, there is no need for already-obsolete embryonics. We already have Repair (Adult) Stem Cells, the most powerful medicine the world has ever seen, capable now of improving the quality of life of millions of patients; something embryonics will never even approach, let alone reach.

Second, no scientist in the world, not just America, has a clue on how to stop the inevitable cancer threat of ESC. None, Zero, Nada. "Fifty years" says one famous embryonic scientist.

Third, our bodies are built to destroy invading enemies. ESCs are so perceived by the human immune system and always will be.

Fourth, California, with $275 million of stem cell funding to give away last spring, could not find one embryonic scientist in the state who was worthy of two cents worth of funding.

Fifth, there are many ways of creating "embryonic-like" stem cells good for lab research, by using what top embryonic scientists have discovered: adult skin cells and many other non-stem cells in the body. However, your pals in the White House and the NIH are about to cremate iPSCs too. And YOU call Christians religious nuts?

To which I add my personal #6:
Economics: there is no way anyone can make money from the disaster known as embryonics. Just ask those who tried to cash in on the Geron hype a few weeks ago."

What are you going to do in 3 years when Geron STILL hasn't started its useless clinical trial (hoping to get bladder control in spinal cord patients when three adult stem cell centers already have paraplegics walking)-- and you no longer can play the Bush card?

After four years of print media lies: "Embryonic stem cells can become all cell types of the body because they are pluripotent while adult stem cells are usually limited to development into cell types of their tissue of origin," the leaders of the hoax, (NY Times and Washington Post) BOTH had major pieces this past week saying just the opposite, something never allowed 2004-2008.

You've just peaked. You are on your way out.
Take your best shot, guys!

The first is immune reprogramming using HSC to repopulate the marrow.
The second is in mice.
The third is using stem cells as a gene therapy vector. No transdifferentiation is claimed.
The fourth is cord blood stem cells, which in my article I acknowledged were quite plastic. However, many of us were not so lucky to have ours archived. Also, the reference is a fox news article, not a paper, so I can't just the technique.
The fifth is an article harvesting neural stem cells, very cleverly, to repair damage in the CNS (again no transdifferentiation). It was a safety trial, one patient apparently showed improvement in pinprick sensation. Efficacy is unproven.
The sixth, cord blood again, making hematopoietic cells for immune/blood reconstitution. Cool, but let's see a paper, a controlled trial demonstrating efficacy over standard transplant.
The seventh, cord blood again, a news article again. No paper, no trial showing efficacy. And it sounds like they're using the cells as a vehicle, not for transdifferentiation. In fact, this idea sounds shady to me.
The eighth, hysterically, is is the regeneration of a prostate using mouse prostate cells. Wow, they used adult stem cells to regenerate a worthless organ. huzzah.
The ninth is HSC transplant for bone marrow suppression post-chemo. Old news.
The tenth, bone marrow reconstitution, old news.
The eleventh, post MI therapy - not working per above.
The twelth, pretty cool. Using cord blood on a scaffold to regenerate a valve. Might work, still experimental.
The thirteenth, bone healing. I've heard a bit about this. Using HSC or bone marrow cells for bone regeneration is a known effective strategy since the HSC are mesenchymal lineage and can make connective tissue. Not transdifferentiation.

Ok I'm getting tired of this. Yada yada, a bunch of phase one trials, testes stem cells (I've written about these before, cool, but hard to harvest and only in boys).

The FRC people just don't get it. Yes adult stem cells can do great stuff, but the sources are limited for many tissues. And most of these cells are not showing evidence of transdifferentiation, and these trials are still highly experimental with inadequate demonstration of efficacy to call these therapies. A bunch of newspaper articles talking up some phase I trial does not a new therapy make. Try harder.

Don Margolis,
Read what I wrote, then complain. You come off as a psychotic crank.

You embryonikarians find it awfully easy to tackle what you call christofacts, but how about this feminist (since 1972) jew? One who has actually been responsible for hundreds of successful stem cell therapies, and whose only agenda is to bring modern medicine to the worst medical system in the developed world. I have, over the past five year helped bring a better quality of life to more human beings than EVERY EMBRYONIC SCIENTIST IN THE WORLD COMBINED.

Well, it is a science still in its infancy. ES cells were isolated from humans in 1998. Adult stem cell therapies were being used since the 1950s, you have a head start.

First, when Dr. Prentice came out with his paper, you complained and changed the rules. You said scientific papers are meaningless unless the FDA approves a clinical trial. Which means if a doctor in India cures fifty people, writes a paper, and doesn't happen to have a quarter billion dollars, IT DOESN'T COUNT!

I complained about what now?

Second, you then complained, "Where are the cures?"

When did I complain about this?

So I started an organization to answer your question. I found the 8 best stem cell treatment centers in the world, and started directing people to them.

All for me? Thank you!

THEN you said that they are "Snake Oil." If you can handle the truth, go to donmargolis.com and read what REAL PATIENTS (or their parents) have to say about adult stem cells.

Ooooh, testimonials. That doesn't sound like snake oil. Try harder.

So much for the science which is helping patients by the thousands. Now on to the science of Illusion---the viability of embryonic stem cells.

You can refute people downgrading embryonics in your closed world simply by calling them religious nuts, but try this on for size, point by point---and realize, gentlemen, that I have a world-class embryonic scientist behind statements 1, 2, & 3 and dozens of news articles about 4 & 5:

Reason one, there is no need for already-obsolete embryonics. We already have Repair (Adult) Stem Cells, the most powerful medicine the world has ever seen, capable now of improving the quality of life of millions of patients; something embryonics will never even approach, let alone reach.

Obsolete? Can adult stem cells make pancreatic islet cells like ES cells? It's already been done with ES cells. Apply that to iPSC and we may even have treatments within a decade.

Second, no scientist in the world, not just America, has a clue on how to stop the inevitable cancer threat of ESC. None, Zero, Nada. "Fifty years" says one famous embryonic scientist.

The teratoma issue is also not impossible to resolve, all you have to do is differentiate the cells before implantation and purify the cell type you want. This is old news.

Third, our bodies are built to destroy invading enemies. ESCs are so perceived by the human immune system and always will be.

This ignores immunologically privileged locations, not to mention tissue augmentation using technology to protect implants from immune attack.

Fourth, California, with $275 million of stem cell funding to give away last spring, could not find one embryonic scientist in the state who was worthy of two cents worth of funding.

Wait what? You mean that funding that's been held up non-stop? This is nonsense. If you fund it, they will come.

Fifth, there are many ways of creating "embryonic-like" stem cells good for lab research, by using what top embryonic scientists have discovered: adult skin cells and many other non-stem cells in the body. However, your pals in the White House and the NIH are about to cremate iPSCs too. And YOU call Christians religious nuts?

Did you read what I wrote at all? Did you notice me talking about iPSC in this very article? Did you see that I when I initially covered the discovery of these cells two years ago.

To which I add my personal #6:
Economics: there is no way anyone can make money from the disaster known as embryonics. Just ask those who tried to cash in on the Geron hype a few weeks ago."

What are you going to do in 3 years when Geron STILL hasn't started its useless clinical trial (hoping to get bladder control in spinal cord patients when three adult stem cell centers already have paraplegics walking)-- and you no longer can play the Bush card?

Three centers have paraplegics walking? Bullshit. Show me the data. Also Geron has started its trial.

After four years of print media lies: "Embryonic stem cells can become all cell types of the body because they are pluripotent while adult stem cells are usually limited to development into cell types of their tissue of origin," the leaders of the hoax, (NY Times and Washington Post) BOTH had major pieces this past week saying just the opposite, something never allowed 2004-2008.

Well, if you include iPSC as adult stem cells. But we never would have had the technology without ESC study. But transdifferentiation does not appear to occur in adult stem cells.

You've just peaked. You are on your way out.
Take your best shot, guys!

You ignored what I said about iPSC, and then make all sorts of bizarre claims about things I've never said. Try dialing it down about 5 notches and start off a lot less cranky.

Well, I for one am glad that Mr. Margolis was so upset that he just had to post his comment. I've learned a great deal just reading his, and others assertions, and your responses. I only wish that we could eliminate the unnecessary religious component that is coloring the opposition's stance on ES cells.

minimalist - Does the WaPo editorial page not inform you that the hyperchristians and their Republican allies are pushing quite hard against abortion clinics?!?

Knew somebody would say this. :)

Not really. If they wanted to, they'd have done so while they were in control of two branches of government, and spittin' distance of the third. Stem cell research is an easier target to make it at least look like they're putting forth the effort.

By minimalist (not verified) on 15 Mar 2009 #permalink

Now, I agree with some of these jokers that they may have one point to argue for their position. As I've said as well, iPSC will likely supplant embryonic stem cell therapy as it is a very promising technology that is less difficult, less expensive, and solves the immune rejection problem.

Maybe iPSC Rx will supplant hESC Rx, but I think it's a long shot. For iPSCs to be considered equivalent to hESCs, wouldn't we at least have to show the same pattern of gene expression under the same conditions? Has anyone seen evidence of similar gene expression patterns in cells derived from iPSCs and hESCs?

By dubiquiabs (not verified) on 15 Mar 2009 #permalink

Why do they have to lie, and lie, and lie, about science?

Because science leads to Hitler and Holocaust and Alien Abductions. Plus, if science is correct, maybe when I die I'll just be dead instead of finally gaining some musical talent and plucking a harp whilst sitting on a cloud.

There's a related article at Dkos.

By Pete Dunkelberg (not verified) on 16 Mar 2009 #permalink

Many mentioned that stem cells are the salvation to all diseases and I think it should not be so, since in some situations if the reaction has been positive but now widespread in the world things and this may generate some concern because they would be determining in advance which solutions are not yet proven.

Anne, if you would RTFA;

it's still a technology in its infancy. We don't know if iPSC are truly ES cell like, or will be in every instance. We don't know yet if we can make them without oncogenic transformation. We don't know if they'll serve the same way ES cells will for basic science research study because of the possibility of fundamental differences in genetic or epigenetic regulation of the cells.

Any other questions?

By LanceR, JSG (not verified) on 19 Mar 2009 #permalink

I get the anti-religious snark but you shouldn't let your personal theology (or lack thereof) interfere with seeing the perfectly valid secular questions at hand. In parallel to the religious problem of ensoulment is the problem of the acquisition of civil rights which is a problem that is not religious per se nor is it scientific but rather political.

The current proposed answers to the acquisition of the right to life range from conception to 6 months post birth. The papacy likes the former and Peter Singer and his acolytes prefer the latter. An awful lot of people fall in between. I sincerely doubt that there is a scientific answer to the question of the acquisition of the right to life as a civil matter though no doubt plenty will try to argue from authority using arguments they claim will be scientific.

So when do humans acquire rights? Why is your dividing line better than the Pope's? Is your definition species specific? Why should it be?

There is a large nexus of relevant rights questions that all have to be answered even if we all turned into atheists tomorrow. So why pretend that it is only the religious that bother with these issues? This idea that objections to embryonic stem cell research is only regious in nature is a form of denialism that probably gets few denunciations in this forum.

It is first time I read this blog and I agree and disagree with some of the opinions.
ESC have a great potential, more than ASC, but they have their issues too, that can be solved with different techniques or methods (iPSC, etc). But it would take time.
Adult SC, are not as powerfull, papers about their use can give them credit after you reset your inmune system, and yet there are reports with no inmunoablative drugs just cells (heart, liver,peripherical vascular disease,etc), that present good results, may be there are phase I studies, they need to be compared to "conventional" treatments, but it is an option now for sick people, who are having a better quality of life, not cure.
So I think we have to focus on the patients and what chances they have now, what can we do about it
Scince will advance, slowly, maybe and the end it is not ESC or iPSC, may be is another cell type, who knows...
People are looking for options now....and they exist

MarkH,
Most of the papers you cited were for malignant diseases, however there are lots of non malignant diseases which do not use chemo, or irradiation, and so do not need replenishing the patient's blood supply with hematopoietic Stem Cells.
Stroke patients for example, many have been helped with their own bone marrow stem cells. I am NOT saying hematopoietic, because what is used is all the mononuclear portion of the bone marrow blood drawn form the iliac crest. This contains several types of stem cells, hematopoietic is only one, others are MAPC, VSEL SCs, Mesencymal, etc.Dr Margolis calls them REAPIR SC. This type of treatment will use these cells, which have minimal manipulation (no cultivation, differenciation or genetic manipulation). one or two hours after the extraction, they are implanted intra arterially, near the damaged area.

The FDA does not require clinical studies for this. They regulate, drugs, devices and HCTPs(human cells, tissues and their products) they need to asses their safety (to secure no infections will be transmitted and that the product is safe), then efficacy, and all the rest is for the commercialization of these products. However they have established some exceptions to HCTPs: As can be seen on the Code of Federal Regulations, Title 21 Sec. 1271.10. Are my HCT/P's regulated solely under section 361 (which guards contamination and infections) of the PHS Act and the regulations in this part...
(a) An HCT/P is regulated solely under section 361 of the PHS Act and the regulations in this part if it meets all of the following criteria:
(1) The HCT/P is minimally manipulated;
(2) The HCT/P is intended for homologous use only, as reflected by the labeling, advertising, or other indications of the manufacturer's objective intent;
(3) The manufacture of the HCT/P does not involve the combination of the cells or tissues with another article, except for water, crystalloids, or a sterilizing, preserving, or storage agent, provided that the addition of water, crystalloids, or the sterilizing, preserving, or storage agent does not raise new clinical safety concerns with respect to the HCT/P; and
(4) Either:
(i) The HCT/P does not have a systemic effect and is not dependent upon the metabolic activity of living cells for its primary function; or
(ii) The HCT/P has a systemic effect or is dependent upon the metabolic activity of living cells for its primary function, and:
(a ) Is for autologous use;

SO WE ARE NOT USING HCTPs which need to be proven in Clinical studies to be offered to patients as treatment. we only need to comply with regulations from Sec 361 (infections).
It is autologous, non manipulated cells taken out and reinfused in circulation during the SAME procedure.
THIS IS NOT A CURE, and will never be. Maybe ESC will someday achieve that. I am not against them. It is the improvement in the quality of life of the patients that is important, and we can give them that NOW, not in 10 or 20 years.
The exact mechanism: Transdifferenciation or not, fusion or not, angiogenesis, growth factors, chemokines... PATIENTS DON´T CARE, IT IS SAFE AND IT WORKS (although it would be good to know... why wait so long?)
This type of treatment is being done worldwide, however, no one can sell this types of cells, they belong to the patient himself, so no REAL profit can be obtained (no industry profit) only patient wellbeing. That is one of the reasons Healthcare is not looking this way. It would be wonderful to be able to do a clinical trial to prove this is effective and better than any available drugs and to know the reasons why it works, but no one will fund something which can not have a Patent or bring some kind of profit once proven effective. ONCE MORE, the only benefits are for the patients and their families!!!!!!

no REAL profit can be obtained (no industry profit) only patient wellbeing. That is one of the reasons Healthcare is not looking this way.

but no one will fund something which can not have a Patent or bring some kind of profit once proven effective.

Bullshit. No profit at all? They just magically pop over and do what is needed?

This is typical anti-science/anti-medicine woo. "They won't look at my (fill in woo garbage here) because they can't make money from it. They are conspiring against me!"

By LanceR, JSG (not verified) on 23 Apr 2009 #permalink

This money problem is the least important. Of course the doctors would be paid for their work and materials used in the procedure. But no industry or pharmaceutical company would benefit and no one said anything about anyone "...conspiring against me!", just that the clinical studies will take longer to do!

Uh-huh. "Healthcare". Notice the inappropriate capitalization, reminiscent of "Big Pharma" and similar scare words.

"No one will fund something..." Conspiracy mongering.

Perhaps I've misread your tone, but it just sounds like more of the same "Big Pharma" rants we get here all the time. You most certainly did not say that the clinical studies will take longer to do. You said "but no one will fund something which can not have a Patent or bring some kind of profit once proven effective." Which is, of course, patent nonsense. (Ooh! A pun!) Researchers the world over are working on these questions. When they finally develop worthwhile treatments based on stem cells, there will be patents aplenty and profits galore. There are funding difficulties in the best research country in the world, so it's a little slow. But that is a consequence of people who believe their magic sky fairy disapproves rather than some evil profit motive.

By LanceR, JSG (not verified) on 23 Apr 2009 #permalink